RTH-AGITATION-A Cry for Survival-Smaller hospitals need support


#RTH-AGITATION- Rajasthan – Sadly doctors are fighting for their genuine rights and dignity against all. No one is with them – media, judiciary, Government and not even patients whom they have saved.

   Aspiring doctors should know  the reality  and introspect- why they wish to be a doctors in such circumstances?

  Smaller hospital and individual doctors’ clinics are backbone of the health care system in India. Their contribution towards public health  can’t be ignored. Be it Covid care  or treatment of daily ailments,  they are actually helpful to the public  and indispensable in real sense. Their contribution to society is huge especially  in view of broken public health care system.

         They provide health care near to public near their residential area at affordable cost. From an another angle, they generate employment to the workers as well as small businesses associated with their small hospitals.

In a populous country like India, strengthening these smaller hospital is a desirable step. To strengthen the health care, Government can actually do well to support these hospitals and achieve health care to  all. Supporting them  will require a fraction of  resources, as compared to the money needed in case  Govt has to provide to public itself.

   It will be a short-sightedness of the Government  policies, if instead of supporting them, Govt wishes to exploit their resources  to give free health care to public.

 But administrators  and bureaucratic system has failed on both fronts. Neither they were able to develop a  dependable health care system for public, nor they tried to support  smaller health systems. What they tried to do was akin to the ancient  story of  ‘ the farmer and the Golden goose’. The Greedy farmer wanted all the golden eggs instantly without feeding the bird and therefore  killed the duck.  Government  with its short-sighted bureaucracy is killing its golden health care and not realizing the real potential and benefits.

In the present day,  ebbed from all sides, doctors need to earn back the dignity of profession and resist oppression. The phenomenon of  oppression of doctors in the name of regulation is a global issue. The populist oppressive schemes in the  misleading names like  #RTH-Rajasthan (RIGHT TO HEALTH)  are prevalent everywhere globally in  some form or another. Doctors and nurses  have been  reduced to no more than moral and economical slaves either by industry or administrators, not infrequently pulled by legal bridle in their noses.

    

Will Rajasthan’s Right to health bill do more harm than Good

Acquiring kind of skill , the years of passionate, merciless, excruciating  medical learning   is placed  at the disposal of  administrators, who themselves have failed to develop a good health care system in real sense.  

    #NO-TO-RTH-AGITATION is  a movement , the result of failure of Government to create public health system, but it has potential to  fail the  existing  private doctors’  system as well. Smaller hospitals are already on verge of closure, will be forced to shut down. It carries the risk of extinction of neighbourhood friendly doctor and hospitals.

      The basic problem is the intentions for the task of developing a good health care system.  The agenda of administration is to control the health care workers rather than developing a good health care system for citizens.

 What NO-TO-RTH-AGITATION is actually doing? It is a  cry for survival of  the smaller hospitals- not only  for themselves but for Indian Health care  system, if short-sighted bureaucracy can understand the real problem.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Exorbitantly expensive medical education and lowered merit

What is wrong with medical profession?  Choosing medical career- a mistake?


    It is not easy to practice as doctor these days. Media full of doctors bashing, credibility crisis and regulators perpetually hounding doctors, who are forced to work under imposed medicolegal sword. There is no day that passes when system does not perpetuate negativity against medical profession.  Doctors, ebbed from all sides, have lost the dignity and independence.        Doctors and nurses have been reduced to no more than moral and economical slaves either by industry or administrators, not infrequently pulled by legal bridle in their noses.

    The complex medical skill, the years of passionate, merciless excruciating medical learning   is placed at the disposal of administrators, who themselves have already failed to develop a good health care system in real sense.  Doctors have become soft targets for populist attention mongering and transforming social nuisance into messiah of the deprived  by administrators -by sprouting the fraudulent generalities.

   All the calculations that usually precede the enslavement of medicine, everything gets discussed by administrators and industry – except the well-being of the doctors and nurses.

     Doctors have often wondered at the smugness with which administrators assert their right to enslave them, to control their work, to force their will, to violate their conscience, to stifle their mind. Irony is that while administrators do this, still they depend on the same doctors for saving lives -whose life they have throttled, who resent   the treatment meted out to the health care workers. 

          In todays’ era there has been bullying of doctors by administrative systems, new unreasonable laws, which use pressure tactics on medical professionals to get their own way – no less than enslavement.

Problems faced by doctors are not only innumerable but are also so exceedingly complex that they are difficult to be analysed. Doctors feel so disgusted   about the entire system that they do not encourage their children to take up this profession which until now was one of the coveted ones, there must be something going terribly wrong with the profession.

