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

Comparison of AIIMS (medical) and IIT (engineer) graduate with 5 years invested. Why doctors do not 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

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

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.

December 4, 2022 1

Disposal of the Dead after Death-Environment Impact & Carbon Cost

Burning the bodies of the dead was an ancient rite and practice in India. It was observed among Buddhists, Hindus and Jains from well before the start of the Common Era, and was later adopted by Sikhs. Burning the dead historically helped demarcate these religious communities from Muslims and Christians, for whom burial was the norm, and from India’s Parsi community who exposed their dead on Towers of Silence. Burning bodies after death, originating at a time when India was still heavily forested, cremation may also have been environmentally more appropriate and sustainable than, for instance, the mummification practised in the dry desert air of ancient Egypt.

Burning Issues: Cremation and Incineration

In India, one estimate reveals that funeral pyres consume 6 crore trees annually and play a huge role in deforesting the country. Air pollution and deforestation are not the only environmental threats of cremation. They also generate large quantities of ash – around 50 lakh tonnes each year – which is later thrown into rivers, adding to their waters’ toxicity. The prolonged burning of fossil fuels for cremation results in around 80 lakh tonnes of carbon dioxide or greenhouse gas emissions per year, according to one estimate. It creates different hazardous gases, including dental mercury, which is vaporised and released into the environment leading to health hazards in the surrounding area. Many of these toxins can bio-accumulate in humans, including mercury – often from dental amalgams, but also from general bioaccumulation in the body. Cremation results in various other toxic emissions including persistent pollutants such as volatile organic compounds, particulate matter, sulphur dioxide, nitrogen oxides and heavy metals. An IIT Kanpur study in 2016 found that open-air cremations contribute 4% of Delhi’s carbon monoxide emissions. There are concerns for crematorium workers as well, who may be exposed to nuclear medicine treatments (chemotherapeutics/radiation), orthopaedic (implants) and pacemaker explosions, and nanoparticles.

. In order to tackle the environmental problems stemming from these sites, the Indian government and environmental groups have over the years tried to promote the use of electric crematoriums as an alternative way of cremation. Electric crematoriums largely unsuccessful, are expensive to run, and crucially, traditional rituals are made impossible.

Carbon Cost estimation -When people are cremated after death, the burning releases carbon into the air. Alkaline hydrolysis, in which the body is dissolved, has about a seventh of the carbon footprint of cremation, and the resulting fluid can be used as fertiliser. A Dutch study of the disposal of bodies found that the lowest amount of money that it would theoretically cost to compensate in terms of the carbon footprint per body was €63·66 for traditional burial, €48·47 for cremation, and €2·59 for alkaline hydrolysis. Composting or natural burial are alternatives.

New Delhi: The National Green Tribunal (NGT) has questioned the centuries-old tradition practised by Hindus to cremate dead bodies at the river banks, saying the method of burning wood leads to air pollution and also effects natural water resources.

Keeping in mind the growing level of pollution, the NGT said that there was a need to adopt environment-friendly methods like electric crematoriums and use of CNG and change the ‘mindset of the people’.

The NGT bench headed by Justice UD Salvi also directed the Union Environment Ministry and the Delhi government to initiate programmes to provide alternative modes of cremation of human remains, saying the traditional emitted hazardous pollutants in the environment.

“It is also the responsibility of the government to facilitate the making of the mindset of the citizens as well as to provide environment-friendly alternatives for cremation to its citizenry,” the bench further said.

The green panel said the traditional means of cremation caused adverse impact on environment and dispersal of ashes in the river led to water pollution.

If we are to survive the climate crisis then almost everything will have to change, including health care, end-of-life care, and how we dispose of the dead.

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.

November 15, 2022 0

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.

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.

