Unique Program of Indian Undergraduate Medical Education – Family Adoption Through Village Outreach

The National Medical Commission (NMC) was established by an Act of Parliament on September 25, 2020. The Undergraduate Medical Education Board (UGMEB), an autonomous body under NMC, was mandated with the task of developing a competency-based dynamic curriculum tailored to the needs of primary health services, community medicine, and family medicine. This curriculum aims to ensure healthcare accessibility in underserved areas. The implementation of competency-based medical education seeks to produce proficient doctors capable of serving as effective and compassionate leaders in primary healthcare, addressing the needs of the most vulnerable members of society. Thus, a Family Adoption Program (FAP) was devised and made mandatory from the academic year 2023–24.1 Under the FAP, a village outreach initiative has been established, with the Community Medicine department taking the lead and involving faculty, social workers, and support staff. Each medical college is required to adopt a village or cluster and assign each student to at least three households. To facilitate this process and garner community acceptance, it is recommended that every college organizes a medical camp in the adopted village, engaging local leaders and addressing prevalent health issues such as anemia (particularly in women), malnutrition in children, hypertension, diabetes mellitus, cancers, ischemic heart diseases, kidney diseases, or any other local health concerns. Furthermore, AYUSH practitioners may also be included in such initiatives and the patients requiring hospitalization may be admitted with the respective student acting as a primary point of contact. It is also proposed that to overcome the financial obstacles, the charges may be waived or discounted according to existing government schemes and concessions. Competency-based training entails structured visits to households every year, commencing from the first month of admission until the student successfully completes the Community Medicine subject. This approach fosters lasting relationships between students and community members, serving as invaluable hands-on experience in addressing the health needs of rural populations. During these visits, students would also be tasked with recording vital demographics such as height, weight, and blood pressure, among other pertinent findings. Several colleges have implemented this initiative, garnering highly positive feedback from participating students. They report significant improvements in communication skills, heightened empathy toward rural communities, and a notable boost in overall confidence and professional self-esteem. Moreover, students actively began case management of prevalent health conditions like diabetes, hypertension, cardiac disorders, and administering vaccinations, among other responsibilities. Beyond these individual benefits, the long-term impact on a national scale is substantial. By establishing Indian standards and parameters for common vital health indicators, as opposed to relying solely on Western benchmarks, the initiative aligns with the government’s objective of fortifying promotive, preventive, and curative healthcare services. This approach aims to empower villages to become self-sufficient in addressing their healthcare needs, thus contributing to the broader goal of enhancing public health infrastructure.2 A significant challenge in sustaining the FAP is the overcrowding of medical colleges, particularly in states like Tamil Nadu, Puducherry, and Karnataka. This overcrowding makes it challenging for colleges to effectively adopt villages. Additionally, there is a notable shortage of faculty, staff, and facilities, coupled with a lack of initiatives dedicated to supporting FAP. However, over time, this initial reluctance is expected to transform to enthusiasm, driven by increased active involvement from all stakeholders. Nevertheless, success stories such as the longstanding village outreach activities at Kasturba Hospital in Sevagram, India, spanning 40 years, provide evidence of the program’s potential. These initiatives have led to the transformation of villages, marked by the absence of vaccination-preventable diseases and reduced rates of maternal and infant mortality.3 In conclusion, the FAP has the potential to elevate undergraduate medical education to new heights, paving the way for a healthier and more empowered nation.