insider news

NEET SS 2021 | Centre tells Supreme Court it has dropped plan for new exam pattern

noreply@blogger.com — Wed, 06 Oct 2021 12:43:00 GMT

Faced with criticism, govt. says scheme has been put off to 2022

The government on Wednesday, October 6, 2021, turned around to inform the Supreme Court that it has dropped its decision to implement a new exam pattern for National Eligibility-cum- Entrance Test- Super Specialty (NEET-SS) 2021 due in November.

Faced with criticism from the court for the sudden manner in which the new pattern has been introduced at the last minute this academic year, the Centre, represented by Additional Solicitor-General Aishwarya Bhati, said the implementation of the new exam pattern has been postponed to 2022.

The November 2021 exam would follow the existing exam pattern, Ms. Bhati submitted.

“In deference of your lordship’s observations & interest of students, the Centre has decided that the revised scheme will be implemented from 2022. The present exam will be held based on the 2020 scheme,” Ms. Bhati submitted.

A Bench led by Justice D.Y. Chandrachud expressed its satisfaction with the government’s change of mind and disposed of the case.

Ms. Bhati said the decision to revert to the old mode was done in consultation with expert bodies such as National Board of Examinations and National Medical Commission, taking into consideration the interests of the students.

The change of tune comes a day after the top court criticised the revision of the exam pattern at the eleventh hour, saying it might have been done to favour private medical colleges.

The new pattern shows questions entirely from the field of general medicine and not from the specialities for which the students want admission. General medicine, the court said, was the largest pool from which students could be found to fill up vacant seats in private institutions for super speciality courses.

On Tuesday, the Supreme Court said the tragedy of medical education was that it had become a business in this country.

“The impression we get is medical education has become a business, and medical regulation has also become a business. That is the tragedy of medical education in this country,” Justice Chandrachud had remarked.

The court noted that questions under the revised pattern were wholly from general medicine, which was a feeder category. The earlier pattern had 60% of the questions coming from the student’s chosen field of speciality and the rest from the feeder category.

“For 12 super specialties, 100% questions are from general medicine. The entire examination is going to be only be on general medicine. The logic seems to be, general medicine is the largest pool, and tap them to fill the seats. That seems to be idea,” the Bench had noted.

In an earlier hearing, the court had lashed out at the government, saying “young doctors cannot be left at the mercy of insensitive bureaucrats and cannot be treated like football”.

“The interests of students is far higher than those of the institutions,” the court had said.

Building consent: On PG Medical Education Regulations 2021

noreply@blogger.com — Thu, 12 Aug 2021 16:00:00 GMT

A consensus on the Postgraduate Medical Education Regulations 2021 is a must

The Indian Medical Association (IMA), the largest organisation of doctors in India, has demanded that the National Medical Commission (NMC) withdraw the draft Postgraduate Medical Education Regulations 2021. In its current form, it notes that there shall be common counselling for admission in all medical educational institutions to all Post-graduate ‘Broad-Specialty’ courses (Diploma/MD/MS) on the basis of the merit list of the National Exit Test. Currently, admissions to such programmes are based on the post-graduate NEET. Half the seats to the various courses are based on the all-India quota and the rest are admitted by the State governments, which comply with reservation norms. The IMA contends that the draft regulations leave States with no power or discretion to manage admissions to State medical colleges, which rely on State funds. If States did not have the freedom to decide on student intake, they would find it hard to provide quality medical services to the local population. The proposed regulations follow from the provisions of the National Medical Commission Act, 2019, that itself replaced the Medical Council Act of India and was a subject of extreme friction between medical professionals and the Centre. In both instances, the heart of the objection is States’ discomfort with ceding powers to the Centre. The familiar argument of the States is that health care is a State subject. Through the decades, while the Centre plays the critical role of funding and conceiving targeted programmes to ameliorate disease and improve overall health-care standards, the matter of implementation has always been left to the States.

The Centre has an important role in setting standards and amplifying best practices so that minimum — but ever improving — standards of health care are delivered across all States. Much like cadres of the IAS are deputed to States based on centralised examinations, there is, in principle, no reason for such a system not to be effective, but the Centre needs to be extremely responsive to States’ views on the same. The very real problem, laid bare during the pandemic, is the shortage and extremely uneven availability of quality health care. Through the years, attempts are being made to improve this by trying to bridge alternative systems of medicines with modern medicine, but these have always been marred by political and religious overtones, and a convergence seems unlikely in the near future. The import of the proposals should not be made hostage to a Centre-States power struggle. Efforts must be made to build more consensus involving stakeholders, such as the IMA, State medical councils and representatives of health-care groups.

TH Editorial, 12-08-2021

Zika Virus

noreply@blogger.com — Sun, 25 Jul 2021 06:54:00 GMT

Zika virus

1.Zika virus mode of transmission is thru mosquito bite .

2.It is spread by Aedes Aegypti and Aedes Albopictus.

3.It can be transmitted from pregnant women to fetus .

4.In pregnancy if virus infection occurs it can lead to MICROCEPHALY and Severe Neural tube defects

5.It can be transmitted from infected person to sex partner .

6.Transmission can be reduced by use of condom.

7.Prevention is mainly by preventing mosquito bite.

8.Especially pregnant women to be taken care of by using approved mosquito repellent.

9.Many mosquito repellent are safe for use during breast feeding and pregnancy.

10.Zika virus can survive in semen than in any other body fluids.So it can be transmitted through sex(vaginal anal or oral).

11.During first week of infection Zika virus is found in blood.

12.Spread to others can be prevented by taking proper precautions to avoid mosquito bite during this period.

13.NO VACCINE AVAILABLE

14.No Medicine available

15.Symptoms: Most people infected with Zika virus is asymptomatic.

symptoms are usually mild Fever,rash,head ache, conjunctivitis,joint pain and muscle pain

16.Patient usually don't fall sick enough to go to hospital

17Testing to be done within a week

18.NAAT(Nucleic Acid Amplification Tests) assays are molecular test used to detect viral genome.

19.IgM antibody is detected in blood after 7 days of infection upto 12 weeks

20.Problem with IgM antibody is cross reactivity with other flavi virus diseases causing increased false positives

21.PRNT(plaque reduction Neutralisation test) is used for confirming IgM antibody positive cases .

22.ln areas with high prevalence of dengue and Zika virus neutralizing antibodies, PRNT may not confirm a significant proportion of IgM positive results.

NEET-PG 2021 Notification

noreply@blogger.com — Tue, 23 Feb 2021 04:09:00 GMT

India’s troubled history of vaccination

noreply@blogger.com — Mon, 22 Feb 2021 15:32:00 GMT

On June 14, 1802, three-year-old Anna Dusthall became the first child in India to successfully receive the smallpox vaccine. Only the barest details are known about Dusthall— she was a healthy girl, possibly of mixed racial identity, “remarkably good tempered” — a trait crucial to the vaccination’s success — and, from the pus that formed on her skin upon vaccination, five more children were vaccinated in the city of Bombay. Thereon, enough vaccine material was collected using her lymph and sent to Poona, Surat, Hyderabad, Ceylon, Madras and more places along the coast and the Deccan.

Dr Helenus Scott, the physician who vaccinated her, hoped that with the availability of the vaccine, “one of the greatest evils that has afflicted humanity” would be diminished or even extinguished. His wish would take root, but not before a confusing century, riddled with challenges and challengers, passed by. As recent research indicates, the history of smallpox vaccination in colonial India wasn’t a simplistic colony-versus-empire dynamic. British and Indian officials would have to contend with diverse fluctuating reasons for the public’s unwillingness to get vaccinated, each concern specific to different sections of society. The opposition, while not widespread, was nearly at every step — right from the vaccine’s safety to its disregard for local cultural and medical practices — and if officials felt they could bulldoze their way through, that was hardly the case.

If there is one feature that marks the periods and contexts of smallpox and COVID-19, it is the issue of trust, observes Sanjoy Bhattacharya, professor, University of York, the UK, who heads the World Health Organization Collaborating Centre for Global Health Histories. While a safe vaccine and vaccinating practices were crucial to creating basic confidence, other factors — such as planning, the willingness of culturally important figures publicly accepting vaccination and the hands that transmitted the vaccine to disparate and complex social groups — were as significant. “A single political event, which annoyed the British Indians, like the Rowlatt Satyagraha (1919), could suddenly increase opposition to all visible forms of state intervention, like smallpox vaccination,” he says.

Unlike COVID-19, a disease that we are still learning about, smallpox was well charted and notorious, dreaded both in India and Europe. Those who survived were left horribly disfigured and blind, and often had a hard time reconciling with the aftermath. Queen Elizabeth I painted her face lead white and 18th century European aristocrats often wore beauty patches — fabric stickers shaped like hearts, moons and stars — to hide their pockmarks. Even in the 20th century, renowned Indian Modernist FN Souza would paint grotesque, pockmarked figures after his own recovery from smallpox as an infant. “Stars in the face are the scars of smallpox,” he would write.

Marks of mortality: FN Souza’s oil on canvas Untitled (Pope), 1961; Souza often painted pockmarked figures after his own recovery from smallpox as an infant (Source: prinseps.com)

Smallpox was endemic through the Indian subcontinent, turning into an epidemic every five years or so. Around the time of Dusthall’s vaccination, it was estimated that smallpox mortality in India was one in three cases. It’s hardly surprising therefore, that Dusthall’s vaccination was a cause for imperial optimism. The vaccine, introduced by country doctor Edward Jenner, used cowpox to produce immunity against smallpox (the word “vaccine” comes from the Latin vacca for cow and vaccinia for cowpox). By 1800, Jenner’s vaccine was delivered “arm-to-arm”, where lymph was taken from vaccine incisions and administered to other subjects.

India’s first vaccination was a concentrated effort across continents. In 1799, Jenner sent threads soaked in lymph vaccine to Vienna; from Vienna via Constantinople (modern-day Istanbul) and then to Baghdad. A vaccinated child from Baghdad was sent to Bussorah (modern-day Basra), and from the child’s arm, successful vaccinations were performed. More lymph was raised here, and, finally, in May 1802, a batch was dispatched to Bombay, where Dusthall was one among 20-odd children to receive it, but the only successful outcome. This intercontinental relay was often lauded in official accounts, but the British administration was yet to fully comprehend the problem of lymph logistics.

In 1805, John Shoolbred, the superintendent general of vaccine inoculation, stated they were keen that Bengal’s provinces received the vaccine. But “the whole tribe of Brahmin inoculators” were determined enemies of the new practice, Shoolbred noted, and were using their influence to stop parents from presenting their children for vaccination.

The tikadar or inoculator/variolator was a product of the region’s existing method of developing immunity against smallpox. Tikadars would manually induce smallpox with preserved dried scabs from previously inoculated subjects. A 1767 account describes how scabs were first sanctified in the water of the Ganga and subjects prepared for inoculation by abstaining from fish, milk and ghee.

Eye |‘His vibrant colours represented India’: Atul Dodiya

The system wasn’t without its flaws — so long as the smallpox virus was present, the risk of outbreaks existed. To quell the tikadars’ influence, in 1805, pensions were granted to those willing to relinquish their practice in and around Calcutta. Some 50 years later, variolation was equated to outdated practices such as sati and infanticide. Acting as both doctor and priest, tikadars were called the ministers of Sitala, the goddess of smallpox, who was supposedly angered by vaccinations.

The administration wasn’t always wholly opposed to variolation. The practice was prevalent in Britain as well, until it was outlawed in 1840. Bhattacharya says that official smallpox control measures — first through variolation and later through vaccination — remained an important facet of British colonial administration in the 19th and 20th centuries. When vaccination first arrived, it was hardly the reliable and safe technology it was made out to be. It is only when British-Indian vaccination technologies and working practices became more reliable, that official support for the new intervention increased. “It was all a question of relative risk,” he observes. Variolation was considered safer than smallpox; vaccination, when it could guarantee protection, was better than variolation.

Weeping mothers, angry fathers and parents absconding with their children before or after vaccinations are common tropes in many official accounts from 19th century India. Indeed, the figure of the vaccinator, who was always Indian, often assumed terrifying proportions. “In these days, vaccinators are a source of annoyance and oppression to the subject population,” noted the newspaper Sindh Sudar (November 26, 1887). The complaint was regarding an incident at a fair, when a vaccinator caught hold of a boatman and his infant, took matter from the child’s incisions and blindly used it to vaccinate every child he saw. Thousands at the fair ran away seeing him. Similar accusations erupted across different parts of British India in the 19th and 20th centuries. The details are different, but the storyline is nearly the same — the public as prey, the vaccinator as predator.

“Even today, people are afraid of injections. You tell them it’s just a prick but it doesn’t stop their fear. It’s just human behaviours and fears which come in to play,” says epidemiologist Dr Chandrakant Lahariya, co-author of the book Till We Win: India’s Fight Against the COVID-19 Pandemic (2020). For most of the 19th century, vaccination was not a quick jab but implemented by a variety of lancets. With the arm-to-arm method, children not only had to bear with the painful procedure but also the extraction of lymph for further vaccinations. Lahariya adds that the acceptance of a vaccine has always been on a spectrum, with those who will take any vaccine offered and those who will refuse every vaccine, no matter how much the scientific evidence, at either end. “There has never been a period when opposition to a vaccine wasn’t there,” he observes.

Namrata Ganneri, assistant professor, history, SNDT College of Arts and SCB College of Commerce and Science for Women, Mumbai, notes, “One of the most important reasons for opposition has always been a doubt in the efficacy of the vaccine.” The liquid lymph, used till the 1950s against smallpox, lost potency in warm temperatures and, in the absence of adequate facilities of refrigeration, the vaccine remained ineffective.

One of the chief debates surrounding COVID-19 vaccinations is about whether to make jabs mandatory, in the interest of public health. Concerns around smallpox vaccination were no different in colonial India. Right from the beginning of the vaccination efforts in India, there were suggestions in the press that a persuasive rather than coercive effort would do the trick. There were others who believed that force would be the best way to promote the vaccine. Compulsory vaccination acts were passed in different parts of the country from the late 1870s onwards, with imprisonment or fines as penalties for evasion.

In 1898, Great Britain banned arm-to-arm vaccinations, citing that syphilis and hepatitis spread through the practice. Calf lymph was seen as a safer alternative. Bovine lymph production took off in India in the late 1800s and vaccine research and production depots were set up. Calf lymph was welcome as caste and religion had undoubtedly been a concern with the arm-to-arm method. “High” caste Indians believed it would be ritually polluting to be vaccinated with the lymph of “lower” caste children. Influential members in the Bombay Presidency argued that a wise government wouldn’t overlook caste and religion, despite what reformers had to say.

Indeed, officials had previously tried to categorise how different castes and religious groups reacted to vaccination efforts. Some vaccination reports of the Bombay Presidency and Sind (1872-73 and 1874-75) lamented that the vaccine department had no influence whatsoever on “the Mahomedan portion of the community, from the poorest mendicant and fakir to the richest merchant and millionaire…” in Bombay. Overall, in 1874-75, Muslims were seen as accepting the vaccine more freely than Hindus, except in the Bombay circle, where they were perhaps too careless or too busy to give thought to a probable danger. The Kolis were criticised for their belief in a Devi who would rather claim her victims sick than vaccinated. Parsis didn’t fare too elegantly in the eyes of this report either. The community “out-hindued the Hindus…in their superstitious regard for smallpox”. There was a good deal of opposition to the vaccine among the native Christians of Salsette; some native Christians in Kurla were open to their children being vaccinated but opposed lymph extraction for further vaccinations.

If officials believed that the public would wholeheartedly embrace vaccines developed from a creature revered by many Hindus, then they were served a lesson in nuance. In 1913, Mahatma Gandhi stated, “vaccination seems to be a savage custom…Vaccine from an infected cow is introduced into our bodies…I personally feel that in taking this vaccine we are guilty of a sacrilege.” In 1929, he would go on to remark that vaccination was “tantamount to partaking of beef”.

Niels Brimnes, associate professor of history at Aarhus University, Denmark, takes into account these and later statements by Gandhi in an essay published in 2017. He explains that there were a number of reasons among the rural masses for following Gandhi but scepticism to vaccination was not among the main ones. He says, “Opposition to Western medicine, including vaccination, was important to the articulate sections of the nationalist movement, because it allowed it to construct a national identity that took pride in the alleged achievements of Ayurvedic and Unani traditions. Medicine became an area where the nationalist movement could claim that India had a distinct and valuable scientific tradition of its own.” The “nationalist” position on medicine was forcefully countered by modernist forces immediately after independence, such as by Rajkumari Amrit Kaur, Union minister of health for a decade after 1947, who was strongly pro-western medicine, and would never question the value of vaccinations.

Brimnes observes that if local leaders in a village supported smallpox vaccination, many villagers would likely follow their lead. “It is not much different from today, where doctors and politicians might be asked to undergo vaccination publicly to persuade people to accept a vaccine,” he says.

