Mental Health: Neglected Domain in the Pandemic Management Training Module for Undergraduates by the Medical Council of India

Sir,

COVID-19 has invaded every country around the globe, profoundly disrupting every sphere of human lives and society. Medical education is no exception. After a long hiatus of 21 years, two years ago, in an attempt to upgrade medical education and to keep up with the recent global trends, the Medical Council of India (MCI) started overhauling the undergraduate (UG) syllabus with its new competency-based curriculum for Indian Medical Graduates (IMG). ¹ However, its development and implementation are a long-term process. ² The COVID-19 pandemic delayed its rolling out process, Curriculum Implementation Support Program (CISP); its second phase, CISP-2, is being conducted online. Recently, MCI came out with a pandemic management module for UGs. However, unfortunately, it lacks any reference for mental health aspects. ³

MCI, with its ambitious project, is trying to replace the traditional teaching method that was based on the primarily cognitive domain of learning with the competency-based medical education that gives equal preference to all the other domains of learning too—cognitive, psychomotor, and affective. The goal is to produce more efficient IMGs who will be simultaneously clinicians, communicators, leaders and members of the health care team, life-long learners, and professionals committed to excellence and ethically accountable to patients. In the current curriculum, psychiatry is allotted 19 topics and 112 core competencies and has a more ubiquitous presence in every stage of learning. ⁴ However, still there are no skill-based certifiable competencies in psychiatry. ⁵

There is a definite gap in the quantity and quality of mental health services and their distribution in the country. ⁶ According to a survey conducted by the Indian Psychiatry Society within a week of the start of the nationwide lockdown in India, the number of reported cases of mental illness in the country had risen by 20%. ⁷ This pandemic, other than its direct consequences, has ubiquitous ripple effects on people’s psyche as a whole. Adverse psychiatric consequences such as fear of infection, anxiety, stress, depression, post-traumatic stress disorders, suicide, ⁸ and stigma are on the rise among the general public as well as health workers.^9,10 There is pouring evidence of an imminent, massive mental health crisis that can further worsen health outcomes, increase burden on health care systems, impair functioning, and cause loss of productivity. ¹¹

In this juncture, when incorporating mental health to primary health care has been the tenets for all national health policies, MCI’s decision is unfortunate. Serious consideration should be made to incorporate mental health aspects of the pandemic in the UG curriculum. Furthermore, the Indian Psychiatric Society must attempt to bring to MCI’s notice the urgent need to include mental health in the pandemic management module.