Tuesday, September 30, 2014

DNB courses in six District Hospitals of Health & Family Welfare Department in West Bengal – big step in generating specialists and improvement of speciality services in Secondary Hospitals


1.     DNB in District Hospitals in West Bengal
In order to achieve the mission of the Health Department to provide affordable, quality health care services that are accessible to all round the clock, several Policy initiatives and interventions have been taken by State Government of West Bengal. Works of 34 super speciality hospitals from BRGF grants and another 6 from State Plan are have been planned and under construction and likely to be operational in next few years. Apart from this, 12 Mother & Child Hubs are planned for mother & child care specialities. 37 SNCUs and 18 CCUs have been made functional and there is plan to have one SNCU and one CCU/ HDU at each Sub divisional hospital in the State.

1.1   Health infrastructure being created needs trained manpower, particularly the specialist doctors, nursing personnel and technicians to utilise the facilities to full capacity. While, steps have been taken to increase postgraduate degree and diploma seats in medical colleges in last three years and absorption of passed out doctors in the Public Health Care through recruitment, there remains a large gap between demand and supply, particularly.

1.2   Multi Disciplinary Expert Group constituted by State Government recommended DNB courses in District Hospitals where CCUs, SNCUs and other speciality health care services are already functional and accordingly, six District Hospitals applied for accreditation to National Board of Examination in January 2014.

1.3   All these DHs got approval for 10 seats in each Hospital under Anaesthesiology, General Medicine, General Surgery, Obstetrics & Gynaecology and Paediatrics specialities. DNB students will be utilised to provide health care in these hospitals as resident doctors.

1.4   Junior Consultants with five years experience and senior consultants with eight years of experience in the specialisation field working in the District Hospital will be teaching faculty and guide to these DNB students. Medical College mentors have been tagged with each District Hospital for providing guidance regarding research, thesis and course curriculum.

1.5   Administrative arrangements and logistics for the DNB courses have already been created in all six hospitals.

1.6   In first round of the counselling, 22 out of 42 Primary seats have already been filled. This is very good response in the first year of accreditation by Government run Secondary hospitals. 

1.7   All arrangements for library, seminar hall, classrooms, faculty rooms, accommodation for DNB doctors and practical examinations have been made in record 8 months time on emergency basis. These hospitals can take the pride that their experienced doctors got the status of teaching consultants.

1.8   Details of seats approved and seats filled so far in six hospitals are given in tabular format below. MR Bangur DH is already running DNB courses. More seats will be filled after second round of counselling.

 Name of DH/ Speciality
Anaesthesiology
General Medicine
General Surgery
Obstetrics & Gynaecology
Paediatrics
Total filled in DH
Percent seat filled
Asansol DH
0
1
1
1
1
4
57%
Purulia DH
0
1
1
0
0
2
29%
Krishnagar DH
0
1
1
1
0
3
43%
Barasat DH
1
1
1
1
1
5
71%
Howrah DH
1
0
2
1
1
5
71%
Chinsurah Imambara DH
1
1
1
0
0
3
43%
Total filled
3
5
7
4
3
22
 
Total seats
6
12
12
6
6
42
 
Total vacant
3
7
5
2
3
20
 
Break up vacant
SC 1, OBC-A 1 and ST 1
SC 4, OBC-A 1, OBC-B 1 and PWD 1
SC 1, OBC-A 2 and OBC-B 2
SC 2
SC 1, OBC-A 1 and PWD 1
Vacant : SC 9, OBC-A 5, OBC-B 3, ST 1 and PWD 2
 

 

2.      What is DNB :-
The Nomenclature of the degree awarded by the National Board of Examinations is called the “Diplomate of National Board”. The list of recognised qualifications awarded by the Board in various Broad and Super specialities as approved by the Government of India and included in the First Schedule of IMC Act 1956.
2.1   The Diplomate qualifications awarded by the National Board of Examinations have been equated with the postgraduate and post doctorate degrees awarded by other Indian Universities by the Government of India, Ministry of Health and Family Welfare; vide their notifications issued from time to time.
2.2   The holders of Board’s qualification awarded after an examination (DNB Final) are eligible to be considered for specialists post in any Hospital including training/teaching institution
2.3   The Board at present conducts postgraduate and postdoctoral examinations in 54 disciplines approved by the Board for the award of Diplomate of National Board. The Medical Council of India has laid down standards for post graduate examinations conducted by various medical colleges and affiliated to concerned universities and other institutions, yet the levels of proficiency and standards of evaluation vary considerably in these institutions.
2.4   The setting up of a National Body to conduct post graduate medical examination was intended to provide a common standard and mechanism of evaluation of minimum level of attainment of the objective for which post graduate courses were started in medical institutions.
3.     Some of the salient advantages and limitations of DNB courses are described below :-

 
a.      Easy of entry. This is the most common reason for someone to choose DNB degree programme. To enrol in MD/MS one need to clear tough nationwide entrance exam for Govt. Medical Colleges or pay expensive capitation fee at Private Medical Colleges. For enrolling in DNB programme one need to clear NBE common entrance test which is relatively easy compared to MD/MS exams followed by interview at the institution of choice.
b.     Inexpensive - All one need to pay is the yearly fee stipulated by the NBE. Compared to the fees charged by private medical colleges it is a very small amount.
c.      Those MBBS who missed opportunity to get admission in MS/ MD can get DNB course done and gets the same status.
d.     Students of West Bengal pursuing DNB can get admission in the State, in districts as total seats in Private Facilities was very low forcing them to go outside the State.
4.     Summary:

 
 West Bengal becomes the only State in India to run DNB courses in such large number at District Hospitals, utilising the expertise of the Specialists already working there. DNB course will not only provide additional doctors in DHs but also augment availability of specialists in the State. Initial response is very good in the first counselling and it is expected most of the seats except few reserve category will be filled up. This is big step to give opportunity to MBBS working in the State and augmentation of manpower for major initiatives by State Government.

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