Similarly, in Bombay, portrayed as one of the best examples of successful vaccination efforts, the role played by Indian doctors was vital in establishing trust. Historian Mridula Ramanna notes that in the 1850s, the British government established vaccination depots in several parts of the city, with the support of the first batch of students who graduated from Grant Medical College in 1851 to promote smallpox vaccination among Indians. Among them was Dr Bhau Daji, after whom the city’s museum in Byculla is named. He had a charitable dispensary at Nagdevi Street, from where he was able to recommend the vaccine to patients who sought him out every week.

In 1980, the WHO declared, “Smallpox is dead”. The last case on the Indian subcontinent would be three-year-old Rahima Banu Begum in 1975, who was treated and her scabs sent for further study. From Anna to Rahima, the scourge was eradicated, but leaving us with important lessons on continually checking the temperature of cautious and complex groups of people, for whom “one nation, one rule” may not suffice.

Covid-19 vaccine private-govt split worries doctors

noreply@blogger.com — Sat, 16 Jan 2021 06:04:00 GMT

The health ministry hasn't explained the criteria to decide how the 11 million doses of Covishield, and 5.5 million of Covaxin would be split between states

The nationwide Covid-19 vaccination drive starts on Saturday amid speculation among some doctors whether the home-grown vaccine, which is yet to prove its efficacy, is being sent to public institutions that have fewer opportunities to question the decision.

The doctors who have questioned the inclusion of the home-grown Covaxin from Bharat Biotech alongside the AstraZeneca-Oxford vaccine at the start of the inoculation campaign say the proposed split of the two vaccines in Delhi has amplified their concerns.

Six government hospitals in Delhi will receive Covaxin while all the 42 private hospitals will receive the AstraZeneca-Oxford vaccine, Covishield, produced in India by the Serum Institute of India, according to a document received by the sites.

While government district hospitals will also receive Covishield with the private hospitals, the public hospitals to receive Covaxin are the All India Institute of Medical Sciences, Safdarjung Hospital, Ram Manohar Lohiya Hospital, Kalawati Saran Hospital and two Employees State Insurance hospitals.

The Union health ministry has not explained the criteria adopted to decide how the 11 million doses of Covishield and 5.5 million doses of Covaxin that have been ordered to initiate the vaccination campaign would be split between the states or between the hospitals within a state.

Multiple messages this newspaper sent to health officials asking about the criteria have remained unanswered.

How the vaccines are split assumes significance because, several doctors and researchers said, many among them are unconvinced about the wisdom of introducing Covaxin before waiting for efficacy results that they expect to emerge in another two months.

In Tamil Nadu, the state government doctors’ association has circulated a note to its 20,000-odd members recommending that all practising doctors go for vaccination and “insist on Covishield” until the efficacy results of Covaxin are out.

“These are suggestions for doctors in government service in the state. Vaccination is voluntary, the choice remains with the individual,” N. Ravishankar, a doctor at the Government Medical College in Coimbatore and the association’s secretary, told The Telegraph.

“We’re not opposed to Covaxin — all we’re pointing out is the absence of evidence for efficacy.”

India’s drug regulatory authority on January 3 accepted the recommendations of an expert panel and approved restricted emergency use of Covaxin on the basis of its safety and its capacity to generate an immune response. Covishield’s efficacy has been proved in trials outside India.

Health officials have over the past week underlined the safety and immunogenicity of Covaxin and defended the accelerated approval, citing the daily lives lost to Covid-19. But several doctors have told this newspaper they do not understand the haste to release the vaccine.

A senior medical doctor from a government academic institution told this newspaper: “Vaccination campaigns should be based on trust. I’m worried that this campaign being rolled out could erode gains that India has made over the decades through vaccines.”

The health ministry has signalled that the recipients will have no choice over the vaccine.

The inoculation campaign will start on Saturday at 3,006 vaccination sites across the country. Each site has been asked to cap the number of inoculations to around 100 per day.

During the campaign’s first stage, around 10 million healthcare workers are expected to receive the vaccines. This is expected to be followed by the inoculation of 20 million frontline public workers.

The vaccine options are under discussion in medical circles across the country. “Many, particularly the younger lot, seem to wish to wait for the efficacy results to come out,” a doctor-researcher said, describing the exchanges among peers.

Many researchers believe that the haste to roll out Covaxin reflects a political desire to launch a home-grown vaccine alongside Covishield, facilitated by officials and researchers willing to play along.

“Not waiting for even preliminary efficacy evidence before starting injections of Covaxin looks like one more step in a process that seems more focused on nationalistic brownie points than on substantive public good,” Satyajit Rath, a medical immunologist and adjunct faculty at the Indian Institute of Science Education and Research, Pune, told this newspaper.

Preparing India for tomorrow’s pandemics

noreply@blogger.com — Sat, 02 Jan 2021 05:40:00 GMT

Early detection is key to minimising health and economic burdens

Chandra Mohan

The history of mankind is replete with ravaging pandemics that have wiped out civilisations. Now Covid-19 has spread to more than 180 countries, infected upwards of 83 million, and killed 1.8 million people in just one year. In India, in 1918 the Spanish Flu killed more than 13 million in just three months. And within the last year the country has reported more than 10 million Covid cases and 1.48 lakh deaths.

Insights provided by Pasteur’s germ theory of disease, rapid advances in the development of new anti-microbial drugs and vaccines, improved housing, sanitation, and clean drinking water have dramatically reduced the burden of infectious diseases over time. Life expectancy in India increased from 32 years in 1947 to 69 years in 2020 leading to the illusion that the scourge of infectious diseases has been conquered. Nothing could be further from the truth. Increasing drug resistance, newly emerging infectious diseases like AIDS, SARS, H1N1, Covid and other zoonoses have turned out to be equally devastating and disruptive. The future could see more pandemics, not less.

Early detection, timely containment, and prevention of spread are key to containing infectious disease outbreaks and minimising their health and economic burdens. India needs an ‘epidemic early warning system’ with real-time surveillance of epidemic-prone diseases. Deploying computational epidemiology that uses big data, artificial intelligence, and algorithms makes for early detection of unusual patterns or clusters of illness. These patterns help assess the risk of an outbreak, forecast the disease trajectory, and provide inputs for issuing warnings about possible outbreaks. Governments will get much-needed time to prepare for and take appropriate preventive and curative measures.

The Covid pandemic and its debilitating impact have exposed the inadequacy of existing public health and institutional mechanisms to respond to health emergencies of this scale. Its containment necessitated multi-lateral cooperation across nations and multi-sectoral involvement within countries. In India the emergency medical relief division of the Directorate General of Health Services found itself without the heft or the authority to reach out and mobilise different stakeholders. The constitution of a statutory Indian health emergency response authority (IHERA) therefore becomes a sine qua non for ensuring seamless coordination and deployment of resources across multiple sectors in diverse situations.

IHERA will strategise and lead the containment effort. It will marshal and deploy necessary resources to rapidly detect, respond to, prevent and recover from any health emergency. The authority will prepare, maintain and update an integrated system of medical countermeasures for all possible public health emergencies. Such measures will include but not be limited to diagnostic tests, anti-microbial drugs and protocols for prevention including vaccines. It will inform decision-making, enabling governments to craft and mount multi-pronged responses under an integrated incident management system. Synergies created by leveraging the strengths of partners and sharing resources will avoid duplication and provide more people with access to life-saving health services.

The National Centre for Disease Control (NCDC) in Delhi monitors communicable disease outbreaks in the country, investigates them and recommends control measures. It collects data about diseases from villages of the country through its integrated disease surveillance programme (IDSP). The Covid pandemic overwhelmed existing surveillance systems and exposed their inadequacies. Public health systems struggled to investigate outbreaks, trace contacts, quarantine suspects and contain outbreaks. Healthcare facilities were overstretched and saw shortages of beds, PPE, drugs and manpower.

NCDC needs to be urgently strengthened to address these issues. It should be recast as the repository of technical knowledge for IHERA. Its current repertoire of disease monitoring must be expanded by including more diseases. Though IDSP is present at state and district levels, it struggles to collect outpatient data because of capacity limitations. Real-time surveillance needs to be enabled by deploying adequate numbers of male health workers in all primary health centres and advanced computing methods. Public health laboratories at state and district levels need real strengthening.

A massive expansion and upgradation of India’s healthcare facilities is an urgent priority. Of the 554 medical colleges in India, only four have teaching programmes in infectious diseases. The case for starting infectious disease specialities in all medical colleges is urgent and compelling. At MBBS/ MD levels the teaching hours for infectious diseases need to increase. Public health systems at the district and sub-district levels need to be professionally staffed and managed. The Tamil Nadu model of public health services delivery has stood the test of time and can provide a good template for replication.

A robust surveillance system, early warning protocols, a vigilant health emergency response, and a well-equipped healthcare system are indispensable for crafting an appropriate response to epidemics. We cannot be sure of what new outbreaks the future will bring, but we can be sure that if we do not prepare for them today, our tomorrows could be catastrophic.

The writer is an IAS officer and member of the Tamil Nadu government team for epidemic monitoring. Views are personal.

Govt doctors in UP must serve in PMHS cadre after doing PG for 10 years or pay Rs 1 cr fine

noreply@blogger.com — Sun, 13 Dec 2020 08:30:00 GMT

In a bid to check the depleting number of specialists in the Provincial Medical and Health Services (PMHS), the UP has made it mandatory for government doctors seeking the NOC to pursue post-graduate courses to serve in the cadre for at least 10 years. Those who don't do so will have to pay back Rs 1 crore as penalty to the government.

"As per the rule, the in-service doctors who undertake PG courses will have to give in writing that they would return to the primary cadre upon completion of their programme and serve for a minimum period of 10 years. In case they fail, they will have to pay a fine of Rs 1 crore to the state exchequer,” said additional chief secretary Amit Mohan Prasad.

Rules in this regard had been framed through an order issued by the Yogi Adityanath government in April 2017. Prasad issued a fresh order on Thursday to enforce this order strictly. The same order also stated that in-service doctors who leave the PG course mid-way will be debarred from taking PG exams for three years.

Government doctors who are a part of the PMHS are encouraged to take up PG courses to fill up the shortage of specialists in the cadre. Out of 8,000 sanctioned posts of specialist doctors in the cadre, 60% seats are lying vacant.

At the time of PG admissions, PMHS doctors get extra marks if they have served in rural areas for a minimum period of three years.

“However, there are examples to prove that people took advantage of the provision but strayed away when the time to return the favour came. The realization made the Yogi Government issue strict orders,” said Dr Sachin Vaishya, president, UP PMHS Association.

The order issued by the state government clearly mentions that the intention behind this scheme is to provide quality medical care and specialist services to the people in rural and difficult-to-reach areas.

An official spokesperson also pointed out that many steps have been taken by the Yogi government to address the shortage of specialist doctors during the pandemic peak.

In August this year, the medical education department made it mandatory for doctors completing MD, MS and PG Diploma courses from state government-run medical colleges to serve in government hospitals for at least two years.

Earlier on Friday, the state government amended the UP Medical and Health Service Rules to make the government services more attractive to post graduates. As per the amendment, the specialists will be appointed one level above the entry level (medical officer). It also stated that they will be allowed to serve in their home districts till level-3 and will not be sent on non-clinical duties.

Allopathy & ayurveda: A study in difference

noreply@blogger.com — Sun, 13 Dec 2020 08:26:00 GMT

Ayurveda practitioners are seeking equivalence with allopathic doctors in doing certain surgeries, but there seems to be a vast difference in the amount of training received in the two systems. Everything from the minimum number of beds in teaching hospitals to bed occupancy and the outpatient attendance required in a medical college to be allowed to do undergraduate and postgraduate training is much less for ayurveda colleges than for allopathic ones.

Barely a quarter of the 414 ayurveda colleges have 100 seats. Nearly two-thirds (64%) of UG ayurveda seats are in colleges with 60 seats or less, which need to have just a 60-bedded teaching hospital with 40% occupancy, or about 24 beds occupied. Of the 60 beds, beds that must be kept aside for shalakya tantra and shalya tantra (surgeries) are just 25. In comparison, almost all MBBS colleges have at least 100 MBBS seats and for that they need a 500-bed teaching hospital with 75% occupancy (375 beds) and 120 beds kept aside for general surgery. Thus students who join for postgraduation in surgical specialties in ayurveda would have seen fewer patients and would have had much fewer opportunities to be trained in surgery.

Postgraduation in the surgical disciplines of shalya tantra and shalakya tantra are taught in the same colleges with stipulation of just marginal augmentation of beds, patients, faculty and support staff — one professor or reader and one lecturer of the concerned subject, under the Indian Medicine Central Council (Post Graduate Ayurveda Education) Regulations, 2016. If a college has more than ten PG seats in clinical subjects, additional beds in the student-bed ratio of 1:4 will have to provided, much less than that for an allopathy college for which the facilities and training mandated are much higher. For instance, just three acres are required to start an ayurveda college with an intake of 60 students or less, and five acres if taking in 61-100 students. For an allopathic college, the stipulation in force is a minimum 25 acres. The number of faculty and support staff required in ayurveda colleges is about a third of that in allopathic colleges.

Unlike at UG level when the ratio is 1:1. Also, the college will have to show 50% bed occupancy the previous year, and not 40% as required at the UG level. But colleges which have less than ten PG seats can make do with the same facilities as stipulated for undergraduate teaching. Thus clinical material is less in ayurvedic colleges than in allopathic ones. Of course, there is no centralised admission or entrance test to get a postgraduate seat.

While there are several government ayurvedic colleges and a few private ones which have teaching hospitals with over 200 beds and high bed occupancy, the majority don’t. More than threefourths of these colleges are private and a large number have been mired in controversies over meeting the minimum standards prescribed, not very different from private allopathy colleges.

Land is one of the most expensive investments and salaries among the biggest chunks of expenses for any medical college. If minimum requirements for allopathic colleges were brought down to the level of ayurveda colleges, arguably hundreds more of them could be opened. But would that be desirable or would it bring down the quality of training and teaching? If so, it raises questions about equivalence too.

A misguided policy that cuts deep into patient safety

noreply@blogger.com — Tue, 01 Dec 2020 17:51:00 GMT

It is impossible for Ayurveda to incorporate surgical techniques while ignoring the other domains of modern medicine

The basic requirement of medical practice is the safety of the patient. Surgery is a branch of medicine in which poor training can have dramatic and disastrous results. This is the strongest argument against the ill-advised move of the government of India to allow graduates in Ayurveda to practise surgery.

Apprenticeship is key

Surgery in the present era is an interdisciplinary endeavour. A well-trained anaesthesiologist keeps the patient free of pain. Other specialist doctors address any other illnesses that the patient has before surgery can be safely performed. The well-trained surgeon must have a good knowledge of the structure of the human body in health and disease. This is one branch of medicine where knowledge can only be acquired through apprenticeship — that is, the learner needs to be guided by an expert. It takes many years and much exposure before a graduate in medicine can safely perform surgery. It is an aphorism in modern medicine that a surgeon needs to know not only how to perform surgery, but when. Importantly, the surgeon needs to know when not to perform surgery, a skill commonly called clinical judgement. These skills are difficult to teach and difficult to master.

Errors in surgery can be devastating. Data from the United States suggests that up to 4,000 surgical errors occur each year despite well-considered controls on who can perform surgery. Efforts to reduce this rate focus on better training. Besides professional codes, legal mechanisms have been developed to ensure safe medical practice.

In India, the Consumer Protection Act serves as an incentive to modern medical practitioners to provide high quality health care. Even this legal mechanism is not accessible to the poor. It is quite clear that there is no shortcut to safe surgical outcomes. One simply cannot get away from it — safe surgery requires years of training.

The idea of competence without comprehension should not beguile us into believing that surgery is a suitable subject for its application. Anecdotes of people not educated, but able to perform complex tasks should be understood in the framework of the psychologist Rasmussen’s Skill, Rule and Knowledge-based Error model. Some complex tasks are a set of repetitive steps where the person acquires proficiency merely by practice, for example, using a complex machine without knowing how it works. This is not applicable in surgery where novel situations are often encountered and a good knowledge base is essential to solve problems which may not have been previously encountered.

What constitutes safe surgery

Modern medicine is an integrated whole in which specialties have developed from the understanding that the knowledge base is so vast that a single human can only ever hope to master a few of the domains required in order to provide the best possible outcomes to patients. Modern medical training consists of a basic degree during which the fundamentals of the functioning of humans in health and disease, and techniques to diagnose illnesses are taught. Increased knowledge in various domains is obtained through post-graduate training. All these domains work together in order to ensure safe surgery. It is impossible for Ayurveda to incorporate surgical techniques while ignoring all the other domains of modern medicine and still perform surgery safely and effectively.

What is scientific knowledge? How is it to be transmitted? Is there any sound basis for different scientific systems in the modern world? More specifically, can there be fundamentally different explanations of how the human body is structured and functions? These are all important questions and have implications for policy in health care. Important decisions with potential to seriously harm thousands of people should not be casually made without clear answers.

