Scope of DNB Family Medicine in India 2022 - familymedicineindia.com Scope of DNB Family Medicine in India 2022 Scope of DNB Family Medicine in India 2022

What is the speciality of FAMILY MEDICINE?

Family medicine is only postgraduate medical speciality in which doctors tend to focus on the entire family and apply a holistic approach regardless of age, gender, illness, or organ system. They look at not just the children but also the parents, even the grandparents and extended family members as the health of one person within the family also can impact the health of the other members in the family.

Definition

American academy of family physicians (AAFP) defines family medicine as “Family medicine is a medical speciality which provides continuing, comprehensive health care for the individual and family. It is a speciality in breadth that integrates the biological, clinical, and behavioural sciences.

Dr. John Murtagh who is a Renowned general Practitioner and author of several internationally adopted textbooks including John Murtagh’s General Practice rightly said “Health does not just mean the physical well-being of the individual but refers to the social, emotional and cultural well-being of the whole community. This is a whole of life view and includes the cyclical concept of life-death-life. Health services should strive to achieve the state where every individual can achieve their full potential as human beings and thus bring about the total wellbeing of their communities.”And who else can be best suited for delivering such type of health care than Family Physicians!
National Aboriginal community controlled health organisation Australia, september 1993

Table of Contents

What is the speciality of FAMILY MEDICINE?
Definition

Difference between family medicine & internal medicine?

Family medicine doctors see people of all ages from birth to death. They see babies, kids, adolescents, teenagers, young adults, pregnant ladies, elderly folks whereas internal medicine doctors see adults only. This is primarily the biggest difference.

Is Family medicine and community medicine same?

Family medicine and community medicine are two different postgraduate medical specialities. Family medicine is a clinical speciality in which doctors are trained in treating patients of all ages; however, community medicine is a non-clinical speciality which is concerned with community health promotion and health education.

Is DNB Family medicine a postgraduate speciality?

Yes! The National Board of Examinations conducts family medicine residency examinations in india. On successful completion of a three-year residency, candidates are awarded Diplomate of National Board (Family Medicine).

Is DNB family medicine recognised by MCI?

Family medicine is a recognized PG speciality through both MCI and NBE.

ELIGIBILITY criteria for admission in DNB FAMILY MEDICINE ?

(A) DNB (Post MBBS) FAMILY MEDICINE

1. Any medical graduate with MBBS qualification, who has qualified the DNB Centralised Entrance Test (DNB CET) conducted by NBE and fulfil the eligibility criteria for admission to DNB Broad Specialty courses is eligible to participate in the Centralised counselling for allocation of DNB Family Medicine seats .

2. Admission to 3 years post MBBS DNB Family Medicine course is only through DNB CET and Centralised Merit Based Counselling.

(B) DNB (Post diploma) Family Medicine Course:

1. Any medical graduate with MBBS qualification who has successfully completed PGDMCH (Post graduate diploma in Maternal & Child Health) or PGDGM (Post Graduate diploma in Geriatric Medicine) course from IGNOU and fulfil the eligibility criteria for admission to DNB (Post Diploma) Broad Specialty courses at various NBE accredited Medical Colleges/ institutions/Hospitals in India is eligible to participate in the Centralised counselling for allocation of DNB (Post Diploma) Family Medicine seats purely on merit cum choice basis.

2. Admission to 2 years post diploma DNB Family Medicine course is only through PDCET Centralised Merit Based Counselling. However, such candidates need not to appear in PDCET conducted by NBE and can participate directly in the centralised counselling for DNB (post Diploma) family medicine seats.

Duration of DNB Family medicine Course?

For post MBBS students : 3 years
For post MBBS + PGDMCH/PGDGM (IGNOU) students : 2 years

Curriculum/Syllabus of DNB family medicine?

During the course, the trainee will attend 27 months of hospital based and 9 months of Field based mandatory rotational postings.During hospital based postings, the trainee will be posted in different departments as follows:

Paediatrics- 6 months
Obstetrics & gynaecology- 6 months
Internal Medicine – 6 months
Emergency Services including ICU -3 months
General Surgery- 3 months
Orthopaedics, Ophthalmology, ENT, dermatology, Psychiatry – 3 months
9 months of rotating field postings for community exposure will be provided through postings at Family Practice Centre (or a primary health centre or a rural/urban health clinic) and satellite clinics as served through outreach camps, Mass screenings, screening OPD’s, Follow up OPD’s, immunisation camps etc.

What PROCEDURAL SKILLS/training will you acquire during 3 years of family medicine ?

1. Anaesthesiology: Endotracheal intubation; intravenous access (peripheral and central lines, venesection, intravenous infusion); anaesthesia (local, regional, intravenous sedation).

2. Medicine : cardio-pulmonary resuscitation (CPR) and advanced cardiac, trauma, obstetric life supports, lumbar puncture, pleural aspiration, peritoneal aspiration, drainage of tension pneumothorax, nasogastric intubation and lavage; intravenous, intramuscular, intradermal and intralesional injections; intra-articular injection and aspiration; take an ECG. Venepuncture, Gastric Lavage and Enema,Urethral Catheterization, Thoracocentesis and Paracentesis.

