Each year, around the time of AIPG counseling, I get a fair number of emails asking about PSM as a career option. These question are mostly from students who have not really considered PSM as a career option, and hence, do not have the information or evidence needed to take an informed call. I usually try my best to provide what I think is my evidence based opinion (yeah, that is an oxymoron right there!). This year, I received an exceptionally well worded email, articulating the questions in a very cogent and coherent manner, and I thought that I could use my responses to frame a series of blog posts that could function as a repository for such future queries (till such time as the content becomes outdated). In the subsequent posts, I shall try to make the case for, and against, joining PSM as a career option, based on the questions posed to me this time around. Hopefully these shall help clarify your doubts, and if not, feel free to write in to me
What are the advantages that colleges in Delhi, Mumbai or central institutes have to offer over other colleges? Especially when compared to newly opened colleges which have released seats in PSM dept. for the first time?
There is a rule of thumb when it comes to choosing where to go for postgraduate education: chase after the subject of your dreams, and not the college or institution of your dreams. It makes a lot of sense especially because you are going to spend a lifetime with the subject. So, even if you end up in an abject hell hole of a college, the torture will last, at the most, for three years (hopefully). However, the problem becomes a bit intense for students who do not have the option of chasing after the subject of their dreams. If you are being forced into a subject that you are ambivalent about, yet, you have no option but join it, where should you go for it? There is a rumor that goes around the system that when it comes to PSM, the Delhi colleges have an edge over the others. And in my eyes, there is more than a fair bit of substance to the rumor.
There is a definite advantage of doing PSM in Delhi. Considering that a lot of the public health agencies are based out of Delhi, a number of central agencies have their main locations in Delhi, and it provides a canvas for a multitude of learning experiences, if you are thinking of doing PSM and have the rank for pulling it off, Delhi should be the place you should think of. It does not mean that all the state colleges are bad, but in general, if you can get a place in a Delhi college, I think the wise decision is to go for it.
I would be very wary of newly opened colleges, especially ones which have released PSM MD seats recently. Without pointing fingers or denigrating anyone, it is just my opinion, and it should not matter to anyone.
At its core, the way PSM or Community Medicine is taught in India, is largely in a theoretical manner. Only a few places have very hands-on training in Community Medicine – from what I have heard, CMC Vellore, AIIMS Delhi, and MGIMS Wardha employ very practical approaches to the teaching and practice of Community Medicine/PSM. Anywhere else, you are going to need good teachers, with extensive field experience as well as a good grasp of the basic understanding of the subject to be able to excel as a student at the MD level.
At the University College of Medical Sciences, I was blessed with wonderful faculty members who had immense knowledge of the subject, and its various sub-sections. I was fortunate to receive training and mentorship from some of the best known figures in the world of academic Community Medicine, and thanks to their leadership, erudition, knowledge, and guidance, I have been able to appreciate how truly complex, beautiful and vast the terrains of Community Medicine/PSM can actually be. Thus, to me, the study of the subject, despite its multiple lacunae and poor recognition factor in the profession, remains an intellectually stimulating exercise. Naturally, you must feel aghast when you read this, remembering the horrors of PSM classes from MBBS days – well, that should explain how much of a difference exists between the UG and the PG levels, and especially if you have great teachers at the helm!
Coming to the problem that plagues the issue of recently opened colleges with fresh seats. The newer colleges (I am assuming these are private ones, though you have not specifically mentioned as such) usually employ MDs right out of their degree colleges, which can sometimes be a good thing, but more often than not, is not. In the government setting, you usually get to a teaching job only when you have completed three years of senior residency or have three years of teaching experience under your belt. So, even the most junior faculty members in a government college have at least three to four years of teaching experience. That is not the case for private colleges, which may hire faculty members right out of MD degree college. In fact, given the severe dearth of senior residency seats in government medical colleges, most fresh MDs end up looking for faculty level jobs in private colleges, at least as a temporary measure till they land a better gig!
Now please do not take this to mean that fresh MDs are incompetent teachers – if anything, they might be better teachers, at least when it comes to the “practical aspects” of studying (also known as jugaad!). While they may be perfectly capable of teaching undergraduate students, most of them (basically people who are at a parallel stage as I am – so, basically, most of us!) are not equipped well enough to be able to mentor, teach and guide MD students. Leading an MD student effectively takes a bit more than book learning and wit; it needs wisdom and experience that comes only with time, that too, to not every one!
So, in brief, it is always a good idea to pursue PSM from a good college, with a good faculty on board, and with a history of churning out good students with great employment history. I have been asked to make rankings of colleges based on their desirability, and though I would desist from claiming the audacity of having the knowhow to achieve that, I could tell you my personal list for PSM/Community Medicine choices. At least these were the places I would consider to go were I deciding to start all over again (thank God I do not have to do it actually!). I think places like PGI Chandigarh, CMC Vellore, AIIMS Delhi, MAMC Delhi, UCMS Delhi, KEM Mumbai, and MGIMS Wardha are probably the best places to do PSM from (that I know of). As you may have noted, some of these colleges need you to take other, institute-specific entrance exams.
If you have any queries regarding picking up Preventive Medicine/Social and Preventive Medicine/Preventive and Social Medicine/Community Medicine as a career option, please consider dropping me an email or leaving a comment in the box below!