Safe and effective health care should not become a casualty of a misguided desire to protect indigenous systems. Traditional knowledge in India has become the victim of self-serving apparatchiks who have fossilised it, preventing its development and growth. Human knowledge is a universal resource, ever growing. The way forward is to incorporate traditional medical systems into modern medicine.

Could deepen inequity

The quality of medical care received in India is highly dependent on personal resources. Surgical facilities manned by graduates of Ayurveda will be patronised only by the very poor who do not have the resources to access modern medical care. This will further entrench the existing grossly unequal access to health care. An epidemic of catastrophic complications, disproportionately affecting the poor can be expected if surgical procedures are performed by the poorly trained.

There is a shortage of trained medical personnel in rural areas. The only way to address this is to greatly increase the number of government medical colleges. This will take a few years, but it is a safe and effective policy. Safety of patients should not become a victim of misguided policies based on poor understanding of what safe surgery requires.

Dr. George Thomas, an orthopaedic surgeon practising in Chennai, is the former editor of the ‘Indian Journal of Medical Ethics’.

The surgeon soldiers

noreply@blogger.com — Sun, 29 Nov 2020 13:48:00 GMT

How Army doctors set a record of the world’s highest-altitude major surgery

S.G. Vombatkere

The soldier protects our nation’s borders with determination, grit and courage, living and fighting all along our Himalayan borders from Ladakh in the west to Arunachal in the east.

A soldier’s life in forward areas is extremely tough. In high-altitude areas (HAA, in Army parlance), it is doubly so because the oxygen intake is halved. Low oxygen, combined with sub-zero temperatures further lowered by wind-chill, seriously affects physical efficiency, as anyone who has served at altitudes of over 12,000 ft (3,700 m) knows. Even routine activities are necessarily slow and difficult, sometimes even painful. Prolonged isolation and loneliness are an additional psychological burden.

Extreme cold, low oxygen intake and treacherous terrain combine as an ever-present risk to life and limb for every soldier, quite apart from the risks of the enemy’s bullet, grenade, bomb and shell.

In these harsh conditions, the soldier-doctors of the Army Medical Corps (AMC) provide succour and help to the injured or ill soldier, right up to the forward areas, with provision for medical evacuation to hospitals, when necessary.

A soldier was treated for appendicitis by Army doctors. This would not even deserve mention but for the fact that the surgery was successfully performed at an altitude of 16,000 ft (4,900 m). The delicate, major surgical procedure was conducted in one of the HAA Forward Surgical Centres (FSCs) constructed in a partially underground dug-out space equipped with a field operating theatre.

On October 28, a 27-year-old jawan (name, unit and location withheld for security reasons) was brought to the FSC with acute abdominal pain. It was rapidly diagnosed as appendicitis, with risk of rupture and fatal consequences. There was no time to evacuate the jawan to a hospital. Immediate surgery was imperative.

The young surgical team consisting of a surgeon and an anaesthetist, assisted by the jawan’s unit MO (names withheld for ethical reasons), rose to the occasion. They took the decision to perform an emergency appendectomy.

According to details received, surgery was commenced under spinal anaesthesia but since the appendix was subhepatic with impending perforation, they had to convert to general anaesthesia. Major surgery was completed successfully in harsh and difficult field conditions. The patient had an uneventful post-operative condition and remained medically stable.

This sets a creditable military-medical record of the world’s highest altitude major surgery, to add to the proud military traditions of India’s Army Medical Corps.

A soldier’s precious life was saved, thanks to the timely decision and competence of the battle-front saviours in the FSC.

The author was commissioned into the Madras Sappers in 1962. In 1993, he was awarded the Vishisht Seva Medal (VSM). He retired in 1996 in the rank of Major General. sg9kere@live.com

Ayurvedic doctors and sanction for surgeries

noreply@blogger.com — Sun, 29 Nov 2020 03:13:00 GMT

Dr Anant Bhan

Is allowing Ayurvedic doctors to perform surgery legally and medically tenable? What are the issues around allowing non-allopathic surgeons to receive training for various procedures?

The story so far: On November 20, the Central Council of Indian Medicine, a statutory body set up under the AYUSH Ministry to regulate Indian systems of medicine, issued a gazette notification allowing postgraduate (PG) Ayurvedic practitioners to receive formal training for a variety of general surgery, ENT, ophthalmology and dental procedures. The decision follows the amendment to the Indian Medicine Central Council (Post Graduate Ayurveda Education) Regulations, 2016, to allow PG students of Ayurveda to practise general surgery.

Is allowing non-allopathic doctors to perform surgery legally and medically tenable?

The passing of the National Medical Commission Act in 2019 allowed for the formalisation of proposals to induct mid-level care providers — Community Health Providers — in primary healthcare in India, who would serve at health and wellness centres across the country, and focus on primary healthcare provision, with a limited range of medicines allowed for them to use for treatment of patients. This move had also attracted strong opposition from modern medicine practitioners, who branded this as a form of quackery through half-baked doctors. Several countries have been using mid-level care providers, such as nurse practitioners, to enhance the access to healthcare, though with strict safeguards around training, certification, and standards.

The current debate revolves around the Central Council of Indian Medicine issuing amendments to the Indian Medicine Central Council (Post Graduate Ayurvedic Education) Regulations, 2016, to allow postgraduates students in Ayurveda undergoing ‘Shalya’ (general surgery) and ‘Shalakya’ (dealing with eye, ear, nose, throat, head and neck, oro-dentistry) to perform 58 specified surgical procedures. This was immediately opposed by many allopathic professionals, with the Indian Medical Association (IMA) decrying it as a mode of allowing mixing of systems of medicine by using terms from allopathy. The AYUSH Ministry subsequently clarified that the ‘Shalya’ and ‘Shalakya’ postgraduates were already learning these procedures in their (surgical) departments in Ayurvedic medical colleges as per their training curriculum, and the amendment merely added clarity and definitions to the 2016 regulations concerning post-graduate Ayurveda education.

Can short-term training equip them to conduct surgeries and will this dilute the medicine standards in India?

As such, the postgraduate Ayurvedic surgical training is not short-term but a formal three-year course. Whether the surgeries conducted in Ayurvedic medical colleges and hospitals have the same standards and outcomes as allopathic institutions requires explication and detailed formal enquiry, in the interest of patient safety.

Will non-allopathic doctors who have undergone training be restricted to practise in rural areas having poor doctor-patient ratios?

As of now, no such restriction exists that limits non-allopathic doctors, including those doing Ayurvedic surgical postgraduation, to rural areas. They have the same rights as allopathic graduates and postgraduates to practise in any setting of their choice.

With allopathic surgeons often unwilling to practise in rural areas, how can this problem be solved?

The shortage and unwillingness of allopathic doctors, including surgeons, to serve in rural areas is now a chronic issue. The government has tried to address this by mechanisms such as rural bonds, a quota for those who have served in rural service in postgraduate seats, as well as, more recently, a plan to work on increasing the number of medical colleges and postgraduate seats. However, we would probably still continue to fall short of enough trained specialists in rural areas. We need to explore creative ways of addressing this gap by evidence-based approaches, such as task-sharing, supported by efficient and quality referral mechanisms. The advent of mid-level healthcare providers, such as Community Health Providers in many States, is also an opportunity to shift some elements of healthcare (preventive, promotive, and limited curative) to these providers, while ensuring clarity of role and career progression.

Is it sensible to allow Ayurvedic surgeons to only assist allopathic surgeons, rather than perform surgeries themselves?

The AYUSH streams are recognised systems of medicine, and as such are allowed to independently practise medicine. They have medical colleges with both undergraduate and postgraduate training, which include surgical disciplines for some systems, such as Ayurveda. There is, however, a difference in approach in the systems of medicine, and hence models, which allow for cross-pathy. An apprenticeship model for Ayurvedic surgeons working with allopathic surgeons might fall into a regulatory grey zone. It might require re-training Ayurvedic practitioners in the science of surgical approaches in modern medicine. Even then, there might be a limit to what they are allowed to do. Any such experiment can put patient safety in peril, and hence, will need careful oversight and evaluation.

Can this lead to substandard care?

Many patients prefer to receive treatment exclusively from AYUSH providers, while some approach this form of treatment as a complement to the existing allopathic treatment they are receiving. For invasive procedures, like surgery, the risk element can be high. Patients have a right to know and understand who their surgeon would be, what system of medicine they belong to, and their expertise and level of training. There should not be a difference in quality of care between urban and rural patients — everyone deserves a right to quality and evidence-based care from trained professionals.

Dr. Anant Bhan is a researcher in global health, bioethics and health policy

Also read | West Bengal doctors’ body opposes move to permit surgery by Ayurveda students

West Bengal doctors’ body opposes move to permit surgery by Ayurveda students

noreply@blogger.com — Sun, 29 Nov 2020 03:08:00 GMT

A leading doctors’ body in West Bengal has strongly opposed the Centre’s decision to train practitioners of alternative medicine to perform surgical procedures, saying such ‘crosspathy’ or ‘mixopathy’ was anti-people and anti-science.

Last week, the Central Council of Indian Medicine issued a notification allowing post-graduate scholars of the Shalya and Shalakya streams of Ayurveda to independently perform 58 kinds of surgeries including those related to the eye and the ears, nose and throat. The Council subsequently issued a ‘clarification’ saying these surgeries were being performed by Ayurveda professionals “since beginning” and that all scientific advances including standardised terminologies were inheritances of entire mankind and no group could claim monopoly over these.

“We don’t have any disregard for other streams of medicine; in fact, we have great respect for ancient medicine. But just as how I am not competent to prescribe Ayurvedic medicines, can an Ayurveda practitioner perform surgeries?” asked Dr. Koushik Chaki, a founding member of the West Bengal Doctors’ Forum. The Forum plans to write to the Prime Minister and the Health Minister against what it calls a “regressive step”.

“For surgery you need anaesthesia and antibiotics. Does Ayurveda have them? If Ayurveda develops its own anaesthesia and antibiotics, I am fine with it; if people choose to get operated upon by an Ayurveda practitioner, I am fine with that too. But you cannot accord legal status to what we call crosspathy or mixopathy. It is anti-people and anti-science,” Dr. Chaki told The Hindu.

Medicine, he said, was an evolving field and treatments changed with time and that mixing several branches of therapy like modern medicine, homeopathy and AYUSH may have a detrimental effect on health.

“We should welcome new studied and tested methods rather than being regressive. Once upon a time you used pigeons to carry mail. Today, when you have email, would it make sense to go back to pigeons?” he asked.

The Forum has asked doctors’ bodies across the country to “unitedly fight and resist the anti-people, anti-science and antigenic dictum.” It has already initiated an online campaign, asking people to say “no to crosspathy” and ‘no to bridge course”.

The Hindu, 23-11-2020

No service quota for super-specialty medical courses this year: SC

noreply@blogger.com — Fri, 27 Nov 2020 12:38:00 GMT

The Supreme Court has ordered that 50% reservation for in-service doctors (doctors in government service) in super-specialty courses shall not be implemented in the current academic year. The order came after petitions challenged the stance taken by Kerala High Court and Madras High Court on the matter. According to reports, a Supreme Court bench headed by Justice L Nageswara Rao passed the orders on Friday, in which it said that the reservation for doctors in government service for postgraduate super-specialty courses shall not be implemented in the current academic year (2020-21).

The court was hearing a petition that challenged the Madras HC’s order allowing the state government to reserve 50% seats in postgraduate medical courses for doctors in government service. The government of Tamil Nadu had passed a government order (GO) on November 7 providing 50% reservation in post-graduate and postgraduate super-specialty courses for doctors who are in government service. This reservation was scheduled to be implemented in academic years 2021-22 (for postgraduate courses) and in 2020-21 (for super-specialty courses).

The Union government had opposed this reservation being implemented in the current academic year and had argued in the apex court that passing a GO after the super-specialty admissions had commenced is like specifying the rules of a game after the game has started. The Medical Council of India (MCI) had also opposed the GO by the state government. The Supreme Court accepted the argument made by the MCI that the prospectus issued for super-specialty admissions did not have information about the reservation and hence it is not fair to the applicants.

The order passed on Friday is an interim order and detailed orders on this matter will be passed in January after further hearing, as per reports.

The Madras High Court had, on November 9, upheld the service quota in medical admissions by the government of Tamil Nadu. The state government had, reportedly, passed the GO because it needs more super-specialty doctors as it needs more professionals who can offer high-end surgeries free of cost to people who choose to get treated at government healthcare facilities.

Supreme Court reserves order on in-service quota for medical admissions

noreply@blogger.com — Thu, 26 Nov 2020 15:24:00 GMT

The Supreme Court on Wednesday reserved its order on the interim question whether Tamil Nadu and Kerala should provide 50% in-service reservation for admissions to super-specialty medical courses in government colleges for the current academic year.

A Bench led by Justice L. Nageswara Rao was hearing a batch of pleas filed by doctors, including postgraduate holders qualified in NEET 2020, challenging reservation of seats for in-service candidates in super-specialty courses.

The Tamil Nadu government argued that there was an acute need for super-specialty qualified doctors both in the medical academia and in practice.

The States argued that preparation for admission to these courses had started almost immediately following the Constitution Bench judgment on August 31. The judgment had empowered States to devise a separate channel of entry for in-service doctors. “State has the legislative competence and authority to provide for a separate source of entry for in-service candidates seeking admission to postgraduate degree/diploma courses in exercise of powers under Entry 25, List III,” the apex court had concluded in the August 31 verdict.

Senior advocate P. Wilson, for caveators, submitted that the issue of in-service reservations to government doctors was already settled. “The matter is being re-agitated again and again,” he said.

Both Madras and Kerala High Courts had not intervened with the States’ move to provide in-service reservation.

However, the doctors, who have challenged the quota, refer to a 1999 Constitution Bench verdict in their favour. This judgment, they said, had held that “merit, and merit alone, is the basis for admission at the super-specialty level”.

One of the pleas challenged a November 7 order of the Tamil Nadu government allowing the Secretary, Selection Committee, to conduct counselling and fill 50% of the super-specialty seats in the government medical colleges with in-service candidates in the State.

The appeal argued that the State order was contrary to the Postgraduate Medical Education (Amendment) Regulations of 2019, which mandated that the Directorate General of Health Services should be in charge of the admission process.

“There is no concept of any reservation for admission to super-specialty medical courses,” they contended.

Centre asks states to take steps to reopen medical colleges from or before Dec 1

noreply@blogger.com — Thu, 26 Nov 2020 15:18:00 GMT

The Union Health Ministry Wednesday asked state governments to initiate steps for reopening of medical colleges from December 1 or before it, but with strict adherence to all Covid-19 related guidelines. Educational institutions in the country have been closed since March in view of the coronavirus pandemic.

In a letter to the chief secretaries and the administrators of all states and Union Territories, Union Health Secretary Rajesh Bhushan also suggested making non-Covid beds available in sufficient numbers in affiliated medical college-hospitals to facilitate undergraduate training.

The Health Ministry has obtained concurrence from the Ministry of Home Affairs for re-opening of medical colleges, the letter mentioned.

“Accordingly, the states and UTs may take necessary steps to open the medical colleges on or before December 1, 2020,” the health secretary said in his letter dated November 25.

“Needless to say, all SOPs/guidelines with respect to social distancing and prevention of spread of epidemic issued by Central/states and UT governments will be followed scrupulously by all the colleges,” he said.

The Centre’s directive comes in the wake of the National Medical Commission recommending reopening of medical colleges from December 1 or before it for the MBBS students already pursuing their courses.

The NMC, which has received representations from students and medical colleges, noted that the current batch of interns (2020) have not completed their required clinical training and unless they do it, they would not be eligible for appearing for the PG-NEET exam. It also noted that the PG-NEET exam for the academic year 2021-22 has been delayed as the eligible candidates will be completing their training late. Their training is required to be completed at the earliest so that the PG -NEET exam for the academic year 2021-22 can be held accordingly, it said.

“Delay in resuming the training would have a cascading effect on training of next PG and super-speciality courses in the coming years,” the NMC noted.

“The delayed new academic session for 2020-21 should commence from February 1, 2021. The new PG session for the academic year 2020-21 should begin from at least July 1, 2021 and therefore the PG-NEET exam for AY 2020-21 would need to be scheduled around March-April 2021,” the NMC said in a communique to the Health Ministry on November 12.

With opening of medical colleges and to facilitate UG training, all medical colleges affiliated hospitals would need to have sufficient number of beds for non-COVID patients and hence facilities for both outpatient and inpatient management for non-COVID patients must be re-started, if not already done, the NMC stated.

Further, it noted that the students today (and would-be doctors tomorrow) should also be familiar with the inherent threats and opportunities in healthcare systems which they would eventually handle themselves. It should not become a missed opportunity for medical students to learn the skills of epidemic management as public health professional, the NMC said.

