We provide coaching program for school students through institutional tie-ups, online modules & class room coaching centres. And we are best in it. We understand each students needs and have courses tailored to its students needs. We care about our students. And it shows in our working structure.

We are at every students service at any given point of time. All you aspirants need to do is, to contact us. And like we always say, we will nurture your dreams.

Tel- 011- 24366349/ 24366316/ 24365715

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Knowledge horizon is unique in its own ways and with our unique strategies of teaching, we help each students with their weak points and help them to see their dreams come true.

1) We give basic knowledge about the examination to the students, then the coach them to be sure of about the preparation of the candidate for the examination. For this there are some strategies for the smart preparation of the examination. Efficiently we train the candidate to understand these strategies.

2)The first and the foremost step in the preparation of the examination is to build a sound and feasible plan for your preparation. Here we devide the time into reasonable time chart. While preparing the time chart the main thing that we keep  in the mind is “you should take the milestones in between into the consideration”.

3) We help the students to develop a habit of studying and checking the previous year question papers, so that it helps them to trace out the most important topics and put them in their early stage of your preparation. This also help the candidate to avoid the missing of the important topics at the time of preparation.

4) We help students clear that “most of the failures take place not because the lack of the ability or intelligence in the students but because of the lack of desire, direction, proper planning, and discipline. And we guide them the best.

5)We make students understand the importance of quality in performance , because quality is more important than quantity. Our course structure helps to sharpen their problem-solving skills. We  help the students in studying the relevant theory again and paying attention to even finer points.

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Tel- 011- 24366349/ 24366316/ 24365715

Email- info@nhindia.com

Website- www.nhindia.com

AIEEE COACHING

The All India Engineering Entrance Exam is organised by CBSE in India for the admission to various under graduate courses in Engineering and Architecture. Therefore an AIEEE coach should keep in mind the importance of the test or the examination and hence the coaching given should be on the basis of the importance of the examination. The coach should know about the colleges where these test are needed, about the subjects candidates should concentrate, as for different options, different subjects are to specialised in. And are master in all. We guide each student to the correct path of their career and give them the best coaching.

For further information please contact us at-

Tel- 011- 24366349/ 24366316/ 24365715

Email- info@nhindia.com

Website- www.nhindia.com

I have been impressed with the changing roles of medical colleges and medical education, as I do feel that inspite of all the criticism, medical education has made enormous strides in this country and elsewhere in the world. At the same time, there is also a growing awareness of our shortcomings and the constant need to change and modify. We see this as we go through the various conferences and seminars held by the Indian Association for the Advancement of Medical Education. We have several reports of commissions ranging from the Bhore Commission to Mudaliar Commission. Quite a few changes have been brought about, though not very speedily and effectively, but the main preoccupation and concern seem to be to make quantitative changes. We have achieved a ten fold increase in the number of medical colleges and the output of doctors, resulting in a large number of specialists and an equally impressive number of superspecialists. This has been largely unplanned and has only resulted in a marked increase in output without any thought for finding rewarding careers for them. Most of them get frustrated and join the westward flood. The promotion of medical colleges in the smaller cities in the districts has not made much of an impact on the distribution of medical manpower. The products of these colleges are more hardhit and the result is brain drain within the country. The overflow from the cities has always been to the west and now the flow is towards the African and Gulf countries. It is time we made a close study of this problem which is basically a study of manpower requirements. Perhaps it may involve painful decisions but these have to be made.

Regional considerations and communal reservations have caused considerable bitterness, because inspite of the good intentions, the seats seem to be grabbed by the relatively affluent classes. Backwardness has to be decided not on simple hereditary criteria but also rational grounds like economic backwardness. It is only when such persons are selected that proper justice would be done.
The present system of deciding the eligibility and merit on the performance at a single qualifying examination like 12th standard is also fallacious. There should be a premedical test and a paper to assess the motivation and aptitude. Such a screening would prevent recurrence of sordid episodes like the Kerala marks scandal.

