Perspectives on the Journey Through the Early Exposure Psychiatry Enrichment Program 2024

Dear Editor,

Undergraduate psychiatry training in India remains an overlooked and underutilized area that needs more focus and resources. ¹ Globally, many universities have implemented early enrichment programs in psychiatry to foster psychiatry learning and enrich pupils’ experience with the subject.^2–5 The first such program was the Combined Accelerated Program in Psychiatry of the University of Maryland. This program involves three and a half years of undergraduate and two and a half years of postgraduate training for selected students with an interest and aptitude for psychiatry. ² Similarly, the Early Experience Program at Kings College London Medical School offers exposure to psychiatry in the very first year. Students must shadow their designated physician for two days every six months throughout their five-year medical school program. ³

However, to our knowledge, such programs are lacking in India. Recently, the Psychiatry Department of All India Institute of Medical Sciences (AIIMS), Bhopal has initiated a 12-week Early Exposure Psychiatry Enrichment Program (EEPEP) for the medical students, marking a pioneering work in psychiatry education in India. These sessions were held twice a week in the evenings after regular classes and clinical postings of the pupils, scheduled during weekdays relatively less busy for them. It introduced undergraduates to psychiatry and mental health right from their second year of medical school. Notably, our Institute of National Importance (INI) provides a single five-week exposure in psychiatry during the 7th semester, with two weeks of elective in the 8th semester and two weeks of mandatory internship. Such variations in psychiatry exposure are prominent across various INIs of our country; therefore, enrichment programs prove to be more valuable in such settings. Moreover, it is worthwhile for any medical colleges in the country, where the pupils’ psychiatry and mental health-related knowledge, attitude, and skills can be enhanced through such programs.

As second-year students (participants henceforth), the invitation to participate in this program intrigued us, as it diverged from our standard curriculum by incorporating novel teaching learning (TL) methods. Our experience with the program may inform psychiatry teachers and medical students to engage in such activities to promote or enhance psychiatry teaching and training.

The course coordinator also corresponding author of this letter of the program personally visited our class and oriented us about the key aspects of the program. Subsequent enrolment took place through an online Google forms-based process. There was no exam or prerequisite to be part of the program, except the potential participants’ motivation and 80% attendance to acquire the program completion certificate.

Our understanding of psychiatry was limited due to minimal exposure during our first year of MBBS. The program’s unconventional teaching methods initially sparked both curiosity and apprehension. However, upon closer examination, we discovered its compatibility with our schedules, particularly during the relatively lighter workload of the early stages of our second year. Although there were moments when integrating the sessions into our academic routine seemed daunting, the program’s flexibility proved invaluable. It provided a supportive framework, enabling us to continue our sessions while maintaining balance in our academic pursuits.

Moreover, providing resources, specific learning objectives, and session roadmaps before each session allowed us to prepare at our convenience, enhancing our ability to grasp concepts effectively during the sessions. The facilitators including the faculty members and senior resident of psychiatry were remarkable in maintaining pace and delivering short, focused sessions, ensuring that each session was well-structured and to the point. Their expertise and dedication to psychiatry teaching enriched our learning experience, making our journey engaging and rewarding. Furthermore, emphasizing teamwork during each session fostered better cooperation, promoting mutual understanding and collaboration, which enhanced our overall learning experience.

The innovative teaching approaches, which included integrated learning, movie club, clinical exposure through OPD/subspecialty visits, debate, small group discussions, self-directed learning (SDL) sessions, and focused group discussions at the end of the program (exploring students’ perspectives on early exposure to psychiatry), enriched our learning experiences. The integrated teaching sessions with pharmacology and forensic medicine (subjects we had already studied) proved instrumental in fostering a deeper understanding of psychiatry among us and interconnected with medical specialties.

The SDL sessions diverged from traditional teacher-centric approaches, empowering participants to identify their learning goals, self-assess, and take ownership of their educational journey. In this, the role of the teacher shifted from that of an instructor to that of a facilitator, guiding and supporting us as we navigated through our personalized learning paths. ⁶

Additionally, the sessions involved regular individual feedback (bidirectional), which was novel compared to the traditional teaching approach. Such feedback improved our understanding and competency about a topic and informed us about future learning courses, cutting across the disciplines. This approach facilitated learning in an environment where we were encouraged to delve into the subject matter more comprehensively. Additionally, more focused interaction with persons with mental illness helped us to understand the nature and clinical features of these disorders, how to conduct mental state examination to establish the diagnosis?, and various treatment modalities. Providing refreshments at the end of each session was a thoughtful gesture, concluding our sessions pleasantly. Studies have echoed our experience, wherein innovative teaching methods have led to a significant positive impact of psychiatry teaching on undergraduates. ⁷

Notably, program participants were honored with certificates and mementos during a Continuing Medical Education event focused on Innovation in Psychiatry Teaching and Training; we shared our program experiences with the attendees. The participants’ feedback generated much excitement among their peers. They were eager to hear more about our experiences and expressed strong interest in joining future editions of the program.

Active participation in programs like EEPEP can cultivate a comprehensive perspective in medical school. This enhances pupils’ communication skills with patients and facilitates the effective implementation of Attitude, Ethics and Communication (AETCOM) modules recommended by the National Medical Commission (NMC). ⁸ By immersing themselves in these initiatives, students develop a deeper understanding of patient care and TL methodologies, thus preparing them to become well-rounded and competent healthcare professionals. ⁹

Expanding the program to include components like the role of artificial intelligence in psychiatry education holds promise for enriching future participants. We are confident that this program will yield positive developments in future participants, and a review after several editions may reveal intriguing findings in undergraduate psychiatry teaching.