A Questionnaire-based Evaluation of the Impact of District Residency Program on Dermatology Training: Challenges, Experiences, and Need for Reform.

BACKGROUND

The District Residency Program (DRP), introduced by the National Medical Commission (NMC), envisages a three-month mandatory posting of all Indian postgraduate (PG) residents in district hospitals. It is aimed at strengthening the district health system; however, its impact on specialty training in dermatology remains unclear.

MATERIALS AND

METHODS

After obtaining institutional ethical clearance, we conducted an anonymized online survey among dermatology PG residents across India, who had completed their DRP posting. It was based on a pre-designed and validated questionnaire, circulated via social media resident networks. The objective and subjective responses were collated and statistically analyzed.

RESULTS

Responses from 292 dermatology residents from government (156, 53.4%), private (91, 31.2%), deemed university (35, 12.1%), and government-aided (10, 3.4%) institutions were analyzed. Majority belonged to the PG-2022 batch (185, 63.4%). A significant hindrance to academics was reported by 96 (39.2%) residents, while it remained unaffected for 46 (15.8%). Thesis work was adversely impacted for 190 (65%) residents, with 133 (45.5%)reporting significant disruption. Dermatology procedural skill training during DRP was limited with no procedural dermatology exposure being reported by 159 (54.5%) respondents, while 42 (14.4%)performed procedures supervised, and 68 (23.3%) performed unsupervised. Accommodation was not provided for 229 (78.4%), while transport was not provided for 259 (88.7%) respondents. Lack of access to hygienic meals (206, 70.5%) and safety concerns (103, 35.3%) were significant issues reported. Regarding training outcomes, communication skills reportedly improved for 133 (45.6%). Exposure to the district health system was rated adequate by only 97 (33.2%), while only 59 (20.2%)felt that DRP strengthened district services. Only 93 (31.9%) agreed with the need for DRP posting during post-graduation, while 98 (33.6%) felt that it hampered their training.

LIMITATIONS: Lack of formal psychometric validation of the questionnaire, a relatively small sample size, and the use of a voluntary online Google Form survey, which may have introduced selection and response bias.

CONCLUSION

Targeted reforms are essential to align the program with dermatology specialty education, while upholding public health objectives at the same time.