We have tinkered long enough with the curriculum and contents of the course. But we have never considered the suitability of a single uniform course when it is known that the final evolution as a General Practitioner or a Specialist or a Scientist requires different courses at the undergraduate level itself. It is time to consider the feasibility of multi-channel courses (say an honours course like B.A. or B.Sc. in a subject deemed eligible for specialization) to suit different groups. This would cover the big gap now seen between the undergraduate course and specialities.
Three such broad channels can be identified, say for a family doctor, the specialist and the health scientist. In this way, it may be possible to plan manpower supply to fulfill the needs of a region or a state.
The next area of expansion is the scope and range of responsibility of a medical college. These have grown beyond the traditional boundaries. The role of a teaching hospital as a static centre to which people come for specialist treatment is no more valid. Preventive and promotive aspects of health have been added in recent years along with physical medicine and rehabilitation. The concept of convalescent homes and homes for aged has, however, not fully matured and leaves a lot to be desired as the number of old people increases. The problem of the aged and retired person is now engaging worldwide attention.
We also find growing interaction with social sciences, thanks to the introduction of Psychology and Psychiatry in teaching hospitals. The increasing use of sophisticated equipment has highlighted the need for close collaboration with engineering, electronic and computer sciences. The traditional medical college has grown into a medical centre of great complexity, bringing in tremendous problems of management.
Inspite of all this change and expansion, we do find a lot of dissatisfaction expressed, both by the people and their representatives. The main criticism is that of neglect of rural and remote areas and overproduction of highly trained persons with no corresponding increase in gainful employment.
The root cause of our problem arises from a mistake. This was the blind imitation of the Western model, which perhaps suited the English situation. This obsession with the Western model and standards has made our products misfits in our own society and perhaps unwittingly promoted brain drain. The truth is that the medical graduate finds himself more at home outside the country than at home.
So, the changes in the curriculum have to be brought about in a more rational way by assessing our own needs. But, who will determine these needs?
Every country, and within each country, a geographical region has its own problems. In a way, the socio-economic groups, the rural-urban settings and other parameters differ from country to country and from state to state.

There are broadly the medical needs of an individual and a community, and the mental health needs. The disease patterns and prevalence rates also determine the needs. These are best analysed by a statistical approach and sample surveys. Having scanned data, the priorities should be set up. Changes and reorientation should be brought about to make the education relevant to the needs of the largest group.
Proper vocational guidance should be made available to the medical graduate, so that reliable data and rationale thinking precede the choice of future career. Perhaps, we might even think of a larger share and inputs in public health so that such a career becomes attractive. To the traditional approach of how to provide clinical cure for individuals, we must provide and add care of well defined populations so that the medical student knows how to be useful to the community at large.

Excellence in medical education is not merely a vertical expansion and achievements. Maximum improvement of health, and relief of suffering within available resources should be our goal. There is thus a clear need to set up innovative models and bring about qualitative changes.
All this means a certain collective approach on the part of the medical faculty which is at present divided into rigid departments. This can be done by establishing a medical education cell, if not a department, in every medical college. The staff for this should be deputed by rotation from different departments for fixed period of 1-2 years. This cell should constantly review the methods of teaching, changing of curriculum, preparation of materials like audio-visual aids. Such a cell should also have a responsibility of conducting seminars and symposia, so that the medical teacher learns how to teach. We have for long assumed that a good student will become a teacher by simply observing another teacher. This has only produced stagnation. It is time we brought the modern concepts of pedagogy, educational psychology, etc. nearer to the medical colleges.
In due course of time, such a unit should be designated as a centre for educational development, at least one for each region or large state. This would also ensure a live contact with people and their needs. The task of continuing education is receiving attention everywhere. The expansion of knowledge is occurring so rapidly that apart from General Practitioners, even specialists working away from teaching institutions get. outdated and obsolete. Refresher courses for both these categories have to be organised so that the practice of medicine keeps up with recent advances.
As a medical administrator with an experience of running two large institutions, I can only add that all the changes suggested can only be brought about if there is freedom for doing so. This means granting a substantial autonomy or even the status of University. If Colleges of Pharmacy, Medicine, Dentistry and Nursing are grouped together they can form a viable University. A department of Life Sciences can be added to give a scientific base for such a venture. Such a step has proved beneficial for fields like agriculture and engineering, who have secured University status for their faculties. If a University is not feasible, provision of autonomy and freedom to run institutions be granted so that on the spot decisions are possible. It is time we realised that medical institutions have their peculiar problems and they cannot be run as a department of the Government.

