|Year : 2020 | Volume
| Issue : 3 | Page : 151-152
Responding to the COVID-19 Pandemic: the Experience and the Road Ahead for the Largest Medical College in India’s Capital City
Maulana Azad Medical College, New Delhi, India
|Date of Submission||07-Dec-2020|
|Date of Acceptance||08-Dec-2020|
|Date of Web Publication||16-Dec-2020|
Prof. Nandini Sharma
Director Professor, Community Medicine & Dean, Maulana Azad Medical College, BSZ Marg, New Delhi 110002; State Task Force Chairperson, RNTCP, GNCT Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sharma N. Responding to the COVID-19 Pandemic: the Experience and the Road Ahead for the Largest Medical College in India’s Capital City. MAMC J Med Sci 2020;6:151-2
|How to cite this URL:|
Sharma N. Responding to the COVID-19 Pandemic: the Experience and the Road Ahead for the Largest Medical College in India’s Capital City. MAMC J Med Sci [serial online] 2020 [cited 2021 Jan 26];6:151-2. Available from: https://www.mamcjms.in/text.asp?2020/6/3/151/303587
The COVID-19 pandemic presented unprecedented challenges for medical professionals worldwide and our experience in Delhi was no different. The requirement of large scale COVID-19 testing and treatment created an enormous burden on Delhi’s public health infrastructure. One of MAMC’s affiliated hospitals − LokNayak hospital, bore the highest-burden as the largest hospital in Delhi dealing with COVID-19. Despite several challenges, the faculty, residents, and allied staff of MAMC rose to the occasion and fulfilled crucial responsibilities toward combating COVID-19.
Unprecedented times require unprecedented measures. Our country, like most parts of the world, entered into a nationwide lockdown and an extended closure of educational institutions was enforced across the country to prevent the spread of COVID-19 and protect students. I was appointed as Dean of MAMC this period, when our bustling medical college was eerily quiet, with its soul − our bright enthusiastic students, missing. The challenges for our institution, which provides both medical education and hospital services, were many. The institution needed to support medical education, research, policy, public health surveillance including contact tracing, and treatment of COVID-19 patients. The road ahead was dark but the never say die spirit of the great institution took over as we confronted these challenges head-on. I share some of the measures driven by innovation, ingenuity, and improvisation that were adoptedby MAMC for fulfilling these needs:
| Continuity of medical education|| |
MAMC is one of the largest medical colleges in the country, which has batch strength of 250 undergraduate (UG) medical students each year. With the onset of the pandemic, UG classes were suspended, hostels were shut down, and the students were relocated to their homes. Providing students with a replacement for their vast course curriculum combining multiple teaching mechanisms, including not only didactic lecture classes, tutorials, and seminars, but also clinical and ward postings, was a daunting challenge in our resource-limited settings. Furthermore, in the context of postgraduate students, physical attendance in department seminars, workshops, and symposia was ceased for similar reasons, though such students continued their clinical duties in the now Covid hospital. Under the circumstances, online education was considered as the most feasible means of supporting medical education and training. However, the lack of existing standards for conducting such online courses has impaired the ability to achieve teaching objectives as per the extant competency-based medical curriculum implemented offline. Prior research conducted by our institution indicated that younger faculty and senior residents had positive attitudes toward inculcating online or mobile learning techniques for UG medical education (Basu et al. 2020); however, some mid-level and senior faculty were hindered by the digital divide. Nevertheless, partnerships and synergy with their younger colleagues bridged these gaps and ensured that all departments of the college actively participated in the online education sessions for UG students. However, the limitations of online education for medical students cannot be overlooked, especially with regard to clinical components of medical education which cannot be adequately replicated through the didactic mode of teaching. Although, state of the art training techniques for virtual learning are available, issues concerning licensing and affordability hinder their adoption especially given the lack of extensive financial support. As they say, each cloud has a silver lining and this can be said to be true for the present situation too. This experience provides us vast postpandemic opportunities for integrating the beneficial aspects of online medical education with our existing medical course curriculum − which arguably needs a radical overhaul in the 21st century. Medical colleges across the country should consider pooling their online teaching experiences to generate learnings that are useful in the postpandemic scenario for overhauling medical education in India.
| Research and training|| |
The contribution of medical colleges toward medical research in India is underwhelming. A review of the last 3 decades indicates a majority of the publications are restricted to a handful of medical institutions among the 450 odd medical colleges functioning in the country (Ghosh and Ghosh, 2019). The COVID-19 pandemic posed several original research questions comprising of epidemiological, clinical, and behavioral challenges for the scientific community with an emergent exigency. This should alert governments and policy-makers toward the urgency to drive research prioritization within medical faculty, residents, and students for optimal capacity building and promotion of public health.
Research contributions by MAMC and LN Hospital have been well-recognized in shaping the public health policy (sero epidemiological surveys by the Department of Community Medicine), clinical diagnosis (Department of Microbiology), clinical trials (department of Medicine), and patient safety and management (all clinical departments). In this context, the development of MAMC, a top-ranking institute, into a leading research-focused medical college in the next decade, warrants the highest prioritization.
| Providing patient services|| |
The state of Delhi has as of date registered over 0.64 million cases including over 9500 deaths (mohfw.gov.in). MAMC and LN Hospital have the distinction of treating over 10,000 COVID-19 patients to date, with rates of recovery that surpass that of developed countries with state-of-the-art health systems (unpublished data). Our young residents, true Covid warriors, have been at the vanguard of according the best possible care to our COVID-19 patients, with many residents themselves having contracted COVID-19 infection in the line of duty. Even residents and young faculty from pre and paraclinical departments, who hitherto had limited experience in critical care management, have actively been involved in caring for COVID-19 patients. Resident doctors of all specialties have been deployed for COVID-19 care, while their specialization has taken a back seat, depriving them of crucial clinical and specialist experience. This professional sacrifice by our residents also requires wider acknowledgment.
| Caring for the psychological well-being of our residents|| |
Factors include long hours of duty in PPE kits, inability to see their families for long periods of time, and the pain of losing patients everyday have taken a huge toll on the psychological well-being of doctors and nurses globally, contributing to increased levels of anxiety, stress, depression, and insomnia. Realizing the crushing psychological impact of the pandemic on our frontline health workers, we started psychological support services at our college. Counseling was done before start of posting and once in between for all. Those red flagged were given individual counseling.
| Towards normalization and the road ahead|| |
The life of a medical college is incomplete without its students. The consequences of delayed admission and graduation of medical students in our country will have a catastrophic impact on our already stretched health care services in India. The direction of the Health Ministry to take necessary measures for reopening of medical colleges is a welcome step but also presents acute challenges, which the faculty is striving to overcome. We have successfully held postgraduate examinations and MBBS supplementary exams during these challenging times. Now, we have also developed SOPs, which can guide us as we wait to welcome the vibrant, young, and bright students toward restoring the lifeline of our college. As aptly said by John Green “The darkest night produces the brightest stars”, this pandemic has honed us and our future generation of doctors to overcome challenges however daunting they may be by relying on our inner strength.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Basu S, Marimuthu Y, Sharma N, Sharma P, Gangadharan N, Santra S. Attitude towards mobile learning among resident doctors involved in undergraduate medical education at a government medical college in Delhi, India. J Edu Health Promot 2020;9:321. [Full text]
Ghosh K, Ghosh K. Medical Research in Medical College in India: Current scenario and ways to improve it. J Assoc Physicians India 2019;67:71-3. PMID: 31299844.