User Voice : From Dr.Vtharavath : D-Pharm / Pharm D / BRMS / BRHC. Who is superior ??

Dear Sir

I believe that it is the proper time to discuss the future of our profession as the situations are slowly revealed from the proposal of MBBS restructuring. While all other braches in the health sector is trying to grab more and more share in the health sector and there by trying to establish their importance and positions, we the MBBS doctors are put in the reverse gear by going down to BRHC course and now restructuring the MBBS curriculum to an effective duration of 3.5 years.(excluding the duration set for the electives as the electives are selectable and different students will have different subject as per their selection. So the duration of the study of electives cannot be included in the core duration of the course ).Instead of going strong by introducing more and more subjects and technologies in the curriculum, MCI is trying to hold us in the elementary level. This will be much more clear from the following discussions.

I am attaching the detailed syllabus and other details of Pharm-D course conducted by the Rajiv Gandhi University. If go carefully through the syllabus, one can very well see that the Pharmacy council of India have covered almost all of the diseases through various subjects and the corresponding practical via different names and heads. It is not like that of MBBS curriculum where the sections are categorized as general medicine, paediatrics, ENT, etc. But here they have concealed every thing and interpreted in a different way so that one cannot make out clearly, at first sight; to what extent the student is taught about general medicine and the clinical aspects. One can realize it only after going through the syllabus in the attached file. After carefully going through the syllabus of Pharm-D (from the attached file) and proposed MBBS curriculum and also the BRHC curriculum one must judge who the better doctor at the first consulting point is?

There is a deliberate attempt from the part of MCI to make the future MBBS course almost equivalent to that of BRHC Course. One cannot expect allthe MBBS graduate will get an opportunity to do Post graduation.

Pharm-D :-

Duration of Course :

Six academic years (Five years study and one year Internship) after PUC or D.Pharm

Course Content :
o Theory and practical subjects very similar for B.Pharm course
o Internship or residency for one year in multi speciality teaching hospital
_ Includes postings in speciality hospital units
_ Six months in general medicine department
_ Two months each in three other speciality departm

Certificate of passing Examination :

Being a doctoral degree, a person with PharmD qualification can keep Dr. as the prefix to his name.

Doctor of Pharmacy
(Pharm.D) Degree will be issued

Duration of the course. –

a) Pharm.D: The duration of the course shall be six academic years (five years of study and one year of internship or residency) full time with each academic year spread over a period of not
less than two hundred working days. The period of six years duration is divided into two phases
–
Phase I – consisting of First, Second, Third, Fourth and Fifth academic year.

Phase II – consisting of internship or residency training during sixth year involving posting in speciality units. It is a phase of training wherein a student is exposed to actual pharmacy practice or clinical pharmacy services and acquires skill under supervision so that he or she may become capable of functioning independently.

Minimum qualification for admission

A pass in any of the following examinations –

(1) 10+2 examination with Physics and Chemistry as compulsory subjects along with one of the following subjects:
Mathematics or Biology.

(2) A pass in D.Pharm course from an institution approved by the Pharmacy Council of India under section 12 of the Pharmacy Act.

(3) Any other qualification approved by the Pharmacy Council of India as equivalent to any of the above examinations.

Provided that a student should complete the age of 17 years on or before 31st December of the year of admission to the course.

Here are a few portion of the syllabus of Pharm-D course which directly have the involvement with MBBS curriculum.

Please don’t look at the name of the subject, but see the contents given in the attached file.

Syllabus of Pharm-D course conducted by Rajiv Gandhi University

One have to go through the syllabus of the below mentioned subjects in the attached file to understand the truth. I have quoted below only the relevant subjects for the discussion.

First Year

1.1 HUMAN ANATOMY & PHYSIOLOGY

1.3 MEDICINAL BIOCHEMISTRY
BIOLOGY :

Second year

2.1 PATHOPHYSIOLOGY

2.2 PHARMACEUTICAL MICROBIOLOGY

2.4 PHARMACOLOGY – I

2.5 COMMUNITY PHARMACY( very important)

1. Scope: In the changing scenario of pharmacy practice in India, Community Pharmacists are expected to offer various pharmaceutical care services. In order to meet this demand, students will be learning various skills such as dispensing of drugs, responding to minor ailments by providing suitable safemedication, patient counselling, health screening services for improved patient care in the community set up.

2.6 PHARMACOTHERAPEUTICS – I

1. Scope of the Subject: This course is designed to impart knowledge and skills necessary for contribution
to quality use of medicines. Chapters dealt cover briefly pathophysiology and mostly therapeutics of various diseases. This will enable the student to understand the pathophysiology of common diseases and their management.

Third year

3.1 PHARMACOLOGY – II

3.3 PHARMACOTHERAPEUTICS – II
1. Scope of the Subject: This course is designed to impart knowledge and skills necessary for contribution to quality use of medicines. Chapters dealt cover briefly pathophysiology and mostly therapeutics of various diseases. This will enable the student to understand the pathophysiology of common diseases and their management.

