The Indian Institute of Technology, Kharagpur, runs a School of Medical Science and Technology which offers a 3 year training followed by a degree called Master in Medical Science and Technology (MMST). Now, it was started in 2001 and a decade has elapsed since its inception, but the course is yet to attract the attention of majority of the medical school pass outs. In this post, I will try to examine the reasons for the same.
1. Poor Marketing:
To be honest, any course looks as good as its marketing. The IIT branding is definitely a major USP for the MMST but since it is very poorly known in the medical student community, its demand is low. The attitude that its IIT, so its bound to be great does not extend to the biomedical/biomedicomechanical sciences yet, so people are skeptical since poor marketing means there is a poor corpus of information around the course.
2. No Idols/Role Models from the MMST Clans!
As medical students, we grow up looking up to and admiring our stethoscope brandishing professors. For the ones who are less clinically oriented, the cerebral acrobatics of Biochemistry bosses or med-detective work of the Forensic dudes is greatly seductive. Whatever we see in the (nearly) 6 years of medical school, we come to identify and idolize. We never see an MMST guy waxing eloquent on developing a total artificial heart. Bloody cool ideas they work on there, but within a cocoon so elaborately woven that the “mainstream” medical students remain completely unaware of the same. This spawns the question what after MMST, which is my next line of argument.
3. What After?
The general conception in the Indian medical student psyche is that if one is to do basic science research or applied biomedical research, the best option is the GRE. Take it, ace it, skip the shores. I kind of see the point in it. I mean what better place to learn research than THE US of A, right? The fact that we do not see too many MMST guys around us but a lot of post GRE fellows thriving, pushes us towards the other side. We need to know what the prospects are. And not just theoretically. Show us the blogs of these MMST people. Lead us to them on Facebook. Show us where their papers are published. Then, I’m sure this apathy will fall.
4. Faulty Faculty:
The media is hardly worth believing most of the time they criticize our education system because of the negative hyperbole they tend to engage in. But the reports that I have come across over time, even if moderated, do not show the SMST in kind light. The lack of trained physicians, rather clinicians, in the faculty does not inspire much confidence in the students. It is headed by Profs from other engineering branches, with loaned doctors on the faculty, who are mostly there on a part time basis. It is just conjecture, but, these sound to me like the IIT treating the SMST in a step motherly fashion.
5. Second Class Citizens:
We all know how there are wheels within wheels in college and we really never get out of high school all our lives long. I have heard from people who have “visited” the course that the MMST students of medical origin are often treated as second class citizens in the batch. And that is quite understandable. With 6 years elapsed, we hardly remember any basic sciences and medical school is remarkable for its ability to numb, nay, destroy our analytical neurons and make us basic science morons. So, the climb is difficult for an incoming MBBS student. This brings me to the next point: The entrance examination!
6. The Entrance Examination:
The entrance test to MMST takes into account Physics, Chemistry, Biological Sciences and MATHEMATICS. Now most of us went into medicine because we sucked at Maths and hence were forced to love Biology. Or whatever. But the bottomline is we sucked at Maths, barring a few rare exceptions. And exceptions, as we all know, prove the law! So, its quite natural that medical students abhor the idea of taking a test where they have to go through the nightmarish rigors of the unholy Trifecta of Physics-Chemistry-Maths, which they thought they had left behind for good with their entry into medical school!
On a more serious note, this examination, while an excellent aid to assess the suitability of a student for bioengineering or biomechanical training, is an absolute hypocrisy. I mean, come on, you call the department School of Medical Science and Technology, so come on and give the Medical guys the preference. As it stands now, most of the trainees are Biological science grads and rarely doctors. And so it will stand until the examination slims down and falls in line with a more medically oriented curriculum.
7. Money Matters!
I hear the trainees are paid a monthly retainer of Rs. 15,000. Oh c’mon. Who’re you kidding here? In West Bengal, interns are paid close to Rs. 14,000 a month. In Delhi, a house staff gets Rs. 50,000 a month. In the central institutes (like AIIMS, PGI), Surgery residents get close to Rs. 60,000 a month. A simple MBBS graduate with working experience in an Intensive Care Unit may get as much as Rs. 200/hour in the private clinics in Mumbai.
You really think that they’d settle for Rs. 15,000 a month?
This course probably has the highest attrition rates of any post graduate medically oriented course in India! With so many people falling out every year, there has to be something or the other wring with it!
As many as 20% of the batch may be whittled away by the end of the 2nd year of the course, if the words on the street are to be believed!
9. Clinical Quarantine!
This course is so radically non-clinical that it is most definitely a turn off for many medical students, who entered medical school with dreams of becoming doctors. Come on, it is best to face the truth. And the ugly truth is that it is really rare that anyone comes in with the aim of becoming a non-clinical researcher. In the pre and para clinical subjects taught in the medical schools at a post graduate level, people get to work in a clinical setting, working the bedside from the bench, and that, in my opinion, is a surrogate fulfilment of their desire to be in medicine itself. There may not be direct patient interaction, but there is definitely a clinical edge which satisfies the egotistic urge of every doctor to be a clinician!
Somehow, I do not see that psychological satisfaction coming from working in a sterile lab which is miles away from a real patient. Most medical students do not have the maturity to deal with the concept of total and complete divorce from the clinical side of the story. Many final year students swear that once they cross the hurdle of Final MBBS, they are done with the clinics for good, only to reverse it when they are interns and experience the thrill of working with patients (I am a living, typing, example of this type!). It is unlikely that they will be drawn to the course as long as it does not introduce a clinical side to the story.
10. New= Too Risky!
With the MD/MS/Diploma courses of career charted out since times immemorial, one often equates the newness of a course as a risky future, and with a lot of reasons too. In a nation such as India, where bureaucracy and red tapism are the norms rather than the exception, solely doing research for a career, that too from a completely non clinical Institute, is a big risk.
Lots of questions are unanswered, or worse, poorly answered. (Going off topic for a bit here: I believe that it is better for a question to be unanswered than to be poorly answered! A poorly answered question may scare away a potential candidate who might have made a great answer had he attempted to find the question unanswered!) Job prospects are ill defined. Funding sources are few and far apart in India just as it is. And they are mostly monopolized by students with a background in basic science research. And after the MMST course gets done, one becomes a clinical cripple, more or less.
Keeping all of these aspects in mind, taking the plunge in the MMST course sure does seem a foolhardy decision. In another post sometime later, I will try to come up with a few strategies to make the course work out better, in the long term, if not in the immediate future. I would not even dare to venture that I, a rookie in the medical education field, would know more than the erudite scholars who sit atop the ivory towers of decision making palaces in India regarding these matters, but it will be just a personal observation to see what can be done to give this situation a little symptomatic treatment!
What do you think? Would you go for it?