Quantitative Analysis of Competency Levels in Medical Interns of a Tertiary Care Hospital in India - A Questionnaire Based Cross Sectional Study.

CONTEXT: The MCI has laid down a basic framework for interns, which it expects all prospective doctors to be well versed in. Asking students to demonstrate their understanding of the subject, ability to think critically, analyze, infer and act accordingly is imperative to the learning process. AIMS: To assess competency levels in medical interns post internship via a questionnaire developed based on MCI framework and departmental expectations of clinical capabilities. SETTINGS AND DESIGN: This descriptive cross-sectional study was done in a tertiary care hospital involving 74 interns nearing end of internship in the year 2017. METHODS AND MATERIAL: A questionnaire consisting of core competencies such as professionalism, communication skills, learning competency, clinical problem solving amongst others was provided to each and competency levels were assessed against a pre-defined scale. Answers were graded as Poor, Average, Good and Excellent with corresponding numerical equivalents 0, 1, 2 and 3 respectively. STATISTICAL ANALYSIS USED: The values obtained were analysed using Weighted Sum technique through Microsoft Excel tool. RESULTS: An ideal average competency score was initially established and overall competency of each intern was adjudged against the same. Out of 74 candidates that answered the questionnaire, a vast majority of 50 were found at below average competency. Cardio pulmonary resuscitation was known only to 13 students. Around 50 students were severely lacking with regards to knowledge about the use of preferred antibiotic in sepsis and seizures. CONCLUSION: There seems to exist significant disconnect in the expectations of MCI on one hand and actual knowledge and skill acquisition of the doctors on other. A departmental wise curriculum and exams at the end of each departmental posting which is more skill based will enable a well-trained doctor with reasonable skills and knowledge to obtain his license to practice.

Can vitamin B-complex aggravate the carbamazepine induced toxic epidermal necrolysis?

Toxic Epidermal Necrolysis (TEN), which is also known as Lyell's syndrome, is a widespread, life-threatening, mucocutaneous disease that is particularly observed secondary to drugtaking and less commonly secondary to infections and immunization. Carbamazepine is associated with benign pruritic rash in 10-15% of the patients, but the life threatening dermatological syndromes like exfoliative dermatitis, erythema multiforme, the Stevens-Johnson Syndrome (SJS) and TEN are rarely seen with the carbamazepine treatment. The 32 year old female suffering from chronic backache, who was prescribed carbamazepine along with an intravenous combination of vitamin B-complex and calcium, developed fever, cough and mucocutaneous manifestations of TEN after 15 days of the treatment. She was treated in the hospital with systemic steroids, intravenous immunoglobulins, antibiotics, intravenous fluids and supportive care. In spite of the above treatment, the patient could not survive for more than seven days.