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 Table of Contents  
LETTER TO EDITOR
Year : 2020  |  Volume : 6  |  Issue : 3  |  Page : 280-281

Narrative medicine in India: Let more medical journals be “vocal for local” voices


Department of Orthopaedics, Government Medical College, Haldwani, Uttarakhand, India

Date of Submission28-Jul-2020
Date of Acceptance09-Sep-2020
Date of Web Publication26-Sep-2020

Correspondence Address:
Dr. Ganesh Singh Dharmshaktu
Department of Orthopaedics, Government Medical College, Haldwani Uttarakhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJAM.IJAM_101_20

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How to cite this article:
Dharmshaktu GS. Narrative medicine in India: Let more medical journals be “vocal for local” voices. Int J Acad Med 2020;6:280-1

How to cite this URL:
Dharmshaktu GS. Narrative medicine in India: Let more medical journals be “vocal for local” voices. Int J Acad Med [serial online] 2020 [cited 2020 Oct 21];6:280-1. Available from: https://www.ijam-web.org/text.asp?2020/6/3/280/296135



To the Editor,

We read with interest the informative and relevant symposia on narrative medicine in the previous issue of International Journal of Academic Medicine.[1] The journal, since its inception, supports variety of articles, which essentially is a holistic medical publication. The narrative medicine indeed is deeply neglected in India, a country with rich milieu for a robust harvest of grains that are not staple yet. It exists as an underappreciated territory of creative expression, and one important reason behind this is scarcity of platforms or fora available to interested candidates to voice their thoughts. Researchers have highlighted the presence of professional alienation from patients and their social landscape in India, and the educational model followed by trainee doctors requires indigenous adaptation to be less provider centric.[2] The conflicting identification of Indian care providers with Western narrative and aspirations thus requires serious introspection. The societal- and system-level barriers need to be addressed to make Indian health-care system more user centric as well.[3] Many niche journals would be required to change its publication landscape here. As the creation, developments, and scaling up of the individual journal or a society is an exhaustive and time-taking endeavor, what can be done right now is promoting local voices of service users and service providers alike through the existing vast pool of available medical journals. As many international medical journals have dedicated columns for creative inputs such as prose, poetry, field reports, student perspectives, personal experience, and anecdotes, among others, on their content list, very few Indian journals have similar appetite. While most of the foreign journals get substantial submission from their own country, the publication in those journals by Indian authors is relatively negligible. Even if some of our work is published, it won't stir the status quo or inspire others. The reason may be less accessibility and interest in larger pool of native readers. Besides it, articles by domestic writers in Indian journals shall gain wider readership as readers relate to it with more comfort and familiarity due to inherent indigenous taste and ethos emanating from it. The abysmal number of enthusiasts, with tales inside them, may just reflect the lack of adequate avenues, which acts as a dampener and not the scarcity of talent. The narrative medicine would be widely acceptable and sought after category once most, if not all, journals dedicate spaces for these articles. There is no dearth of stories waiting to find readers that shall ultimately benefit the medical fraternity as a whole to regain the human touch which seems withering in the eyes of the contemporary society due to materialism, globalization, and commercialization of the health-care facilities. These narrative inputs help rejuvenate, self-reflect, and sometimes embrace ourselves with all our vulnerabilities through the humdrum of professional life. The writing process offers moment of solace with the self and creative catharsis, which not only has therapeutic benefit but also makes us more empathetic in patient care and reduces professional burnout.[4] The perspective of patient or user is also important to gain insight into nuanced doctor–patient relationship and also to understand the unmet needs of their therapeutic journey.

Journals pertaining to professional association or societies of various medical disciplines should have no problem in adding couple of pages on narrative inputs that may be scaled up if the contributions surge. Leading medical institutes can initiate their own journals relating to medical or nursing student perspectives. The medical schools require indigenous framework and curriculum development to establish medical humanities in respective facilities.[5] According to Arthur Kleinman, interpretive theory and methods formulated on real life-based situations and critical self-reflection shall enable the students and practitioners to understand and respond to barriers that are failing art of healing.[6] The assimilation of medical humanities and narrative medicine would require framed modules and curricular involvement. The scholars believe that well-intentioned proposals by the Medical Council of India such as inclusion of “Introduction to Community Medicine including Humanities” in Pre-Clinical Phase as 60-h exercise and Attitude, Ethics, and Communication modules are not adequately cohesive to serve as guideline in this regard.[7] Establishing medical humanities in colleges of India shall require creative use of strategy and is doable despite hurdles such as increased number of students, lack of separate department, and challenges in modification of the existing teaching system among others.[8] The positive factors that may help the initiative are large body of experienced faculty, favorable attitude toward medical humanities, and diverse student pool. On a positive note, many institutes have well-functioning medical humanities groups supported by respective medical education units, leading to rich dividends like one leading institute in New Delhi proudly encourages “RHiME,” a journal devoted to humanities in health professional education with abundant submissions.[9] The current pandemic has prompted a national resolve of becoming economically self-reliant by urging everyone to support it with popular slogan “vocal for local” that affirms the idea of being vocal and supportive about locally made goods, merchandise, or business idea. We can adopt similar theme on being vocal about adequate broadcast of native, home-grown perspective and stories regarding health care on scientific platforms. It is high time more Indian journals lead by the example on this matter.

Financial support and sponsorship

Nil.

Conflicts of interest

There is no conflicts of interest.

Research quality and ethics statement

The authors of this manuscript declare that this scientific work complies with reporting quality, formatting, and reproducibility guidelines set forth by the EQUATOR Network. The authors also attest that this manuscript was determined to not require institutional review board/ethics committee review, and the corresponding protocol/approval number is not applicable.



 
  References Top

1.
Krinock M, Defenbaugh N, DeTurk S, Pellegrino AN. An introduction to narrative medicine. Int J Acad Med 2020;6:121-3.  Back to cited text no. 1
  [Full text]  
2.
Samudre S, Shidhaye R, Ahuja S, Nanda S, Khan A, Evans-Lacko S, et al. Service user involvement for mental health system strengthening in India: A qualitative study. BMC Psychiatry 2016;16:269.  Back to cited text no. 2
    
3.
Bayetti C, Jadhav S, Deshpande SN. How do psychiatrists in India construct their professional identity? A critical literature review. Indian J Psychiatry 2017;59:27-38.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Gillon R. Welcome to medical humanities – And why. J Med Ethics 2000;26:155-6.  Back to cited text no. 4
    
5.
Grant VJ. Making room for medical humanities. Med Humanit 2002;28:45-8.  Back to cited text no. 5
    
6.
Kleinman A. Catastrophe and caregiving: The failure of medicine as an art. Lancet 2008;371:22-3.  Back to cited text no. 6
    
7.
Prabhu G. The disappearing act: Humanities in the medical curriculum in India. Indian J Med Ethics 2019;4:194-7.  Back to cited text no. 7
    
8.
Shankar PR. Medical humanities in medical colleges in India: Travellators and speed breakers. Arch Med Health Sci 2020;8:122-9.  Back to cited text no. 8
    
9.
No Authors Listed. About the Journal New Delhi. Available from: https://www.rhime.in/ojs/index.php/rhime/about. [Last accessed on 2020 Aug 17].  Back to cited text no. 9
    




 

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