Duty Hours of Resident Doctors

noreply@blogger.com — Thu, 08 Oct 2020 06:48:00 GMT

Duty hours of resident doctors as per Central Residency Scheme.

Hindu Rao Doctor Terminated, IAS Officer Brags on Twitter

noreply@blogger.com — Thu, 16 Apr 2020 17:49:00 GMT

Orthopaedics junior resident terminated, will not be able to complete DNB course

A junior resident doctor from North Delhi Municipal Corporation''s (North DMC) Hindu Rao Hospital was terminated by the hospital authorities allegedly after he posted a video on his social media page complaining about the mismanagement in the hospital. "The Doctor in the Orthopedics department is terminated from his services with immediate effect for bringing disrepute to the institution," a letter from the hospital said.

The doctor, however, has refuted the allegations made by the hospital administration and claimed that the termination came after he distributed face shields procured through an NGO, among the residents doctors.

"I had distributed face shields among the doctors which I got from an NGO, but the Medical Superintendent of the hospital told me to return them. I even tried getting them back but the other doctors denied returning them, and now this has caused me the job," doctor Piyush Singh, DNB (Ortho) told IANS.

However, senior authorities in the hospital claimed that the termination came for a video that Singh posted about a month ago, where he was seen showing leaking water from hospital ceiling and other mismanagement. Singh was also given a show cause notice for the same by the hospital authorities.

"You have bypassed the available channels to you for addressing your grievance and directly recorded it to social media, which is an objection," the letter issued on March 16 read.

Singh was then given 24 hours to explain himself, however the termination after a month has left Singh questioning.

"I had then written various apology letters and also explained myself before each authorities that I did not post the video, but had just shared someone else''s post on my timeline. I was told that the matter and over and I continued to go to the office," Singh claimed.

Meanwhile, in a brazen display of administrative terrorism against doctors, NDMC Commissioner Varsha Joshi (IAS) has come out in defence of the hospital authorities & made it clear that the termination order was served as per her instruction. In a series of tweets reflecting her authoritarian attitude and lack of respect towards established democratic norms, she has made unverified allegations, used unparliamentary language and made derogatory comments on the doctor's conduct and character, which amount to violation of CCS (Conduct) Rules, 1964. In one tweet, she mentions: "...and directed his termination only, so that he can pursue his career elsewhere, since I certainly don't want such folk HERE." In another vindictive tweet, she says: "If some other organisation wants such folk, well, you're welcome to him." Going a notch above, in another tweet she accuses the doctor of theft and threatens him: "The thief. If I wanted to "kill" I would have started proceedings under the Act. I still can, would you like that?" At a time when Prime Minister Narendra Modi has expressed his gratitude towards doctors and the whole nation has echoed his words, use of such language and that too on social media is totally unwarranted. By her words and action, she has brought a bad name not only to herself and NDMC, but also to the esteemed civil services to which she belongs. Resident doctors who are the on-ground Covid warriors across the nation are seething in anger at such autocratic behaviour and injustice meted out to one of their colleagues, who had done no wrong other than ensuring adequate Personal Protective Equipments (PPE) for frontline covid workers.

A doctor from Hindu Rao Hospital, on conditions of anonymity, informed: "Dr. Piyush had done no wrong. As the authorities were unable to arrange adequate PPEs, he took the initiative to contact an NGO and arrange PPEs for us. Two days ago, he even paid from his own pocket to arrange face shields & PPEs for some of us who are posted in high-risk wards. Is it wrong to arrange adequate protection for ourselves? And these are not govt. supply, then why should it be routed through the hospital store? Few days ago, the doctors and nurses of Hindu Rao Hospital who submitted their resignation due to lack of PPE were being threatened by the administration for disciplinary action. On what basis do they take action? Doctors are under no obligation to work without protective equipments. The Commissioner considers NDMC as her private property. She has terminated him just to instil fear in us so that we do not speak about the shortage of PPE. Termination of a junior resident means he would not be able to complete his DNB postgraduate course, thus destroying his career. We are not going to accept this lying down."

Further Reading:

Hindu Rao doctor's services terminated for 'bringing disrepute': https://www.hindustantimes.com/delhi-news/hindu-rao-doctor-s-services-terminated-for-bringing-disrepute/story-GSxwtYUV1FiJ5jNRHuTCZN.html
Hindu Rao doc dismissed for uploading hospital's video on social media: https://www.aninews.in/news/national/general-news/hindu-rao-doc-dismissed-for-uploading-hospitals-video-on-social-media20200416172342/
Delhi hospital sacks doctor for social media post: https://www.outlookindia.com/newsscroll/delhi-hospital-sacks-doctor-for-social-media-post/1804303
Four Hindu Rao Hospital doctors resign, warned of action by administration: https://timesofindia.indiatimes.com/city/delhi/delhi-four-hindu-rao-hospital-doctors-resign-warned-of-action-by-administration/articleshow/74940804.cms
Delhi municipal doctors protest 'faulty' Covid-19 protection, get warning: https://www.ndtv.com/delhi-news/coronavirus-delhi-municipal-doctors-protest-faulty-covid-19-protection-get-warning-2204734
Doctors are stricken, gear concern mounts: https://www.telegraphindia.com/india/coronavirus-outbreak-doctors-are-stricken-gear-concern-mounts/cid/1761599
दिल्ली के हिन्दूरावअस्पताल ने डॉक्टरको किया बर्खास्त, लगा गंभीर आरोप: https://www.jagran.com/delhi/new-delhi-city-ncr-delhis-hindu-rao-hospital-terminate-a-junior-resident-doctor-for-indiscipline-20194989.html

Personal Protective Equipment (PPE) - Every Healthcare Worker's Right

noreply@blogger.com — Sun, 22 Mar 2020 07:38:00 GMT

There is no emergency in a pandemic

This article is for the healthcare workers, doctors, surgeons, nurses, aides, EMS and all staff. This article should be read along with many news reports of doctors dying from COVID-19 throughout the world. Do not repeat the same mistakes that they made. If you do not have proper PPE, do not go in. No matter what. There is no emergency in a pandemic.

You as a healthcare worker are a force multiplier. Your training and experience are invaluable moving into this crisis. So, you're going to be faced with some very difficult moments. You're going to have to put your needs first. I'm speaking specifically about PPE and your safety.

If you're an ICU doctor or an ICU nurse, and you become infected, not only are you out of the game for potentially weeks (or killed), but your replacements could be people without your expertise. Your remaining co-workers are short-staffed now, more likely to make mistakes and become ill themselves. You stop being a force multiplier and start using healthcare resources.

Your going in may save the patient, it may not. But you can't save any patients in the weeks you are lying in a hospital bed or using a vent yourself. People are going to die. Do not become one of them. There is no emergency in a pandemic.

You may work in long term care, and want to rush in to save a patient you have had for years. Do not go in without your PPE. You may have a survivor in the room, screaming at you to come in because their mother is crashing. Do not go in without your PPE. You may have an infected woman in labour screaming for help. Do not go in without your PPE. You may have a self quarantined patient with a gunshot wound and is bleeding out. Do not go in there without your PPE. There is no emergency in a pandemic.

Doing nothing may be the hardest thing you've ever had to do in your life. Many of you say I could never do that. I wouldn't be able to stop myself from rushing in and saving my patient. Many nurses and doctors said the same thing, and many did run in to help, saying PPE be damned, my patients need me. Then they became infected, they infected others. And they died. They didn't help anyone after that.

In Italy, 8% of COVID-19 cases are medical staff. Do not let the deaths of hundreds of healthcare workers be forgotten. Do not repeat the same errors made by medics in other nations. Be prepared, protect yourself, stay alive to treat the patients and fight the pandemic.

References:

Europe’s Doctors Repeat Errors Made in Wuhan, China Medics Say https://www.bloomberg.com/news/articles/2020-03-17/europe-s-doctors-getting-sick-like-in-wuhan-chinese-doctors-say
Thirteen medics have died in Italy, over 2600 health workers infected https://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=12318564
Lancet piece warns of threat to doctors & paramedics https://timesofindia.indiatimes.com/india/lancet-piece-warns-of-threat-to-doctors-paramedics/articleshow/74740402.cms
WHO Warns: Health Workers Endangered Worldwide by Shortage of Personal Protective Equipment https://scitechdaily.com/who-warns-health-workers-endangered-worldwide-by-shortage-of-personal-protective-equipment/
Marcello Natali, Italian doctor who exposed supply shortage, dies from coronavirus https://nypost.com/2020/03/19/marcello-natali-italian-doctor-who-exposed-supply-shortage-dies-from-coronavirus/
Coronavirus kills Chinese whistleblower doctor https://www.bbc.com/news/world-asia-china-51403795
Several young doctors in China have died of the coronavirus https://www.businessinsider.in/science/news/several-young-doctors-in-china-have-died-of-the-coronavirus-medical-workers-are-far-more-vulnerable-to-infection-than-the-general-population-/articleshow/74417449.cms
Europe’s Desperate Doctors Are Shielded by Trash Bags https://www.bloomberg.com/news/articles/2020-03-21/europe-s-desperate-doctors-are-shielded-by-trash-bags
China’s Doctors, Fighting the Coronavirus, Beg for Masks https://www.nytimes.com/2020/02/14/world/asia/china-coronavirus-doctors.html
Hospital director dies in Wuhan as China designates dead nurses and doctors as 'martyrs' https://edition.cnn.com/2020/02/17/asia/coronavirus-covid-19-update-intl-hnk/index.html
Karnataka doctor who treated India's first coronavirus victim tests positive https://timesofindia.indiatimes.com/city/hubballi/doctor-who-treated-indias-first-coronavirus-victim-also-tests-positive/articleshow/74668229.cms
NHS staff protection 'short of WHO guidelines' https://www.bbc.com/news/uk-51989700
NHS doctors feel like ‘lambs to slaughter’ without protective kit, warns senior medic https://www.independent.co.uk/news/uk/politics/url-coronavirus-uk-update-nhs-boris-johnson-covid-19-latest-a9416586.html

Coronavirus pandemic: Grim prognosis, tough drill

noreply@blogger.com — Thu, 19 Mar 2020 09:45:00 GMT

Social distancing of entire populations may be inevitable for countries wishing to suppress the novel coronavirus, scientists have said in a study that has also predicted tens of thousands of deaths even with the strongest measures.

The study by Imperial College, London, has suggested that effective suppression of the epidemic would require a combination of four interventions — social distancing of entire populations, home isolation of positive cases and home quarantine of their family members and closure of educational institutions.

The coronavirus, reported by China to the World Health Organisation on December 31, 2019, has since then spread to 164 countries, infected 212,000 and killed over 8,700 people.

Epidemiologist Neil Ferguson and his colleagues who used mathematical models to predict coronavirus epidemic scenarios have shown that suppression — an effort to prevent an infected person from transmitting the virus to even one other person — is the “only viable strategy” at the current time.

Their description of social distancing of entire populations is: all households reduce contact outside household, school or workplace by 75 per cent, school contact rates remain unchanged, workplace contact reduced by 25 per cent and household contact increased by 25 per cent.

Their findings, intended to guide government policy makers, indicate that even the most effective alternative strategy of mitigation — an effort to slow the infection spread and reduce incidence and deaths — would lead to hundreds of thousands of deaths and overwhelm hospitals.

The most optimistic mitigation options — a combination of home isolation of positive cases, home quarantine of their family members, and social distancing of the elderly and people at the highest risk of severe disease — would lead to around 250,000 deaths in the UK and 1.1 million deaths in the US.

The scientists assumed an infection fatality ratio of 0.9 per cent with 4.4 per cent infections hospitalised and 30 per cent of hospitalised cases requiring critical care beds. Even under the best mitigation scenario, the peak demand for critical care beds in the UK would exceed surge limits by eightfold.

Under the combination of four interventions aimed at suppression, the predicted deaths in the UK fall to 39,000.

The study has shown that, for the UK, suppression would be best initiated early in the epidemic when the demand for critical care is around 200 per week and keep the demand for critical care below the UK’s surge limit capacity.

Scientists believe the study’s findings could have broad implications for India although they caution that it is too early to predict the behaviour of the virus in the country because there is no evidence for community transmission yet.

“The paper validates the social distancing measures implemented by India,” said Tarun Bhatnagar, a senior scientist at the National Institute of Epidemiology, Chennai, who is currently pursuing a study to model coronavirus scenarios in the country.

The findings underscore the need for appropriate timing of the mitigation measures, Bhatnagar said. There may be need to implement the mitigation measures more than once.

The Imperial College researchers have said the suppression strategies might need to be maintained until stocks of a vaccine are available to immunise the population, which could take at least 18 months.

“However, we emphasise that it is not at all certain that suppression will succeed long term,” Ferguson and his team said in their paper. “No public health intervention with such disruptive effects on society has been previously attempted for such a duration of time. How populations and societies will respond remains unclear.”

Nod for 4,800 more medical PG seats

noreply@blogger.com — Tue, 17 Mar 2020 09:19:00 GMT

The Medical Council of India’s board of governors has approved increasing postgraduate medical seats for MD and MS programmes by over 4,800 to 36,192 for the next academic session, an official said on Monday.

BoG chairman and Niti Aayog member V.K. Paul said the increase is more than the total number of additional seats created in the past five years.

“The Narendra Modi government in 2014 had promised to double PG and UG medical seats by 2024. So, in that direction the board of governors-vested with power of the Medical Council of India has given its approval to increase postgraduate medical seats (broad speciality) in 2020-21 session by 4,807.

“So, as a result, in the new academic session counselling, 36,192 PG medical seats (MD/MS, broad speciality) will be available,” Paul said.

Paul also said the capacity expansion would improve tertiary care in the country.

“In 2020-21 academic session, approximately 44,000 postgraduate medical seats (36,192 MD/MS seats and 8,000 DNB/FNB seats) will be available for 54,000 undergraduate MBBS pass-outs,” he said.

MS is the postgraduate degree in general surgery, while MD is the postgraduate degree in general medicine. In 2014-15, there were over 23,000 PG medical seats in both government and private medical colleges.

Paul said the Niti Aayog is working with the health ministry to encourage large hospitals to offer resident doctors Diplomate or Fellow of National Board (DNB/FNB) courses.

Recently, to address the shortage of qualified doctors, the Niti Aayog had come out with the public-private partnership model to link new or existing private medical colleges with district hospital to augment medical seats.

Testing enough? With a billion plus populace, failing to ramp up testing will make Covid-19 unmanageable soon

noreply@blogger.com — Mon, 16 Mar 2020 04:08:00 GMT

Indian Council of Medical Research’s warning that India has 30 days to halt the onset of Stage-III or community transmission of the novel coronavirus must kick off wider testing. ICMR has said that disease transmission is now limited to those with travel history to affected countries and those in contact with them. This is not as reassuring as it sounds. For every traveller reaching India and subsequently seeking medical help, there are too many loose ends in their whereabouts for public health authorities to tie up. Moreover, screening efforts at airports miss out many asymptomatic travellers.

This is where wider testing and greater access to testing facilities can nip community transmission in the bud. The 60-odd labs notified by ICMR for testing swabs – and a similar number of sample collection centres – can conduct nearly 5,000 tests daily. But these get just 60-70 samples per day according to ICMR officials. Large, populous states like UP, Bihar and Rajasthan having just 2-3 sample collection centres is woefully inadequate. Government claims it has 1 lakh test kits and made orders for 2 lakh more. However, until March 13 India had performed just 6,500 tests on 5,900 individuals, mostly in 2-3 states, much too few for a 1.4 billion population. Equally important is that test results must return quickly in a matter of minutes or a few hours, not 1-2 days as presently experienced in many places.

South Korea’s success in shrinking fresh cases without resorting to lockdowns was achieved by conducting a whopping 10,000 tests a day. China’s makeshift fever clinics, though initially panned for allowing potential carriers to congregate, prevented overcrowding inside hospitals and offered quick testing facilities. Quick turnaround times ensured patients couldn’t slip away, a problem India faces presently.

News reports and social media accounts in recent days raise doubts about preparedness. Hospitals without adequate doctors and protective gear have been reported in and around the national capital itself. Functioning of state helplines and their capability to address heavy patient load needs scrutiny. Doctors must be able to send more patients for testing and frequently get themselves tested. Roping in the private sector – for setting up fever clinics, manufacturing test kits and handling diagnostic logistics – will improve access. With nearly a million registered doctors and over two million registered nurses and ASHA workers, execution of plans must proceed on a war footing. India shouldn’t become the next big country to be caught napping.

This piece appeared as an editorial opinion in the print edition of The Times of India.

NEET-PG 2020 Counselling Notification

noreply@blogger.com — Fri, 06 Mar 2020 09:24:00 GMT

Online counselling likely to start from 12th March 2020.