But in addition to these cognitive and technical reasons for the imbalance between “learning that” and “learning how,” important social and emotional reasons have been at work in medical education as well. Pure or basic science is regarded in the scientific and scholarly communities as having greater explanatory power, hence greater intellectual worth, than applied or practical science. The social status of applied or “soft” sciences is therefore generally lower than that of pure or “hard” sciences.

Fortunately, as we have noted elsewhere, there has been some recent progress in understanding the nature of working knowledge. Most importantly, it is increasingly clear that competence is acquired primarily through experiential learning – a four-element cycle (or spiral) in which learners move from direct personal involvement in experiences, to reflection on those experiences, integration of their observations with sense-making concepts and mental models, and finally back to more experiences. Formal training for all high-performance (applied) professions, for example, music, architecture, theater, and athletics, is grounded in the unique requirements of experiential learning: case-based coaching, rather than lectures by content experts; hands-on, practicum experiences (including simulations, if necessary) in addition to written end-objectives; repeated experiences and outcome evaluations over time rather than initial, one-shot exercises; and, ultimately, acquisition of the advanced skills of “reflection-in-action,” which is required for high-level performance and “reflection-on-action,” which is required for continued self-evaluation and self-instruction.

The delivery of medical care is a form of performance; in fact, medicine is arguably an extremely high-performance profession. As late as the mid-nineteenth century, however, medical education included only fragments of the experiential learning cycle – minimal classroom exposure to (inadequate) biological and clinical concepts, without linkage to actual case understanding and management; and hit-or-miss apprenticeships, with little connection of cases to meaningful conceptual knowledge. In the US, experiential learning moved into the medical education mainstream in a meaningful sense only in the late 1800s, primarily under the influence of Osler’s innovation of hospital-based clinical clerkships.

Despite the introduction of clerkships into the formal structure of medical education, followed soon thereafter by residency and fellowship training, the primary focus of medical educators has been, and remains, on cognition – helping learners understand the biomedical concepts that are medicine’s unique intellectual asset – rather than on competence – the working knowledge that determines the quality and consistency of performance. As a consequence, the experiential learning component of medical education continues to exist in uneasy equilibrium with the learning of abstract biomedical concepts .

Thus, for over 100 years, medical students in their preclinical years have been expected to acquire enormous (and ever-increasing) amounts of conceptual biomedical knowledge, primarily through lectures and readings, supplemented by seminars and lab exercises, and driven by written exams. Not surprisingly, students initially try to understand and solve clinical problems in terms of those basic concepts. But during their clinical clerkships and residencies they switch over almost entirely to experiential learning as they begin to solve the complex problems of real, individual patients in real-world contexts. In order to do so, they need to acquire the concepts, vocabulary, and logic distilled directly from the collective experience of managing illness; this concrete, working knowledge differs fundamentally from the abstract biomedical knowledge acquired during their preclinical years.

But despite frequent reaffirmation of their mantra of “knowledge, skills, and attitudes,” medical educators have during the past 150 years focused their attention, energy, and resources predominantly on the first of these: the “transcription” of conceptual biomedical knowledge into the heads of medical students and residents. Once that transcription is accomplished, medical education is less clear about how students should learn to “translate” their hard-earned biomedical knowledge into reliable, safe, and efficient clinical performance Indeed, recent documentation of the glaring deficiencies in the quality and safety of care delivery have demonstrated convincingly that this translation process is far from ideal), leaving little doubt that there exists a serious “knowledge-performance” gap.

