The new Graduate Medical Education Regulations (GMER) 2019 guidelines brought in a diverse spectrum of much-wanted changes in the MBBS curriculum to cope up with the increasing demands of the medical profession. Electives have been a part of health professions training, many of which have tried offering electives on an experimental basis and others in a regular mode.[1,2] However, guidelines of the National Medical Commission (NMC) mandated to start of electives in all medical colleges throughout India from the admission batch 2019, after completion of the final phase part 1 study. Hence, the timeline for offering this course was tentatively fixed toward February 2023. For smooth implementation, the “Elective module” was released by the NMC for guidance; however, the actual implementation was left to the wisdom of the colleges.
We at our institute have tried to lay out our journey through the process. Since the preparation had to start early, the planning of the program was laid out.
Constitution of Core Committee
To commence with the planning phase, the Elective Core Committee (ECC) was formulated with the Principal as the Chairperson and the medical education unit (MEU) coordinator as the member secretary. Four other members were included in the committee, all of whom were experts in medical education, and were either members of MEU or the curriculum committee. This committee deliberated and a plan with a timeline for the program was prepared as depicted in Figure 1.
Needs Assessment Survey
The ECC planned to have inputs from all stakeholders regarding their opinions and preferences for the electives and conducted a “needs assessment survey” through a Google Form by involving students of the 2019 Batch. Informed consent was obtained from all participants for data collection.
Of the total 150 students, 128 students responded to the survey and submitted their responses. The survey included responses related to their choice of elective topics for blocks 1 and 2 from the list suggested in NMC Elective Module 6. In addition, students were also asked to suggest more electives they would wish to have and the reasons for selection.
Focus group discussions (FGDs) were held with the faculty. FGD-1 was conducted with the faculty representatives from pre and paraclinical subjects to discuss Block 1. FGD-2 was conducted with the faculty representatives from clinical departments for Block 2. The electives suggested by the faculty were enlisted. The FGDs also focused on various enabling and disabling institutional factors related to the electives and the same were addressed.
Preparation of Provisional List of Intended Electives
Regular meetings of the members of the ECC were held thereafter and a provisional list of intended electives was prepared considering the available facilities and responses received in the needs assessment survey. A provisional list of intended electives was compiled [Table 1].
Faculty Development Program
Next, a Faculty Development Program (FDP) was planned for training all the preceptors who were identified or volunteered. The FDP focused on the identification and finalization of the electives from various departments, preparation of the materials/modules as per the guidelines of NMC, preparation of the logbooks, and the individual plan of implementation.
The workshop cum training for all preceptors was held in January 2022 through an online zoom platform due to COVID restrictions. The FDP was conducted by the resource faculty of the ECC. A total of 69 faculty members were trained in the first round followed by another to facilitate more preceptors after identification from the departments. The workshop schedule is given in Table 2 for ready reference.
The training session was later uploaded on YouTube to assist faculty to refer for the preparation of modules. The link to the recorded session is https://youtu.be/gJVUTmo-Izw.
Preparation of Modules and Validation
Further, the phase of preparation of modules and validation was launched, wherein the departmental heads were asked to submit the elective modules for each of the intended electives as per the guidelines of NMC Module 6. The final list of faculty preceptors and the number of students that could be accommodated in each elective was also finalized (we are an institution with 150 students/year).
Each module was prepared under various sections such as – block specified, name of the elective, duration, why this elective, what do I gain as a learner, location, name (s) of internal and external preceptors, goal/competency, learning objectives along with domain, proficiency level and teaching-learning methods planned, day wise list of student activities planned, number of students that can be accommodated, student prerequisites, learning resources for students, logbook entries required, portfolio entries required, assessment plan, additional resources and funding required if any.
The ECC proceeded to check and validate the modules. The parameters used for validation were – allotment of faculty preceptors, number of students accommodated, availability of equipment, and infrastructure in the department, learning objectives framed, day-wise planning, experiential learning component present, and assessment plan included.
A final list of the total of 13 modules in Block 1 and 37 modules in Block 2 was finally prepared and modules were validated by the ECC. The modules were then revised by respective departments and finally published [Tables 3 and 4].
A common logbook for both blocks was considered logistically more convenient and the same was prepared. The logbook included personal details, logbook certificate, general instructions, daily log for 4 weeks, details of cocurricular activities, and final summary. The daily log includes the day number, date, competency addressed, name of the activity, learning objective(s), details of experiential learning activity, summary of concepts learned, assessment details (if done) as – B/M/E (below expectations/meets expectations/exceeds expectations), and finally reflections. At last, space has been given for the initials with a date of the faculty and the learner (documenting that feedback has been received).
Students were sensitized by the MEU Coordinator and they were apprised of the program plan. The students were provided with the final list of electives along with a “Curtain Raiser” – a brief summary of what each elective offers along with the learning objectives of each module. This document was circulated to the students as hardcopy as well as softcopy.
Counseling and Allocation of Electives to Students
For the allocation process, the merit list of students was prepared. The ranking of students was done on the average marks scored in the previous two university examinations. The students having failed in one or more subjects, 5% marks per subject were deducted to calculate marks weightage. For the same average marks, students scoring higher marks in Phase 2 were ranked higher in merit, to break the tie.
The final lists were prepared and transparent and open counseling for students for both blocks was conducted by the office of the Dean Academics along with the MEU coordinator and electives were allocated. The final lists of allotments were displayed to the students and any grievances were asked to be submitted within 1 month. The final lists have been prepared and published by the office of the principal. All the students and preceptors are well prepared enough to start with the actual program which is to be offered between February and March 2023 for batch 2019. The office of the Principal, Dean Academics along with the MEU coordinator and ECC shall continue to provide the necessary support for further implementation and evaluation of the program.
Initials are used for faculty names for confidentiality reasons.
1. Shrivastava SR, Shrivastava PS. Introducing electives in the undergraduate medical training period:Points to ponder. J Sci Soc 2021;48:52–3.
2. Mahajan R, Singh T. Electives in undergraduate health professions training:Opportunities and utility. Med J Armed Forces India 2021;77:S12–5.
3. Medical Council of India Electives for the Undergraduate Medical Education Training Program 2020 1–30.