Money and Health - heading for the abyss

noreply@blogger.com — Wed, 26 Feb 2020 08:39:00 GMT

By Dr Jimmy Mathew

It was 2006. I had become a Plastic Surgeon. After four and a half years of MBBS, I did One year of that rotating slave work called internship. Then three years of surgical residency at JIPMER. I had done eighty to hundred hours of work per week in those years, and I didnt know what a weekend really was. Of course, I knew drunken nights, and smoked for two years during that period, and my eating habits were the worst in the world. Have no doubts- my arteries were hardened, head baldened and a little of the nicer part of my predisposition erased permanently.

Three more years of mostly assisting, retracting, dressing wounds, taking calls and pointlessly sleepless nights made me A Plastic Surgeon. Now I had a wife and a daughter. No weekends.

It was immediately after that I joined a well known private hospital as the third person in the Plastic Surgery team. I was offered thirty thousand rupees a month. I accepted. The centre was very busy and well known for micro surgery and trauma reconstruction. The point, we young doctors knew, was not money, but experience. I had to take calls on alternate days. I did Three to four surgeries every other night. Every day we had surgeries and outpatient clinic filled with follow up dressings, while patients with slit wrists, amputated hands and legs with trucks run over them poured into the emergency room.

Now- there is nothing more irritating than a whining physician.

Why the fuck did you take it up in the first place? Did anyone force you to take medicine?

I can’t lie to you. I did not take medicine for the sole purpose of serving humanity. I don’t even believe that humanity can be saved that easily.

I went for it because I could get into a Medical School. I thought that it was a profession that is supposedly good, and well thought of by many. I also hoped that the money would be enough to lead a good life.

May be I could serve some patients, but that was merely an afterthought.

I was a selfish bastard, and hence no more whining.

One night, an eighteen year old boy was brought with burns. He had tried to kill himself.

I was on call, and examined him carefully after first aid. He had burned over fifty percent of his body. It was not easy to save him. In fact, it was very difficult. There was a good chance that in spite of our best efforts, he would die. One had to tell this, and that- to the boy’s mother and father.

This was one of those situations where you ardently wish one had never taken medicine. These situations do arise, and too frequently, in my opinion. Again, no whining. I do forget.

It takes an hour of talk, emotionally wrenching, at one in the morning.

The family wants us to go all out.

We do an excision and grafting. The burnt skin gets colonised by bacteria, and then they invade the body. Taking out charred skin and putting new skin from intact parts of the body is the accepted procedure all over the world. We did two such surgeries. He needed daily dressing changes under general anaesthesia. He had to be on the intensive care unit. In spite of these treatments, the second week he developed a massive blood infection, and had to be put on ventilator. Anti-biotics, worth tens of thousands of rupees per vial were given, as per culture and sensitivity reports.

Meanwhile, every day we talked to the parents half an hour to one hour every day and prepared them for the worst.

Our routine work continued unabated.

He died on the third week. It was a Sunday, and I was called urgently to the ICU. A crowd had gathered. Local politicians, goons and a bevy of ruffians were beating up security men, while nurses scurried like mice. A bearded bloke caught me by the collar.

“You murderer, you killed him.”

I felt numb. My mind was blank- absolutely blank.

The police arrived, fortunately and I extricated myself from the scene.

The way my heart beat, and the manner in which a little of humanity leached from me, never to return, need not concern you, dear readers. Moreover, it would count as whining.

The point I am trying to make is:

The hospital bill came to six lakhs (600,000 rs). The hospital administration told me that fights happened frequently, and was part of a ploy to escape from paying the bill. Maybe. Maybe not.

Hardly two kilometres away, was the government hospital. The Medical School where I had trained as a Plastic Surgeon. He could have been taken there. There the patient would have been kept in a corner of the Surgery ward where scores of burns patients were piled up in rows, under mosquito nets that took away the starkness of the burned naked bodies. The parents would be asked to apply ointments twice a day, while overworked interns and nurses will brave the smell for brief visits.

He would have surely died.

But now also he did. And the family is poorer by six lakhs. Did they sell their land? Their house? I will never know.

I looked at the records and went to the account section. I had a friend there, and I could look at the details. Let me tell you a secret- no doctor can usually do this.

What did not surprise me, but would probably surprise you, is that the bill wasn’t really inflated.

A thousand pairs of gloves were actually used.

Second interesting fact was that even if the entire professional fee of the doctor (the top surgeon was paid really well and not a pittance like us junior minions. And he was on fee for each service, not a salary) was waived off, the bill would have come to five lakh and twenty five thousand.

This doesn’t mean that the bills can’t be artificially inflated. They can be, and I am sure it happens on occasion.

All Doctors don’t whine. They do try to recover their investments on money, effort and years.

What did you think? It is a profit model, for heaven’s sake.

What I am saying is that this model is not working well. At all.

Market Economics works remarkably well in most areas of human endeavour, but it falls flat in the health sector.

Look at the facts:

All over the developed countries, most basic problems are solved! Food- there is plenty of food. Everyone can have a roof over their heads.

But not healthcare. UK spends close to 16 percent of its entire income on it. They have a model of exclusively free medical care, sponsored by the government. A majority of its population pays fifty percent income tax on their earnings. And it is a rich country.

The system there is struggling to survive, due to money issues.

The US spends 20 percent of its income on healthcare, and half of it is public sector. The rest is the private sector, and the private sector is almost exclusively controlled, and kept in a vice-like grip, by insurance companies. Insurance monitors spending of hospitals and the treatment. Without insurance, the cost would have shot up through the roof. And no one seems happy with the present system.

To cut through the crap, ideal cutting edge medicine, as per the standards set by western countries, is enormously expensive.

India spends three percent of its GDP on health, as compared to the 15 to 20 percent of developed countries. Out of which only one percent of it is by the government. The 2 percent private health spending is paid by individuals on small clinics, private practitioners and quacks.

Remember that per capita GDP of the US is thirty times that of India. And our people are expected to get care at ‘world standards.’!

World class care is given by a miniscule number of pure private ‘for-profit’ players.

These centres are not monitored by insurance (mostly) and the government oscillates between populist obstructionism and corrupt lassaiz fare.

Increasingly, we are demanding medical care on par with the standards of the west. Our doctors try to do that, and the courts want doctors to do that.

And we expect the exclusive profit driven system to take out-of-pocket money from our impoverished population and give that care? What the hell are we smoking?

We are sitting on a time- bomb. And soon the shit will hit the fan.

Stop whining, and start doing.

An unrelenting battle for gender equality

noreply@blogger.com — Tue, 25 Feb 2020 12:46:00 GMT

Sameera Jahagirdar says MBBS textbooks continue to ‘criminalise’ a transgender

Sameera M. Jahagirdar is now going to take her fight for the rights of LGBT+ to the Medical Council of India, which has not yet recognised the need to restructure the MBBS curriculum in which the textbooks continue to criminalise a transgender or a homosexual or anyone who does not fall within the two-gender sexual orientations of society.

Her journey as a woman trapped in a man’s body and taking up the medical profession to unravel the biological enigma of the human body was one of continuous trauma. The fight within herself to realise her sexual orientation leading later to gender identity and with society’s unrelenting stand on homosexuality and transgender was too much to handle as she had no one to talk to about what she was going through.

“I used to internalise everything that it damaged my psyche,” said Dr. Jahagirdar, Assistant Professor, Department of Critical Care Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry.

At one stage she decided to run away from Pune, her native place, seeking a life that would help her live her life the way she saw it.

“I had turned to medicine hoping that learning the human biology threadbare would provide some answers. But, no, she said. All the medical texts were very harsh on homosexuality. This increased my sense of isolation in society, many times even contemplating and attempting suicide.”

It was much later while working at JIPMER, going through medical literature in the institute’s library, she realised that her sexual orientation was not a disorder. The American Psychiatric Society had done some good work in the field in the 1970s, she said.

That was in 2003 and she stopped running away from her own self thereafter. But, then, to actually take the sex reassignment surgery, it took about 13 years. The battle was only half won with herself at that time. The society at large still was the same. Backed by the Supreme Court’s ruling on creating space for another gender, Dr. Jahagirdar began her advocacy in the institution where she works.

“It was an uphill task, but I got positive responses from the staff and colleagues, which was a beginning in itself.”

Her work was recognised by Annamalai University that conducted a meeting on the nursing curriculum board of studies. The National Health Mission, Tamil Nadu, appreciated her work in establishing gender affirmative procedures and building a dedicated multi-disciplinary team.

“My educational qualifications have given me the rights to live with dignity in the institution. However, the society outside the walls of my workspace continues to be harsh. When I found that people were not ready to give me house on rent, I thought of buying an apartment. But even for that, I had to rely on my partner to get the work done in my name,” said Dr. Jahagirdar.

PG medical fees in private colleges may rise by 15%

noreply@blogger.com — Mon, 24 Feb 2020 05:13:00 GMT

Last year too, the fee was hiked by 15% in private colleges and minority institutions

Students enrolling in postgraduate courses in private medical colleges may have to cough up a higher fee from the coming academic year as the government is likely to increase the fees by about 15%.

The hike is expected to be applicable to the government quota as well as the institutional quota seats in private medical colleges.

Medical Education Minister K.Sudhakar said that senior officials of the Medical Education Department had formed a committee and had conducted several meetings with different medical college associations and recommended a hike. “The State government will, however, take a call on the matter. I am likely to receive this file next week and take a call after studying the recommendations of the committee’s report,” he said. He added that he would meet with Chief Minister B.S. Yediyurappa and seek his advice on the matter.

‘Steep hikes’

But students say that the hike in postgraduate medical course fees has been steep year after year, making it difficult for those from middle-class families.

Last academic year too, the State government had hiked the fees by 15% and it was applicable to private medical colleges as well as minority institutions. For the 2019-20 academic year, the fee structure was in the range of ₹72,737 to ₹5.81 lakh for government quota medical seats, while institutional quota seats were priced between ₹1.09 lakh and ₹8.72 lakh.

Students threaten strike

Subhashini S., a PG medical seat aspirant said, “If the fees are hiked then we will take up a Statewide agitation till the government rolls it back. Increasing fees every year is not acceptable.”

Another MBBS student, Anand S., who is hoping to secure a PG seat in dermatology, said medical students will be unable to bear the cost as the stipends provided to postgraduates was ‘meagre’.

The admission process for PG seats for students who have written the National Eligibility cum Entrance Test (NEET) is likely to begin in March and will be conducted by the Karnataka Examinations Authority. The State government is likely to enter into a consensual agreement with colleges later this week.

PG Blazer Did you attend any classroom coaching? Was it useful? Do you think cla...

ADrPlexus — Tue, 23 Jun 2015 16:13:27 GMT

PG Blazer Did you attend any classroom coaching? Was it useful? Do you think classroom coaching is essential for getting a good rank?

Dr.Vikram Damaraju: I attended Adrplexus coaching for one month in March-April 2014.
It helped me in quickly revising important concepts within a short duration.
Coaching is very essential for getting a good rank.

PG Blazer: Did you attend any test series? If so, did you find it useful?

Dr.Vikram Damaraju: I wrote PGI mock exams by Adrplexus for this session.
PGI is still an exam where you have to darken the circles. For this you have to be fast, like 40-45 questions for every 30 mins and 40-45 seconds for each question (including for shading). This kind of preparation is possible only if u write mock exams.

PGI topper interview: Dr.Vikram Damaraju, 8th Rank, May 2015
pgblazer.com
Congratulations on securing a top rank in the PGI entrance exam! What is the secret of your success? Consistency, intelligent hard work, planning and most importantly a goal.

ADr-Digital Strides Colour Palettes

ADrPlexus — Tue, 23 Jun 2015 07:54:52 GMT

ADr-Digital Strides Colour Palettes

ADrPlexus — Sun, 21 Jun 2015 11:24:43 GMT

https://scontent.xx.fbcdn.net/hphotos-xtf1/v/t1.0-9/p100x100/11402812_10204541293912772_1411177128299038962_n.jpg?oh=6ce3a826850b5d0f8a7d90ace41598f2&oe=5631CDAC

Daljit Singh

Overwhelming Response from Medical PG Aspirants!!!More than 200 + Medical PG Aspirants appeared for Scholarship Examination in Hyderabad on 11.06.2015 !!!

Admissions are now open in Delhi also for various CBT and T & D Modules !!!

ADrPlexus — Sat, 20 Jun 2015 11:08:51 GMT

Admissions are now open in Delhi also for various CBT and T & D Modules !!!

https://scontent.xx.fbcdn.net/hphotos-xft1/v/t1.0-9/p100x100/11391283_10204531693072757_1670837240630575633_n.jpg?oh=4dc3dabb63c35f3ac14aa37d0dfda8f7&oe=5635197C

Daljit Singh

Again Good News for PG Medical Aspirants !!!ADrPlexus-Digital Strides Delhi Centre@ D-4,Kalkaji,Near Kalkaji Metro Station, Near Kalkaji Police Station !!!Impact Hoarding with all relevant information is readily installed at Gautam Nagar in New Delhi for the convenience of all PG Aspirants !!!New Medico Chapter now also begins in New Delhi and NCR !!!For details pls Call/SMS/WhatsApp your name and mail id to our helpline no-9569-345678 or mail at-- info@digitalstrides.co.in or visit www.pay.adrplexus.com !!!Have a Blast !!!!

Thank You to Hyderabad students for an overwhelming response to our various CBT...

ADrPlexus — Fri, 19 Jun 2015 07:14:54 GMT

Thank You to Hyderabad students for an overwhelming response to our various CBT modules !

We are glad to announce our second batch !

Admissions are open and group discounts are available too for the first three groups !

“Always, Always have a plan”

ADrPlexus — Mon, 15 Jun 2015 17:20:43 GMT

“Always, Always have a plan”

Dr Annapureddy Jagadish from Andhra Medical College takes his Dream Branch MD Ge...

ADrPlexus — Fri, 12 Jun 2015 07:55:46 GMT

Dr Annapureddy Jagadish from Andhra Medical College takes his Dream Branch MD General Medicine at his Dream College ( PGIMER ) . ADrPlexus Digital Strides Pvt. Ltd Salutes him and wishes him success in all his future endeavours

Timeline Photos
Success is stumbling from failure to failure with no loss of enthusiasm.” ― Winston S. Churchill ..He was a topper in all central Institute exams since May 2014 but he failed to get his Passionate seat of choice i.e " General Medicine In May PGI 2014 his rank was 36 . He could have easily settled with Pediatrics but he never wanted to compromise his desires. He decided to give another effort. In Nov PGI 2014 , he again secured Rank 27 which took him very close to General Medicine seat but he missed it by few ranks....Everyone demotivated him and tried convincing him to take Pediatrics.....But he made up his mind very strong He knew very well that " Most people give up just when they’re about to achieve success. They quit on the one yard line. They give up at the last minute of the game, one foot from a winning touchdown " Finally he decided to give his best shot for MAY 2015 central Institute exams He secured RANK 7 in NIMHANS 2015 and Rank 12 in MAY PGI 2015 and Rank 15 in JIPMER 2015 Dr Annapureddy Jagadish from Andhra medical College takes DM Neurology in NIMHANS 2015 counselling on 8th June 2015 .It is a real celebration day for ADrPlexus - Digital Strides. We wish him Grand Success in all his endeavours

ADrPlexus-Digital Strides 2015 - Chennai Course - Dr Arun ( UG : Bangalore Medi...

ADrPlexus — Fri, 12 Jun 2015 07:52:46 GMT

ADrPlexus-Digital Strides 2015 - Chennai Course - Dr Arun ( UG : Bangalore Medical College ) takes MS Orthopedics @ AIIMS ( May 2015 ) . ADrPlexus Digital Strides salutes him

ADr- Digital Strides Congratulates Dr M Ranjith ( Hyderabad ) for topping ADrPle...

ADrPlexus — Thu, 11 Jun 2015 13:44:54 GMT

ADr- Digital Strides Congratulates Dr M Ranjith ( Hyderabad ) for topping ADrPlexus-Digital Strides Exam 2015 conducted on June 10th 2015.

ADrPlexus - Digital Strides 2015 Scholarship Exam Results Announced in www.adrpl...

ADrPlexus — Thu, 11 Jun 2015 11:37:23 GMT

ADrPlexus - Digital Strides 2015 Scholarship Exam Results Announced in www.adrplexus.com . Top 100 Rankers can avail discounts in Chennai Target Nov 50 Days course or in anyone of the programs offered by ADrPlexus-Digital Strides

ADrPlexus — Thu, 11 Jun 2015 07:42:56 GMT

ADrPlexus — Tue, 09 Jun 2015 16:49:50 GMT

https://scontent.xx.fbcdn.net/hphotos-xft1/v/t1.0-9/p100x100/11391283_10204531693072757_1670837240630575633_n.jpg?oh=4dc3dabb63c35f3ac14aa37d0dfda8f7&oe=5635197C

Daljit Singh

Again Good News for PG Medical Aspirants !!!ADrPlexus-Digital Strides Delhi Centre@ D-4,Kalkaji,Near Kalkaji Metro Station, Near Kalkaji Police Station !!!Impact Hoarding with all relevant information is readily installed at Gautam Nagar in New Delhi for the convenience of all PG Aspirants !!!New Medico Chapter now also begins in New Delhi and NCR !!!For details pls Call/SMS/WhatsApp your name and mail id to our helpline no-9569-345678 or mail at-- info@digitalstrides.co.in or visit www.pay.adrplexus.com !!!Have a Blast !!!!