Fortunately, medical education in the US has begun taking the translation process more seriously than it had in previous years. No longer is it sufficient for medical students and residents to “know that” certain generalizable biomedical principles and facts are true; they are now expected to “know how” to apply that knowledge in individual patients and groups of patients in ever more sophisticated ways. This increase in expectations regarding working knowledge is reassuring, since it reflects what is known about the process by which learners become true professionals: moving from being a novice through the stages of advanced beginner, acquiring competence and proficiency and, ultimately, achieving high-level expertise). More specifically, these expectations are reflected in a current and ongoing shift from a medical education curriculum focused mainly on structure and process to one concerned mainly with the development and measurement of competent performance – that is, the ability to act, to deliver care – a shift that has been referred to as “the Flexnerian revolution of the 21 ^st century”

Although medical education is notoriously resistant to change, a number of innovative educational initiatives specifically designed to help students acquire working knowledge have now taken root and are beginning to spread. As we have noted elsewhere (Batalden and Davidoff, 2007a), these programmes are directed at two very different but complementary levels of medical performance: the delivery of care to individual patients by individual providers, and the overall operation of the systems in which that individual care takes place.

Though the number of medical colleges has increased substantially to meet the health-care needs of the country, the institutions have to compete with each other to get expert medical educationists who could impart effective training. Highly lucrative jobs that are offered to an engineering or IT professional after four years of less strenuous training shake up the medical student, as well as those who are aspiring to take up the medical profession, and make them ponder whether it is worth its effort in terms of job satisfaction and remuneration. Recent introduction of changes by the policy makers, including the compulsory service in rural areas by the newly trained doctors, could pose an added stress. This is complicated by the fact that even in rural settings, the patients, as well as their relatives, have become so increasingly better informed that they tend to question the decisions and approaches of the physicians to the extent of affecting the doctor-patient relationship. In this paper we review the present curriculum in terms of the psychology component and the probable ways in which it can be effectively implemented in order to train a physician who could be facing the challenges posed, and propose to review the current selection procedure to recruit those with good aptitude for the profession.

Worley,analyzing community-based medical education, has delineated four types of relationships that are needed in undergraduate medical education. Apart from the clinical, the doctor-patient relationship, he highlights the importance of social, community and interpersonal relationships that are needed for community-based medical education. With the Panchayat Raj system being introduced in the country, for the doctors working in primary health center, as well as those working in other health centers, the society lays a great demand on the doctors’ skills with regard to interpersonal relationship, at various local administrative forums. Therefore, the content on formation and maintenance of healthy relationships and interpersonal communication needs to be included in the curriculum.

Clinical empathy, which involves the ability to understand the patient’s situation, perspective and feelings; and the ability to communicate with the patient in an accurate and effective manner have a major role to play in patient care. Mercer and Reynolds  emphasized that empathy can be enhanced and successfully imparted in medical schools, provided it is embedded with the actual experiences of students with the patients.

With the inclusion of psychiatric care in primary-care centers, the primary-care physician is expected to identify, treat or refer the major psychiatric disorders, various disabilities, including intellectual disability and prevent some of the disorders. The attained skills in relating would help in fulfilling these objectives. Tharyan et al., in their study, observed that exposure to psychiatry training did have an influence on the change in attitude to mental illness, though it did not influence the choice of career. Rao et al.did a prospective study to elicit and monitor over time the medical students’ attitudes to psychiatry, psychiatrists, psychiatric patients and their treatment. There was a significant shift in favorable direction in the general attitude to psychiatry, both before and after training. Majority of them considered psychiatric specialty as challenging and scientific, and almost all felt that too little time is being spent on psychiatry in UG curriculum. Another study on the same subjects  to know their interest to specialize in psychiatry provided very interesting findings before and following training at UG level. Sixteen percent of boys were sure, 28% undecided and 56% against a career in psychiatry; while no female student considered career in psychiatry, but 50% were not sure. Majority of students had opted for medical and surgical branches. Interest in another branch of medicine was the commonest explanation given for not intending to take up psychiatric specialization. The conclusion reached in the editorial published in the Lancet on “Who puts medical students off psychiatry?” was that the best teaching in the world is unlikely to prevail against the poor working conditions, a bad professional image and the frustrations of dealing with society’s misfits and people who rarely appeared cured; and this may be equally true even today in the Indian context. Even though the above statement may look pessimistic the bright spot is that almost all of our students mention “too little time devoted to psychiatry in medical curriculum”; which needs immediate correction, in addition to improvement in teaching methods. Another related neglected area is sexuality training, which is very close to psychiatry. Evidence has been provided for the need to improve knowledge about different aspects of sex among a sample of Indian medical students.

