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Research by psychiatry residents in Indian scenario: Challenges and opportunities
Asian Journal of Psychiatry 19 (2016) 3
Contents lists available at ScienceDirect
Asian Journal of Psychiatry journal homepage: www.elsevier.com/locate/ajp
Research by psychiatry residents in Indian scenario: Challenges and opportunities Sir, India is a country with a large mental health care gap (Kohn et al., 2004). Though there has been a recent increase in the number of residents opting for psychiatry residency, there still exists a large gap and hence residents working in psychiatry departments are also overburdened with the clinical work like other departments’ residents. Starting research efforts early in the career helps residents to develop an opportunity to balance clinical duties with research work which in turn may influence their long-term professional career and choices. Though it is really important for residents to be involved in the research work early in their training, due to a variety of reasons, they are unable to do so in an Indian psychiatric setting. Residents face many obstacles in a research work (Abrams et al., 2003). Due to less exposure in the subject of psychiatry during their M.B.B.S. period, residents know very little about it during their initial residency period (Das et al., 2002). However, their unbiased views can help to give new insights into the longstanding debated issues in psychiatry. Another important issue is the long duty hours during the residency with more clinical workload leading to very little time left for research work. Unlike many other countries where dedicated research rotations without clinical duties are given, this is not the case in India and residents themselves have to manage their research timings on their own. During residency, residents have to submit a thesis in order to be eligible to appear in their M.D. exam in India. This is an important learning experience for students making them aware of the research going on in the field of psychiatry, and also helps them in managing their clinical duties along with research work. Choosing a mentor for thesis and a topic to work upon, residents are given a head start to work on their own interests in the field of psychiatry. One-to-one guidance given by a mentor with the help of senior residents as peer mentors helps residents in integrating research with clinical duties. While in the West, the funding sources are vast and gives an ample opportunity to do research work during residency (Torous and Padmanabhan, 2015), funding sources are very few in India, and so very few psychiatrists can do research work at a consistent level. Due to this reason, basic research is almost nonexistent in India and exposure to research is very limited (Zisook et al., 2007). Many residents become discouraged because of this reason. Exposure to the conferences has also been a persistent source of encouragement to the residents. But, that has also been hindered due to the paucity of funds and the absence of dedicated leaves for this purpose in most institutions. Inadequate training of the statistical aspects of the research is also an important barrier to research. Our challenges can be considered comparable in various aspects to the challenges faced in the western countries (Torous and http://dx.doi.org/10.1016/j.ajp.2015.11.001 1876-2018/ß 2015 Elsevier B.V. All rights reserved.
Padmanabhan, 2015). However, certain challenges like improper funding pose greater hindrance in Indian scenario. Also, there seems to be no counterpart for the various regulatory bodies like the Accreditation Council for Graduate Medical Education milestone evaluation criteria for psychiatry residency programs (Thomas and Keepers, 2014) in India. Research during residency has potential benefits and offers many rewards. It helps a resident to gain in-depth knowledge about some aspects of psychiatry, understand the basic notions of research, and gain analytical and technical skills. Also, the opportunity to present one’s work at conferences allows residents to value their efforts and gives an emotional as well as professional satisfaction. The satisfaction of contributing to advancement of the field is also immense. Residents involved in research work have a role in shaping the future of psychiatry at the largest and smallest levels. Yet, the logistic hurdles are still a barrier for those interested in research work, especially in India. References Abrams, M.T., Patchan, K., Boat, T.F. (Eds.), 2003. Institute of Medicine (US) Committee on Incorporating Research into Psychiatry Residency Training. Research Training in Psychiatry Residency: Strategies for Reform. National Academies Press (US), Washington, DC, Available from: http://www.ncbi.nlm.nih.gov/books/ NBK222021/ Das, M., Gupta, N., Dutta, K., 2002. Psychiatric training in India. Psychiatrist 26 (2), 70–72. Kohn, R., Saxena, S., Levav, I., Saraceno, B., 2004. The treatment gap in mental health care. Bull. World Health Organ. 82 (11), 858–866. Thomas, C.R., Keepers, G., 2014. The milestones for general psychiatry residency training. Acad. Psychiatry 38 (3), 255–260. Torous, J., Padmanabhan, J., 2015. Research by residents: obstacles and opportunities. Asian J. Psychiatry 13, 81–82. Zisook, S., Balon, R., Bjo¨rkste´n, K.S., Everall, I., Dunn, L., Ganadjian, K., Yoo, T., 2007. Psychiatry residency training around the world. Acad. Psychiatry 31 (4), 309–325.
