Tag: celebrities

Clean chit to Max doctors in baby death : media reverse news, but mistrust generated in medical profession irreversible


After five months of the incidence, media has now decided to place the correct picture before public. A fact which was very clear to medical fraternity  at the onset, was presented by section of media in a twisted form.  Venomous propaganda and unilateral versions  by media were  projected as doctor’s error, maligning the profession fully. Now the media has to give the correct picture to public after DMC inquiry. But due to wrong information propagated at that time, an environment of mistrust has been generated. Media jumped to wrong  and premature conclusions,   which  created a sense of uncertainties in the minds of patients.  Untrue assertions  about medical profession and maligning of doctors  were propagated just to  create a sensation.  Projection of true picture  by media is   of  great importance and need of hour. If media propagates a stray incidence  and makes sensational news out of nothing, it will further erode trust of public in medical profession. Media people will earn fame and money at the cost of people lives. Mistrust thus generated is definitely detrimental to medical profession as a whole, but in the long run it  will cause  irreversible harm to society.

The Delhi Medical Council (DMC) has given a clean chit to the doctors at Max Shalimar Bagh in a case where a new born was allegedly wrongly declared dead. His parents discovered that the baby was still alive when they were going to cremate him.
The state medical council, in its report to Delhi Police’s crime branch which is probing the case, has stated that the parents of the new born, delivered at 23 weeks of pregnancy, had signed the Do Not Resuscitate (DNR) document.

“International medical literature clearly suggests that fetus less than 24 weeks, if born, is not viable and not likely to survive. The Delhi Registration of Birth and Death Rules, 1999, prescribe that 28 weeks is period of gestation for it to be viable,” said Dr Girish Tyagi, registrar of DMC.  He added that there were procedural lapses and inadequate documentation, which was probably due to absence of standard operating guidelines when managing such cases. “We have written to the Centre and the state to develop protocol for dealing with them in the future,” Tyagi said.

Media should be  show responsibility and refrain from making early conclusions specially in cases involving medical complexities. Defaming the medical profession just on unilateral version of the story may help  media make some money but can be highly detrimental for the society in future.   Damage to doctor patient relationship and trust is irreversible. Can now media undo the damage done to medical profession and mistrust generated between patient and doctor?

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14 of world’s 15 most polluted cities in India : is crime and pollution related?


The WHO report said 14 of world’s 15 most polluted cities were in India which includes Delhi, Kanpur and Varanasi.  This will need  soul searching  and introspection by every one including policy makers.

Air pollution is related to lung diseases like asthma, emphysema or COPD.  It can have effects on pregnant women, Heart patients and outdoor workers etc.  but another aspect of relationship  of pollution with crime is also coming up, which concerns the psychological aspect.

There is a study  in London which relates pollution and crime rate. Although it appears strange but it gives some thing to ponder. If proved correct it may be dangerous environment to the people living in polluted cities.

A new report by researchers at the London School of Economics (LSE) suggests that crime in the capital is being driven by air pollution.

Their results show more polluted areas will see spikes in crime, particularly for less serious offences.

While the study relies on observational data and therefore cannot make definitive conclusions, it adds to a small but growing body of evidence linking pollution and crime.

Previous experiments have shown that increased levels of particulate matter in the air lead to increased blood levels of stress hormones such as cortisol.

The authors therefore suggest that behavioural changes resulting from increased stress hormone levels may in turn lead to an increased likelihood a person will commit a crime.

This means is that pollution can have a negative effect on people’s ways of thinking, including decision making and the way they think about future punishment.

Higher levels of pollution mean higher levels of cortisol. Higher levels of cortisol affect the way that punishment is being perceived by criminals.

Though the paper has yet to be peer reviewed and published in an academic journal, it has undergone internal peer review at LSE’s Grantham Research Institute on Climate Change and the Environment.

The research is not the first to explore links between air pollution levels and crime.