  1.  Medical courses are comparatively lengthy and expensive study course and difficult training with slave like duties. “enslavement of doctors”.
  2.   Uncertain future for aspiring doctors at time of training: Nowadays, doing just MBBS is not enough and it is important to specialize. Because of lesser seats in post-graduation, poor regulation of medical education, uneven criteria, ultimately very few people get the branch and college of their choice. 
  3.  Hostile environment for doctors to begin: Suddenly young and bright children complete  training and find themselves working in a hostile environment, at the receiving end of public wrath, law, media for reasons they can’t fathom. They face continuous negative publicity, poor infrastructure and preoccupied negative beliefs of society.
  4. Difficult start of career:  After a difficult time at medical college, an unsettled family life and with no money, these brilliant doctors begin their struggle. Even before they start earning a penny, the society already has its preconceived notions because of negative media publicity and  treats them as cheats and dishonest. Their work is seen with suspicion and often criticised.
  5. The fear and anxiety about the actual treatment, favourable and unfavourable prognosis of patient, keeps mind of a doctor occupied.
  6. Blamed for all malaise: The society gets biased because of the   media reports and some celebrity talking glib against medical profession. The blame for inept medical system, administrative failure and complexity of medical industry is conveniently loaded on doctors. These lead to formation of generalised sentiment against all doctors and are then unfortunately blamed for all the malaise in the entire healthcare system.
  7. Personal and family life suffers: Large number of patients with lesser number of doctors is a cause of difficult working circumstances, and the frequent odd hour duties have a very negative impact on the family and personal life of the doctor.
  8. Risk doctoring himself: Repeated exposure to infected patients in addition to long work hours without proper meals make them prone to certain health hazards, like infections which commonly include   tuberculosis and other bacterial and viral illnesses. Radiologists get radiation exposure. Because of difficult working conditions, some doctors are prone to depression, anxiety and may start on substance abuse.21 occupational risks to doctors and nurses
  9. Unrealistic expectations of society:  Every patient is not salvageable but commonly the relatives do not accept this reality. Pressure is mounted on doctor to do more while alleging that he is not working properly. Allegations of incompetency and negligence are quite common in such circumstances. These painful discussions can go to any extent and a single such relative every day is enough to spoil the mood for the day.
  10. Retrospective analysis of doctor’s every action continues all the life. It could be by  patients and relatives every day  in the form of  “ Why this was not done before?” Everyday irritating discussions, arguments, complaints, disagreements add to further pain and discontentment, in case the patient is not improving. Or it could be by courts and so many regulatory bodies. If unfortunately there is a lawsuit against a doctor, he will be wasting all his time with lawyers and courts, which will takes years to sort out.

The decision taken in emergency will be questioned  and  in retrospect they may not turn out to be the best one, but later retrospective analysis along with wisdom of hindsight with luxury of time, may be labelled as wrong if a fault-finding approach is used. This along with general sentiment and sympathy with sufferer makes medical profession a sitting duck for lawsuit and punishments. Even if the doctor is proved to be not guilty, his harassment and tarnishing of reputation would be full and almost permanent.

11. Physical assault, routine instances of verbal abuse and threat are common for no fault of theirs. Many become punching bags for the inept medical system and invisible medical industry. Recently, even female doctors have not been spared by mobs. Silence of prominent  people, celebrities and society icons on this issue is a pointer towards increasing uncivilized mind-set of society.

12. Medical industry may be rich but not the doctors: The belief that doctor’s is a rich community is not correct. Although decent or average earnings may be there, but earnings of most doctors is still not commiserate with their hard work viz-a-viz other professions. Doctors who also work like investor, a manager or collaborate with industry may be richer. But definitely most of doctors who are just doing medical care are not really rich.

13. Windfall profits for lawyers and law industry at the cost of doctors is a disadvantage for medical profession:  zero fee and fixed commission ads on television by lawyers in health systems are a common advertisement to harass doctors.  They lure patients to file law suits and promise them hefty reimbursements. There is no dearth of such   relatives, lawyers who are ready to try their luck, sometimes in vengeance and sometimes for lure of money received in compensations.  This encouragement and instigation of lawsuit against doctors is a  major disadvantage for medical profession.

14. Overall, a complex scenario for doctors: There is increasing discontentment among doctors because of this complex and punishing system. They are bound by so many factors that they finally end up at the receiving end all the time. They are under Hippocratic oath and therefore expected to work with very high morality, goodwill and kindness for the sufferings of mankind and dying patients.  They are also supposed to maintain meticulous documentation and also supposed to work under norms of  medical industry. They are supposed to see large number of patients with fewer staff and nursing support while still giving excellent care in these circumstances. And if these were not enough, the fear of courts and medico-legal cases, verbal threats, abuses, and physical assaults and show of distrust by patient and relatives further makes working difficult.

In this era, a thought is gradually getting prevalent-‘Is choosing medical career or becoming a doctor is a mistake?

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Exorbitantly expensive medical education and lowered merit

Medical Education #NEET & Termite of Corruption, Legalities, Touts


Our society has failed itself  to develop  a robust system of choosing and nurturing good doctors and therefore itself responsible for decline in standards of medical profession. Therefore the quality of doctors who survive and flourish in such system will be a natural consequence of how society chooses and nurtures the best for themselves.

     A  complicated admission process  of NEET counselling  has spawned a micro industry of medical education counsellors- nothing more than mediators and touts.

   Imagine, an opportunity is available to a patient, to decide the doctor as based on his route or marks for entry into medical college. Whether patient will like to get treated by a doctor, who   secured 20% marks, 30 % marks or 60% marks or 80% marks for medical college.  Even   an illiterate person can answer that well. But strangely for selection of doctors, rules were framed so as to dilute the merit to the minimum possible. What is the need to dilute and shortlist around half a million for few thousand seats? Answer to that is simple.  To select and find only those students from millions, who can pay millions to become doctors? 

Doctors are just as offshoots of a tree called as society. They essentially are the same as rest of the society. It is a specialized branch of tree which helps other offshoots of tree to save others. As part of same tree, they resemble the parent society, of which they are part. Society needs to choose and nurture a force of doctors carefully with an aim to combat for safety of its own people.

Exorbitantly expensive medical education and lowered merit has hollowed the quality of doctors  like  termite.  Aspiring doctors are now forced to pay exorbitant fee, in millions. Many go under heavy debt to pay medical colleges fee. Children with lower ranks in merit pay millions and can become doctors. The real problem here is that real deserving will be left out.

