PHARMD going to replace MBBS

This is article by Dr.Vtharavath in www.targetpg.in saying indirectly that pharmD creating fear in mbbs heart's...






A speech by a senior official of IPA forced me to write this article: I request you to spend few minutes for reading this article.

Is there anybody clearly aware of the PharmD course? If not, here are some points and it is the time to
think about it.( Another headache for the doctor community.)

It is approved by the Government of India, Ministry of Health vide letter No. V.13013/1/2007-PMS dated 13th March 2008 announced in the Gazette on India dated 10th May 2008.

Being a doctoral degree, a person with PharmD qualification can keep Dr. as the prefix to his name. So he becomes a Doctor. It is a course of six year duration after +2 (more than that of MBBS course and imagine the situation of BRMS course!!!) and it should be conducted in a teaching hospital. It is a clinically oriented, community pharmacy course. According to the rules and regulations given by the PCI, the institutions which are starting the PharmD course should provide 300 bed hospital facilities. It is as good as starting a medical college.

As per the PCI guidelines: For PharmD Courses

Hospital posting. Every student shall be posted in constituent hospital for a period of not less than fifty hours to be covered in not less than 200 working days in each of second, third & fourth year course. Each student shall submit report duly certified by the preceptor and duly attested by the Head of the Department or Institution as prescribed. In the fifth year, every student shall spend half a day in the morning hours attending ward rounds on daily basis as a part of clerkship. Theory teaching may be scheduled in the afternoon.

One can understand the truth behind it while going down this article.

According to IPA, the justification for introducing this course is that (recently I came across a speech by a senior official of IPA) in the present days the pharmacists are not getting the required acceptance from the public and health community, because of the existing structure of syllabus and curriculum of the pharmacy courses. According to him there are around 60000 formulations in modern drugs. Hence it is difficult to remember all these formulations and its dosages by a doctor (will it be possible by a compounder to remember all these formulation and its dosages? If he is that much intelligent enough to remember all these formulations, he would not have become a compounder) and hence to eliminate any possible medical errors, the pharmacists must be well equipped with the subject that is clinically oriented and hence the new course. It is designed in such a way that it is more clinically oriented, community based pharmacy course. According to him main job of a PharmD person is to function as an interface between the doctor and the patients and to be with the doctors always during the consultation of patients. That means – that a PharmD person will be always with a doctor to advice the patients on drugs and its dosages.

He said that the Pharmacists are the back bones of the health care system (that means the doctors are peripheral isn’t it?) I heard the above quoted words directly from the IPA official’s speech. That indicated their ambitions and future plans. In practical, according to them, the doctor should only diagnose the disease and give a note to the so called PharmD doctors about the disease and health condition of the patients. Then these pharma doctors will prescribe the medicines (Imagine the situation of the doctor?).

Some of the roles of PharmD (community) pharmacists are as follows:
1. Patient medication history interview
2. Medication order review
3. Patient counseling regarding safe and rational use of drug
4. Adverse drug reaction monitoring
5. Drug interaction monitoring
6. Therapeutic drug monitoring
7. Participating in ward rounds – (what are they going do to there??)
8. Providing drug information at the drug information and poison information centre

That means ultimately doctors are going to loose the entire control of medicines and so called pharma doctors are going to gain the total control of medicines. In such a situation no medical representatives are going to meet the doctors and there will not be any up gradation in the drug information to a doctor. A doctor in the future is going to be unaware of any drug formulations. Doctors need only to diagnose the disease or carry out any clinical procedures and rest will be done by these Pharma doctors. Now the said course is introduced in India as if it is a doctoral qualification for pharmacy students and also to upgrade the Indian pharmacy education standard to the International level. But see that each improvement in this field is, definitely, at the expense of professional importance and freedom of doctors.

Actually this is to bifurcate or to reduce the medical importance of present day’s doctor. Definitely these pharma doctors are the old wine in a new bottle. In olden days when the doctors were less the compounders were practicing modern medicines. I have seen in my child hood days many compounders practicing modern medicine. I believe that this is the latest move by PCI to bring back the extinct “medicine practicing compounders” again. Definitely a tough competition between doctors and pharma doctors will be created in respect of powers, position and importance in the health sector, in the future.

Really we should be ashamed of speaking about our greatness after degrading ourselves by promoting a 3 1/2 year BRMS course. Considering the PharmD course, our MBBS degree must be renamed as DBBS— Bachelor of Diagnosis and Bachelor of Surgery!!! This situation must be considered and must be thought of at the beginning itself. A remedy must be formulated to save the future of the entire doctor community.

It is high time to reorganize and upgrade the structure of modern medicine. Why we are not taking any positive steps in this regard? While every sector in the health care system are trying to upgrade or reorganize their structure and curriculum, we are traveling in the reverse gear— Going down for 31/2 year BRMS course.
In my opinion, MBBS should be of 7 1/2 years duration and the curriculum should be modified to compete with and to maintain the importance of the doctors in the health care system of India.

Or even abolish the Bachelor degree and make the medical degrees as an integrated postgraduate specialized degree instead of mere MBBS graduation.

We cannot stop others from changing, but we have to reorganize or restructure ourselves to go atleast one step in front of others.