Revalidation: Are We Meeting Training Needs? Training and Its Influence on the Practice of Child Psychiatry and Psychotherapy

Article excerpt

Byline: Arun. Kishore, K. Shaji, K. Praveenlal

Revalidation and renewal of registration are issues of concern to most psychiatrists. Keeping up-to-date with current knowledge is an essential part of the renewal of license to practice. Training needs of psychiatrists are addressed in postgraduate courses and the gaps in training and updating of knowledge addressed through continuing medical education programs. This study aims to look at whether the training needs of psychiatrists working in the state of Kerala are being met. Two aspects of training and practice, child and adolescent psychiatry and psychotherapy, were assessed using a questionnaire. A significant number of respondents had not received any training in either of these areas in their postgraduate training. This did not affect their practice; most respondents continued to practice psychotherapy and see child patients despite not being trained. These two areas can thus be identified as lacunae in the curriculum as well as a need which should be addressed through Continuation Medical education programs.

Introduction

The directives of the Medical Council sets out the principles and values on which good practice is founded; these principles together describe medical professionalism in action. [sup][1] Principles of good medical practice exhorts practitioners to keep up-to-date in knowledge and skills, familiarize themselves with developments in their field, and take part in educational activities that maintain and further their competence. These are the basic aims of revalidation too. Revalidation is the process by which doctors will have to demonstrate to the Medical Council that they are up to date and fit to practice and that they are complying with the relevant professional standards. [sup][2] Revalidation has two elements: relicensing and recertification.

The purpose of recertification is to show that practicing doctors who undertake specialist practice continue to meet the particular standards that apply to their medical specialty or area of practice. [sup][3] Basic knowledge and skills, while fundamentally important, will not be enough on their own. As undergraduate and postgraduate education may be insufficient to ensure lifelong physicians' competencies, it is essential to remedy gaps in skills, and to enable professionals to respond to the challenges of rapidly growing knowledge and technologies, changing health needs and the social, political and economic factors in the practice of medicine. Continuing professional development (CPD) is the basic process to identify gaps in professionals development and help them fill these gaps. This is a continuous process of acquiring new knowledge and skills throughout one's professional life. In contrast to continuing medical education (CME), which involves updating only clinical knowledge, CPD also embraces developing and improving a broad range of skills necessary for medical practice such as management skills, communication, teaching and learning skills, and knowledge of information technology. [sup][4] CME depends highly upon learner motivation and self-directed learning skills [sup][5]

Kerala has a comparatively large number of trained mental health personnel.

Psychiatrists working in the government sector are attached to Medical colleges, District hospitals and state run Mental hospitals. The state has a well-developed private sector with psychiatrists and clinical psychologists attached to large private medical colleges, private hospitals, private mental hospitals and clinics.

Post graduate training in psychiatry started late in Kerala. An MD psychiatry course was started in 1984. Most psychiatrists working within the state had undergone training in post-graduate centers outside the state such as NIMHANS, Bangalore, AIIMS, Delhi, CMC, Vellore, JIPMER, Pondicherry, PGI, Chandigarh, and training centers at Chennai, Mumbai, or Mangalore. The state currently has six seats for MD in psychiatry and five seats for DPM. …