ADrPlexus — Mon, 08 Jun 2015 16:04:30 GMT

ADrPlexus - Digital Strides ( Vaishnavi Communications ) Hyderabad CBT Centre In...

ADrPlexus — Mon, 08 Jun 2015 14:15:18 GMT

ADrPlexus - Digital Strides ( Vaishnavi Communications ) Hyderabad CBT Centre Inauguration on JUNE 7 , 2015 .

Dr Jawaharlal ( May PGI 2015 Topper ) cut the ribbons and launched the First Exclusive CBT Centre for Doctors at Hyderabad - Padma Rao Nagar...Dr Khaleel ( Director of Arise Medical Education ) graced the occasion .Many PG Aspirants and PG Doctors were present at the venue on the first day of inauguration . Digital Strides Director Pankaj Ji and Vaishnavi communications Director Srinivas Ji and ADrPlexus co-ordinator Dr Arun Kumar were present during the opening ceremony.

https://scontent.xx.fbcdn.net/hphotos-xat1/v/t1.0-9/p100x100/11392808_864109000327292_2271145138141857044_n.jpg?oh=f896f647d2a8bddc50639e54fd5761dd&oe=55F094B7

ADrPlexus

ADrPlexus - Digital Strides ( Vaishnavi Communications ) Hyderabad CBT Centre Inauguration on JUNE 7 , 2015 . Dr Jawaharlal ( May PGI 2015 Topper ) cut the ribbons and launched the First Exclusive CBT Centre for Doctors at Hyderabad - Padma Rao Nagar...Dr Khaleel ( Director of Arise Medical Education ) graced the occasion .Many PG Aspirants and PG Doctors were present at the venue on the first day of inauguration . Digital Strides Director Pankaj Ji and Vaishnavi communications Director Srinivas Ji and ADrPlexus co-ordinator Dr Arun Kumar were present during the opening ceremony.

ADrPlexus - Digital Strides ( Vaishnavi Communications ) Hyderabad CBT Centre In...

ADrPlexus — Mon, 08 Jun 2015 14:14:28 GMT

Success is stumbling from failure to failure with no loss of enthusiasm.” ― Wins...

ADrPlexus — Mon, 08 Jun 2015 13:01:07 GMT

Success is stumbling from failure to failure with no loss of enthusiasm.” ― Winston S. Churchill ..He was a topper in all central Institute exams since May 2014 but he failed to get his Passionate seat of choice i.e " General Medicine

In May PGI 2014 his rank was 36 . He could have easily settled with Pediatrics but he never wanted to compromise his desires. He decided to give another effort.

In Nov PGI 2014 , he again secured Rank 27 which took him very close to General Medicine seat but he missed it by few ranks....Everyone demotivated him and tried convincing him to take Pediatrics.....But he made up his mind very strong

He knew very well that " Most people give up just when they’re about to achieve success. They quit on the one yard line. They give up at the last minute of the game, one foot from a winning touchdown "

Finally he decided to give his best shot for MAY 2015 central Institute exams

He secured RANK 7 in NIMHANS 2015 and Rank 12 in MAY PGI 2015 and Rank 15 in JIPMER 2015

Dr Annapureddy Jagadish from Andhra medical College takes DM Neurology in NIMHANS 2015 counselling on 8th June 2015 .It is a real celebration day for ADrPlexus - Digital Strides. We wish him Grand Success in all his endeavours

ADrPlexus — Mon, 08 Jun 2015 11:40:35 GMT

Timeline Photos

ADrPlexus — Mon, 08 Jun 2015 11:26:36 GMT

Timeline Photos

Adrplexus digital strides ( Vaishnavi communications ) Hyderabad centre is getti...

ADrPlexus — Sat, 06 Jun 2015 14:19:58 GMT

Adrplexus digital strides ( Vaishnavi communications ) Hyderabad centre is getting inaugurated on June 7,2015 @ 10:30am

We travel along in our lives doing the mundane things all of us must, thinking a...

ADrPlexus — Fri, 05 Jun 2015 23:12:52 GMT

We travel along in our lives doing the mundane things all of us must, thinking about future plans, concerned about world events, and a host of other issues we entangle ourselves in. But then suddenly, for some of us, those things come to a screeching halt because of a catastrophe dropping in and tossing everything into chaos. We are then faced with a choice. Make the most of our time left on Earth or obsess over the fate that has befallen us. The doctor in this video has settled his score with his Karma and is a learning tool for the rest of us.

A Strange Relativity: Altered Time for Surgeon-Turned-Patient

Paul Kalanithi, MD, was a Stanford neurosurgeon who was diagnosed with lung cancer in his mid-30s. He wrote a popular op-ed for The New York Times in early 2...

By Taking this profession , My Family believed that I will be considered next to...

ADrPlexus — Wed, 03 Jun 2015 22:21:45 GMT

By Taking this profession , My Family believed that I will be considered next to GOD . New trend has begun where INDIAN PATIENTS will help Doctors to get an appointment with GOD . Corp-orates and commercialization spoiled our DIGNITY

So the lady doctor broke the bad news of an intrauterine death to the parents based on the ultrasound report in Haridwar. She was apparently not even involved in the antenatal care of the woman concerned. Irrespective of which, she gets violence like this at her workplace.Agreed the news may be devastating to the parents. But What in this world can EVER justify taking out that frustration & hurting a treating physician? Blood boils each time this clip is played. (and hundreds more like these)

ADrPlexus Salutes Dr KUMAR BN for getting RANK 26 .

ADrPlexus — Wed, 03 Jun 2015 12:05:21 GMT

ADrPlexus Salutes Dr KUMAR BN for getting RANK 26 .

ADrPlexus - Digital Strides Salutes JIPMER Toppers from our instiute 1. Dr. Ka...

ADrPlexus — Wed, 03 Jun 2015 09:56:13 GMT

ADrPlexus - Digital Strides Salutes JIPMER Toppers from our instiute

1. Dr. Kanaga Durga Rank 8
2. Dr. Gargi Das Rank 9
3. Dr. Rakesh Kumar Sharma Rank 10
4. Dr. Ashwin Raghavendra A Rank 11
5. Dr. Annapureddy Rank 15
6. Dr. Vadlamani Bharat Rank 23
7. Dr. Adithya Nagendran Rank 25
8. Dr. Kumar BN Rank 26
9. Dr. Sachin HJ Rank 34
10. Dr. Vishwa CR Rank 38
11. Dr. Naveen Kumar Rank 44
12. Dr. Chaitanya BK Rank 45
13. Dr. Anusha D Rank 50
14. Dr. Pushpanjali Rank 56
15. Dr. Subhrashis Guha Niyogi Rank 57
16. Dr. Sabia Handa 61
17. Dr. Aman Yusuf Khan Rank 68
18. Dr. Bhavika Ym Rank 84
19. Dr. Mangala Gowri K Rank 94
20. Dr. Raghavendra Rao Yalala Rank 95
21. Dr. Gnanaendra Reddy Rank 104
22. Dr. Tapan Kumar Ray Rank 147
23. Dr. Manjinder Singh Randhawa Rank 159
24. Dr. Jasmeet Singh Rank 169
25. Dr. Sagnik Sen Rank 172
26. Dr. Tarang Preet Kaur Rank 195
27. Dr. Anurag Rana Rank 208
28. Dr. Deepika Sinha Rank 214
29. Dr. Shilpi Rank 225
30. Dr. Pranay Kumar B Rank 238
31. Dr. Ashish Dwivedi Rank 240
32. Dr. Rashi Gupta Rank 246
33. Dr. Mayank Jain Rank 250
34. Dr. Ankur Rai Rank 267
35. Dr. Setu Gupta Rank 268
36. Dr. Adrija Datta Rank 282
37. Dr. Sumit Kumar Rank 289
38. Dr. Haynes Raja Rank 312
39. Dr. Sumanth Koppolu Rank 342
40. Dr. Dileep Kumar Rank 345
41. Dr. Ganapriya Rank 368
42. Dr. Neradi Deepak Rank 370
43. Dr. Achyudhananda Govindan Rank 386
44. Dr. Arindam Mitra Rank 404
45. Dr. Abhishek Chakladar Rank 429
46. Dr. Pooja Wadhwani Rank 446
47. Dr. Sahil Agrawal Rank 491
48. Dr. Sehaj Roop Kaur Rank 492
49. Dr. V.S. Saravanan Rank 503

ADrPlexus — Mon, 01 Jun 2015 13:23:11 GMT

ADrPlexus — Mon, 01 Jun 2015 06:28:55 GMT

Steps sought to solve acute dearth of specialist doctors

noreply@blogger.com — Mon, 02 Sep 2013 11:40:00 GMT

Citing an urgent need to tackle the acute dearth of specialised doctors owing to inadequate PG seats, a campaign called ‘Save doctors who save your lives’ will be launched by medical practitioners across the state soon, as part of a nation wide campaign. The campaign says that an increase in the number of specialised doctors is the need of the hour as an MBBS doctor cannot treat non-communicable diseases (NCD) including those contributing to Maternal Mortality Rate (MMR).

“Treating NCDs is a gargantuan task and is going to be the major challenge in the days to come. To name a few, the top ten causes of death in India include cardiac diseases, diarrhoeal disease, chronic respiratory diseases and stroke. Nine out of those ten require specialist doctors. Unfortunately, we do not have enough specialised doctors due to inadequate number of PG seats in medical institutions”, said Dr Prem Kumar Nair, medical director, Amrita Institute of Medical Sciences, who heads the campaign in Kerala.

He pointed out that it is ironic that there exist a huge disparity in the seats allotted for PG and UG in a country which has the largest number of medical institutions.

“The mandatory rural posting also affects them as they end up spending 13 years only for studying. If this trend persists the risk will increase as there will be a dearth of specialists when a senior specialist doctors or surgeons retire”, he said. Dr Prem Kumar said that the government can solve the issue by adding more number of PG seats in the hospitals.

“For instance, the number of students under each professor or associate professor has to be increased. If they are currently handling one, it has to be increased to five”, he said. Approximately 15 to 20 per cent of pregnancies end up requiring Caesarian section and if not managed well, the repercussion will be a high MMR. Caesarian sections need a radiologist to perform ultrasound scan to predict complications during childbirth, an anaesthesiologist to anaesthetize the pregnant woman, a gynaecologist to conduct the operation and a paediatrician to resuscitate the baby. A doctor with MBBS degree can attend to a normal delivery but a doctor with post graduation degree can reduce Infant Mortality Rate and MMR.

Dr Prem also said that owing to the dearth of specialists in rural areas, the infant mortality rate and MMR are high.

Besides, by increasing the number of post graduation seats, ‘brain drain’ will also come down drastically. “Many are opting for foreign countries as they could not secure PG seats. Increasing PG seats will be the right solution in this regard”, he added.

Medical students gather in Mumbai pleading health ministry to equalize UG and PG seats

noreply@blogger.com — Sun, 01 Sep 2013 16:41:00 GMT

Medical students gather in Mumbai pleading health ministry to equalize UG and PG seats

MUMBAI: Over 300 medical students gathered at Indian Medical Association House (IMA) last week to once again plead to the Union Health Ministry to equalize Under Graduation (UG) and Post Graduation (PG) medical seats. The movement by the medical students called 'Save the Doctor' also took place in other cities like Bangalore, Jaipur, Hyderabad, Mysore, Guwahati and Hisar, on the same day. Dressed in their regular lab coats along with a black ribbon, the students made their hand impression on a large piece of canvas as a symbolic gesture to articulate the lack of specialist doctors in the country. The students also wrote their message "Save the Doctors" on the floor lit each alphabet was lit with candles.

Commenting about the movement, Dr. Naresh Trehan, CMD, Medanta said "I am quite concerned about the present state of affairs for the medical students in our country. We are all aware that the number of students graduating and the number of PG seats available are not equal. Students are struggling to get a PG seat today. We should take measures to change the system as soon as possible, as we need more specialists in the country." He also added, "If one notices, many a times, getting an appointment from a specialist, be it a gynecologist, orthopedic, etc is increasingly becoming an issue. The reason is because to serve the healthcare needs of a billion plus people, the number of specialists available is simple not enough. We have written to the ministry and authorities and we have received favorable response and we are hopeful there will soon be solutions."

The top ten causes of death in India include diseases of the heart, diarrheal disease, chronic respiratory diseases and strokes, to name a few. Nine out of the ten require specialist doctors to treat them. Today, India lacks specialist doctors due to inadequate number of PG seats in medical institutions. Though the country has the largest number of medical institutions, the disparity in the number of seats allotted for PG and UG students along with the mandatory rural posting are affecting young doctors, as they end up spending 13 years merely studying. This also means that the future of our healthcare system is at a huge risk if the current scenario continues. As senior specialist doctors/ surgeons retire in the future, there will be a dearth of specialist doctors and surgeons in India. Pursuing a Post Graduation in any stream of medicine is essential for a doctor to become a specialist such as Gynecologist, Neurologist, Surgeon, Radiologist etc.

Dr. Narendra Saini, Secretary General, IMA, said, "The young doctors of India are losing their productive years in studying to get a PG seat. There is a dearth of specialists in the country and limited PG seats will gravely affect the number of specialist doctors, available in the coming years. He further added, "'Save the Doctor' movement is a step to resolve the problem and we need the support of the nation."

There are 47,600 UG seats which is likely to reach 50,000 shortly due to the progressive steps taken by the MCI. Whereas, there are only 12,000 PG seats in clinical disciplines! In comparison, in a developed country such as the USA, there are 19,000 UG seats and 32,000 PG and fellowship seats. With a pass rate of 80% to 90%, nearly 40,000 doctors graduate every year and compete for the 12,000 clinical seats with their batch mates and over a lakh seniors. In the last PG entrance exam under NEET, over 90,000 doctors appeared for the test to claim one of the 12,000 seats. Adding to this, the one year compulsory rural posting as a pre-requisite to apply for PG course has worsened the situation.

Central Zone Executive of 'Save the Doctor' movement, Dr. Suranjana Basak, said, "The gathering we had today across India is just our humble appeal to make our voice heard. We want the leaders to take action and save the future."

Lakhs of young pregnant women who die during delivery is a testimony to show how lack of PG seats is taking away precious lives due to dearth in gynecologists. There are 28 million babies born every year in India, which means at least 28 million deliveries need to be handled annually. ""To perform this number the country requires that many gynecologists. Unfortunately we have only 40,000 practicing gynecologists and most of them are practicing mainly in cities. Our government is spending lakhs of rupees to reduce Maternity Mortality Rate without great success. What people and policy makers fail to realize is that it's not due to lack of money that young pregnant women are dying, but because the country does not have enough qualified gynecologists and pediatricians to take care of the mother and baby"", voiced Dr. Devi Prasad Shetty, Treasurer, AHPI.

REPORT IN PUNE MIRROR TODAY

noreply@blogger.com — Sun, 01 Sep 2013 16:38:00 GMT

Rural stint conditional for MD-

Diploma certificate

A plethora of problems plagues medical care in rural areas of the state; not least on the list is a lack of doctors. Most doctors who sign up for work in state-run hospitals invariably quit, frustrated by poor working conditions and facilities.

The government, though, is taking iron-clad action. Earlier this week, it sacked 43 doctors who refused to show up for work, as reported by Mirror on Saturday.

Now, the Directorate of Medical Education and Research (DMER) had made it mandatory for Doctor of Medicine-Diploma (MD-Diploma) students to complete a one-year stint in rural areas before pursuing higher education.

Until now, students were allowed to serve out their bond — pledging that they would work in rural areas for a year — after completing higher studies.

But a circular issued by the DMER on August 6, puts an end to this practice. About 230 students would be affected, more so as the order comes after several students had appeared for entrance exams to higher education courses.

“Earlier, thanks to a court order which stated that no one could stop students from pursuing their education, students used to return later and serve out their one-year bond,” said Dr Santosh Wakchaure, president, Maharashtra Association of Resident Doctors.

“Now, diploma students cannot secure admission for higher education unless they complete their one-year stint in a rural area. The DMER issued this order after social activist, Pournima Upadhay, filed a PIL against the lack of doctors in rural areas.”

Dr Pravin Shingare, director of DMER, claimed that the decision also stemmed from the fact that many students did not turn up to execute their bond. “Previously, they would sign an affidavit stating that they would return to serve out their bond after completing their education.”

But most students did not come back which is one of the reasons for this circular. We have also started imposing a penalty on them.”