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Death of radio executive TANIA: result of misplaced priorities of media in civic negligence: hundreds healthy deaths vs one in hospital due to disease


        Just Compare the media  projection, burden of negligence and accountability of  hundreds of healthy deaths by civic negligence   with one hospital death by disease. In fact the burden of   negligence here in healthy deaths is massive and  these deaths are unpardonable. But reality is opposite. It is just to compare how  a naked “negligence  in deaths of healthy people” in such cases   to the  “alleged and perceived negligence ( with no proof and no investigation )  in death of someone already having disease  and death in hospital”  during treatment  is projected by our society and  media. 

An unfortunate incident   of untimely death of a young and talented person happened yesterday due to civic negligence.  The family lost their dear daughter due to an incident which was totally preventable . Another recent incident was of unlicensed school vans being driven rashly, again leading to  entirely preventable loss of lives. These incidents bring fore to my mind the misplaced priorities of media and society  which too have  contributed to  some extent to these unabated ongoing preventable   deaths  of  hundreds of  healthy people.

An open drain and a poorly lit road claimed the life of a young executive in Noida in the early hours of Wednesday. The victim, Tania Khanna was driving  car that plunged into the eight-foot-wide drain. Such a huge drain has been left uncovered and there is no proper mechanism of streets lights in the area. There is also no CCTV camera installed there. Noida Authority officials did not respond to requests for a comment.

An open drain next to a road with no barrier or signage and not even street lighting is a recipe for disaster. No civilized part of the world would allow such a situation to exist. That this particular area is still in the process of being developed is beside the point. Whether an area is fully developed or is being developed, there should either be no open drain or if there is one that has not yet been covered, it must be clearly separated from the road and pavements by barriers. There should also be clear signs warning people of the potential danger and lighting to ensure they can see it. That this is not done amounts to negligence by the civic authorities, for which individual accountability must be fixed and action taken.

Multiple  Deaths  in healthy people by civic negligence :

Large numbers of death and morbidity happen amongst absolutely healthy population due to preventable causes like open manholes, drains, live electric wires, water contamination, dengue, malaria, recurring floods  etc. Which somehow are never made as headlines or breaking news by media due to lack of sensational substance. These deaths  of people are in thousands, and are almost entirely of healthy people, who otherwise were not at risk of death. In fact the burden of   negligence here is massive and  these deaths are unpardonable.  It’s time media took it upon itself to bring to fore these issues so that many innocent lives of  many more healthy people like Tania can be saved.

 

       Single  Death in Hospital due to disease:

The  media has always, instead, focused on the stray  and occasional incidents of perceived alleged negligence  in hospital deaths which could have occurred due to critical medical condition of patient. However an impression is created as if the doctors have killed a healthy person. It is assumed without any investigation that it was doctor’s fault.  Media has been responsible for  creating a misunderstanding about the whole process of treatment . The patient coming to hospital already is diseased and some are critical and have a finite percent chance of death. The doctor tries his best to treat him but  may not always succeed. Making an issue out of a hospital death of a sick patient despite the doctors’ best efforts may get some high viewership to the paper but is it right?  No. They have ignored other important things like civic negligence and has instead trained their entire energy in  blaming the doctors  in an effort  to get something sensational out of nothing.

The whole blame  is cleverly put  on doctors. Even after doing everything possible, doctor may be running for his life, trying to save himself from goons. He may be an object for revenge. He may be running after lawyers, if a medical lawsuit is filed. He may have to stand like a culprit in front of relatives of deceased, who can abuse or threaten him in the language they choose, in garb of emotional outburst. Doctors are advised in such situations to be calm and suffer silently or just apologize, as it is thought to be correct in front of relatives stuck with grief. Even if court give the judgement after decades in favor of doctor, harassment of the doctor is permanent and irreversible damage is  done  to doctor. He is already punished.

Here it will be seen later, whether some one can be punished or not.

Point to ponder-Misplaced priorities:

Who is to be  blamed for  the deaths of healthy people which occur because of civic negligence? Here relatives may be helpless and  the vital questions  may go unanswered or taken as a routine.  There are no punching bags like doctor  for revenge. Any stray incident of death of an already ill patient is blown out of proportion by media forgetting the fact that thousands of patients are saved everyday by  doctors. But media instead chose to defame medical profession by igniting the emotions of people by sensationalising death of diseased and ill,  who probably were already at risk of death and did not give due importance to highlighting prevention of healthy  and absolutely 100% preventable deaths.

