European Journal of Cardiovascular Medicine

The Family Adoption Programme (FAP) promotes a community-oriented approach by improving healthcare access for impoverished families and offering community-based training for healthcare professionals¹. It emphasizes health promotion, disease prevention, and comprehensive training across all levels of healthcare. As part of Competency-Based Medical Education (CBME), the National Medical Commission (NMC) recommends FAP for MBBS students to bridge the gap between theory and practice. This initiative fosters communication, empathy, and patient-centered care, preparing students for the practical and emotional demands of medicine². By integrating families into the educational process, FAP ensures a realistic and holistic teaching environment. Despite its benefits, implementing and sustaining the programme through consistent follow-ups poses significant challenges. The Family Adoption Programme (FAP) provides MBBS students with hands-on experience in community-based healthcare by adopting at least five families and engaging in village or slum outreach. Students collect socio-demographic data, assess socio-cultural and health factors, perform basic physical exams, and provide health education to promote behavioural change and link families to healthcare services³. FAP enhances students’ communication skills, empathy, and professional development. As per the National Medical Commission (2023) guidelines, medical colleges must organize diagnostic medical camps to address common non-communicable diseases like diabetes, hypertension, anaemia, and malnutrition. These camps, led by the community medicine department, involve support from ASHA workers, Anganwadi sevikas, and local volunteers. Students actively participate in organizing these camps, and patients requiring further care are referred to hospitals for treatment. In the first professional year, medical students focus on building effective communication skills with adopted families, gaining confidence, and understanding regional dynamics, screening programs, and government health initiatives. They analyze data to identify health issues and socio-demographic challenges within the families. By the second year, students encourage community participation, act as the family’s first point of reference, and track progress towards health targets⁴. In the third year, students present reports addressing health improvements, vaccinations, sanitation, and malnutrition control. They assist families during medical emergencies and participate in environmental preservation efforts⁵. Engaging with families fosters empathy, communication, and teamwork, enhancing students’ understanding of patients’ needs and the Indian healthcare system. Activities like health check-up camps, treatment supervision, and awareness campaigns promote community engagement. However, challenges include resource limitations, transportation issues, and stakeholder motivation. Additional hurdles involve gaining family acceptance, ensuring team security, and addressing inappropriate expectations for curative treatments from unqualified team members. Despite numerous challenges, the Family Adoption Programme (FAP) offers invaluable opportunities for medical students to understand the living conditions and lifestyles of people in rural and urban slum areas⁶. It helps students develop interpersonal skills and gain deeper insights into families’ health needs through repeated interactions. This enables them to recommend appropriate health interventions confidently. FAP not only enhances healthcare access and health-seeking behaviors within communities but also provides students with vital exposure to rural and urban healthcare dynamics, shaping them into well-rounded community health physicians.

AIM

To assess the opinions, perceptions, and attitudes of medical students regarding the Family Adoption Programme (FAP) introduced by the National Medical Commission and its role in shaping their professional development and community health involvement

This cross-sectional study was conducted in January 2024 among 300 MBBS students from Sardar patel Medical College, Bikaner, using purposive sampling. The students, 100 from each academic phase (Phase-1 to Phase-3), had adopted five families each from ridmalsar, udasar and ghanthala areas under the Family Adoption Programme (FAP). The students collected detailed socio-demographic and health histories of the families using a structured proforma after undergoing sensitization. Necessary permissions, approvals, and informed consent were obtained prior to the study. A pretested proforma containing 18 Likert scale questions (8 on opinion, 6 on perception, and 4 on attitude) was distributed to the students. Of the 300 students, 232 completed and returned the proforma, and their responses were included in the study. Data were entered into Microsoft Excel and analyzed using descriptive and inferential statistics, with results presented in tables. The standard error of the difference between two proportions was used to test significance, with p<0.05 considered statistically significant.

Table 1: Age of participating students

In this study, 53% of MBBS students were aged 17-20 years, while 47% were aged 21-24 years.

Table 2: Distribution of gender of participating students

57% of the participants were male (144), while 43% were female (110).

Table 3: reflecting the opinions of MBBS students about the Family Adoption Programme (FAP)

The table shows the distribution of student responses on various aspects of FAP, with most agreeing or strongly agreeing that FAP is valuable for understanding family dynamics, health issues, and developing skills like empathy and communication.

Table 4: Perception of the MBBS students related to FAP (n=254)

The table reflects student responses on FAP's potential, showing that most agree or strongly agree on its importance for guiding patient care, being foundational for community medicine, and being an innovative approach, with preferences for conducting FAP in both urban and rural areas.