Medical students from the very onset,  are victims and witness to these practices and exploitation. They see their parents pay this unreasonable fee through their noses or take loans. Such blatant injustice will have an everlasting effect on the young impressionable minds.  

        The paradox- Society  and armchair preachers give doctors  lessons about  corruption and exploitation.

Medical admission season sees flood of legal cases

Mumbai TIMES OF INDIA: Chief Justice of India D Y Chandrachud, while speaking at a recent event in a Delhi hospital, called for reforms in medical education, referring to the sheer volume of cases that have made their way to the Supreme Court. It is no exaggeration, as the Directorate of General of Health Services’ Medical Counselling Committee (MCC), under the umbrella body of the union ministry of health and family welfare, alone has to deal with nearly 400 cases every year. From high courts to the apex court, the admission season is marred by litigation, from students aspiring to be doctors to doctors aspiring to be specialists and super-specialists. Sometimes, there are other stakeholders too and the stakes are indeed high. The National Eligibility and Entrance Test (NEET) for undergraduate courses, for instance. In the past four years, the number of MBBS aspirants registering for the test rose almost by 25%. Around 17.6 lakh students appeared for NEET-UG in 2022 —the highest for any competitive exam. On the contrary, the number of aspirants for engineering (registering for JEE-Main) dropped in the corresponding four years—from 11.5 lakh in 2019 to 9.05 lakh in 2022. If one takes into account the direct ratio of students to medical seats, 33 are vying for a single seat in a government college. It is further skewed if one considers the pool of seats in each category. The number of seats shrink at PG level. “The competition is fierce for students in the lower rank bracket. Eligibility issues are also a concern in lawsuits. There is a lot of emphasis on students bagging a PG degree, from parents, even colleges.

More students going for higher studies give colleges brownie points in the accreditation process. There is a general sense of feeling that only an MBBS degree is of no consequence. After all of it, if students lose their seat over a technical point, they will prefer moving court over losing a year, he said. Even as thousands of students appear for their NEET-PG today, courts saw several litigation seeking postponement of the exam till last week. “There is no uniformity in the schedule followed by different states, even as there is one central exam for all. Students have to mandatorily complete their internship to be eligible for a PG seat, but the internship deadline in states differ. What is the point of completing the exam in March and waiting till July for the counselling round? Such policy decisions are not student-friendly, and therefore are met with opposition,” said parent representative.  Former member (board of governor), erstwhile Medical Council of India and dean (projects) at Tata Memorial Hospital, Dr Kailash Sharma, said clarity from National Medical Commission, from MCC, government of India, is expected. “Similar cases in lower courts should be bundled and heard by the apex court that will also reduce time on each case,” said Sharma. Meanwhile, a complicated admission process has spawned a micro industry of medical education counsellors. The process is complicated for an 18-year old to manage on his own.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Exorbitantly expensive medical education and lowered merit

Selling of the Medical Seats near Bubble Burst: lower percentiles #NEET


Lowering NEET Percentile In PG or SS Making seats available at a lower percentile (15 -20) in post graduate and Super specialities courses will jeopardize the already crumbling quality of Medical Education  and will result in bidding for the  seats.

    This potpourri portends to be a travesty of quality, not just of medical education but more seriously, of the quality of doctors. Allotment of medical seats is being left to the vagaries of populism and commercialism, through a false sense ‘the illusion of merit’ secured via NEET. Admission criteria whittled down to mere 10-20 percent, will result in an irreversible and regressive compromise with quality of doctors. Will patients approve such dizzying choice and at what cost?       

       Going by selection of candidates as doctors, if given a choice, by which a patient will like to get treated? A candidate who scored 20 % marks or a person getting 60% or 80% marks.   NEET eligibility getting lower and a candidate getting around 20 % of marks may be able to secure a degree to treat patients.  What will be the deciding factor? The criteria as to why a person with 60% marks not getting a seat and another with 20% marks will be able to secure. It will depend upon, whether a candidate is able to pay the exorbitant fee or not. Present system and mechanism of admission permit and accept such huge variation! That strange equation is acceptable in lieu of money paid!

 Lowering NEET Percentile In PG or SS is an illusion of merit.   Overplayed narrative of fewer doctors in the country, rather than a system  for proper utilization is an effort to increase numbers of doctors is associated with dilution of merit. But this goal needs to be achieved with preserving quality of medical education.  

      Selling the medical seats is heading towards bubble burst, when despite declining demand for poor quality and expensive medical education, new private colleges being approved along with lowering merit to a dismal percentage.   

       Future doctors getting admissions by scoring just 10-20 percent of marks, poor teacher student ratio, seats being awarded to highest bidder are few pointers to the poor quality of medical education. Few years back NEET percent system was changed to percentile and now the bar is lowered further, just to accommodate more ‘bidders’ with less marks, to be able to buy  medical seats.   

Now, super specialty medical seat cut-offs slashed to 20 percentile

MUMBAI: Post-graduate doctors scoring as low as 20 percentile in NEET-SS will now be eligible for superspecialty seats in the country. Despite two rounds of admissions, over one-fifth of the seats in the courses are lying vacant. To ensure these seats do not go wasted, the National Board of Examinations in Medical Sciences slashed the cut-offs to 20 percentile from 50. In some of the courses, the raw scores for eligibility have dropped even to 188 or 217 out of 600. 2/10/23, 6:39 PM Now, superspecialty medical seat cut-offs slashed to 20 percentile.

