May 30, 2008

Thinking of Russia beyond medicine?

Is it possible to think of Russia as an education destination beyond medical degrees? It doesn't seem so till the time the Indian government, Medical Council of India (MCI) and Russian government arrive on a consensus related to the acceptance of Russian medical degrees in India. A seminar organised by the Russian Centre of Science and Culture and the Russian Centre of International Studies to explore educational ties with Indian universities became a debating ground to discuss issues related to the validity of a Russian medical degree.

Russia has been a preferred destination for Indian students to pursue MBBS degrees. But the MCI does not allow those with Russian degrees to practice in India without clearing a screening test. For quite some time, Indian doctors from Russia and MCI have been in a tussle over this issue. "My son pursued a medical degree from Russia and we spent a lot of money, but now he is not able to practice in India," said a concerned parent present at the seminar.

"It is true that many Indian students face problems after they return from Russia with a medical degree. They have to appear for a screening test. Even after that they have to work as an intern for at least one year. Moreover, an MD from Russia is only considered an MBBS in India," informed Ramadhikari Kumar, rector, Jawaharlal Nehru University. He advised students to verify the Russian institute's validity with MCI to be on the safer side.

Abhai Maurya, vice-chancellor, The English and Foreign languages University, while tracing the genesis of the problem said, "Earlier, only good students used to go to Russia to pursue a degree. But at the time of disintegration of USSR, all kinds of students started going to Russia in lure of attaining a foreign degree which actually created the need for a screening test." Both Kumar and Maurya, however, agreed that Russia had a long tradition of producing world-class professionals in fields like aviation and power engineering.

Dmitry V Bazhenov, vice-rector of Tver State Medical Academy and a member of the Russian Academy of Medical Science, while refuting the concerns raised by parents present at the seminar said, "Russian medical institutes have a long history of producing world class doctors. Even MCI recognises 12 medical institutes from Russia. It is a rule in India to appear for a screening test after doing a foreign degree and after you clear that you can easily practice. Besides, our institute houses around 600 Indian students at present."

"We agree that the issue of Russian medical degrees is very sensitive and both governments should sit together and take steps to solve this problem," said Sergey V Cherkas, deputy director, Russian Centre of Science and Culture.

Smart cards for wider health access to mothers

The Directorate of Public Health will soon launch a scheme to provide ‘smart’ cards to mothers who seek to access public health centres (PHCs). The scheme will eventually be extended to those seeking to access other government health facilities.

The government is planning to assign a smart card for every mother who registers at a PHC, in order to improve access to health care and remove the disadvantage of distance. The card will have a photo of the mother and the medical history of the family, including immunisation schedules. The mother can produce the card to be swiped at any PHC or government health unit and be treated based on the information available in the card.

“Sometimes, when we ask the people of a particular village to come to a PHC, it may be inconvenient for them. Though their village falls within the functioning area of the PHC, it might be far from their homes,” Director of Public Health P. Padmanabhan said. “With a smart card, they need not let distance come in the way of accessing health care. Take the card to any health centre close by and be treated or get a vaccine,” he told The Hindu.

As a prelude to this, the directorate will give each mother a unique number, which if fed into a computer will throw up all the relevant details. “We are in the process of getting all patient information online. Once it is complete, patients will be able to access health care in any government facility across the State, instead of having to go back to the same PHC,” Dr. Padmanabhan said.

Also, to ensure universal coverage of vaccination, the Tamil Nadu government has decided to double the number of days of immunisation to two a week . This decision was taken after the State’s new immunisation strategy — that involves bringing children to the PHCs for vaccination — raised issues of inadequate coverage. It was implemented on Tuesday, May 27.

“We have noticed that there is 85-90 per cent coverage on immunisation day [with the revised strategy]. That is not enough; we cannot afford to have 10 per cent left uncovered by vaccination,” Dr. Padmanabhan said. Currently, the PHCs have about 100 vans or ambulances to transport mothers and children. More vehicles will be allotted. “Once we have the required number of ambulances, it will be easier to fetch children to a PHC.”

May 27, 2008

Bartronics’ RFID-based wristband for patient care

Bartronics America Inc, a wholly-owned subsidiary of Bartronics India Ltd, today announced it has implemented radio frequency identification (RFID)-based wrist band that helps better manage patient medication process.

This RFID wrist band assists nurses and in health care by automating the process of administering patient medication.

This device was used in a clinical trial involving cancer patients at the Halifax Health Medical Centre in the US.

A study conducted on patients who used these RFID tags showed that 95 per cent of patients involved found the device easy to use and they were better able to control pain.

