Identifying Competencies in Community Medicine: An Explorative Study in a Medical College in Delhi

Background: Role of medical education at the undergraduate level has been considered of utmost importance as it sows the seeds on which the foundations of a budding doctor are built. Need of the public health competencies among medical graduates is important because these will enable them to provide primary healthcare to the community. Aims and Objectives: To identify various competencies that are needed in community medicine and to assess the competencies developed among undergraduate medical students after field posting in community medicine. Methodology: 30 faculty members across the country were sent an open-ended questionnaire to list out core competencies needed for undergraduate medical students in community medicine. On the basis of competencies list suggested by faculty members, a self-appraisal questionnaire was designed and distributed to students studying in 4/5 semester and 6/7 semester and also to one batch of students after completion of field posting in community medicine in a medical college in New Delhi. During the study period, a total of three batches were covered where 118 students from 4/5 semesters and 109 students from 6/7 semesters completed their questionnaires. All students who had completed their questionnaires were included in the study and for analysis. From one batch consisting of 38 students of 7 semester, pre- and post-field posting competencies were assessed. Findings: Community medicine teachers expressed that following competencies should be present in a doctor when he or she completes undergraduate course: management (100%), health assessment of the population and determinants of health and disease (93.3%), communication and counselling (83.3%), concept and application of prevention of diseases (83.3%), etc. There was no significant difference in 4/5 and 6/7 semester students in skills acquired in community medicine except smear preparation and categorization of TB patients. Some of the competencies like smear preparation, TB patient categorization, plotting growth chart, water chlorination and diet planning of a malnourished child improved during the postings. Conclusions: The skills suggested by experts in the field need to be integrated in the curriculum planning for schedules for teaching. The postings should focus on providing essential skills to students in the field so that the students learn actively about the primary healthcare services. Efforts should be made for improve all skills among students.