On February 8, the board issued a circular announcing the special mop-up round in NEET-SS counselling and also the revised cut-offs in different specialty groups. The schedule for the mop-up round will be released soon. An official from the ministry of health and family welfare said that approximately 1,000 seats are vacant out of close to 5,000 superspecialty seats in the country. The Federation of Resident Doctors’ Association India had requested the Centre to relax the eligibility criteria to ensure there is no wastage of seats, after receiving representations from aspirants, said Dr Kulsaurabh Kaushik, a member. He said sometimes seats go vacant in private colleges because of higher fees. Dr Avinash Supe, former dean of KEM Hospital, said, “Total SS seats in the country have gone up tremendously in recent years and students have become selective. For instance, in the surgical group, many are now preferring urology, gastrointestinal (GI) surgery and surgical oncology, whereas there is not much demand for paediatric, or cardiovascular and thoracic surgery. You need larger set-ups for these, which many cannot invest in. On the contrary, urology and GI surgeries need smaller set-ups and there is a demand too,” said Supe. He added in some courses, supply is higher than demand in the country. For a long time, even KEM did not get students for courses such as paediatric surgery. Last year, the Centre brought down the cut-off to 15 percentile after seats remained vacant in superspecialty courses.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Comparison of AIIMS (medical) and IIT (Engineer) graduate with 5 years invested. Do doctors deserve better salaries?


       Let us compare the start of career for medical and engineering graduates. To have a balance, comparing apples to apples, comparison of AIIMS graduates (premier institute –medical) to IIT graduates (Premier institute -Engineering) looks justified.  This goes without any need to emphasize that students selected in both are exceptionally brilliant and toppers of the country.

    Although this comparison is not a secret and everyone knows about it, but still it need an attention from a different point of view. It should be an eye opener not only to medical students or aspiring doctors but to the society as well. It projects the severe disparity to an extent of blatant injustice towards medical students.

  When engineering students after a course of  4 years  (at 21 years of age )are placed with package of 1.2 to 3.6 crores (1-4 lakh dollars), the medical students are starting with internship. Medical students still need to study for at least 5 years more (at 21 years of age ) to start earning maximum 12 -15 lakh per annum ( 15 thousand dollars). It may be raised to 24-30 lakhs (30000 dollars) per annum after 10 years, still one tenth of their contemporaries from IIT. Remember we are talking about only premier institutes, what happens to others is still a matter of luck.

   When engineering students earn crores, do jobs and get experience about the real world, medical students are worrying about the problems, which should not have been there in the first place. The common issues bogging down the medical students are trying to get into post graduate courses, inhuman duties lasting 24-48 hours, payment of unjustified fee of medical colleges, trying to fend off bond policies, court cases, bearing with assault on doctors, working in poor and inept health care infrastructure- just to name a few.  With all these problems lingering for years, doctors remain unwise in worldly matters, financially illiterate and sitting ducks for punishments due to excessive regulation and unjustified moral burden.  

      This comparison is essential to be kept in mind by aspiring doctors when they choose medical career. The respect and money associated with the hard work to be a good doctor is no more available even to the best.


   A Point to  ponder for everyone, what is the reason for such disparity?  Why doctors do not deserve better salaries? What is the need for  aspiring doctors to choose lowly  paid jobs for more hard work and more noble work? A fodder for thought for society  and administrators as well.

IIT hiring: Domestic offer hits record Rs 1.8 crore

IIT hiring: Domestic offer hits record Rs 1.8 crore

MUMBAI: After a lull in the first pandemic year, crore-plus job packages returned with a bang on premier IIT campuses. On the opening day of the season, several IITians entered the crore-plus salary club, as the highest domestic package touched an all-time high of Rs 1.8 crore and international offers crossed the Rs 2 crore mark. While Uber picked one student each from at least five IITs, including IITBombay and Madras, for a package of Rs 2.05 crore (or $274,000), one student at IIT-Roorkee received an international offer of Rs 2.15 crore ($287,550) and three others got domestic offers ranging from Rs 1.30 crore to Rs 1.8 crore. In the first slot at IITB, the highest offer after Uber came from cloud data management company Rubrik, with a Rs 90.6 lakh (or $121,000) package.  Of the domestic roles, investment management firm Millennium picked students for a package of Rs 62 lakh in the first slot, while WorldQuant offered Rs 52.7 lakh and Blackstone Rs 46.6 lakh. IIT-Madras students get 176 offers in first session on day 1 ALSO READ IIT-BHU student bags Rs 2 crore package from US company in placement . The highest numbers of domestic offers were made by Google, Microsoft, Qualcomm, Boston Consulting Group (BCG), Airbus and Bain & Company. IT/software, core engineering and consulting were the leading sectors to hire from the institute in the first slot. As many as 11 international offers were made at IIT-Madras on day one, said professor CS Shankar Ram, adviser (training and placement), IIT Madras. The institute recorded 407 offers in the first session of the placements, its best ever, including 231 PPOs. In all, 11 students received offers that crossed Rs 1 crore and of them 10 got domestic offers and 13 students signed up for an international offer, of which 12 opted for packages less than Rs 1 crore to take up jobs in Japan and Singapore.