      Is  it due to a misplaced priorities of  the media or in an effort to create sensational news? Had media made an appropriate noise about right  issues and scratched the right pole for  preventing  death of healthy people , Tania might have been alive today and thousands more.

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Expensive Medical college education (NEET) & poor health system: systematic root rot


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 20 -25 % marks also becomes eligible to become a doctor. 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.  

      Although the whole effort and huge expenditure to become doctors in this way may be really worthless in today’s scenario, considering the difficult times and vulnerability of medical profession. By allowing a intentional dilution of quality  can be advantageous only to  few and detrimental to others.

  • Beneficiaries are rich candidates, medical colleges who collecting fee and may be public who will get numbers of doctors. Surplus of doctors is thought to be an advantage to society. But here quality is least of the consideration.
  • Disadvantage to students, who are meritorious but can’t pay, and possibly society in long run, who is deprived of good quality doctors.

 

Dilution of Merit :

  • Before NEET was made mandatory in 2016, the cut-offs for admission were 50% marks for the general category, and 40% for the reserved categories. From the 2016 admission year, these were changed to 50th and 40th percentile, respectively, opening the doors to candidates with just 18-20% marks in the NEET aggregate. Thereby candidates securing 5% marks (physics) and 20% in  biology are also eligible to be doctors (times of India).
  • The student with the highest NEET marks among those admitted into the private university had lower marks than the last student admitted to the open category in each of the government colleges.
  • In the private university, the fees for the MBBS course are Rs 64 lakh compared to just Rs 4 lakh in the government colleges.
  • when NEET was introduced, many private colleges increased their tuition fees many fold.  This  ensured that meritorious students without money would never get admission. The tuition fee is fixed arbitrarily to cater to only rich or super rich students. (times of India)         System of medical business and  medical education is created based on willful dilution of merit.   Quite a few successful candidates may eventually feel that the money spent and the hard work may not be worth it especially those candidates who may have invested in heavy fees or bought a seat in medical colleges with hefty amount. Some of them, who invested millions for becoming doctors, will be even probably unable to recover their investments. The students with strong financial backgrounds may be more benefited as they can become health  investors or health managers. But for others, it could be a dream turning into a nightmare.

    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, 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 children have to be careful while choosing medical careers from the beginning.

    A famous axiom “as you sow so shall you reap” has an application to health system in this scenario, so people should not rue scarcity of good doctors.  

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Real story of a female doctor assault: serving an uncivilized society


Few words here can’t describe the plight of a female doctor, who was brutally assaulted by a mob at her residence, for no fault of hers. This incidence happened about a year back, about 200 KM away from Delhi.

It was an evening time and a boy had an accident with a bus. He was brought to a community health centre.  Female medical officer who had her residence inside the hospital in staff quarters examined the patient and found that he was already dead. She explained the situation to the family members with due sensitivity, did all the paper work and returned to her residence in about an hour. Mob kept on gathering and after half an hour, they barged into the house of the lady medical officer.

They dragged her by hair in front of her teenage daughter. Mob started assaulting her with fists and legs along with a rod. Her daughter cried and shouted for help.   Mob even tried to set her on fire. This brutal and devilish assault continued till neighbours from other staff quarters saved her with great difficulty and took her away. Mob continued rampage in her house and hospital, trying to break everything.

She sustained severe head injuries and was admitted in a hospital for about ten days. What was her fault and why mob did this to her? Is being a doctor and working in remote area her fault? Everybody knew that the reason for death of the boy was what happened outside the hospital.  There was an errant bus driver, who was responsible.  Then why was she made a punching bag for venting out emotions of the bereaved relatives. Nothing and really nothing can justify this barbaric act. Emotions should not be allowed to take such a demonic form.

