Traditional Medical Teaching in India did not consider the need of addresing of communication skills by the Indian medical Graduate (IMG). Communication Skills are essential in dealing with patients, development of rapport and fiduciary relationship with the patients. The traditional curricula of Medical Institutes in our country could not gauge the paramount importance of communication skills to be taught to our graduates. The ability to communicate effectively is a core competency for Medical practitioners. Inculcating habit of good communication skills training during the formative years keeps the medical students and future practitioners in establishing utopian Doctor Patient relationship. Communication is a backbone over which lot of areas of patient care rest, such as first contact patient interviews, probing for associated and additional problems, counseling the patient, explaining treatment options, its complications and advising follow up. It is also necessary for explaining risks to the patients, counseling in bereavement or mishap, providing information about surgical procedures, complications, taking their informed consent and other areas of patient care.
With this background, the Indian Medical Graduate as a communicator, naturally seeks most attention by the Medical Educationists of our country. The undergraduate Medical Education Program as envisaged in the revised regulations on Graduate Medical Education 2012 (GMR), the Indian Medical Graduate has to possess requisite knowledge, skills, attitudes, values and responsiveness so that he or she may function appropriately and effectively as a Physician of first contact of the community while being globally relevant. Amongst the prescribed five roles of Indian Medical Graduate most important is Indian Medical Graduate as a communicator.
Indian Medical Graduates as communicators necessitates their proper training and facilitation which can be shouldered by the Communication Skill Laboratory, now essential for all the Medical Institutes.
It is therefore the duty of Medical Teacher to train and teach them this grey area in Medical Education. They can be trained through different modules depending on their levels in years during the MBBS Course. We, at our place have a well established CAP Labs Communication, Attitude and behaviour, Phonetic and Linguistic Lab at DMIMS (Deemed to be University) Wardha, wherein, we train our undergraduates with the help of our pre-validated Modules. We have the Sensitization module for the first year health professionals and the Consolidation modules, relevant to their year of MBBS Course.
The Medical Graduate as a communicator is expected to reach all the essential steps in medical communication, right from embarkment of Medical Course. Likewise, the first year MBBS student is expected to respect cadaver and consider the cadaver as his or her first teacher. When they attend the hospital in the 2nd year they are expected to estalish rapport with the patients and relatives, develop the competencies of appropriate history taking, thorough clinical examination and rapport building with the patient. In the successive years, they are expected to be trained in informed consent, breaking bad news, patient’s secrecy and rights, listening skills, questioning skills and counseling the patient.
Their assessment, though difficult, should be periodically performed using various scales for assessment of communication skills for e.g Kalamazoo Consensus scale which identifies seven skills by the medical graduates namely, building a relationship with patients and their relatives, opening of discussion, gathering information, understanding patients perspective, sharing information, reaching agreement and providing closure. Indian Medical Graduate as a communicator is expected to be trained in all these competencies. The Indian Medical Graduate should realise that the patients too have expectations from the graduates. The patients want to be treated respectfully, want to participate in the treatment options, want to be listened carefully. These expectations of the patients from the communicators should be accomplished by the IMG, and therefore amongst all the roles of the IMG, the role of Indian Medical Graduate as a communicator is extremely important for sublime Doctor-patient relationship.