They managed to take care themselves instead of relying on nurses to provide pills. And 84 per cent of nurses said this saved them time.

Bartronics RFID wristband features inlay antenna and a chip that is tamper proof. Once affixed, it has to be cut open and discarded.

The Managing Director of Bartronics India, Sudhir Rao, in a statement said besides healthcare, the company’s focus on the leisure and entertainment space, the transportation sector and the education sector offer a $2-billion opportunity.

During the current financial year, Bartronics America expects to generate revenues of $40 million.

Medical Tourism Forex Earnings To Grow Rs. 8000 Cr. From 2012

Easy access of Visa facilities often permitted by India to overseas patients coupled with best emerging medical infrastructure facilities in its large and tertiary towns, prospects of India Medical Tourism becoming a lead foreign exchange earners will grow to an extent of Rs. 8000 crore by 2012.

The above findings are arrived at The Associated Chambers of Commerce and Industry of India (ASSOCHAM) on Prospects of Medical Tourism for Higher Forex Earning� under the supervision of its Health Committee chaired by Chairman, Sir Ganga Ram Hospital, Dr. B K Rao in which other lead doctors from Medicity Moolchand, AIIMS, Max etc. are involved.

Releasing the ASSOCHAM estimates, its President, Mr. Venugopal N. Dhoot pointed out that currently, the earnings accrued through medical tourism annually are estimated at Rs.3500 crore.

The primary reasons as to why medical tourism would flourish in India include much more lower medical costs for various ailments such as bone narrow transparent, bye-pass surgery, knee surgery and liver transplant as compared to western countries�.

As a result of higher and very expensive medical costs in the western countries, patients from economies of scale including Africa, Gulf and various Asian countries have started exploring medical treatment in hospitals located in various well-to do places in India because its medical infrastructure has geared up to provide them non-subsidized medical treatment at much more lower costs which are many times considered reasonable.

The other reasons as to why India would emerge as a lead hub for excellent medical treatment is because of its strength of highly qualified medical professionals and even equally higher qualities of availability of nurses. India has about 7 lakh qualified doctors and numbers of qualified nursing graduates and diploma holders are equally good and of high professional caliber who are content and satisfied with reasonable professional feels.

A comparison of treatment costs is given in the tabulated form, comparing India�s cost of medical treatment with countries such as USA, UK and Thailand :

The major advantage which works in favour of India as a result of which movement of patients from various developing and developed countries would shift towards India as its hospital infrastructure is not only confined to large metros but equally getting better in tertiary towns in which the cost of living is still lower with quality of supreme nature.

Still other reasons for medical tourism getting wide spread in India is because of its strength of traditional treatment in homeopathy, naturapathy, ayurvedic, unani etc. which are becoming popular because of their non-side effects.

The Indian healthcare policy is getting adequately recongised from the policy makers as in India health spends in proportion to its GDP is about 1% which the government is gradually trying to increase. The increase in health GDP ratio would amount to proliferation of new health facilities as well as their centres for patients and such centres of excellence will finally be able to accommodate overseas patients as with increasing health facilities, its health infrastructure would still move for better and find acceptance in great deal of patients. Therefore, the prospects of medical tourism in India would be of super facilities and holds an excellent future.

May 22, 2008

Google Health, an Online Medical Records Service launched

“Health is wealth!” But how many of us actually take care of it. In this busy life, where the little joys and pleasures of life take a backseat, concerns about health seem to be amongst the least of the priorities. But here’s someone who truly cares.

Google has rolled out Google Health, a US health information service that blends the company’s search applications with a user’s personal health records over the internet.

Interested users can store their health information on the site

From the individual’s basic medical history to key information linked to their health condition, schedule appointments, refill prescriptions, receiving diagnostic results online, and instantly adding their doctors’ e-mail addresses to a list of contacts at the site, it includes it all. The “virtual pillbox” will automatically send alerts to people’s mobile phones, reminding them when it is time to pop in the pills.

And users need not fret about the information shared going in unsafe hands, as according to Google, the new service is password-protected and the internet giant would store the information on systems that are separate from the company’s other endeavors and developed an additional layer of security.

At a news conference at Google headquarters, Michael Roizen, the chief wellness officer for the Cleveland Clinic, a major private U.S. medical group said, “If anyone can demystify what health is, and make it fun … Google can.”

Electronic health records are used by several health care providers. With Google Health, all those records find a common roof and are put together in an easily accessible place. Links to leading U.S. pharmacies, doctors’ groups and medical testing labs, including Walgreen Co, Longs Drugs Stores Corp, CVS Caremark Group, AllScripts, Quest Diagnostics and the Cleveland Clinic are all included in the service.