November 12, 2022 0

How to Reduce Social Media Addiction-Digital Minimalism

The Demons of social media and online gaming has rewired the people’s mind to live life and remain in virtual world. The chaos and turmoil in the society can be linked to social media that exploits the deep wired craving of masses to know more about the “realities”. Once a curiosity is fired, each one at social media starts feeding something or other. In the mad game of TRP’s, clouts and engagements, these players cross ethical lines and create rifts. They literally hunt and scavenge news items that suit their narrative. They embellish it with more provocative words and share it with their name hoping to drive more engagement Conspiratorial and alarmist thinking is likely to keep people glued to social media.

Covid-19 pandemic worsened addiction to the internet among children. The footfall at psychiatric out-patient departments in hospitals, especially those offering help to kids hooked to the net, be it for online gaming, chatting with friends or sharing videos, offers a glimpse of the problem.

Digital Minimalism- break free from “internet compulsions”

Freedom, Cold Turkey, RescueTime, Toggl, StayFocusd, FocusMe, SelfControl, AntiSocial… They are not random words pulsed together in a blender, but names of some of the top apps that, ironically, help you stay away from your digital addictions. As Thakur said in Sholay, “loha lohe ko kaat-ta hai”, so now we need apps to stay away from apps. This farcical situation hides a deeper reality – too many of us are spending too much time online. So, amid the launch of 5G and other high-speed tech, a growing army of people doesn’t want to be addicted to social media and googling. They aspire to live frugal, almost ascetic, digital lives without completely switching off from the internet. It’s a trend called ‘digital minimalism’, and it is different from a ‘digital detox’ where you unplug completely. To illustrate, detox is what Mohityanche Vadgaon village in Maharashtra’s Sangli district does. A siren goes off at 7pm, and residents put their electronic devices away for 90 minutes. Children are encouraged to read while the older people meet and chat.

Digital minimalism, however, does not require complete withdrawal. Coined by author Cal Newport, it is a way of using technology in which you focus your online time on a few carefully selected tasks that strongly support the things you value. It advises against excessive use of gadgets.

Digital Minimalism- break free from “internet compulsions”

Digital minimalism is based on three tenets: clutter is expensive, optimization is critical, and intention is satisfying. The objective is that the usage should be intentional and controlled for a limited period of time. And the apps mentioned above are meant to stop you from jumping from one attention-diverting push notification to another. They can block other apps from operating, create blocklists, schedule apps to run only during a specific time of the day, and alert you about the excessive time spent online.

This philosophy is being discussed now, especially after the pandemic when people began spending more time online, adding that children aged 13-18 years have become more prone to digital addiction since the pandemic. The parents are taking their children to counsellors as they have become addicted to screens and feel isolated and tense when they have to interact with people in the real world. For them, online networking is secure and simple.” He advised gradually introducing such children to digital minimalism, to reduce their reliance and time spent on digital platforms. He also said it is critical for parents and adults to see if those who are addicted to digital devices have any anxiety issues. Because digital addiction has been observed in people who already have anxiety issues, these issues must be addressed first. WHO has classified excessive use of the internet and mobile phones as screen addiction, and provided a set of guidelines. There is certainly a 50% increase in screen time addiction cases post-pandemic, we should be more concerned about the changes that will occur with advancements, like the metaverse. Need to first introduce minimalistic practices, and then, in some cases, recommend mild medication to help people break free from their “internet compulsions”.

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.

November 8, 2022 1

A Child is Born Free till he chooses to be Doctor # Rohtak-Medicos-fight-Unjust-Bonds

Choosing medical career or being a doctor has become a struggle in present era. Aspiring doctors need to first think- why they want to be a doctor in such circumstances-enduring all kind of exploitation- from all corners of society?

Unable to give doctors their rightful, there has been an administrators’ wish to enslave medical profession. Arm chair preachers would just say “yes, as a doctor, they should do it as moral duty.” In a new era of consumerism, when patient is defined as consumer and medical industry controls medical profession and the financial boundaries. All components of medical industry want their pound of flesh from hard work of doctors and nurses. Every day routine issues turning into medico-legal hassles have put doctors in the corner, resulting in severe distraction from real point of intention-treatment of patients.