This is simply jungle raj, goonism and  expression of a most  uncivilized kind of society, which simply cannot be excused by any sort of reasoning. The incident was protested by the professional bodies as is the routine and after few day things normalized for everybody else except that terrorised family. The said lady medical officer took posting elsewhere and as is usual, nothing much happened to the accused.

Woman doctor assault : Era worse than MAHABHARATA for female doctors

There was again same silence and little concern shown by our media, courts, prominent people, celebrities, human right commission, woman right activists and women commission. This again brings forth the hypocrisy of these people and organizations, who otherwise cry 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.

Doctors in remote area, where there are minimal medical facilities, doctors are  at more risk  than ever. In larger institutions and cities, doctors still gather and have some support. But at remote places,  they are at mercy of local goons with no protection.

Beti bachao Beti padhao vs Violence against female doctors

Violence against female doctors: Silence of human and  woman right commissions

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.

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Doctor’s assault at D Y Patil Medical College: incident hits doctor’s compassion and trust towards patients


unwillingness or failure of government  to prevent such attacks on doctors will have deep ramifications on future of medical profession. Silence of authorities, human right commission is really appalling.  Role of doctor associations, parent institutes have been spineless and not encouraging.  Role of media, celebrities, film stars in spreading the hatred against the medical profession and creating an environment of mistrust is unpardonable, where stray incidents were portrayed as normal routine just to earn money and fame. Ultimately doctors have been left to fend for themselves individually or with friend groups.

 Discussion always revolves around the trust of the patients on the doctor. But in reality, situation is getting opposite gradually. Empathy, sympathy, compassion and trust  of the doctor towards the patient, will definitely get a hit after these incidents. Everyday  the news of assaults on doctors, court cases against doctors, negative projection of the medical profession   in the media are viewed  by doctor’s community anxiously. Recent senseless attack  on doctor  at

D Y Patil Medical College Pune  is another example. 

A resident doctor was assaulted with a scalpel and a few paramedics were roughed up by relatives of 26 -year-old man after he suddenly died following a cardiac arrest at D Y Patil Medical College and Hospital in Pimpri late on Friday evening.
The resident doctor suffered a deep cut on his face and some blunt injuries in the assault.

 

        Merely taking some token  action and showing  protest will not solve the problem. It does not compensate for the  damage done to medical profession. Sympathy, compassion and trust of the doctors towards patients will definitely reduce. Who will be  the ultimate sufferer, does not need a Einstein brain to predict.

          Formal and informal discussions among medical professional at various forums  have taken a center stage about the changing scenario. It  gives a perception that patients are loosing faith in doctors. That perception is not incorrect. But what remains hidden is that every incidence of verbal, legal, and physical assault  brings some kind of feeling of insecurity in minds of all doctors, who deal with patients.

                    This insecurity or fear of the uncertainty tends to affect the thinking process of doctors and the way they practice medicine or deal with the patients. Many will like to be defensive in practice, or try not to treat very sick patients.  Why would someone try complex surgeries with risk involved? Few will limit themselves to follow protocols. Going extra mile with risk, which not everyone will like to take. Many will become health managers or  do something else than do active clinical work. Who should risk his life while doing routine work?

  Every incidence of verbal, legal, and physical assault is a trust breaker. It is not only erosion of patient’s trust on doctors but the vice versa is also true.  As  a rule of nature, as violence increases, compassion decreases.

    Patients might get their revenge for the  naturally occurring disease, but they will lose compassion and trust of doctors in the long run. If that is the way to impart justice in this era, doctors will have to find some way to save themselves.

 

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Supreme Court judgement on End of Life & Living Will: Partaking moral and ethical dilemma of doctors and relatives


A welcome, long awaited judgement, where law has come to help the doctors and relatives of terminally ill patients. Doctors are often accused of over treatment, without realizing that law does not permit them the termination of treatment as desired by patients or relatives. commonly  doctors come to face these difficult situations, where moral and ethical dilemma  is larger than treatment itself.

The Supreme Court ruled on Friday that individuals have a right to die with dignity, in a verdict that permits the removal of life-support systems for the terminally ill or those in incurable comas.

