Reconsidering the Family Adoption Programme in Medical Education: A Call for Alternative Approaches to Community-based Learning

Dear Editor, We are writing in response to the article “Family adoption programme (FAP) for MBBS students: Perceptions of various stakeholders regarding challenges and opportunities”.[1] While the authors present a balanced view of the FAP, We believe there are compelling reasons to reconsider and potentially discontinue this program. First, the FAP poses significant ethical and privacy concerns. As noted in the article, there are risks of “misuse of personal information, numbers, and pictures of students”.[1] This concern extends to the families as well, who may feel that their privacy is invaded by having medical students involved in their personal health matters. The power imbalance between medical institutions and potentially vulnerable families raises questions about whether truly informed consent is being obtained.[2] Second, the program faces severe logistical challenges that compromise its effectiveness. The article highlights issues such as insufficient transport, a lack of faculty and support staff, and difficulties in scheduling.[1] These practical constraints can lead to rushed, superficial interactions that fail to meet the program’s educational objectives while potentially disrupting the lives of the families involved. The question of student readiness is another critical concern. As one faculty member pointed out, “In the first year, the student has no knowledge, having just completed Intermediate (10 + 2). If we send him into the field, he will not be able to manage”.[1] Exposing unprepared students to complex community health situations may lead to misunderstandings, misdiagnoses, or inappropriate advice, potentially harming both the students and families. Furthermore, the FAP may provide a narrow and potentially biased view of community health. By focusing on a limited number of families, students may develop skewed perspectives that do not accurately represent broader population health issues.[3] This limitation could inadvertently reinforce stereotypes rather than promote a comprehensive understanding of community health dynamics. The program also raises concerns about continuity of care. As students progress through their education, their involvement with families will inevitably be disrupted. This disruption can lead to fragmented care experiences for families and may even discourage them from forming trusting relationships with healthcare providers in the future.[4] Last, the FAP may not align well with evolving healthcare trends. Modern medical education increasingly emphasizes evidence-based practice, data-driven decision making, and technological integration.[5] The individualized, anecdotal experiences provided by the FAP may not adequately prepare students for these aspects of contemporary healthcare. Given these significant drawbacks, we propose that medical education policymakers consider alternative approaches to community-based learning. These could include structured rotations through diverse community health settings, involvement in population-level health projects, or the use of advanced simulations that provide a broad range of experiences without the ethical and practical complications of the FAP.[6] While the intentions behind the FAP are commendable, its implementation presents more challenges than benefits. A thorough re-evaluation of this approach is necessary to ensure that community medicine education evolves in a direction that truly benefits all stakeholders—students, families, and the broader healthcare system. Sincerely, Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.