Struggling to get admission in medical college, slogging in wards to learn and earn degrees, work in inhuman conditions, listen to endless abuses, tolerate the false media criticism, dragged in courts for alleged negligence, work with fear of physical assaults, work without proper infrastructure and manpower, endangering their own lives, exploited by medical industry and administrators, poorly paid and still not respected.

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

MBBS medical students protest against Haryana Govt Bond Policy-Rohtak

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.

Projection of high cost of making a doctor 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 medical colleges.

MBBS medical students protest against Haryana Govt Bond Policy-Rohtak

MBBS medical students protest against Haryana Govt bond policy detained

In a crackdown on MBBS students protesting against Haryana government’s bond policy for government medical colleges, the Rohtak Police detained around 300 students in the early hours of Saturday and registered a First Information Report in this connection.

The police action came ahead of the visit of Governor, Chief Minister and Home Minister to PGI campus for the convocation of Pt. Bhagwat Dayal Sharma University of Health Sciences, Rohtak.

He added that the students were now co-operating with the administration and a meeting was being facilitated between them and the Chief Minister soon after the convocation.

The Haryana government had come out with a policy to incentivise doctors to opt for government service in the State on November 6, 2020, saying that the candidates selected for MBBS degree course in government medical colleges need to execute an annual bond for ₹10 lakh minus the fee at the start of every academic year. The candidate can pay the entire bond amount without recourse to the loan or the State government will facilitate them for availing an education loan for this bond amount. As per the policy, the government will repay the annual instalments of the loan if the candidate obtains employment with the State government.

However, in view of the protests, the CM had three days ago announced that students need not pay the ₹10 lakh bond amount at the time of admission, but instead have to sign a bond-cum-loan agreement of the amount with the college and the bank.

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.

November 6, 2022 0

Blowin’ In The Wind-Delhi Air Pollution: Colossal Administrative failure

An eight year old child –scared, sitting terrified in mother’s lap, feeling breathless and feeling a bit dizzy. News about rising levels of smog and pollution send shivers down her spine every year. Her mother closing all the doors of house and trying to avoid the fumes entering the room like ghosts from every small crevices, peepholes and slits. The mother prays for the smooth sail through these days as she knows very well that the season has come when the environment will be full of pollutants. The child will writhe with suffocation due to air pollution in the same proportion. The reasons for dangerous levels of air pollution can be multiple like vehicles, crackers or farm waste burning, but accumulate near the some cities due to geographical distribution and environmental factors. Irony is that it is someone else’s problem like farm waste burning and ball of a time with polluting crackers adds to child's suffering. Here the sufferer is not the real cause pollution. Unlike if someone smokes or drinks alcohol, it is the doer who is sufferer. But here the root cause of her trouble emanates from poor governance and administrative failure to control the irresponsible behaviour of few. Every year, many factors collectively add to enormous pollution and air becomes thick with smog and suspended particulate matter at a predictable time. It is a cause of breathlessness in children and adults and vulnerable to asthmatic attacks.

Blowin’ In The Wind Yes, and how many times can a man turn his head

And pretend that he just doesn’t see?

The answer, my friend, is blowin’ in the wind

The answer is blowin’ in the wind

Yes, and how many times must a man look up

Before he can see the sky?

And how many ears must one man have

Before he can hear people cry?

Yes, and how many deaths will it take ’til he knows

That too many people have died?

The answer, my friend, is blowin’ in the wind

The answer is blowin’ in the wind

An eight year old child –scared, sitting terrified in mother’s lap, feeling breathless and feeling a bit dizzy. News about rising levels of smog and pollution send shivers down her spine every year. Her mother closing all the doors of house and trying to avoid the fumes entering the room like ghosts from every small crevices, peepholes and slits. The mother prays for the smooth sail through these days as she knows very well that the season has come when the environment will be full of pollutants. The child will writhe with suffocation due to air pollution in the same proportion. The reasons for dangerous levels of air pollution can be multiple like vehicles, crackers or farm waste burning, but accumulate near the some cities due to geographical distribution and environmental factors.

