Using the health humanities to impart disability competencies to undergraduate medical students.

Background: Disability competencies were included, for the first time, in India's new undergraduate competency-based curriculum as a result of physician-led advocacy in 2019; the regulatory body also recommended the use of the humanities in medicine.

Objective: To use tools from the health humanities to impart disability competencies and help students appreciate the social and human rights issues associated with disability.

Methods: A module was developed and piloted in the foundation course on the new cohort of students.

Developing Humanistic Competencies Within the Competency-Based Curriculum.

We herein, describe the rationale, content, methodology and evaluation of a health humanities module in the new competency-based curriculum, and share our experience of the same. Providing training in health humanities to the healthcare trainees will definitely go a long way in having a professional and responsive Indian medical graduate, who is able to provide empathetic and holistic healthcare to all sections of the society.

Evaluation of a faculty development workshop aimed at development and implementation of a competency-based curriculum for medical undergraduates.

Introduction: Faculty development to implement competency-based medical education (CBME) is urgently needed as the Medical Council of India has implemented the competency-based curriculum this year onwards.

Objectives: To evaluate a 2-day faculty development workshop in terms of: (a) increase in knowledge about CBME terminology and concepts, (b) self-reported capacity to develop and implement a competency-based module in their respective disciplines, and (c) satisfaction of the participants.

Methodology: A single arm interventional study using mixed methods was carried out in which faculty members were purposively identified and requested to volunteer for a two-day faculty development workshop on the development and implementation of CBME.

Disability-inclusive compassionate care: Disability competencies for an Indian Medical Graduate.

The new curriculum of the Medical Council of India (MCI) lacks disability-related competencies. This further involves the risk of perpetuating the medicalization of diverse human experiences and many medical students may graduate with little to no exposure to the principles of disability-inclusive compassionate care. Taking into consideration the UN Convention, the Rights of Persons with Disabilities, Act 2016, and by involving the three key stakeholders - disability rights activists, doctors with disabilities, and health profession educators - in the focus group discussions, 52 disability competencies were framed under the five roles of an Indian Medical Graduate (IMG) as prescribed by the MCI.

Transformational learning for health professionals through a Theatre of the Oppressed workshop.

Theatre of the Oppressed (TO) is a powerful participatory tool for communities to examine their struggles against oppression. The healthcare community has problems inherent to complex, unequal power equations, and TO may be a useful means to understand and respond to their struggle. A 3-day workshop on TO was facilitated by the authors in the Himalayan Institute of Medical Sciences (HIMS) in Dehradun, India, in August 2017.

Current practice in handling and reporting needle biopsies: A hospital-based survey.

Context: Core-needle biopsy (CNB) is a minimally invasive screening and diagnostic tool which provides intact tissue fragments for histopathological examination.

Aims: This study was conducted to review the current practices of handling and reporting CNBs performed for core-needle biopsies from four organ systems which are frequently encountered in our institution. These include breast, prostate, soft tissues, and lymph nodes.

Reflective student narratives: honing professionalism and empathy.

The affective domain is not explicitly targeted during medical studies and poor skills in this domain may lead to conflict when dealing with patients. Reflective narratives are said to promote humanitarianism and professional development. We aimed to examine reflective narratives written by medical students in our institution for content relating to ethical and professional Attitude and Behaviour, Communication, respect for Diversity and Disability, and Empathy (the ABCDE paradigm).

Intestinal GIST masquerading as an ovarian mass: Diagnosed on FNAC.

The preoperative diagnosis of metastatic intestinal gastrointestinal stromal tumors (GIST) on cytology can be quite difficult at times. The present case characterizes the cytomorphological and immunocytochemical features of GIST, emphasizing the utility of fine-needle aspiration cytology (FNAC) in the evaluation of spindle cell tumors of gastrointestinal tract. An accurate and early diagnosis of GIST affects the treatment, primarily allowing the use of tyrosine kinase inhibitors in unresectable or metastatic cases.

Multifocal Tuberculosis Verrucosa Cutis: A Manifestation Extraordinary of Reactivation Secondary Tuberculosis.

A BCG (Bacillus Calmette-Guérin)-vaccinated 78-year-old man, a native Indian, reported with numerous asymptomatic, peanut-sized, dirty gray, elevated eruptions of 1 year's duration appearing over apparently normal skin on the upper and lower extremities (Figure 1). The onset of the eruptions had been sudden, but they had progressed slowly. A history of cough and/or expectoration, evening rise of temperature, night sweats, or loss of appetite and weight was denied.

Fine needle aspiration biopsy: An entrustable professional activity in cytopathology postgraduate training.

Context: In the context of competency-based medical education being advocated worldwide, fine needle aspiration biopsy (FNAB) is considered as an entrustable professional activity (EPA). There is no information regarding how much time and training are required to achieve a "competent level" for performing and documenting FNAB in the Indian context.

Aim: To determine the time taken by an average postgraduate pathology trainee to become competent in performing FNAB with respect to history taking, clinical examination, and fine needle aspirate adequacy.

Harnessing the medical humanities for experiential learning.