We must change our medical education to train basic doctors that are capable of practising medicine without the hi-tech, self-defeating systems of diagnosis and management. A small per cent of patients would need that kind of medicine. That could easily be done in a few hi-tech centres specially reserved for this kind of patients. Ninety per cent of the patients would do well without hi-tech.

The highest technology needed for universal patient care is the kind words of a good doctor that stimulate the patient’s immune system. It is the immune system that heals and not the drug or the surgery that the doctor performs. A humane doctor has a placebo effect on the patient’s immune system. The future medical training must be such that the young doctor feels confident to make accurate diagnosis and arrive at management protocols based on his bedside skills alone.

Our status quoist attitude has killed innovation in medical education in India all these years. Time has come to ponder over what we do or do not do for our patients in the present modern medical hi-tech based system. A quick audit of the present system would show the lacunae.

AIDS and cancer deaths are on the rise. Doctors striking work recently in Israel, years ago in Los Angeles county and Saskatchewan in Canada, has had a good effect on society. Screening apparently healthy people could be very dangerous to human health and happiness. Most, if not all, drugs used on long-term basis in chronic degenerative diseases have resulted in more people suffering and dying compared to those helped by the drugs. There has never been a proper study done on drug combinations in science. While studies were done on single drug in ideal laboratory conditions, in reality, multiple drugs are used for patient care in anything but ideal situations. Patient compliance is so poor that one wonders if patients are alive because they do not take drugs in doses that are prescribed by doctors! To cap it, modern hi-tech medicine has become prohibitively expensive.

Doctor is trained to look after the health of the public. Doctors are not trained only to intervene with quick-fix methods when the human machinery fails, although the latter is very important for the individual concerned at that point in time. Time and energy spent to keep the public health would lessen the need for expensive quick-fixes in the long run. Our medical education does not stress on public health. Clean drinking water for every citizen; toilets in every house, cooking smoke free houses in the villages to avoid cancer and heart attack deaths in women and pneumonic deaths in children below the age of five years; a damp proof house to avoid bacterial infections; and economic empowerment and education of women to improve infant and maternal mortality are vital in this effort. Time has come to change our medical education and supplement the western knowledge with Indian wisdom of yore in Ayurveda and other systems of medical care to do most good to most people most of the time.

We need a cadre of basic doctors to man our family medicine facilities in towns as well as in our far-flung villages. We also need a small number of specialists and sub-specialists to man our hi-tech set-ups. The whole course of study, from day one, should be patient centred and community based. Classroom teaching should be minimum and an occasional didactic lecture could clarify some theoretical points. The grading system of evaluation with semester credits should be the foundation of evaluation. Keen bedside observation and trying to unravel some of the clinical mysteries should form the basis of clinical research in medicine. Refutative research to demolish many myths in medicine is the need of the hour.

The students should live and work with the practitioner for a year before graduation. Care should be taken to see that the basic doctor is not financially inferior to the sub-specialist. This is one of the reasons why our young doctors despise family medicine.

2. Library. This can seem like a given, but sometimes students are intimidated by the library. A lot of libraries have floors that are for individual studying and floors that are for group studying.

3. Comfort. Find a place that is comfortable for you. This may be in the library, your dorm room, outside, or in a lounge.

4. Schedule. If you follow a study schedule, you will find that it can be easier to study. You will know when and where studying is best for you.

5. Roommates. Create a quite time for your dorm room/apartment. You can all get some studying done or just have some peace and quiet.

6. Close the door. When you’re in a dorm, keeping your door open is the best way to socialize with people. This is great, but if you don’t want any distractions, shut the door during that time.

7. Study rooms. Several buildings on campus will have rooms that are devoted to studying.

8. Public areas. Avoid studying in a public place like the student center if you can’t handle that type of noise and activity. Some people can handle it and even prefer it, but for most, it is not an ideal place.