Irony is that it is someone else’s problem like farm waste burning and ball of a time with polluting crackers adds to child’s suffering. Here the sufferer is not the real cause pollution. Unlike if someone smokes or drinks alcohol, it is the doer who is sufferer. But here the root cause of her trouble emanates from poor governance and administrative failure to control the irresponsible behaviour of few.

Every year, many factors collectively add to enormous pollution and air becomes thick with smog and suspended particulate matter at a predictable time. It is a cause of breathlessness in children and adults and vulnerable to asthmatic attacks.

Like this one child, there are thousands of them and people from all ages suffer during this season because of mistakes and thrill of others. These sufferers, who are frustrated due to their plight, with no fault of theirs, have to undergo treatment and visit emergencies of the hospitals. This irresponsible behaviour of people puts burden on the medical services and the doctors, who are already overstretched due to workload. But it is only the doctors and nurses, who are visible round the clock, whereas people who have polluted the air and the administrators remain invisible. For many, it is very hard to understand the complexity of the situation. Patients many a times will rather tend to blame the doctors for their sufferings, poor treatment and difficulty in treatment, without realizing that constant pollution is the reason for poor response to treatment.

Why all of us cannot keep in mind the plight of such patients? Why the administrators wake up and come out of their slumber every year when AQI is more than 500 already?

There are no punishments for repeated administrative failures.

But inconsequential pleasure and poor governance should not be allowed to inflict health and life of others.

Delhi Air Pollution: AQI more than 500. Apart from climate change, air pollution is just another biggest environmental threat to human health at present. And with pollution levels worsening in the national capital and neighbouring regions, residents of Delhi have started complaining of several health problems like difficulty in breathing, tightness of chest, asthmatic symptoms, runny nose, sore throat, itchy and watery eyes. As the city has been waking up to a thick blanket of hazardous smog every morning since Diwali, Delhi hospitals are also witnessing a surge in the number of patients coming to OPDs with health issues. And it’s the elders and children, who have lower immunity levels, complained of breathing issues. The hazardous level of air pollution towards the end of October triggered a series of official measures such as shutting down construction work across Delhi and smoke-emitting factories.

It requires sincere administrative will and not merely tokenism to control such hazardous pollution.

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

November 4, 2022 0

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.

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.

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?

October 30, 2022 48

Transition from ‘Natural death’ to Medicalized Death- Paradox of dying process

Death is the inevitable conclusion of life, a universal destiny that all living creatures share. It’s an age-old idea that a good life and a good death go together. Death and dying have become unbalanced in high-income countries, and increasingly in low-and-middle-income countries; there is an excessive focus on clinical interventions at the end of life, to the detriment of broader inputs and contributions.

The story of dying in the 21st century is a story of paradox. While many people are over-treated in hospitals, with families and communities relegated to the margins, still more remain undertreated, dying of preventable conditions and without access to basic pain relief. In this present era, process of dying represents unbalanced and contradictory picture of death.

Even though medical advances continue to increase life expectancy, they have raised an entirely new set of issues associated with death and dying. For example, how long should advanced medical technology be used to keep comatose people alive? How should the elderly or incapacitated be cared for? Is it reasonable for people to stop medical treatment, or even actively end their life, if that is what they wish?

Before the 12th century he describes a period of “Tamed death,” where death was familiar, and people knew how to die. The dying and their families accepted death calmly; they knew when death was coming and what to do; dying was a public event attended by children.

Death can occur through conflict, accident, natural disaster, pandemic, violence, suicide, neglect, or disease. The great success with antibiotics vaccines has perhaps further fuelled the fantasy that science can defeat death. But this temporary success as only has been the result of discovery of germ theory and antibiotics.

In true sense, Death still remains invincible.