The court also permitted individuals to decide against artificial life support, should the need arise, by creating a “living will”.

 Living will

A ‘living will’ is a concept where a patient can give consent that allows withdrawal of life support systems if the individual is reduced to a permanent vegetative state with no real chance of survival.

It is a type of advance directive that may be used by a person before incapacitation to outline a full range of treatment preferences or, most often, to reject treatment. A living can detail a person’s preferences for tube-feeding, artificial hydration, and pain medication when an individual cannot communicate his/her choices.

In its verdict on Friday, SC has attached strict conditions for executing “a living will that was made by a person in his normal state of health and mind”.

The US, UK, Germany and Netherlands have advance medical directive laws that allow people to create a ‘living will’.

 Active and passive euthanasia

Active euthanasia, the intentional act of causing the death of a patient in great suffering, is illegal in India. It entails deliberately causing the patient’s death through injections or overdose.

But passive euthanasia, the withdrawal of medical treatment with the deliberate intention to hasten a terminally ill patient’s death was allowed by the Supreme Court in Friday’s landmark verdict.

The court also laid down guidelines on who would execute the will and how a nod for passive euthanasia would be granted by a medical board set up to determine and carry out any “advance directive”.

In cases where there is no “advance directive”, the patient, family, friends and legal guardians can’t take the decision on their own, but can approach a high court for stopping treatment .

 Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill

In 2012, the union health ministry posted a draft of the Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill on its website and invited public reactions.

The Bill is popularly referred to as the Passive Euthanasia Bill although its draft did not use the emotive word “euthanasia” to skirt complications around the term, a health ministry official told HT in 2016. It says every advance medical directive (also called ‘living will’) or medical power of attorney executed by a person shall be taken into consideration in matter of withholding or withdrawing medical treatment but it shall not be binding on any medical practitioner.

 Misuse of law

A major concern is the misuse of the law. If it is legal to passively allow or hasten death, what’s to say an aged parent won’t be hastened in favor of an inheritance, or a spouse have treatment withdrawn for the sake of a hefty insurance payout? That is why there are legal provisions  in the judgement  by Supreme court, to safe guard the patients.

The bench also stipulated strict conditions for the execution of the living will, which includes the setting up of two medical boards and certification by the judicial magistrate. It also directed high courts to maintain a record of all living will documents prepared within the state.

 Euthanasia in other countries

Euthanasia and physician-assisted suicide have been legal in The Netherlands and Belgium since 2001 and 2002. In the US, Switzerland and Germany, euthanasia is illegal but physician-assisted suicide is legal. Euthanasia remains illegal in the UK, France, Canada and Australia.

Source- Hindustan times

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LNJP hospital doctor’s assault: Role of Doctor’s Associations and Parent Institutes, human right commissions?


The  impunity with which attendant easily and brutally assault doctors is really appalling, that too in bigger institutes like LNJP Delhi , should be shameful to law enforcing agencies. Are we a lawless society? More problematic is the government apathy and silence of human right commission. Here comes the point that what is the role of our doctor’s organizations and parent hospital and institute, where the incident happens.

         Why  in each and every case of doctor’ s assault, doctor’s bodies and organization do not file a case in the court against the  responsible  authority for security. Non action by Doctor’s Associations, bodies and organizations, not able to take a stand for their children is  most disappointing.

     Another issue is with the parent institute, where such incident happens. Institutes as a unit or a parent  should file cases, rather than few suffering doctors running here and there for help.

 Role of Government, Doctor’s Associations and Parent Institutes is akin to a “father”, who is wining and dining, whereas  his  working and brilliant children are being beaten black and blue.  This is certainly  a poor advertisement, if society wants good doctors.  At least  it should not rue about extinction of good doctors. 

doctor assault CMC Ludhiana

Beti padhao beti bacchao

assault of female doctors

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Doctor’s assault (CMC Ludhiana): Every incident hits doctor’s compassion towards patients


Discussion always revolves around the trust of the patients on the doctor. But in reality, situation is getting different gradually. Empathy, sympathy, compassion and trust  of the doctor towards the patient  are important factors during the treatment.  Everyday  the news of assaults on doctors, court cases against doctors, negative projection of the medical profession   in the media are viewed  by doctor’s community anxiously. Recent senseless attack  on doctor in Christian medical college Ludhiana is another example. Merely taking some action after protest will not solve the problem. It does not compensate for the  damage done to medical profession. Also it erodes the trust and compassion of doctors towards patients.