3.4 PHARMACEUTICAL JURISPRUDENCE

1. Scope of the Subject:) This course exposes the student to several important legislations related to the profession of pharmacy in India. The Drugs and Cosmetics Act, along with its amendments are the core of this course. Other acts, which are covered, include the Pharmacy Act, dangerous drugs, medicinal and toilet preparation Act etc. Besides this the new drug policy, professional ethics, DPCO, patent and design Act will be discussed.

Fourth year

4.1 PHARMACOTHERAPEUTICS – III

1. Scope : This course is designed to impart knowledge and skills necessary for contribution to quality use of medicines. Chapters dealt cover briefly pathophysiology and mostly therapeutics of various diseases. This will enable the student to understand the pathophysiology of common diseases and their management.

4.2 HOSPITAL PHARMACY

1. Scope: In the changing scenario of pharmacy practice in India, for successful practice of Hospital Pharmacy, the students are required to learn various skills like drug distribution, drug dispensing, manufacturing of parenteral preparations, drug information, patient counselling, and therapeutic drug monitoring for improved patient care.

4.3 CLINICAL PHARMACY

1. Objectives of the Subject :
Upon completion of the subject student shall be able to (Know, do, appreciate) –

a. monitor drug therapy of patient through medication chart review and clinical review;

b. obtain medication history interview and counsel the patients;

c. identify and resolve drug related problems;

d. detect, assess and monitor adverse drug reaction;
e. interpret selected laboratory results (as monitoring parameters in therapeutics) of specific disease states; and

f. retrieve, analyse, interpret and formulate drug or medicine information.

4.6 CLINICAL TOXICOLOGY

Sixth Year:

Internship or residency training including postings in speciality units. Student should independently provide the clinical pharmacy services to the allotted wards.
(i) Six months in General Medicine department, and
(ii) Two months each in three other speciality departments

Internship._ (1) Internship is a phase of training wherein a student is expected to conduct actual practice of pharmacy and health care and acquires skills under the supervision so that he or she may become capable of functioning independently.

The following are the expected role of a pharmacist in the future health sector which given by IPA:

Some of the roles of PharmD (community) pharmacists are as follows:

1. Patient medication history interview

2. Medication order review

3. Patient counseling regarding safe and rational use of drug

4. Adverse drug reaction monitoring

5. Drug interaction monitoring

6. Therapeutic drug monitoring

7. Participating in ward rounds

8. Providing drug information at the drug information and poison information centre.
.
Career options available to PharmD Graduates:

v Community Pharmacy
v Hospital Pharmacy
v Pharmaceutical Industry
v Pharmacy Education
v Bio-medical research
v Geriatric Pharmacy
v Governmental Agencies
v Home Healthcare
(Possibly General Practice in Modern Medicines also considered)

Came to know that PCI is having a plan to, gradually, phase out BPharm Degree in few years, by giving opportunity for existing BPharm Graduates to attain PharmD by some method, as done in USA earlier.

Proposed MBBS curriculum by MCI

Structure and Duration of the Course

The committee recommends the following for consideration for implementation:
A 4+1 model of training (4 years course + 1 year internship); 1+1+2+1

4 year course + 1 year internship (which includes 6 months of electives) Effectively the course duration will be three and half years(excluding the duration for electives which is as good as BRHC course duration)
The course would be of 4 years duration with one year internship and provision for elective periods of 6 months before or after internship. Curriculum can be divided into core and non-core with the non-core part of the curriculum be made elective or applied.

Minimum qualification for admission:

Class XII with Physics, Chemistry and Biology as subjects with 50 % marks for Biology alone and an aggregate of 50% for all the subjects.

Subject covered

Group A:

Year1-
Anatomy,
Physiology and Biochemistry;

Year 2-
Pathology,
Microbiology and Pharmacology

Group B:

Year 4-
Medicine,
Surgery
Obstetrics and Gyanecology,
Paediatrics,
Family Medicine and Community health

Group C :

Year 2-
Forensic medicine

Year 3 and 4-

ENT and Opthalmology,
STD and Dermatology,
Orthopaedics,
Accident and Emergency Medicine,
Radiology,
Anaesthesia,
Psychiatry
Elective options- clinical and research electives

Even after passing the restructured MBBS one should undergo the following:

Certification of skills is necessary before licensure.

Career options available to MBBS Graduates:

What should I write here????

Now here we have to see the scope of the pharmacist and must compare it with that of the MBBS doctor:

BRHC Course

Structure and Duration of the Course

The course would be offer in three-and-half-year (approximately same as proposed MBBS Course—When Electives kept away) and will not have any specialization.
(To show the difference between MBBS and BRHC Course the electives are introduced in the MBBS restructuring proposal)

Minimum qualification for admission:

Class XII with Physics, Chemistry and Biology as subjects.

Weightage will be given to those who have studied in village schools.

Subject covered

The course will be broken up into
Anatomy,
Physiology and Biochemistry,
Pathology and Microbiology,
Pharmacology,
Forensic medicine,
Medicine and allied disciplines,
Paediatrics,
Surgical an allied disciplines,
Orthopaedics,
Obstetrics and Gynaecology
community medicine.
Career options available to BRHC Graduates:

To spoil the medical profession ! !

“The key points listed in the draft will be the skeleton for the implementation of this course. Only a few changes are expected in the final framework.”

Now you decide who is the better doctor?

Vtharavath