MD-Diploma students are livid, claiming that instead of the DMER going after the few black sheep, it is punishing them all. Moreover, they say, it points to a failure on the part of the government to enforce the affidavit.

“The government took the affidavit lightly,” said a student from BJ Medical College. “Why don’t they punish the students who signed the affidavit, but did not show up for work? We are willing to serve out the bond, but we want to finish our education first in one go.”

Students fear that they would lose touch if they were to break their studies for a year. "How can one study for a competitive exam while working in a rural area?” wondered the student.

“Most of us have appeared for Diplomate of National Board (DNB) exams and are awaiting our results. We now have to go for counselling, but DMER is not releasing our certificates. Had they told us earlier, we would have sat for the exams in the first place.”

Another student from BJMC said, "This circular has been issued only in Maharashtra. Instead of asking us to serve in rural areas, the government should instead appoint those who have completed their MBBS.

This would not only serve the government’s purpose, but it would help rural folk too as a patient who requires a super-specialist would have access to one. Now they are simply referred to a district hospital. Why don’t they properly utilise the skills of these super-specialists?"

'We'll soon have hospitals without doctors'

noreply@blogger.com — Thu, 29 Aug 2013 03:24:00 GMT

'We'll soon have hospitals without doctors'

How is the skewed ratio between undergraduate and postgraduate medical seats affecting access to healthcare?

India has the highest maternal mortality rate in the world. Of the 28 million babies born every year, 5-6 million are delivered by Caesarean section. The women need gynaecologists to enable smooth delivery. Today, many women die during childbirth because there aren't enough doctors around to treat them. We need 1.5 lakh gynaecologists but have just 40,000. The US has 5,000 postgraduate seats while India has just 450. There's a shortage of radiologists, who are so crucial for diagnosing any ailment even in cities.

Why this restriction?

We in India believe that if we increase the number of seats, the value or quality will go down. But that's not true. Therefore, we've restricted the number of postgraduate seats and deprived lakhs of MBBS doctors from becoming specialists, which is dangerous for the healthcare system in India. If we don't rectify the ratio now, there will be hospitals without doctors in our Tier 2 cities too.

What's the solution?

The government must tell the Medical Council of India to increase the number of PG seats significantly. When there are thousands of medical graduates who want to pursue specialization and spend years preparing for that coveted PG seat, why are we depriving them and losing them to other countries?

LAST CHANCE TO ATTEND A COUNSELLING THIS YEAR-KERALA

noreply@blogger.com — Tue, 27 Aug 2013 19:22:00 GMT

NOTIFICATION

POST GRADUATE MEDICAL DEGREE / DIPLOMA COURSES, KERALA - 2013

LAST ROUND OF COUNSELLING TO FILL UP THE LEFT OVER STATE QUOTA

AND SURRENDERED ALL INDIA QUOTA SEATS

The last and final round of counseling to fill up the vacant Government Quota seats,

State Quota seats which became vacant consequent to the fourth round of All India

Counselling and Surrendered All India Quota seats in P G Medical courses - 2013 under

Government/Self Financing colleges will be conducted on 29.08.2013 (Thursday) at

Dr. C O Karunakaran Memorial auditorium near Regional Cancer Centre, Medical College

campus, Thiruvananthapuram. The counseling will be manual and subject to the conditions

and stipulations specified in G.O.(Rt) No. 3006/2013/H&FWD dated 26.08.2013. The

counseling to the General Quota seats will be based on the various merit and category lists

published by the Commissioner for Entrance Examinations and that to the Service Quota

seats will be based on the seniority-wise lists of service candidates prepared by the Heads

of Departments concerned. The allotment to the Health Service Quota seats will be as per

the modified seniority-wise list prepared by the Director of Health Services in accordance

with the verdict of the Hon’ble High Court of Kerala dated. 30.07.2013 in WP(C)

No.13330/2013 and connected cases.

The service candidates and SC/ST candidates are directed to report to the venue of

the personal counseling at 9.30 am on 29.08.2013. The General Quota candidates are

directed to report to the venue of the personal counseling at 11.30 am on 29.08.2013.

The candidates who have already taken admission under All India Quota and holding

All India Quota seat at present are not allowed to attend the counseling.

The candidates coming from the Self Financing Medical Colleges to attend the

counseling shall produce all their original certificates, NOC and necessary affidavits stating

that the Self financing Medical College Management is willing to admit candidates allotted

by the CEE from the Government Merit list in the resultant vacancies.

The candidates who are allotted a subject in the counseling and do not join the

course on any reason shall be liable to pay the liquidated damages as per the conditions in

the prospectus.

No candidates who have already admitted in Government Medical Colleges are

allowed to move to another Government Medical College in the same subject

No transfer from one Self Financing Medical College to another shall be allowed.

The vacancies created at the time of allotment will be filled up then and there itself

according to merit and eligibility.

The candidates who get allotment will be issued with an allotment memo and the

fee to be paid will be shown in the memo. This amount of fee should be paid in the college

concerned.

All details related to the allotment process are available on the website

www.cee.kerala.gov.in.

Help Line Numbers: 0471 2339101, 2339102, 2339103, and 2339104

Over 200 medicos participate in ‘Save the doctor’ movement

noreply@blogger.com — Tue, 27 Aug 2013 19:15:00 GMT

Over 200 medicos participate in ‘Save the doctor’ movement

Seeking equalisation of UG and PG seats in medical courses, more than 200 medicos staged a rally in the city on Monday.

This was part of the nation-wide ‘Save the Doctor’ movement, wherein similar rallies were taken out in different parts of the country in support of their demands.

Students and doctors walked from JK Grounds to Mysore Medical College and Research Institute, and from there to Gandhi Square.

Disparity

The rationale behind the rally, as explained by the organisers, is that India lacked specialist doctors due to inadequate number of PG seats in medical institutions.

It was argued that though India had the highest number of medical institutions, the disparity in the number of seats for UG and PG courses was too high. The participants were also opposed to the rural postings made mandatory and wanted it clubbed with the PG internship.

They expressed fears that if the scenario continued unchanged then India may have to rope in experts from other countries to fill the gap.

As against nearly 50,000 UG seats, there were only 12,000 seats for PG courses for which about 90,000 students compete, said organisers.

The movement is supported by Indian Medical Association and Association of Healthcare Providers.

4 - southern states account for more than 41% of all medical colleges in the country

noreply@blogger.com — Wed, 21 Aug 2013 13:33:00 GMT

CHENNAI: The four southern states account for more than 41% of all medical colleges in the country. According to a statement tabled by Union health minister Ghulam Nabi Azad in the Lok Sabha on Tuesday, Kerala, Karnataka, Andhra Pradesh and Tamil Nadu together have 159 of the country's 387 medical colleges (both government and private).

When it comes to government-run medical colleges, Tamil Nadu tops the list with 21 colleges, which produce 2,715 medical graduates every year. Karnataka has the maximum number of private colleges at 34, followed by Andhra Pradesh (28), Maharashtra (25) and Tamil Nadu (24). Sikkim is the only state which has no government college. It only has one private college, while Goa has only one government college and no private college.

Karnataka produces 6,755 medical graduates every year, the highest in the country, followed by Andhra Pradesh (6,350) and TN (6,215).

"With the maximum number of government medical colleges, Tamil Nadu offers better healthcare to its residents than states like Bihar and Uttar Pradesh," said Dr Devi Shetty, founder of Narayana Hrudayalaya, Bangalore. "Yet the system of education, which is archaic, needs to be changed," he said.

"The system of medical education in the country is still what it was when I was a medical student 40 years ago. There have been many changes in the way medical students are trained in the west. In order to produce quality doctors, the system should change," said Shetty.

"The country needs more government medical colleges. There are states where there is absolutely no medical care in rural areas and opening more government colleges will reduce the shortage of doctors in rural areas," said Prof A Rajasekaran, former president of National Board of Postgraduate Medical Education, New Delhi.

Karnataka produces the maximum number of postgraduate doctors with 3,286 graduating from its colleges every year. Maharashtra comes second with 3,108 and Tamil Nadu has an intake of 2,392 in PG courses. "Financial assistance has been granted to 72 state government medical colleges under a scheme for strengthening and upgrading state government medical colleges for starting new PG course or increasing PG seats," Azad said in the statement.

In the last three years, the southern states, barring Kerala, have sought an increase in number of undergraduate seats as well as approval for new colleges in both private and public sectors. The three states have got approvals for 37 of their proposals, out of the total 87 granted since 2011 across the country.

TOI news link -click

Medical students hold candle march, want more seats for specialists

noreply@blogger.com — Mon, 19 Aug 2013 13:54:00 GMT

Medical students hold candle march, want more seats for specialists

JAIPUR: Medical students in state have demanded an increase in seats for specialists and super-specialists in medical education. A candle march by medical students across Rajasthan was organized on Saturday to highlight the issue. The four kilometre candlelight march started at SMS Medical College, Jaipur and ended at Statue Circle Jaipur which was part of the nationwide movement 'Save the Doctor'.

The students took out the march as they claimed that pursuing post graduation in any stream of medicine is essential for a doctor to become a specialist such as gynecologists, neurologist, surgeons and radiologists. They demanded an increase in seats as they anticipate that there will be dearth of specialist doctors and surgeons in India, if the seats are not increased.

However, a medical and health department official said that in Rajasthan the number of seats have increased considerably in medical education over the past five years. He said in 2008 there were 7 medical colleges, which had 750 seats for MBBS, but now the seats have increased to 1,300.

He said that not only MBBS seats increased but even seats for post graduation have increased considerably. In 2008, there were only 450 seats for PG which have also increased to 694.

He added that as far as super-specialty seats are concerned those seats which were only 20 in number earlier had also increased to 87 collectively in all the medical colleges of the state.

The official said that the overall increase in the medical education in the last five years has been huge. A new medical college will soon open in Jaipur and there are also plans to open more medical colleges in the state.

REVIEW -TOI REPORT

noreply@blogger.com — Sun, 18 Aug 2013 11:45:00 GMT

MCI seeks review of Supreme Court judgment on NEET

NEW DELHI: The Medical Council of India (MCI), which formulated the single-window admission process through National Eligibility-cum-Entrance Test, (NEET), on Saturday moved the Supreme Court seeking review of its July 18 verdict quashing the NEET.

The court had by two to one majority ruled that the MCI did not have the jurisdiction to enforce common entrance test (CET) on private medical colleges and that the move could also violate constitutional guarantee to minority communities to establish and manage their own educational institutions.

The MCI's review petition — drafted by senior advocate Nidesh Gupta — hit hard at the logic put forth in the majority judgment authored by the then Chief Justice of India (CJI) Altamas Kabir and said it was wrong on many counts such as it ignored the settled principles laid down by constitution benches of the apex court, wrong understanding of the MCI's powers and wrong appreciation of facts relating to medical admissions.

It said the only reason behind the opposition to NEET by private medical colleges was that the single-window system blocked the thriving practice among them to admit less meritorious students through backdoor for exorbitant donation or capitation fee.

Referring to the ratio laid down in constitution bench judgments in TMA Pai, Islamic Academy and PA Inamdar cases, the MCI said, "the majority judgment under review suffers from series of error apparent on the face of record. It unsettles the settled legal position that merit as determined in common entrance test is to be the basis for admission for professional education."

"The emphasis on matters of heart, human sympathies, beliefs and aspirations in preference to marks obtained in common entrance test will ruin medical education and adversely impact quality of professional education in our country," the council said.

It said the minority judgment had captured the correct legal position and aptly described that NEET regulations as "boon to the student seeking to join medical profession".

Alert

noreply@blogger.com — Sat, 17 Aug 2013 19:56:00 GMT

official pdf link -click

The right prescription

noreply@blogger.com — Thu, 15 Aug 2013 14:56:00 GMT

RIGHT PRESCRIPTION-INDIAN

EXPRESS REPORT

Medical students have an ethical obligation to serve the rural community

Last week, medical students took to the streets of Delhi, protesting against the government's order to extend the rural internship from three months to 12 months. The government had passed such an order to fill up the vacancies in the rural health services. Emotions are running high, and doctors and students have launched a "save the doctor" campaign in response. As a doctor who has worked in rural areas for decades, I would like to shed some light on this debate.

Let us review the arguments raised by the striking students and doctors. The first and most frequently voiced objection to this order is that there is no infrastructure in rural areas for doctors to practise. While this was true a few years ago, the National Rural Health Mission has strengthened the infrastructure, equipment and human resources in rural areas. According to 2013 figures, 92 per cent of primary health centres (PHCs) in the country function from a building. There are more than 2,00,000 nurses working in the 1,70,000 PHCs and sub centres. Each PHC medical officer also receives more than Rs 1 lakh every year to improve health services at the PHC.

The next objection is that the one year rural posting will increase the duration of medical education. The period between entering a medical college and getting the licence to practice will increase from five and a half years to six and a quarter years. However, at this stage, it is important to get an international perspective. German and Brazilian medical students require six years to graduate, while their American and Thai counterparts require seven years. South African students can practise only after eight years of training. It is clear from this that the Indian MBBS doctor has a shorter training period than many high- and middle-income countries.

This could be the reason that students say they do not have the expertise to manage patients in rural areas. Here, the students are correct in their analysis. They are trained in tertiary centres for five years and are exposed mostly to complicated cases like cancers and kidney failures. Rarely do medical students get exposed to patients with basic illnesses. Moreover, they are used to technology and being supervised by their seniors. So it is not fair to send them to a facility that does not have either fancy equipment or the staff to guide them. The government is doing an injustice to the poor of our country by sending a partially trained and poorly equipped doctor to the toughest posting, the PHC. My suggestion would be that the students be posted at the community health centres (CHC) or taluk hospitals. There are two benefits to be reaped from this step. First, students would be able to learn and practise medicine under the supervision of more experienced doctors. So they would be able to provide quality care, better than if they were left to cope alone at the PHC. The second benefit would be for the health system. From my experience in Karnataka, I find that most of the specialists at the CHC and the taluk hospital have to provide generalist care. So a paediatrician sees surgical patients and an obstetrician treats medical patients. This is because only specialists are posted at these facilities and there are no generalists. If generalists (MBBS interns) were posted there, they could manage the outpatient clinic and refer the serious cases to the appropriate specialist. This would improve the quality of care at these facilities, while specialist services are effectively and efficiently utilised.

Last but not least, students demand that the rural posting be shifted to after they complete their post-graduate studies. However, as they have stated, about 45,000 MBBS students graduate annually, but only 12,000 get admission into postgraduate courses. So is it fair to excuse the rest from rural service? Considering that the government spends a lot of money to train doctors and that the patients (especially the poor) contribute to this training by permitting medical students to test their skills on them, it is only ethical that students give something back to the community. Moreover, many of the postgraduates will have trained in non-clinical subjects and so will be of no use as medical officers in PHCs. Hence, it is better to place MBBS interns rather than postgraduates at the rural facilities.

Medical students have an ethical obligation to serve the rural community. But they need to be posted at the CHCs and hospitals, so that they can practise and learn under supervision while supplementing the health services.

The writer is director, Institute of Public Health, Bangalore

LINK HERE

TOI REPORT

noreply@blogger.com — Wed, 14 Aug 2013 12:39:00 GMT

Centre seeks review of SC order scrapping joint admission for medical colleges

NEW DELHI: The Centre on Tuesday sought review of the Supreme Court's controversial judgment junking the National Eligibility-cum-Entrance Test (NEET) providing for single-window admission process for all medical colleges and said it had erred by holding that NEET breached the rights of religious and linguistic minorities to self-administer educational institutions.

Faulting the majority judgment authored by then Chief Justice Altamas Kabir and relying on the powerful dissent delivered by Justice A R Dave, the Centre said ensuring uniform standards for medical education was of paramount interest to the patient and the Medical Council of India-mandated single-window system to draw the merit list was a step in that regard.

In the petition seeking review of the July 18 judgment delivered on the last working day of the then CJI, the government said it was under duty to ensure that medical education must meet standards of merit.

The review petition, drafted by additional solicitor general Sidharth Luthra and vetted by solicitor general Mohan Parasaran, made a strong pitch for exclusion of narrow considerations of creed and religious minority when it came to medical education.

Refusing to couch its request in niceties, found in petitions seeking reconsideration of judgments, the Centre bluntly said, "It is not as if doctors of a linguistic or religious minority will not be treating patients of all creeds, classes and denominations. The interest of the patient is a major consideration in ensuring that inter-se merit is a criteria for entry into medical education and NEET is a reflection of that need."

The Centre said the Supreme Court had always recognized even in the context of minority rights that merit in the field of medicine was of critical importance. "Right to life (health) requires a need for excellence in medical education," the Centre said and cited numerous constitution bench judgments in support of its stand.

The government said holding of common entrance test came about as a consequence of the Supreme Court's orders in Simran Jain case, during the hearing of which a decision was taken that MCI would hold a single entrance test since merit in medical education was essential to ensure quality healthcare to citizens.