The fear of death also involves the fear of separation.

As families and communities want more and more hospital care, when critically sick, health systems have occupied the centre stage in the process of dying. Dying people are whisked away to hospitals or hospices, and whereas two generations ago most children would have seen a dead body, people may now be in their 40s or 50s without ever seeing a dead person. The language, knowledge, and confidence to support and manage dying are being lost, further fuelling a dependence on health-care services.

Death systems are the means by which death and dying are understood, regulated, and managed. These systems implicitly or explicitly determine where people die, how people dying and their families should behave, how bodies are disposed of, how people mourn, and what death means for that culture or community.

Death systems are unique to societies and cultures.

The increased number of deaths in hospital means that ever fewer people have witnessed or managed a death at home. This lack of experience and confidence causes a positive feedback loop that reinforces a dependence on institutional care of the dying.

Medical culture, fear of litigation, and financial complexities contribute to overtreatment at the end of life, further fuelling institutional deaths and the sense that professionals must manage death. Social customs influence the conversations in clinics and in intensive care units, often maintaining the tradition of not discussing death openly. More undiscussed deaths in institutions behind closed doors further reduce social familiarity with and understanding of death and dying.

How people die has changed radically over recent generations. Death comes later in life for many and dying is often prolonged. Futile or potentially inappropriate treatment can continue into the last hours of life. The roles of families and communities have receded as death and dying have become unfamiliar and skills, traditions, and knowledge are lost.

At first only the rich could expect that doctors would delay death. However, by the 20th century this expectation had come to be seen as a civic right.

‘Natural death’ is now the point at which the human organism refuses any further input of treatment.

Corporatization of health care has projected medicine as a purchasable commodity and consequently resulted in an illogical distribution of health care. People, who can afford, spend millions in the last few days of their life, just to have only a few more days to live. Resources spent in such a futile quest are equivalent to thousands of times the money for food and medicines for the poor who lose lives for fraction of that expense.

Death is not so much denied but has become invisible to people. People now have less understanding and less acceptance of death. The death is more perceived as failure of medical treatment rather than an invincible power or a certain final event.

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October 4, 2022 4

Travel Associated Infections & Diseases

Depending on the travel destination, travellers may be exposed to a number of infectious diseases; exposure depends on the presence of infectious agents in the area to be visited. The risk of becoming infected will vary according to the purpose of the trip and the itinerary within the area, the standards of accommodation, hygiene and sanitation, as well as the behaviour of the traveller. In some instances, disease can be prevented by vaccination, but there are some infectious diseases, including some of the most important and most dangerous, for which no vaccines exist.

As many of such diseases are infections, general precautions can greatly reduce the risk of exposure to infectious agents and should always be taken for visits to any destination where there is a significant risk of exposure, regardless of whether any vaccinations or medication have been administered.

Modes of transmission and general precautions

The modes of transmission for different infectious diseases are diverse:

Foodborne and waterborne diseases transmitted by consumption of contaminated food and drink.
Vector-borne diseases transmitted by insects such as mosquitoes and other vectors such as ticks.
Diseases transmitted to humans by animals (zoonoses), more particularly through animal bites or contact with animals, contaminated body fluids or faeces, or by consumption of foods of animal origin, particularly meat and milk products.
Sexually transmitted diseases passed from person to person through unsafe sexual practices.
Bloodborne diseases transmitted by direct contact with infected blood or other body fluids
Airborne diseases involving droplets and droplets nuclei. Droplet nuclei <5 µm in size are disseminated in the air and breathed in. These droplet nuclei can remain suspended in the air for some time. Droplet nuclei are the residuals of evaporated droplets. Droplet transmission occurs when larger particles (>5 µm) contact the mucous membranes of the nose and mouth or conjunctivae of a susceptible individual. Droplets are usually generated by the infected individual during coughing, sneezing or talking.
Diseases transmitted via soil include those caused by dormant forms (spores) of infectious agents, which can cause infection by contact with broken skin (minor cuts, scratches, etc).