Table 5: Attitude of MBBS students towards family adoption programme (FAP) (n=254)

The table shows that most students are highly satisfied with their FAP mentors, allotted families, and communities, and view FAP as foundational to their future medical practice.

The Family Adoption Programme (FAP) offers invaluable opportunities for medical students to understand the living conditions and lifestyles of people.

 In our study the age distribution of MBBS students is as follows: A total of 135 students (53%) are in the age group of 17-20 years, while 119 students (47%) fall within the age group of 21-24 years. Vanikar et al in their study mentioned that, many studies related to evaluation of deep-rooted community engagement programmes voiced concerns about cooperation from the community and adjustment to the academic schedule7.

The gender distribution of students participating is as follows: 144 students (57%) are male, while 110 students (43%) are female. Yalamanchili et al in their study observed, participants felt that FAP will provide a good insight into the living conditions of the people staying in villages or in urban slums8.

Our study demonstrates FAP effectiveness, with the majority of students agreeing or strongly agreeing across all aspects. For example, 86.9% agreed or strongly agreed that FAP is useful for understanding the concept and structure of a family, while 96% felt it was important for understanding health problems in urban slums. Additionally, 99.17% agreed that FAP improves communication skills, and 95.46% believed it helps develop empathy and a patient-centered approach, highlighting its valuable role in medical education. Chakraborty et al in their review article mentioned that FAP is an innovative and crucial part of the CBME curriculum for MBBS students mandated by NMC of India9.

Our study highlights its perceived value in various aspects. For conducting FAP in urban areas, 69.6% of students agreed or strongly agreed, while 93.2% supported conducting it in rural areas. Regarding its role in guiding medical students toward the right approach and care for patients, 95.3% of students agreed or strongly agreed. Additionally, 90.93% viewed FAP as the foundation for Community Medicine, and 93.6% considered it an innovative way to learn community medicine. These responses underscore the program's overall effectiveness and impact on medical education. The majority agreed that FAP helps guide medical students in patient care, serves as a foundation for community medicine, and is an innovative approach to learning the subject. Neutral or negative responses were minimal across all variables, emphasizing the program's overall effectiveness. Mudey et al proposed an integrated holistic health team model to implement FAP so as to address needs of community and build consensus amongst medical students to enhance learning10.Shree et al in their study in Mysuru, observed that the majority of the medical students were feeling empathetic towards the adopted family11.

The majority of students expressed high satisfaction with the Family Adoption Programme (FAP). A significant 73% of students strongly agreed that they were happy with their FAP mentors, while 19.6% agreed, and 7% remained neutral. Regarding the allotted families, 57% strongly agreed, 32% agreed, 8.2% were neutral, and a small percentage (0.3%) strongly disagreed. For the allotted communities, 50.3% strongly agreed, 37% agreed, and 9.8% were neutral, with 0.7% strongly disagreeing. Lastly, 66% of students strongly agreed that FAP is foundational to their future medical practice, with 25.5% agreeing, 3.9% neutral, and 2.3% disagreeing. Overall, the responses highlight the program's positive impact on student learning and engagement. Shikha et al in their study mentioned that FAP has an opportunity to achieve the larger goal of ‘health for all’12.Vanikar et al mentioned that FAP has the ability to upgrade undergraduate medical education to new height, paving the way for a healthier and more empowered nation13.

Our study observed that MBBS students have a positive attitude towards the Family Adoption Programme mandated by the National Medical Commission of India. Their opinions and perceptions are affirmative, which suggests the programme’s potential for success. This initiative will significantly contribute to community health promotion. It is recommended that after completing the Third MBBS Part-1 course, the next batch of students should take over the adopted families from the previous batch and continue providing healthcare services.

1. National Medical Commission (Undergraduate Medical Education Board), U.14021/8/2023-UGMEB, 2023. Available from: https://www.nmc.org.in/MCIRest/open/getDocument?path=/Documents/Public/Portal/LatestNews/246254.pdf. Accessed on 11 May 2024.
2. National Medical Commission. U.11026/1/2022 UGMEB Dated 31st March 2022. Implementation of New Competency-Based Medical Education for Undergraduate Course Curriculum. Available from: https://www.nmc.org.in/MCIRest/open/getDocumen

t?path=/Documents/Public/Portal/LatestNews/Implementation.pdf. Accessed on 11 May 2024.

3. World Health Organization. Community Engagement: a health promotion guide for universal health coverage in the hands of the people. World Health Organization. 2020. Available from: https://www.who.int/publications/i/item/9789240010529. Accessed on 11 May 2024.
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