A month-long workshop on medical humanities was held in the Jorhat Medical College, Assam in September 2015. It employed experiential learning (both online and onsite) using humanities tools, such as the theatre of the oppressed, art, literature, reflective narratives, movies, the history of medicine, graphic medicine, poetry and diversity studies. As a result of the interactions, 28 volunteer participants, comprising students and faculty members, wrote reflective narratives on doctor​-patient relationships, produced a newsletter and a logo for their medical humanities group, and staged cultural performances and forum theatre.

Clinical audit of ultrasound guided fine needle aspiration in a general cytopathology service.

Background: Studies on ultrasonography (USG) guided fine needle aspiration cytology (FNAC) have been conducted in specialized settings such as thyroid, breast, and intra-abdominal aspirates. There is a paucity of literature on the practices of guided FNAC in a general cytopathology service.

Aim: The aim was to determine prevailing practices of USG guided FNAC in a general cytopathology service of a teaching hospital.

Is it Askin Tumour? A Question You Must Ask Even in Elderly.

Primitive neuroectodermal tumour of chest wall has been given the name Askin tumour after FB Askin who first reported this distinctive clinicopathologic entity in 1979. Most of the patients are either children or adolescents, however, rarely it may affect older patients. This case report emphasizes on the diagnostic approach to this rare tumour and underlines the importance of keeping it in the differential diagnosis even in elderly patients.

Clinical audit of repeat fine needle aspiration in a general cytopathology service.

Background: The few studies on repeat aspiration focussed on accuracy of diagnosis following repeat. Numbers and documented reasons for repeat remain unaddressed.

Aim: To study factors associated with requests for repeat fine needle aspiration cytology (FNAC).

Near-peer mentoring to complement faculty mentoring of first-year medical students in India.

Purpose: The first year is stressful for new medical students who have to cope with curricular challenges, relocation issues, and separation from family. Mentoring reduces stress and facilitates adaptation. A program for faculty mentoring of first-semester students was initiated by the Medical Education Unit in 2009 at University College of Medical Sciences, Delhi.

Implementation of the bethesda system for reporting thyroid cytopathology: interobserver concordance and reclassification of previously inconclusive aspirates.

Standardized diagnostic terminology was introduced by the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) in an effort to bring uniformity to the reporting of thyroid cytopathology, provide more defined categories to enable clinical management, and minimize the number of inconclusive cases. Previous studies indicate that the BSRTC is a reliable and valid reporting system for thyroid cytology. This study was conducted to compare the concordance between observers with varying cytopathology experience when using the BSRTC, and to assess the impact on the number of inconclusive reports.

Immunocytochemical detection of mycobacterial antigen in extrapulmonary tuberculosis.

The aim of the study is to determine whether immunostaining for mycobacterial antigen can contribute to the cytological diagnosis of extrapulmonary tuberculosis (EPTB). The study was carried out on aspirated material of lymph nodes, and other accessible sites, from 65 patients with clinical diagnosis of tuberculosis (TB). Twenty patients, diagnosed by fine-needle aspiration, with non-tuberculous granulomas served as controls.

Theatre of the Oppressed in medical humanities education: the road less travelled.

Internationally, there is an increasing awareness of the need to include humanities in the medical curriculum. The Medical Humanities Group at the University College of Medical Sciences, Delhi, organised a series of events to explore this area. This paper describes our experience with Augusto Boal's "Theatre of the Oppressed" (TO).

Mentoring for first year medical students: humanising medical education.

New entrants are vulnerable to the challenges of the medical course; mentoring programmes are known to offer support. This paper evaluated the experiences of students and faculty enrolled in a new mentoring programme. After needs analysis of students and faculty, a small-group mentoring programme for new medical students was initiated.

Cytokeratin-20 immunocytochemistry in voided urine cytology and its comparison with nuclear matrix protein-22 and urine cytology in the detection of urothelial carcinoma.

This study was done on 59 subjects (42 urinary bladder carcinoma patients and 17 non-neoplastic controls). Urine cytology and bladder chek NMP22 test was done on all cases. CK20 immunostaining was performed on archived papanicolaou stained urine cytology smears in 34 cases (27 bladder carcinoma and 7 negative controls).

Whither medical humanities?

Understanding the medical humanities (MH) and their role in medical education is in its infancy in India. Students are initiated into professional (medical) education too early in life, usually at the expense of a basic grounding in the humanities, resulting in warped intellectual growth. The author, arguing against the wholesale import of foreign systems, advocates free inquiry by medical educators to evolve a humanities programme for medical students derived from our own cultural context.

Exclusive plaque psoriasis of the lips: efficacy of combination therapy of topical tacrolimus, calcipotriol, and betamethasone dipropionate.

A 16-year-old unmarried woman presented with recurrent cracking of the lips indicated by the appearance of grayish white flakes since October 2004, which, in due course, shed off leaving behind an apparently normal mucous membrane. Chewing roasted corn treated with salt and lemon (bhutta) initially caused the lesions. Ever since, it has been a cause of its exacerbation.