DCH Vs Primary DNB in Pediatrics - Choices I made

Being a primary DNB in Pediatrics myself, I usually get questions from the aspiring medical students who want to make their career in pediatrics. So I decided to write the answers here as I think many of you must have these in your mind.....

These candidates are either

1. Those who are confused between MD and DNB for postgraduation but getting the DCH through CET.
2. Those who have finished their DCH and are confused about whether to go ahead with DNB or just leave it there.

When it comes to DCH vs primary DNB, the following questions are unavoidable

1. Is doing DCH better than DNB?
2. Shall I do DNB after DCH ?
3. Shall I do DNB after CPS DCH?
4. Is DNB equivalent to MD?
5. Which institution should I join?

Let me explain my background a bit before I dwell deep into the subject. I was never a pro PG guy when I was doing my MBBS, but once I was out, I ultimately got sucked into the PG mania like my contemporaries.

To make a long story short, I didn’t get it in the next 4 years and finally did get it because I got married. Yup, you read it right.. Like all good wives, she nagged me into studying and I qualified for both NEET and DNB. I was getting both DCH via All India and DNB Pediatrics. Now the reason why I took DNB Primary was purely logical and there was no scientific thought process. I was getting old and needed to finish fast.

Now that I declared myself unbiased by admitting the above story, I can actually answer the above questions by what a learned in the journey of becoming a pediatrician by choosing DNB in place of DCH.
(DISCLAIMER: The views expressed here are entirely personal)

Is doing DCH better than primary DNB?

The answer is simple “ NO”. Do DNB ahead of diploma. You are saving 2 years of your career. If you choose the Diploma, you do it from a prestigious or from someplace and you pass out but you will have to do MD/MS/DNB now.

The competition has increased substantially.

You have to do a master's because you believe it or not the diploma is getting obsolete. This applies to every subject. Remember Those days when MBBS was enough, but that time has gone already and so is the time of choosing a diploma.

This was ok at the time when the only option you had was MD. Now there is one more option which is DNB. More options, more opportunities, right? So friends, do not even blink an eye to choose DNB over Diploma.

The counter-arguments in the debate of Primary DNB vs DCH are

DNB is as good or better ( this is arguable and everyone will have their own perspective and let this rant be there for hyper intellectuals).

But one cannot deny your capabilities if you do it from a good institution. Period. However, there are only very few ideal centers like this. So ....?

So what? Even if you do it from some average place, and study well during that period and remove your deficiencies by working later at high volume or a renowned place for 6 months. You still save time and earn a degree. 

Yes, it is low compared to Diploma/MD. To be honest, when I did it, it was low but now the scene seems completely changed. Whoever I meet says, I cleared.

The results are now the candidates are choosing DNB with the determination of finishing it as against previous when DNB was not chosen by people like us but moreover senior staff in the colleges and hospitals who already were practicing. 

The students now have more resources like the DNB Pediatrics blog which actually opens the whole structure of the exam for you and gives you a feel ahead, on how the exam is going to be like.

There was a time when there were no resources like this. The students are in more touch with each other through such websites and groups. There is no more isolation now.

The education activities are no more limited now, especially after 2020 education is not limited by walls anymore. The education systems which are still bounded by such walls, either will have to change their attitude or shall perish.

The National Board of Examination even though started slowly has now come up as a board which adopted a better education system by incorporating exam pattern like OSCE.

The National Board of Examination has recently conducted its first online theory and practical exam successfully without compromising its standard. Here are the details of the Virtual DNB exams conducted by NBE.

National Board of Exam is becoming saner in putting up question papers and evaluating the answer papers. It is still nowhere ideal but things are improving. The reasons for the low passing rate were improper question papers, tight valuation, a sadistic mentality, and incompetent candidates. This has definitely changed.

Simply look at the trend, you will find that the passing rate has increased dramatically in recent years once centralized counseling has come and the selection of better candidates is one of the top reason. 

This discussion is not going to end soon. Here is more on this - breaking the bubble of Insecurity

Even with the latest MCI guidelines on equivalence, there is gross inequality. Agreed but not at all places, I can vouch there are places that prefer DNBs over MDs and definitely over DCH.

The very logic that the discussion of MD vs DNB is getting more prominent, points to the rise of DNB in medical training.

In terms of standard, the sole things which decide the standard of training are your institute and you. This applies universally for all the degrees.

There are stories of discrimination in government places. However, if you are looking to work in a corporate set up in your future, then DNB holds a better stand.

One of the key, why probably the corporate choose DNBs over MDs, is that they are familiar with the culture and the importance of communication, and are also exposed to the latest technology and standards.

I am not demeaning government colleges by any means, just stating certain bitter truths. The chances of making contact with abroad faculties and training there become more. Also, DNB candidates are equally competing in all DM and fellowship exams in India itself. 

Should I first complete DCH and then choose secondary DNB Pediatrics?

I am not a secondary candidate, so I can't comment on clinical advantage here.  But if a certain education system requires another similar degree to complete its existence then there is a big question mark.

Three years of residency doesn't teach everything in pediatrics so definitely the time frame of the diploma looks a little less.

Plus by its name itself, one is a degree while the other is a diploma, it has its own shortcoming, in terms of job opportunities, even though you may not be necessarily lacking clinically.

I have done DCH, shall I go for secondary DNB in Pediatrics now?

Hell yes, even when I have not done DCH, I can surely tell you that the more time you spend in a certain specialty the stronger clinician you become.

Plus if you think cutting down the time spent on education will do you any good, then the answer is no. You are going to end up studying the same while practicing to get an answer which will arise during practice.

So if you have done DCH, it is advisable to do two more years of residency and get DNB in Pediatric.

How to choose a good DNB institute via DNB CET counseling?

Consider this as your ultrashort DNB CET counseling guide for Pediatrics.

Well, there are many points you can consider while comparing amongst institute which provides DNB training.

But our perspective and suggestion are different. Let us try to have a  simple answer. A good DNB institute is that which has run successful DNB programs for quite some time. 

Look at the history of the institution. Has the DNB program been going on for some time now and is the passing rate good. If both are ticked, then look no further, whichever it is.

A bad institute will only be looking at DNB candidates as cheap labor and the consultants there will be more oriented to money-making and sorting their own thing.

Doesn't matter how reputed or unreputed the institute may be, it should carry the attitude of teaching the student. That's all. and then it's also your responsibility to make that place better for you and your juniors, Isn't it?

This article is reviewed post-publication and is updated in 2021

Author

Arun Thomas | DCH, DNB(Pediatrics)

Arun is DNB in Pediatrics from Manipal, Banglore and is currently working as Pediatrician at Aster Medcity, Kochi, Kerala