Record Rs 3.6cr offers to 3 from Delhi, Bombay, Madras IITs for Hong Kong posting

MUMBAI: Hong Kong and Singapore seems to be the destinations where IITians are heading to this placement season, with most big-ticket offers being offered by trading firms there. Jane Street, a quantitative trading firm, has picked at least one student each from IIT-Bombay, Delhi and Kanpur for its Hong Kong office for a record package of Rs 3.6 crore. These, however, were made as pre-placement offers (PPOs) before the season kicked off on December 1. Another high-frequency trading firm Quantbox Research has made an offer of Rs 1.6 crore at multiple IITs for its Singapore office. one IIT-Bombay student, there are other PPOs that have made offers to students of close to Rs 2 crore,” said a source at IIT-B. On-campus job offers have not touched the Rs 2 crore mark. “There are several Rs 1 crore job offers and there are 15 companies with international locations, On the first day of placements, IIT-Bombay had 46 companies interviewing candidates either online or in-person. Of the 250 job offers on Day 1, more than 175 were accepted. On Day 2, a total of 48 companies were at IIT-B. The highest package so far this year domestically is Rs 1.9 crore, while there are a good number of packages from international recruiters as well.

Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Assault on a Woman Doctor #Kerala: Medics Serving Uncivilized Society with Poor Law & Order


THIRUVANANTHAPURAM- Kerala: The assault on a woman doctor at Thiruvananthapuram Government Medical College has made doctors preparing for a career in the medical profession worried. A bystander kicked the woman doctor on her lower abdomen in front of an ICU in the middle of the night on November 23. The CCTV visuals showed that she was surrounded by a group of bystanders.

    The physical assault on a lady doctor reflects that doctors are serving an uncivilized society.  Such news is viewed by medical community anxiously and is definitely a poor advertisement for younger generation to take medicine as profession.

     Strangely media, courts, prominent people, celebrities, human right commission, woman right activists and women commission are little concerned about the blatant injustice done towards doctors.  This again brings forth the hypocrisy of these people and organizations, who otherwise cry hoarse about woman rights and empowerment.  Whenever a female is assaulted, there is an outrage but the same support is not extended to a female if she is a doctor. Such bestiality should create havoc in minds of civilized people but this apathy to such incidents clearly indicates otherwise. Have we become so uncivilized that an incident such as this just remains as a small news item in a local paper? Can’t we see that such incidents are harbinger of many more in future? It is important to realize that this is the time to unify and condemn such episodes vehemently and prominently so that the miscreants realize that they cannot get away with it.

     Brutality against doctors reveals a deep prejudice and lawlessness, merely on the basis of perceived negligence. Government is either unwilling to act and establish a strong culture of deterrence, so justice been elusive for medical professionals.

Even murderous assaults on doctors are not enough to shake administrators, courts  and doctors’  organizations  out of slumber.  Definitely such violence, if unabated will be   poor advertisement for   next generation to take medical profession as a first choice.

Media and celebrities   have proudly  projected in films and television that doctors can be beaten and assaulted, in case there are unexpected results or in case of dissatisfaction. The “Reel Heroes” depicting violence against the doctor is seen as a routine and looked as an   easily do-able- adventure due to unwillingness of  Government  to take stringent action. As patients will continue to get treatment in hospitals and few cannot be saved, so every death declaration may be a harbinger to such attacks in future.

A notion has been propagated   that   assaulting a doctor under emotional  outburst  to be taken as normal and should not be punished.

THIRUVANANTHAPURAM: The assault on a woman doctor at Thiruvananthapuram Government Medical College has made doctors preparing for a career in the medical profession worried. A bystander kicked the woman doctor on her lower abdomen in front of an ICU in the middle of the night on November 23. The CCTV visuals showed that she was surrounded by a group of bystanders. She survived the attack and is recuperating. But the incident has left her shattered. “I am reconsidering my decision to become a neurosurgeon and even the career of a doctor,” she told Sulphi N, IMA state president, when he visited her in the hospital.The Kerala Medical Post Graduate Association has taken up her cause and demanded justice.

They are worried that such attacks would happen again and there would be a new victim. “It is unnerving that such attacks happen in medical colleges which are supposed to be a secure location. What will happen to us if we go to peripheral hospitals for practice,” said Dr Ruwise E A, Thiruvananthapuram unit president of Kerala Medical Post Graduate Association.He came to know from police officers that an arrest was unlikely on Friday and the accused was trying to secure bail. “The government should have arrested the culprit immediately and sent a message to the public that such attacks are not tolerated,” said Dr Ruwise.KMPGA plans to strengthen the strike if there is no arrest till Sunday. The doctors association has extended support to the protest by residents. “We cannot leave the students alone on this issue. It was an assault on a woman who was doing her duty. If it was a senior doctor who received such a kick on the lower abdomen he or she would not have survived the attack,” said Dr Nirmal Bhaskar, state president of Kerala Government Medical College Teachers Association (KGMCTA).The doctors share their angst as there was not enough support from government and society even when the attacks keep repeating. They did not take the Facebook post by Health Minister Veena George condemning the attack seriously.There are health experts who think that a multi-pronged approach is necessary to prevent such attacks. It involves reducing the crowd by strengthening peripheral hospitals, increasing staff and providing better security.“The government health system has become an easy target nowadays. Such attacks do not happen in private hospitals where bystanders pay the remaining hospital bills without uttering a word of protest even after the patient could not be rescued,” said Dr Althaf A, secretary of IMA, Thiruvananthapuram branch. He pointed out that there are no trained administrative cadres to manage a 4,000-bed MCH. All of this is managed by a superintendent who is also a professor with teaching responsibilities.

     Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

SC Rejects Greedy decision by Govt & Private Medical College-Fee Hike


 

    The Supreme Court set aside an Andhra Pradesh government order of 2017 prescribing a seven-fold increase in MBBS fees that made it ₹24 lakh per annum.