3. Obstetrics & Gynaecology : conduction of normal delivery, making and suturing of episiotomy, management of breech delivery and retained placenta; repair of perineal laceration; vacuum extraction, forceps extraction; speculum examination, cervical smear, IUCD insertion.

4. Ophthalmology : fundoscopy, removal of foreign bodies.

5. Orthopaedics : splinting of fractures, reduction of simple fractures and dislocation; application of casts.

6. Otorhinolaryngology : removal of foreign bodies from ear and nose, syringing of ear, nasal packing; use of otoscope,hearing test,Otoscopy, Rhinoscopy, Laryngoscopy

7. Paediatrics : resuscitation of the newborn; intraosseous infusions,IV cannulation

9. Surgery : Assessment and closure of traumatic wounds; burns; incision and drainage of abscess; in-growing toe-nails; excision and biopsy of superficial swellings; venesection; urethral catheterization; suprapubic cystostomy; circumcision in adults; intercostals tube drainage; tracheostomy; screening for breast cancer.

What about the DNB family medicine examination ?

a) The theory examination comprises four papers, maximum marks 100 each.

Maximum time permitted is 3 hours for each paper
Trainees must score at least 50% in the aggregate of 4 papers to qualify the theory examination.
Trainees who have qualified the theory examination are permitted to take up the practical examination.

b) Practical Examination:

Maximum Marks: 300.
Consists of Clinical Examination and Viva.
Trainees must obtain a minimum of 50% marks in the Clinical Examination (including Viva) to qualify for the Practical Examination.
maximum of three attempts can be availed by the trainee for Practical Examination.

Pros and cons of doing family medicine?

Pros:-

There is just enormous opportunity in the field of family medicine to accomplish so many interesting things, to reinvent yourself, and give back to the community.
Among corporate hospitals, there is a considerable demand for family medicine specialists.
No expensive resources or infrastructure is needed for practice. A family physician can see a variety of patients in their private practice setting. They have no restriction of patients based on age, sex, or symptoms. They see a wide variety of health problems which makes their practice interesting.

Cons:-

NO well organised FAMILY MEDICINE DEPARTMENT in most of the medical colleges in India.For this reason, even if you get a post in the department of internal medicine after completion of your DNB, administrators will not promote you to SR (Senior resident), assistant professor, and other academic positions at present.
Most of the faculty of hospitals in which you get admission don’t know what family medicine is all about. You have to be smart enough to know your syllabus and learn the subjects accordingly. They won’t deny teaching you but yes you have to tell them what all you need to learn. As I said you have to take charge of your own career.
Implementation of the family medicine curriculum is very poor in most of the DNB accredited hospitals.
There is so much to cover in the course that 3 years of residency would not be enough .In order to do that, Just like other postgraduate students, we must complete SRships but the problem with family medicine DNB and MD in India is that, as of yet, no DNB-certified hospitals have well-organised family medical departments. Therefore, we are unable to join as a SR in family medicine. Of course you will get a job in the internal medicine department but that doesn’t fulfill the purpose of family medicine practice . From my perspective, the training would need to be around 4-5 years (3 years of DNB/MD +1-2 years of SRship) in a well organised Family medicine department itself for FM to be an appealing model for the majority of medical students.

Which Fellowships can we do after DNB Family medicine?

There are no MCI recognized fellowships for DNB/MD Family Medicine. People need to understand that concept of family medicine is to provide care to everyone if we further narrowed down our specialisation we will defeat our whole aim of family medicine but yes you can pursue some courses according to your special interest areas like rheumatology, endocrinology, pain medicine, palliative care, sports medicine etc..

Is it wise to opt for DNB family medicine in india?

For somebody who always wants to learn their entire lives, who likes challenges, who doesn’t want to be bored, and who likes treating a variety of health issues and for those who intend to do private practice in future I would say this is the best rewarding branch .

Scope/career in Family medicine in india?

Once you have completed your DNB family medicine training you can set up your own practice or you have the opportunity to join corporate hospitals or you can join the government hospitals as family medicine specialist at CHCs (community health centres) and district hospitals (DH). Recently PGIMER chandigarh has invited applications for posts of Senior resident and assistant professor in the family medicine department. AIIMS offers postgraduate programmes in Family medicine . Community and Family Medicine Department runs a daily Family Medicine OPD in AIIMS Hospital. In the present context, family medicine doctors have an opportunity to evolve to changes in the healthcare environment, reinforce their professional influence, and pave the path for the advancement of the Indian health care system.In order to do so we have to focus on Building and maintaining patients trust . To strengthen the foundation for our field, we may start this process by refining our clinical skills to offer patient-centered and evidence-based treatment.

Best hospitals for DNB family medicine in india?

Sir Ganga Ram Hospital New Delhi
Govt R.D.B.P jaipuria hospital jaipur
C.S.I kalyani general hospital chennai
Jaiprakash district hospital bhopal
holy family hospital mumbai
kamakshi memorial hospital chennai
Jahangir hospital pune
St stephen’s hospital delhi
Maharaja agrasen hospital new delhi
Aditya Birla Memorial Hospital P.O. Chinchwad,Pune
Indira Gandhi Govt. General Hospital & PG Institute PONDICHERRY
Jan Swasthya Sahyog Vill. & PO Ganiyari District Bilaspur, Chhattisgarh