General precautions to prevent infections are outlined in the Chapter 5 of the international travel and health situation publication.

Non vaccine-preventable diseases

The main infectious diseases to which travellers may be exposed, and precautions for each, are detailed in the Chapter 5 of the International travel and health situation publication. The most common infectious illness to affect travellers, namely travellers’ diarrhoea, is covered in Chapter 3 of the International travel and health situation publication (WHO). Because travellers’ diarrhoea can be caused by many different foodborne and waterborne infectious agents, for which treatment and precautions are essentially the same, the illness is not included with the specific infectious diseases.

Information on malaria, one of the most important infectious disease threats for travellers, is provided separately (WHO).

The infectious diseases listed below have been selected on the basis of the following criteria:

Diseases that have a sufficiently high global or regional prevalence to constitute a significant risk for travellers;
Diseases that are severe and life-threatening, even though the risk of exposure may be low for most travellers;
Diseases for which the perceived risk may be much greater than the real risk, and which may therefore cause anxiety to travellers;
Diseases that involve a public health risk due to transmission of infection to others by the infected traveller.

Amoebiasis
Angiostrongyliasis
Anthrax
Brucellosis
Chikungunya
Coccidioidomycosis
Dengue
Giardiasis
Haemorrhagic fevers
Hantavirus diseases
Hepatitis C
Hepatitis E
Histoplasmosis
HIV/AIDS and other sexually transmitted infections

Legionellosis
Leishmaniasis (cutaneous, mucosal and visceral forms)
Leptospirosis (including Weil disease)
Listeriosis
Lyme Borreliosis (Lyme disease)
Lymphatic filariasis
Malaria
Onchocerciasis
Plague
SARS (Severe Acute Respiratory Syndrome)
Schistosomiasis (Bilharziasis)
Trypanosomiasis
Typhus fever (Epidemic louse-borne typhus)
Zoonotic influenza

Some of the diseases included in this chapter, such as brucellosis, HIV/AIDS, leishmaniasis and TB, have prolonged and variable incubation periods. Clinical manifestations of these diseases may appear long after the return from travel, so that the link with the travel destination where the infection was acquired may not be readily apparent.

Special feature

Vaccine-preventable diseases

Cholera
Hepatitis A
Hepatitis E
Japanese encephalitis
Meningococcal disease
Rabies
Tick-borne encephalitis
Typhoid fever
Yellow fever

Information about available vaccines and indications for their use by travellers is provided in the pdf entitled vaccine-preventable diseases and vaccines beside. Advice concerning the diseases for which vaccination is routinely administered in childhood, i.e. diphtheria, measles, mumps and rubella, pertussis, poliomyelitis and tetanus, and the use of the corresponding vaccines later in life and for travel, is also given in the section Vaccines.

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August 19, 2022 0

Malta Fever- Brucellosis- Mediterranean fever

Brucellosis is a common zoonotic infection caused by bacterial genus Brucella. Brucellosis is an old disease known by various names including undulant fever or Mediterranean fever. This is one of the infectious diseases transmissible between animals and humans.

Global distribution of Brucellosis-

This infection is more common in Mediterranean areas, the south and the center of America, Africa, Asia, Arab peninsula, Indian subcontinent and the Middle East. The maximum incidence in the world had been reported in Syria.

Other names:

Brucellosis, undulant fever, Mediterranean fever, Cyprus fever, and goat fever.

Summary:

‘Malta fever’ is a bacterial disease caused by various brucella species, which mainly infect cattle, swine, goats, sheep and dogs.
Malta fever is transmitted to humans through direct and indirect contact with infected animals.
Infection is most likely caused by ingesting unpasteurized milk or cheese from infected goats or sheep.
It causes flu-like symptoms, including fever and lethargy.
There is no human vaccine to prevent Malta fever, but it is important to take precautions to avoid it.