          Formal and informal discussions among medical professional at various forums  have taken a center stage about the changing scenario. It  gives a perception that patients are loosing faith in doctors. That perception is not incorrect. But what remains hidden is that every incidence of verbal, legal, and physical assault  brings some kind of feeling of insecurity in minds of all doctors, who deal with patients.

                    This insecurity or fear of the uncertainty tends to affect the thinking process of doctors and the way they practice medicine or deal with the patients. Many will like to be defensive in practice, or try not to treat very sick patients.  Why would someone try complex surgeries with risk involved? Few will limit themselves to follow protocols. Going extra mile with risk, which not everyone will like to take. Many will become health managers or  do something else than do active clinical work. Who should risk his life while doing routine work? Brilliant students  will not be inspired to be doctors.

  Every incidence of verbal, legal, and physical assault is a trust breaker. It is not only erosion of patient’s trust on doctors but the vice versa is also true.  As  a rule of nature, as violence increases, compassion decreases. Patients might get their revenge for the disease, but they will lose compassion and trust of doctors in the long run.

 

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NMC Bill and bridge course, a suggestion: How to create doctors for area of need, if required?


Crosspathy is dangerous to human race and potential global catastrophe because of antibiotic resistence.  All  allopathic medicines are hazardous chemicals in inexperienced hands. Incorrect and massive use of antibiotics will  cause antibiotic resistance, which has global ramifications. From this angle, it is a retrograde step. When all over the world, need is being felt that there has to be better control of antibiotic prescription.  We are entering an era, where antibiotics are getting useless and more so because of rampant misuse of antibiotics.  Rather than exercising a better control, it will be a catastrophic to human race world over by causing antibiotic resistance.

Will  thousands of alternate medicine graduate will dispense all antibiotics,  anticancer , anti diabetic , cardiac medications? It is hard to think about hundreds of potentially dangerous medicines being given without structured training and  proper exams in this system of crosspathy.

Following steps should be taken before implementation:

 

Main Aim; to create doctors  for area of need. (AON doctor)

  1. To identify areas of need; most basic step is to identify the areas of need, where doctors are not available. Government should identify area of need and implement the scheme in selected areas, and with  selected simple drugs. Such areas should be such that which do not have medical facilities or lack doctors. Areas which already have doctors will not accept the diluted  or suboptimal care, for example urban population.
  2. Limited seats-To identify the number required; let us say start with pilot project of  selecting 500 to1000 such doctors. All the lakhs of alternate doctors  can not be allowed to prescribe allopathic medicines. It will put the community at risk.

 

  1. To identify the skills required for the area; for example emergency, for paediatrics or obstretics and gynaecology, trauma.
  2. Willingness to work in area of need- to identify the doctors: have a written competition from all candidates who apply for bridge course. To identify doctors who have given willingness to work in these areas of need. People who perform well should be taken for bridge course  only on limited seats. Bridge course should not ne free for all.
  3. To develop a structured bridge course, which should be around one year after comparing the course of MBBS and the course done by the candidate.
  4. Admission and exit in the bridge course should be through exam and limited seats.
  5. Bridge course and allopathic medicines should not be made free for all, that any body can dispense it. We can get benefit only if is specific to needs of people. If everyone is allowed to practice allopathy in all locality, it will be a global hazard besides our community as well.
  6. These trained doctors will have an undertaking to serve in area of need only. For a period at least 10 to 20 years.
  7. Number should be limited but training should be good.
  8. A special course needs to be designed separately for one year, so that people in area of need do not get substandard care

Without proper planning and implementation and identification of area of need, this bridge course will not benefit anyone, rather it can be disastrous.

 

 

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