The Supreme Court in a judgment on Monday held that education is not a business to earn profit as it set aside an Andhra Pradesh government order of 2017 prescribing a seven-fold increase in MBBS fees that made it ₹24 lakh per annum.

Directing the private colleges to refund the amount collected in excess of the fees last fixed by the state government in 2011, a bench of justices MR Shah and Sudhanshu Dhulia said, “Education is not the business to earn profit. The tuition fee shall always be affordable.”

The order came on a petition filed by the Narayana Medical College challenging a September 2019 decision of the Andhra Pradesh high court striking down the fee increase and ordering refund to students admitted in the college since the academic year 2017-18. The apex court dismissed the petition with cost of ₹5 lakh to be borne equally by the petitioner college and state government and deposited in court within six weeks. The amount was directed for use in legal services by the Supreme Court Mediation and Conciliation Committee and the National Legal Services Authority.

The top court agreed with the conclusion made by the high court and said, “To enhance the fee to ₹24 lakh per annum, I.e., seven times more than the fee fixed earlier was not justifiable at all.” The aggrieved medical students who had to pay through their nose had said that the government order raising the fees issued on September 6, 2017 was done without awaiting the recommendation of the Admission and Fee Regulatory Committee (AFRC).

The bench held the order passed by the state government to be “wholly impermissible and most arbitrary”. The court even went to the extent of saying that the hike was done “only with a view to favour or oblige the private medical colleges.”

“Any enhancement of the tuition fee without the recommendation of the AFRC shall be contrary to the decision of this court in case of P.A Inamdar in 2005 and the relevant provisions of the 2006 AFRC Rules (prevailing in the state). The high court has rightly quashed and set aside the GO dated September 6, 2017.”

The students pointed out that in 2011, the tuition fee hike was introduced by the state after consulting AFRC. However, in 2019, the state acted solely on representations received from private medical colleges. Rule 4 of the Admission and Fee Regulatory Committee (for Professional Courses offered in Private, Unaided Professional Institutions) Rules, 2006 mandated the state to seek a prior report from AFRC before altering the fee.

This rule required AFRC to factor in the location of the institution, nature of professional course, cost of available infrastructure, expenditure on administration and maintenance, reasonable surplus required for growth and development of the institution, revenue foregone on account of waiver of fee in respect of students from reserved category or economically weaker sections (EWS) of the society.

The top court said, “Determination of fee/review of fee shall be within the parameters of the fixation rules and shall have the direct nexus on the factors mentioned in Rule 4 of the 2006 Rules…the state government enhanced the tuition fee at an exorbitant rate of ₹24 lakh per annum, almost seven times the tuition fee notified for the previous block period.”

The next question arose regarding refund as ordered by the high court in its order of September 24, 2019. The high court said that the colleges cannot take benefit of the unjust enrichment in fees that was wrongly increased. Accordingly, it asked the colleges to refund the students after adjusting the amounts payable under the earlier fee structure recommended by AFRC and issued in June 2011.

The bench upheld this part of the high court order and said, “The medical colleges are the beneficiaries of the illegal GO which is rightly set aside by the high court.” The bench was conscious of the hardships faced by students who arranged to pay the amount by obtaining loan from banks and financial institutions at high rate of interest. “The management cannot be permitted to retain the amount recovered or collected pursuant to the illegal GO,” it held.

The college told the Supreme Court that between 2011 and 2017, they incurred added expenses due to the requirement introduced in 2016 to pay stipend to students even as the fee remained unchanged since 2011. The bench told the college that this component would be compensated as and when the higher tuition fee is fixed by AFRC. However, the court did not permit the college to retain the illegally collected amount.

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NEET- Not so Neat- percentile system

The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Projection of  Inflated Cost of Medical Education- Global Exploitation of Young Doctors


The  Myth  of  cost of  spending  on  medical  education needs to be made  transparent.

Educating a doctor cost less what   medical colleges  claim- a global phenomenon.

   Instead of   often  repeated statements  about high expense on running medical college and  projecting it   as a  hard  fact, the amount spent  on  medical students by all medical colleges should be made transparent by all institutions. The  frequent  statement  is made that  cost of  making a doctor is very high and  gleefully  propagated  by  the  private medical colleges to extract millions out of  young  medical students . 

Such statements without any actual public data  is repeated  to the   extent  that  it  is  firmly  entrenched  in  public  mind without any real evidence.

     High cost  is  the  reason    with an intention  to  exploit the young doctors in various ways to get cheap labour and extract  millions from aspiring doctors  by private medical colleges.

      The  basis  of  such calculation should be transparent for every medical college and all institutions. 

       In any medical college,  only the   Departments  of  Anatomy and Physiology  are purely for medical students. The  remaining  subjects  taught  in  medical  colleges  across  the  country  are  related  to  patient 

care  and  medical  education  is only  a  by-product.  All the medical teachers are actually doctors involved in treatment of patients, running  the hospital  and students observe the treatment and learn medicine. The interns and  postgraduate  students  provide the cheap and labour and actually save the costs of running the hospital.

 Therefore   if  some college   is  actually  spending  millions   to  produce  one  MBBS  doctor ,  it  is  a  either an   inefficient  model   or costs are inflated and exaggerated to exploit the young doctors.