Overview:

Malta fever is a bacterial disease caused by various brucella species. Infection is transmitted to humans through direct and indirect contact with infected animals. It mostly affects individuals who work in the livestock sector. The consumption of raw milk and cheese made from raw milk (fresh cheese) is the major source of infection in man; however, human-to-human transmission is very rare. On the other hand, Malta fever remains a problem globally, because it is the most common bacterial infection spread from animals to humans around the world, as animals may be carrying the bacteria without showing any symptoms of illness.

Types of Brucella bacteria:

Types of brucella bacteria:

There are 8 known species of the brucella bacteria, but only four of them cause brucellosis in humans:

Maltese Brucellosis (B. melitensis): This type is the most common and most severe, and is found in lambs.
Pig Brucellosis (B. suis): This type infects individuals who come in contact with animals. It has a severe impact on humans.
Brucella abortus (B. abortus): It infects cows and is moderately severe.
Canine Brucellosis (B. canis): It infects individuals who come in contact with dogs and is moderately severe.

Other animals are also considered a primary source of the Brucella bacteria, including wild animals.

Cause:

Brucellosis is the result of being infected with the brucella bacteria.

Transmission:

Humans contract brucellosis by consuming unpasteurized dairy products and undercooked or raw meat of infected animals.
Direct contact with an infected animal or its bodily discharge (such as tissues, blood, urine, vaginal discharge, aborted fetuses, and placentas), via cracked skin, can also occur.
The disease can also be transmitted to humans through inhaling airborne agents in barns, stables, and sometimes laboratory and slaughterhouse.

Rare Means of Transmission:

From mother to fetus through the placenta
Sexual contact
Blood transfusion or marrow transplant from a person infected with Brucella
Few cases result from accidental pollination of an animal with brucellosis.

Incubation Period:

Symptoms usually appear within 5 to 60 days, and sometimes they takes several months to appear.

Who is at risk?

Vets
Livestock farmers
Slaughterhouse workers
Hunters
Microbiologists
Medical lab workers

Symptoms:

Malta fever can cause several symptoms. Some of them last for a long period of time. Initial symptoms include:

Fever
Sweating
Chills
Loss of appetite
Headache
Muscle, joint, and back pain
Fatigue and lethargy

When to see a doctor?

When a rapid rise in temperature, muscle pain or unusual weakness and persistent fever occurs. It is also crucial to see your doctor if you are among the groups at a higher risk of contracting the disease.

Complications:

Endocarditis (an infection of the endocardium, which is the inner lining of the heart or valves)
Arthritis
Orchitis (inflammation of the testicles)
Spleen or liver inflammation
Central nervous system inflammation.

Diagnosis:

Clinical examination
Laboratory tests: They involve searching for the bacteria in samples of blood, bone marrow, or other body fluids.

Treatment:

Treatment aims to relieve symptoms and prevent complications. It depends on the timing and severity of the disease. The disease may take a few weeks to several months to be cured. Patients take antibiotics for at least six weeks.

Prevention:

There is no human vaccine that can prevent Malta fever, so it is important to take precautions to prevent it with the following steps:

Make sure to cook meat well at a temperature of 63-74°C.
Do not drink or eat unpasteurized dairy products, including milk and cheese.
Take safety precautions at workplaces (e.g. during handling samples in laboratories).
Wash your hands before and after handling animals.
Wear rubber gloves and protective clothing and glasses if you work in a field where you come in contact with animals.
Ensure that wounds are covered with a bandage.

FAQs:

How long do brucella bacteria live outside the body?
- Brucella bacteria are resistant to natural conditions, and they can survive for several hours up to over 60 days if the surrounding environment is moist.
How long should meat be cooked?
- Meat and liver should be well cooked at 63°C for half an hour.

What is the risk to pregnant women?

Women who are pregnant and have been exposed to Brucella should consult with their obstetricians/healthcare provider for evaluation. Prompt diagnosis and treatment of brucellosis in pregnant women can prevent complications including miscarriage.

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