Training and National deficit of psychiatrists in India - A critical analysis

Abstract

India is the second most populous country in the world, with an estimated current population of 1.17 billion. This article aims to estimate the deficit of psychiatrists in India in relation to epidemiological burden of mental illness, propose short-term and long-term strategies to tackle the deficit and emphasize the importance of modifying the curriculum of undergraduate medical education to enable the proposed strategies. With 6.5% prevalence of serious mental disorder, the average national deficit of India is estimated to be 77%. More than one-third of the population has more than 90% deficit of psychiatrists. The authors estimated that the undergraduate medical curriculum devotes only 1.4% of lecture time and 3.8-4.1% of internship time to psychiatry, thereby leaving the general practitioners and the non-psychiatrist specialists unprepared to competently deal with mental illness in their practice. We propose short and long-term strategies to manage this deficit of psychiatrists.

Keywords: Burden of mental illness; deficit of psychiatrists; psychiatric training.

Figure 1

Indian map showing state-wise psychiatrist deficit/surplus distribution

Figure 2

Demonstrates the number of hours of lecturing or clinical instruction devoted to the various specialties during MBBS, as stipulated by the Medical Council of India. The data plotted in the graph was obtained by accessing the official website of the Medical Council of India (www.mciiindia.org, last accessed December, 2009)

Figure 3

Demonstrates the number of weeks of clinical internship experience devoted to the various specialties during MBBS, as stipulated by the Medical Council of India. The data plotted in the graph was obtained by accessing the official website of the Medical Council of India (www.mciiindia. org, last accessed December, 2009)

Figure 4

Dynamics of patient flow leading to specialist psychiatric care