Educating a doctor cost less what   medical colleges claim

The average cost of producing a doctor or nurse went down across most parts of the world between 2008 and 2018, but almost tripled in China and doubled in India, a Lancet study shows. Despite this, the estimated expenditure per medical graduate in China at $41,000 is higher only than in sub-Saharan Africa and about 42% lower than in India ($70,000) against a global average of $114,000. The pattern was the same for nurses with the estimated expenditure per nursing graduate dropping across the world while it went up by 167% in China and doubled in India. The only other region where the per graduate cost went up was in North Africa, where cost per doctor went up by 47% and by 25% for nurses. Approximately $110 billion was invested globally by governments and students’ families in medical and nursing education in 2018. Of this, $60.9 billion was invested in doctors and $48.8 billion was invested in nurses and midwives, the study estimated.

The paper looks at important developments in medical education to assess potential progress and issues with education of health professionals after the Covid-19 pandemic. Mean costs in 2018 were $114,000 per doctor and $32,000 per nurse. In 2008, China had the lowest estimated expenditure per medical graduate at just $14,000 (Rs 6 lakh) followed by India, where it was just $35,000 (Rs 15 lakh at the 2008 exchange rate of Rs 43 to a dollar). This is much lower than the estimate of Rs 1 crore or more that Indian colleges widely claim as expenditure per medical graduate.

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   Medical-Consumer protection Act- Pros and Cons

Expensive Medical College  seat- Is it worth it?

ZERO Percentiles Requirement to be a Super Specialist Doctor- a Cruel Joke


          MUMBAI: With hundreds of medical super specialty course seats vacant, the authorities have removed the qualifying mark criterion for aspirants. So, rock-bottom scores or a zero percentile would be acceptable for a course at this level.

            Such decisions appear to be   cruel joke to the life of patients. A wise decision would be to review into reasons for vacant seats for example- policies, fee structure, facilities, demand for the course, and disillusionment of students by existing system or falling percentages to be a super-specialist doctor.  

          Imagine, an opportunity is available to a patient, to decide the doctor as based on his route or marks for entry into medical college. Whether patient will like to get treated by a doctor, who   secured 20% marks, 30 % marks or 60% marks or 80% marks for medical college.  Even   an illiterate person can answer that well. But strangely for selection of doctors, rules were framed so as to dilute the merit to the minimum possible. So that a candidate who scores 15-20 % marks also becomes eligible to become a doctor. That is now further diluted to nearly Zero percentile. Answer to that is simple.  To select and find only those students, who can pay millions to become doctors,  and hence marks and quality of doctors don’t matter?  

   If the society continues to accept such below par practices, it has to introspect, whether it actually deserves to get good doctors. Paying the irrational fee of medical colleges may be unwise idea for the candidates, especially those who are not from strong financial backgrounds. But at the same time unfortunately, it may be a compulsion and entrapment for students, who have entered the profession and there is no way  forward.  

So, rock-bottom scores or a zero percentile would be acceptable for a course at this level.

      Society needs to choose and nurture a force of doctors carefully with an aim to combat for safety of its own people. If society has failed to demand for a good doctors and robust system, it should not rue scarcity of good doctors. Merit based cheap good medical education system is the need of the society. This is in interest of society to nurture good doctors for its own safety.      The quality of doctors who survive and flourish in such system will be a natural consequence of how society chooses and nurtures the best for themselves.

    MUMBAI: With hundreds of medical super specialty course seats vacant, the authorities have removed the qualifying mark criterion for aspirants. So, rock-bottom scores or a zero percentile would be acceptable for a course at this level. “Seats have been going vacant every year. The government felt that as a one-time measure, in the larger context of things, we can even accept students with a zero percentile. This will not have any precedence. It is being taken up as a test case. After all, the entrance test was not conducted to eliminate students, but merely to grade them,” said a senior officer from the health ministry. With 748 super speciality seats unfilled after four rounds of admission this year, the Medical Counselling Committee (MCC) took the drastic step. As a one-time measure, any candidate who had taken the NEET super speciality 2021 exam can participate in the special mop-up admission round irrespective of his/her scores.

When admissions began this year, two rounds conducted by the MCC got a cold response. This led to a special mop-up round with the qualifying bar lowered by 15%. Yet, there weren’t many takers. Now the second mop-up round is open to all aspirants. India has about 4,500 super specialty medical seats. There is more vacancy in the surgical branches than the clinical ones. “Candidates have realised that having a broad speciality gives them a good career and money. Hence, many do not want to spend more time in pursuing a super specialty course,” said Dr Pravin Shingare, former head of the Directorate of Medical Education and Research (DMER). “If you look at Grant Medical College, 80% seats in super specialty have been lying vacant for 10 years. At GS Medical College, 40% seats in the last 4-5 years have been unfilled,” he added. But the trend has extended to the non-surgical branches too in the past three years. The bias in selecting programmes often is dictated by considerations that in the case of a surgical branch, a candidate needs to work with a team, have an operation theatre, but a clinical course allows the doctor to work independently out of a clinic.

Parent representative Sudha Shenoy said the problem also lies with the long bond that candidates need to serve if they join a government college. “Any candidate who joins a super specialty programme would be at least 30 years old. If they have to serve a 10-year bond, when will they start earning? So, government hospitals go off most students’ choice list. And when it comes to private and deemed institutes, the fee is out of bounds for most,” explained Shenoy

Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes        

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons              

Expensive Medical College  seat- Is it worth it?

Demonize Doctors: New Fad of Administrators- Accepted Norm for Populism? #Dr-Raj-Bahadur-VC-BFUHS Resigns


Dr Raj Bahadur, the vice-chancellor of Baba Farid University of Health Sciences (BFUHS) in the state’s Faridkot district Punjab, submitted his resignation to the Chief Minister’s Office late on the night of Friday, July 29.  He has resigned after state health minister allegedly forced him to lie on a dirty mattress at a hospital.