Arpit Parmar Senior resident, Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India Pragya Sharma PhD scholar, Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India Arghya Pal Senior resident, Department of Psychiatry, Medical College, Kolkata, India 4 October 2015 10 November 2015 15 November 2015
Contents lists available at ScienceDirect
Asian Journal of Psychiatry journal homepage: www.elsevier.com/locate/ajp
Research by psychiatry residents in Indian scenario: Challenges and opportunities Sir, India is a country with a large mental health care gap (Kohn et al., 2004). Though there has been a recent increase in the number of residents opting for psychiatry residency, there still exists a large gap and hence residents working in psychiatry departments are also overburdened with the clinical work like other departments’ residents. Starting research efforts early in the career helps residents to develop an opportunity to balance clinical duties with research work which in turn may influence their long-term professional career and choices. Though it is really important for residents to be involved in the research work early in their training, due to a variety of reasons, they are unable to do so in an Indian psychiatric setting. Residents face many obstacles in a research work (Abrams et al., 2003). Due to less exposure in the subject of psychiatry during their M.B.B.S. period, residents know very little about it during their initial residency period (Das et al., 2002). However, their unbiased views can help to give new insights into the longstanding debated issues in psychiatry. Another important issue is the long duty hours during the residency with more clinical workload leading to very little time left for research work. Unlike many other countries where dedicated research rotations without clinical duties are given, this is not the case in India and residents themselves have to manage their research timings on their own. During residency, residents have to submit a thesis in order to be eligible to appear in their M.D. exam in India. This is an important learning experience for students making them aware of the research going on in the field of psychiatry, and also helps them in managing their clinical duties along with research work. Choosing a mentor for thesis and a topic to work upon, residents are given a head start to work on their own interests in the field of psychiatry. One-to-one guidance given by a mentor with the help of senior residents as peer mentors helps residents in integrating research with clinical duties. While in the West, the funding sources are vast and gives an ample opportunity to do research work during residency (Torous and Padmanabhan, 2015), funding sources are very few in India, and so very few psychiatrists can do research work at a consistent level. Due to this reason, basic research is almost nonexistent in India and exposure to research is very limited (Zisook et al., 2007). Many residents become discouraged because of this reason. Exposure to the conferences has also been a persistent source of encouragement to the residents. But, that has also been hindered due to the paucity of funds and the absence of dedicated leaves for this purpose in most institutions. Inadequate training of the statistical aspects of the research is also an important barrier to research. Our challenges can be considered comparable in various aspects to the challenges faced in the western countries (Torous and http://dx.doi.org/10.1016/j.ajp.2015.11.001 1876-2018/ß 2015 Elsevier B.V. All rights reserved.
Padmanabhan, 2015). However, certain challenges like improper funding pose greater hindrance in Indian scenario. Also, there seems to be no counterpart for the various regulatory bodies like the Accreditation Council for Graduate Medical Education milestone evaluation criteria for psychiatry residency programs (Thomas and Keepers, 2014) in India. Research during residency has potential benefits and offers many rewards. It helps a resident to gain in-depth knowledge about some aspects of psychiatry, understand the basic notions of research, and gain analytical and technical skills. Also, the opportunity to present one’s work at conferences allows residents to value their efforts and gives an emotional as well as professional satisfaction. The satisfaction of contributing to advancement of the field is also immense. Residents involved in research work have a role in shaping the future of psychiatry at the largest and smallest levels. Yet, the logistic hurdles are still a barrier for those interested in research work, especially in India. References Abrams, M.T., Patchan, K., Boat, T.F. (Eds.), 2003. Institute of Medicine (US) Committee on Incorporating Research into Psychiatry Residency Training. Research Training in Psychiatry Residency: Strategies for Reform. National Academies Press (US), Washington, DC, Available from: http://www.ncbi.nlm.nih.gov/books/ NBK222021/ Das, M., Gupta, N., Dutta, K., 2002. Psychiatric training in India. Psychiatrist 26 (2), 70–72. Kohn, R., Saxena, S., Levav, I., Saraceno, B., 2004. The treatment gap in mental health care. Bull. World Health Organ. 82 (11), 858–866. Thomas, C.R., Keepers, G., 2014. The milestones for general psychiatry residency training. Acad. Psychiatry 38 (3), 255–260. Torous, J., Padmanabhan, J., 2015. Research by residents: obstacles and opportunities. Asian J. Psychiatry 13, 81–82. Zisook, S., Balon, R., Bjo¨rkste´n, K.S., Everall, I., Dunn, L., Ganadjian, K., Yoo, T., 2007. Psychiatry residency training around the world. Acad. Psychiatry 31 (4), 309–325.
Arpit Parmar Senior resident, Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India Pragya Sharma PhD scholar, Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India Arghya Pal Senior resident, Department of Psychiatry, Medical College, Kolkata, India 4 October 2015 10 November 2015 15 November 2015