Gopichandran Vijayaprasad, Tirupakuzhi Vijayaraghavan Bharath Kumar
Department of Community Medicine, ESIC Medical College and PGIMSR, Chennai, Tamil Nadu, India.
Department of Critical Care Medicine, Apollo Hospitals, Chennai, Tamil Nadu; The George Institute for Global Health, New Delhi, India.
Educ Health (Abingdon). 2020 May-Aug;33(2):70-73. doi: 10.4103/efh.EfH_251_19.
The undergraduate medical curriculum has undergone a major revision. This study was designed to systematically review the revised Indian medical school curriculum to assess the extent of coverage of antimicrobial resistance (AMR) and antibiotic stewardship-related competencies.
We undertook a document review of the recently revised Indian medical curriculum to identify the extent of coverage of competencies related to AMR and antibiotic stewardship. With the use of a previously described search strategy, we queried the online freely accessible version of the curriculum in duplicate and independently. We describe by volume, by subject and by the tenets of Miller's pyramid all references to AMR and stewardship.
Out of 2939 competencies that medical students are expected to complete over a 5.5-year period, 17 (0.57%) relate to AMR and antibiotic stewardship policies (ASP). There are no references to AMR or ASP in Pediatrics, Surgery, Obstetrics and Gynecology, Ear, Nose and Throat, Ophthalmology and Orthopedics. Community Medicine has few links through integrated teaching but has no direct AMR or ASP content. When categorized by Miller's domains, two of the competencies, both in Pharmacology, deal with the "Does" category, which is the practical skill gained by the student. There are five competencies which belong to the "Shows How" category and the remaining 10 belong to the knowledge categories.
There is poor coverage of AMR and stewardship in the revised Indian medical curriculum, suggesting that there is very little appreciation of the enormous threat that AMR poses to public health. This is a huge missed opportunity that needs immediate corrective action.
本科医学课程已进行了重大修订。本研究旨在系统回顾修订后的印度医学院课程，以评估抗菌药物耐药性（AMR）和抗生素管理相关能力的涵盖范围。
我们对最近修订的印度医学课程进行了文献回顾，以确定与AMR和抗生素管理相关能力的涵盖范围。通过使用先前描述的搜索策略，我们对课程的在线免费获取版本进行了重复且独立的查询。我们按篇幅、主题以及米勒金字塔原则描述了所有与AMR和管理相关的参考文献。
在医学生预计在5.5年期间完成的2939项能力中，有17项（0.57%）与AMR和抗生素管理政策（ASP）相关。儿科学、外科学、妇产科学、耳鼻喉科学、眼科学和骨科学中均未提及AMR或ASP。社区医学通过整合教学有少量关联，但没有直接的AMR或ASP内容。按米勒领域分类时，药理学中的两项能力属于“做”的类别，即学生获得的实践技能。有五项能力属于“展示如何做”类别，其余十项属于知识类别。
修订后的印度医学课程中AMR和管理的涵盖范围较差，这表明对AMR对公众健康构成的巨大威胁认识非常不足。这是一个巨大的错失机会，需要立即采取纠正行动。
