Background and Justification

Medical graduates have nearly one years wait before starting internship in Sri Lanka. Skills accrued in medical school are not enhanced, but rather regress, if no clinical practice happens; most are not involved in clinical care. The technical skills needed for internship are difficult to gather without hands on practice. Patient care suffers when new inerns start due to low skill levels and low levels of confidence. There have been requests by pre-interns to address this perceived lack of skills before commencing internship. Many other countries have recognized this skills gap and taken remedial measures.

Good Intern Programme conducted for the first time in 2013 by the GMOA with MOH addresses these problems; as part of this approach it is important to allow pre-interns to practice their skills before starting internship.

We propose allowing pre-interns to voluntarily spend between 4-7 days in an operating theater setting and ETU/PCU/Wards (5 days) under the supervision of a Consultant Anesthetist/Physician to acquire these skills. A voluntary competency record can be maintained.

Time period

July to November – 1000 pre-interns. Numbers per group to be decided depending on feasibility, availability of hospitals and number of applicants.


Collaborators
  • Government Medical Officers Association
  • Ministry of Health
  • The College of Anesthesiologists of Sri Lanka
  • Ceylon College of Physicians
  • Society for Health Research and Innovations

Assessments and feedback

All assessments will be voluntary.

  1. Needs assessment- already done- skill list generated and need for practical training established.
  2. Pre skills course self assessment
  3. Post skills course self assessment
  4. Post skill course non binding assessment by Consultant Anesthetist/Physician- as attached.
  5. Feedback from participants- to improve program
  6. Voluntary logbook by participants

Funding

As training will be through MOH Hospitals and thier employees, no extra funding is needed for the training perse.

The following costs need to be addressed.

  • Pre intern  to coordinate
  • Costs of printed material for logbook and other stationary
  • Costs for electronic services including telephones/Faxes
  • Printing of certificates

ERPM doctors

Those who have completed ERPM and are eligible for internship can also partcipate.


Certfication

A certificate of participation will be issued by the MOH in partnership with GMOA if a logbook is maintained and assessments are filled in. Coordination Will be by the GMOA and SHRI with Directorate of ET&R of MOH.


Hospitals

Teaching hospitals may have medical students. If there are no medical students undertaking anesthesia appointments, then these can be utilized. If not, General/Provincial Hospitals or upto large Base Hospitals can be utilized.

Registration: Will be online, coordinated by the SHRI and will include registration for Good Intern Programme and pre-assessment.
Scientific output: Scientific publication of the process and outcome will be done. Ethical review will be obtained form the Faculty of Medicine, University of Colombo.
Annexures: Skills list with essential/desirable skills and levels of competence grading.

 

Assessment of Knowledge attitudes and future prospectus among Pre intern doctors 2015