Hearing impairment in the aged.

Ageing affects all parts of the ear. The effect on the inner ear and its central connections is the most important cause of presbyacusis and contributes maximally to communication difficulties faced by the aged. A number of studies have been conducted on prevalence of presbyacusis. A prevalence of 3.7 to 3.3 per cent was found in the general populations surveyed in rural and urban areas respectively. There is hardly any systematic arrangement available for rehabilitation and fitting of hearing aid as an organized facility. Further research is needed to develop better quality hearing aids which will fully satisfy the needs of the aged.

Inquiry-driven strategies for innovation in medical education: experiences in India.

Four medical institutes, viz, AIIMS, New Delhi; CMC, Vellore; JIPMER, Pondicherry and IMS-BHU, Varanasi formed a consortium to introduce reforms in undergraduate medical education. A detailed inquiry was conducted by administering questionnaires to the faculty, recent graduates and patients to identify the deficiencies in the present system. Morbidity patterns prevalent in the community at primary, secondary and tertiary care levels were determined. These were matched with the actual curricula being followed and the assessment patterns. The main findings were: inadequate emphasis on practical skills (including communication), insufficient coverage of common diseases; and neglect of behavioral, social and ethical aspects in the curriculum. Based on these findings certain corrective programmes are being introduced. The content areas in the curriculum have been classified in to 'must know', 'good to know' and 'need not know'. A list of essential skills have been identified. Steps are on to ensure that these skills are acquired by the graduates. A modular approach to the teaching was suggested and modules on some of these topics are under preparation.

Need-based undergraduate medical curriculum.

There is a growing concern over the quality of medical education for undergraduates in India. This paper is an attempt to define a need-based curriculum and outline the initiatives taken by the Medical Council of India (M.C.I.) in developing a need-based curriculum. The steps include: clear delineation of goals and objectives of education; adoption of innovative teaching and learning methodology, adjustments in the course structure, updating of course content, rationalizing assessment strategy, and emphasis on structured and skill oriented internship. For effective implementation of these measures, strategies such as establishment of Medical Education Unites (MEUs), visible funding of education, more recognition to teaching and impetus to staff development activities have been suggested.