It said the guidelines annexed to NEET ensured that the single-window admission system would be in breach neither of the rights of states nor interfere with rights of religious and linguistic minorities.

AMENDMENT IN MCI REGULATIONS ON 1 YEAR RURAL SERVICE BEFORE PG IMPLEMENTED

noreply@blogger.com — Wed, 14 Aug 2013 04:16:00 GMT

Rural posting must for doctors seeking PG admission: MCI

The government on Tuesday said that the Medical Council of India (MCI) has amended post graduate medical education regulations to make it mandatory for candidates seeking admission in post graduate courses to have served in rural areas for at least one year.

The Minister of Health and Family Welfare Ghulam Nabi Azad admitted to the Rajya Sabha in a written reply to a query, that there were reports of instances of misuse of NRHM funds in some states, but said it would not be correct to infer that funds allocated under the scheme are not properly used in rural areas.

Mr. Azad said monitoring mechanisms have already been put in place by the Ministry for adherence to financial procedures and proper financial utilisation of funds under NRHM.

These include submission of quarterly financial monitoring reports by states, annual statutory audits, concurrent audits, visits by teams of financial management group of the ministry to states for periodical financial reviews.

The Ministry had also requested Comptroller & Auditor General to conduct annual transaction audits of National Rural Health Mission in all the states from the financial year 2011-12 in order to identify the existing gaps, facilitate independent monitoring and timely corrective measures so that a quality and timely audit assessment becomes available to assist the state governments in undertaking remedial measures and achieving the targets of NRHM, Mr. Azad said.

He said the implementation of NRHM in states is reviewed through Common Review Missions and periodical reviews by the ministry.

“The deficiencies or shortcomings noticed during the reviews are immediately brought to the notice of the states for remedial action”, Mr. Azad said.

4th ROUND COUNSELLING RESULTS

noreply@blogger.com — Wed, 14 Aug 2013 04:05:00 GMT

4th ROUND COUNSELLING RESULTS

4TH ROUND COUNSELLING RESULTS PUBLISHED IN MCC.NIC.IN .

TO VIEW YOUR RESULTS CLICK HERE

TO KNOW THE RESULTS COMPLETE ALLOTMENT LIST CLICK HERE

ZEE NEWS REPORT

noreply@blogger.com — Tue, 13 Aug 2013 17:35:00 GMT

Govt to file review petition on SC order on NEET: Azad

New Delhi: The government has decided to file a review petition against Supreme Court verdict scrapping NEET, a single-window examination for filling MBBS, BDS and post-graduation seats in medical colleges.

This was stated by Minister for Health and Family Welfare Ghulam Nabi Azad in a written reply to a question in the Rajya Sabha on the legality of the National Eligibility-Cum-Entrance Examination.

"The Government is of the opinion that it would be in the larger interest of the society and students aspiring to study medicine to have NEET. Therefore it has decided to file a review petition against the majority judgement delivered by the Supreme Court on 18.7.2013 in Christian Medical College, Vellore vs Union of India and Others," Azad said.

A three-judge bench of the Supreme Court by a two-to-one majority on July 18 had scrapped holding of NEET and held that Medical Council of India (MCI) is not empowered to prescribe all India medical entrance tests and the MCI notification was in violation of Articles 19, 25, 26, 29 and 30 of the Constitution.

NEW NOTICE MOHFW

noreply@blogger.com — Tue, 13 Aug 2013 12:58:00 GMT

Shortage of Medical Personnel in Rural Areas

The State/UT wise detail of shortfall of doctors, nurses and paramedical staff as per Rural Health Statistics in India, 2012 is placed at Annexure I to VI.

The shortage of doctors in rural areas as per Rural Health Statistics in India, 2012 indicates that doctors are unwilling to work in rural areas. The details of measures taken by the Central Government to encourage doctors to work in rural and remote areas include:

(1) provision of financial support to state/UTs for providing additional incentives and higher remuneration to doctors to serve in rural areas and improved accommodation arrangements in rural areas, so that they find it attractive to join public health facilities in rural areas.

(2) amendment of the Post Graduate Medical Education Regulations, 2000 to provide:-

(i) 50% reservation in Post Graduate Diploma Courses for Medical Officers in the Government service who have served for at least three years in remote and difficult areas; and

(ii) incentive at the rate of 10% of the marks obtained for each year in service in remote or difficult areas up to the maximum of 30% of the marks obtained in the entrance test for admissions in Post Graduate Medical Courses

Public health being a state subject, financial support is being provided based on requirement and need projected by the state in the Programme Implementation Plan.
LINK HERE

PRESS INFORMATION BUREAU NEW NOTICE

noreply@blogger.com — Tue, 13 Aug 2013 12:45:00 GMT

Legality of Common Medical Admission Test

In Christian Medical College, Vellore vs Union of India &Ors a three-judge bench of the Hon’ble Supreme Court by a 2:1 verdict has held that Medical Council of India (MCI) is not empowered to prescribe all India medical entrance tests. The bench said that the MCI notification was in violation of Articles 19, 25, 26, 29 and 30 of the Constitution.

Justice A.R. Dave however rendered a dissenting opinion and has said he did not share the view of Chief Justice Kabir and Justice Sen and held that holding of National Eligibility-Cum- Entrance Examination (NEET) is legal, practical and is the need of the society.

The Government is of the opinion that it would be in the larger interest of the society and students aspiring to study medicine to have NEET. Therefore it has decided to file a review petition against the majority judgment delivered by the Supreme Court on 18.7.2013 in Christian Medical College, Vellore vs Union of India &Ors.

This information was given by Union Minister of Health & Family Welfare Shri Ghulam Nabi Azad, in written reply to a question in the Rajya Sabha today.

BN/HB
(Release ID :98095)
LINK HERE

Allot equal PG seats to govt, private medical colleges

noreply@blogger.com — Tue, 13 Aug 2013 05:03:00 GMT

Allot equal PG seats to govt, private medical colleges: HC

JABALPUR: A division bench of MP high court has directed the state government to adhere to a 50:50 distribution ratio of post graduate seats in the state-run and private medical colleges. Justice Rajendra Menon and Justice Vimla Jain made it mandatory for the director, medical education to follow the directions during counseling for medical PG seats scheduled this month.

Taking a serious view of allegations about private medical colleges auctioning PG seats to moneyed and unworthy for as high as Rs 2 crore, the bench disallowed the state's plea for four weeks time to file its reply, considering the delay could adversely affect young careers. The next hearing in the case will be held on August 26.

The court had admitted the PIL filed by a medical student Dr Shailednra Singh and others on Thursday who expected a post graduate seat strictly according to merit list after the last round of counseling on August 21. The PIL had charged the state medical education authorities with deliberately creating congenial conditions for the private colleges to usurp as many seats from the PG quota as they wished.

The most sought after seats in the streams like radiology, orthopedic surgery and gynecology the petitioner alleged had been hijacked in bulk by these private institutions and the state medical colleges have no access to them. This trend has caught on due to mushrooming private medical colleges across the state- that have no moral compulsions but were commercializing the medical profession.

The counsel for petitioner Aditya Sanghi submitted that in a clever manner to ward off criticism, the authorities has diverted subjects like anesthesia and other non-clinical streams - which apparently have few takers - to the state-owned medical colleges.

Questioning the duplicity and therefore intention of the concerned authorities, the counsel quoted the Supreme Court's judgment in the Modern Dental College and Research Centre, Indore versus state of MP in his favour where Justice Markandey Katju and Justice Deepak Verma had ruled that PG seats had to be divided in three parts. After reserving 15% under the NRI quota, the rest of the 85% seats should be distributed equally between the state and private colleges.

Moreover the distribution, as per the directive will apply to each subject and not to the bulk to beat the insidious game plan which, the petitioner had claimed, had pushed practically all the coveted streams out of the reach of meritorious students so far.

TENTATIVE DATE OF NEXT AIIMS

noreply@blogger.com — Mon, 12 Aug 2013 14:05:00 GMT

TENTATIVE DATE OF NEXT AIIMS

THIS POST IS TO INFORM YOU ON TENTATIVE DATE OF NOVEMBER AIIMS.EXACT DATE IS NOT PUBLISHED YET.BUT MOSTLY THE EXAM WILL BE CONDUCTED ON NOVEMBER 10 2013 AS GIVEN IN AIIMS SITE.EXACT DATE OF EXAM WILL BE INFORMED ONCE NOTIFICATION ON THIS IS AVAILABLE.

LINK TO KEY DATES IN AIIMS SITE CLICK HERE

NOTICE IN PRESS INFORMATION BUREAU MOHFW

noreply@blogger.com — Sun, 11 Aug 2013 19:08:00 GMT

Under graduate students requested the Government to have a relook at the recent amendment in the PG Medical Education Regulations of MCI

The under graduate students of four medical colleges of Delhi viz., AIIMS, MAMC, LHMC and UCMS met Additional Secretary and Joint Secretary of Ministry of Health & Family Welfare and lodged their protest against the recent amendment in the PG Medical Education Regulations of MCI which makes one year rural posting in a PHC mandatory for becoming eligible to take admission in a PG course.

The students requested the Government to have a relook at the proposal and demanded that one year rural posting should not be made an eligibility criterion for admission to PG courses. They suggested that such posting should be made voluntary and the respective State Governments should take the responsibility for providing security to doctors posted in rural areas. They also proposed that the PHCs in rural areas should be inspected from time to time by an independent panel of doctors. The student representatives wanted them to be consulted in this matter as it concerns their career prospects. Shri Mishra and Dr. Mehta heard the students and informed them that the amendment in PG medical regulation was in line with the commitment of the Government to improve the availability of doctors in rural and remote areas of the country. Nonetheless they assured the students that the Government would examine their grievances and take necessary action.

LINK TO NOTICE

Medical College managements bypass ASC directive

noreply@blogger.com — Sun, 11 Aug 2013 05:08:00 GMT

Medical College managements bypass ASC directive

It appears that the Kerala Private Medical College Managements Association (KPMCMA) is leaving no stone unturned to get around the Admission Supervisory Committee’s (ASC) directive that admission to privilege/community seats within the management quota should be made only from the rank list prepared by it.

The eight medical colleges under the KPMCMA have already admitted students to the 135 privilege/community seats from ranklists of various entrance examinations, including the National Eligibility-cum-Entrance Test.However, Justice J M James, who heads the ASC, has categorically said admission of students to privilege seats from lists other than that of the ASC would be invalid. That means the KPMCMA has to cancel the admission given to candidates from the NEET list.

Sources said KPMCMA office-bearers met Chief Minister Oommen Chandy and Health Minister V S Sivakumar in Thiruvananthapuram the other day, urging to ease the regulations imposed by the James committee for admission to privilege seats. It is reliably learnt that the Chief Minister had enquired about the matter to Justice James over the phone in the presence of KPMCMA office-bearers. KPMCMA secretary V Anilkumar said: “We have completed admission to majority of the privilege seats based on the eligibility of the candidates. As per the KPMCMA’s discretion, we have picked qualified candidates from the NEET list as well.”

Of the 35 per cent management quota seats at colleges under the KPMCMA, admission to 20 per cent seats should be on merit basis, while the remaining 15 per cent seats are considered privilege quota seats. According to the ASC, managements can follow ‘pick and choose’ method, but the candidates should have scored at least 50 per cent marks in the entrance exam conducted by the committee. ASC sources said it would act against the invalid admissions once the process gets completed and the list published by the KPMCMA

Government's decision on doubling medical PG seats might be impractical

noreply@blogger.com — Sun, 11 Aug 2013 05:03:00 GMT

Government's decision on doubling

medical PG seats might be impractical

PANAJI: The state government's submission to the Supreme Court (SC) that it wants to retain both groups of postgraduate students-those selected through the national entrance-cum-eligibility test (NEET) and those admitted via the MBBS merit list-is probably a ploy to silence critics by throwing the ball into the court of the Medical Council of India (MCI).

Sources in the know of admissions at the Goa Medical College say the state's attempt to double the PG seats in such a short time is impractical.

"Getting permission from the MCI to increase seats is a long-drawn process. This move to increase seats is therefore only an attempt to shut up critics," said sources.

Explaining, they said the GMC presently has 85 PG seats, of which 43 are for the all-India quota and the balance for Goa. To accommodate both sets of students, GMC needs at least 31-35 more seats. But to get the increase, a request has to first be made to the union ministry of health and family welfare, which in turn informs MCI.

MCI then sends a team to inspect the institute's infrastructure and to assess if it has the capacity to make the necessary changes to accommodate an increased student-load. The entire procedure, before MCI grants permission, takes about six to nine months, at times even a year. The number of beds and overall patient turnover at the institute is also considered before permission is granted. Moreover, any request to increase seats for an academic year, whether for undergraduate or postgraduate courses, has to be made in advance, stressed sources.

"The government's attempt to admit all PG students is a shabby move to cover its blunder," said a PG student, who believes it is highly improbable that MCI will agree with the state government at this stage. The PG academic year began on June 25.

Another student opined, "If MCI grants the Goa government request as a special case, it will be flooded with similar requests from other medical colleges in the country."

Health minister Laxmikant Parsekar merely said the matter is sub-judice, adding, "The SC will do justice to all."

Things are expected to be clear on August 13, when the matter comes up for hearing in the apex court and the MCI, which has been made a party in the petition, gives its say.

PG students selected via NEET, meanwhile, gave their joining letters on Thursday, but said, they will formally join classes from Saturday. "Friday being a holiday (Eid) we have not attended classes," a student said.

Doctors protest against rural posting

noreply@blogger.com — Fri, 09 Aug 2013 17:39:00 GMT

Doctors protest against rural posting

NEW DELHI: Hundreds of doctors from AIIMS, Vardhman Mahavir Medical College in Safdarjung hospital, Lady Hardinge Medical College, Maulana Azad Medical College and University College of Medical Sciences protested at Jantar Mantar on Thursday against the government's decision to make one year rural posting compulsory for medicos applying for post-graduate entrance exams.

"We are willing to serve in rural areas. But this term should be a part of the internship or post-graduate training program. Also, the infrastructure in primary health care centres and security for female doctors have to be upgraded," said Dr Navneet Motreja, who is leading the campaign.

He added that there are no proper labs to carry out investigations or research and the number of lab attendants or nurses is very less.

The protesters said that the huge gap in the number of undergraduate and post-graduate medical seats in the country is discouraging young students entering this profession. There are 46,300 undergraduate seats and 22,000 post-graduate seats out of which only 12,000 are in clinical subjects of interest.

"While the country suffers from acute shortage of specialists and super specialists, lack of post-graduate seats forces thousands of medical graduates to wait for years to get into specialty courses.

Private colleges charge huge capitation fee for admission in super specialty courses like radiology and orthopedics among others," said IMA secretary Dr Narender Saini.

He also said that the number of undergraduate and post-graduate medical seats should be equal.

A delegation of medicos met top health ministry officials and lodged their protest against the recent amendment in the PG medical education regulations of MCI which makes one year rural posting in a PHC mandatory for becoming eligible to take admission in a PG course.

"We heard the students and informed them that the amendment in PG medical regulation was in line with the commitment made by the the government to improve the availability of doctors in rural and remote areas of the country," a senior health ministry official said.

Why medical students are fighting rural posting

noreply@blogger.com — Fri, 09 Aug 2013 17:29:00 GMT

Why medical students are fighting rural posting

New Delhi: There were hundreds of them, without stethoscopes and with placards that declared "Save the Doctor." Medical students gathered on Thursday at Delhi's Jantar Mantar, the designated spot for protesters, explaining why they are fighting a new rule that needs them to spend a year in a village after they have qualified as doctors.

Water cannons were used to stop the students, most of them in their early 20s, from marching to the office of Health Minister Ghulam Nabi Azad.

In May this year, the government said that after getting their MBBS degree and before they start work as doctors, all students from private and government colleges have to spend a year at a rural posting. The rule is meant to apply next year and will affect nearly 40,000 students.

Without proof that they have completed this one-year internship, doctors cannot apply for the entrance test for a post-graduate course for specialisation.

The government says that it wants to improve services under the National Rural Health Mission and has, therefore, increased the three-month internship period to one year after they complete their MBBS.

medical_rally295x200.jpgBut students say that their five-and-half-year MBBS course does not give them the expertise to handle emergencies in rural areas with poor infrastructure. Many say that the constraint of resources makes it impossible to help patients improve. They also point to an alarming number of attacks on doctors by frustrated relatives in government hospitals where there is little security.

Students want the rural posting to be voluntary and a part of their post-graduate course.

"We already spend about 8.5 years studying to be a doctor. Many have to miss a couple of years studying to get into a good post-graduate course. Why not include this one year as a part of the PG program instead of us having to spend an additional year on the internship?" asked Karandeep Singh, who was among Thursday's protesters.

For now, the Health Ministry has assured the medical students that their concerns will be considered, without giving a time frame.

LINK TO NDTV REPORT CLICK HERE