         Administrators, who have never treated a patient in their lifetimes, not only try to control treatment of thousands of patients, but project themselves messiah by demonizing doctors. Lowly educated celebrities and administrators have found a new easy way to project themselves on higher pedestrian by publically insulting highly educated but vulnerable doctors. The biggest tragedy to the medical profession in the present era is the new fad of administrators to discourage and demonize  the  medical profession for their popularity gains.
          Being  so distant from the ground reality, their role should not have been more than facilitators, but they have become medical  administrators. To control the health system, administrators have a tendency to pretend that shortcomings in the patient care can be rectified by punishing the doctors and nurses.
          Such vulnerability to insult is intrinsic to the doctors’ work, makes them sitting ducks, an easy target for harassment and punishments, if administrators wishes to do so. This vulnerability is exploited by everyone to their advantage. Administrators use this vulnerability to supress them. It is used by media and   celebrities who projected themselves as Messiah for the cause of patients, and sell their news and shows by labelling the whole community of doctors as king of fleece tragedy based on just one stray incident. 

       The painful incident of Dr Raj Bahadur’s   humiliation unmasks the everyday struggle of the doctors in the present era. His resignation  after the public insult  depicts the plight of doctors – being undervalued and demonized by administrators, forced to work as a sub-servant to bureaucrats, irresponsible policing, blackmail by goons and vulture journalism-all have become an accepted form of harassment.  The incident has unveiled the despondency, moral burden of mistrust that doctors carry.

  Sadly, the society is unable to realize its loss.

    Bullied by  administrative systems,  indifference of Government and venomous media has made it impossible for health care workers to work in a peaceful environment.  Is there any punishment for the  administrators for mismanagement or poor infrastructure or lack of funds? Looks impossible but punishment to the sufferers is on the cards.

     Medical students or aspiring doctors should be carefully watching the behaviour and cruelty by which doctors are governed, regulated and treated by administrators. Mere few words of respect and false lip service during Covid-pandemic  should not mask the real face of administrators, indifference of courts and harshness of Government towards medical profession. Choosing medical careers can land anyone into the situations, which are unimaginable in a civilized world. Role of doctor associations, parent institutes has remained more or less weak, spineless and not encouraging.

     Hence by selective projection the blame for deficiencies of inept system, powerful industry, inadequate infrastructure and poor outcomes of serious diseases is shifted conveniently to doctors, who are unable to retaliate to the powerful media machinery.

Faridkot district, submitted his resignation to the Chief Minister’s Office late on the night of Friday, July 29.

 

       New Delhi: The vice-chancellor of a medical college in Punjab has resigned after state health minister allegedly forced him to lie on a dirty mattress at a hospital.

Dr Raj Bahadur, the vice-chancellor of Baba Farid University of Health Sciences (BFUHS) in the state’s Faridkot district, submitted his resignation to the Chief Minister’s Office late on the night of Friday, July 29.

Hours earlier state health minister Chetan Singh Jouramajra had asked him to lie down on a dirty mattress during an inspection of Faridkot’s Guru Gobind Singh Medical College and Hospital, which comes under the BFUHS.

A video clip of the incident that circulated on the social media, showed Jouramajra place a hand on the veteran surgeon’s shoulder as he pointed towards the “damaged and dirty condition” of the mattress inside the hospital’s skin department.

The minister then allegedly forced Bahadur to lie down on the same mattress.

Though the vice-chancellor himself did not confirm his resignation, highly placed sources in the health department confirmed the same to multiple outlets. When approached for comments,  reports that The Tribune Bahadur said, “I have expressed my anguish to the Chief Minister and said I felt humiliated.”

Reports have it that chief minister Bhagwant Mann has expressed his displeasure over the incident and spoken to Jouramajra. Mann has also asked Bahadur to meet him next week.

Speaking to The Indian Express, Bahadur additionally said: “I have worked in 12-13 hospitals so far but have never faced such behaviour from anyone till now. I shouldn’t have been treated this way… it affects this noble profession. It is very painful. He showed his temperament, I showed my humility.”

Bahadur is a specialist in spinal surgery and joint replacement and a former director-principal of Government Medical College and Hospital in Chandigarh. He has also been the head of the orthopaedic department at PGIMER, Chandigarh.

Asked whether new mattresses had been ordered for the hospital, he said: “Two firms sent their quotations and the rate finalisation needs to be done. It is a 1,100-bed hospital and not all mattresses are in bad condition. This mattress shouldn’t have been there but hospital management is the prerogative of the Medical Superintendent.”

Speaking to reporters at the hospital, Jouramajra said: “My intention was not to do any inspection. In fact, I am visiting various hospitals to see what the requirements are so that we can fulfil them.”

Various quarters, including the Indian Medical Association, have criticised Jouramajra.

PCMS Association, a doctors’ body in Punjab, to,  in a statement, strongly condemned the “unceremonious treatment” meted out to Bahadur. PCMSA said the way the V-C was treated was “deplorable”, its reason notwithstanding.

The body expressed its “deep resentment” over the incident and said “public shaming of a senior doctor on systemic issues is strongly condemn-able.”

Advantages-Disadvantage of being a doctor

     25 factors- why health care is expensive

REEL Heroes Vs Real Heroes        

 21 occupational risks to doctors and nurses

Covid paradox: salary cut for doctors other paid at home

   Medical-Consumer protection Act- Pros and Cons              

Expensive Medical College  seat- Is it worth it?

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