May 20, 2008


Renowned American author John A Shedd, once said: "“A ship is safe in harbour, but that is not what ships are for.”

In the journey towards postgraduate medical education, this rings true in more ways than one. Upon completion of the MBBS in India, there are several avenues open to doctors for specialisation. With degrees, diplomas and specialised courses offered in every field imaginable, the options are endless.

When deciding to pursue residency abroad though, the United States of America offers doctors tremendous opportunity in the medical specialties with the benefit of a highly structured application procedure for international medical graduates.

The Education Commission for Foreign Medical Graduates (ECFMG) is the organisation, which certifies international medical graduates for entry to US graduate medical education programmes.


The first, and easily the most important requirement for applying to residency programmes in the US, is completion of the United States Medical Licensing Examinations (USMLE).The USMLE consists of four parts:

Step One and Step Two Clinical Knowledge are both computer-based examinations comprised of multiplechoice questions.

Step Two Clinical Skills is a practical exam that involves examining and diagnosing standardised patients.
Step Three, the final exam in the series, is a computer-based exam with both multiple choice questions and clinical case simulations.

These exams can be taken in any order, except Step Three, which requires the candidate to have passed the prior steps, and which can be taken in advance or during residency training itself.While Step One and Two CK are offered at various centres across India, Step Two CS and Step Three can only be taken at centres in the US and its territories.

It is essential to apply well in advance for these exams, as the demand is tremendous and dates get filled rapidly. Applications for all the exams, except Step Three, are made through the ECFMG website

Rigorous preparation for the USMLE is vital, because even though the exams can be taken repeatedly on failure to pass, a passing score remains valid for seven years and cannot be bettered by repeated attempts at the examination. There are various resources in the form of classes, as well as online question banks, which can be purchased to aid with exam preparation.

It is also imperative to solve questions early on in order to become accustomed to the style of answering, which is quite different from that of the Indian medical exams. More information about the USMLE is available on the website (


Certification awarded by the ECFMG is a measure of the readiness of foreign-trained doctors to enter accredited residency programmes in the United States. Certification is awarded when the following criteria are met: successful completion of Step One and Two (CK and CS) and verification of medical education credentials - a procedure involving correspondence between ECFMG and your medical college in India.

Receiving ECFMG Certification is mandatory for international, medical graduates prior to entering accredited residency programmes in the United States. The USMLE Step Three Examination also, can only be applied for after obtaining ECFMG Certification.


If you are an international medical graduate, it is important and highly advantageous to have gained US clinical or research experience prior to applying. Such experience can be obtained in various forms and should ideally continue for at least two to three months.

An Observership involves shadowing a doctor or a team but has strict regulations, forbidding direct patient contact. An Externship, which is done during medical school or internship, offers more hands-on training, and hence provides a more thorough clinical experience.

Says Dr Rohit Singhania, who has just completed a residency in internal medicine from a hospital in New York City,“With the increasingly competitive process of getting into a residency in the US, apart from good scores (which are a prerequisite), it definitely helps to have clinical experience here in the US, along with the related letters of recommendation.These help to strengthen the application significantly.”


Applications for most residency programmes are routed via the online Electronic Residency Application System (ERAS), to which you can submit your application and apply to programmes as well.

The ERAS system generally starts accepting applications around the beginning of September, and it is important to note that each programme has its own application deadline. No matter what the deadline, it is highly beneficial to apply early.

Letters of recommendation and the personal statement are integral parts of the application. It is vital to obtain strong, sincere letters of recommendation from people who have known you as a student/ doctor for a reasonable period of time. If you have had the chance to observe/ work under doctors in the US, submitting letters of recommendation from them is extremely valuable as well.

A personal statement is the one chance you have to give programme directors an insight into your personality, beliefs and career goals. Make it honest, interesting and powerful. Perfecting your personal statement is time well spent, as it can create an extremely favourable impression about you.


Based on the applications submitted to ERAS, programmes invite suitable candidates for a personal interview. Interviews are generally scheduled between October and January, but this varies between programmes. If you are travelling from India for an interview, it is helpful to schedule the interviews well in advance, as well as anticipate air/ road travel between various cities, hotel reservations, etc.

It is essential to be well prepared for the interview, as programmes meet with hundreds of candidates during each application season. Acquaint yourself with the programme through its website and be ready to talk about yourself and the features you have listed in your CV. Also, since interviews offer a chance to learn more about the programme, feel free to ask questions to the faculty and other residents you meet there.

The final step in the journey to obtain a residency position in the United States is known as ‘The Match’ . Both applicants and residency programmes submit rank order lists based on individual preferences.

The National Residency Matching Programme (NRMP) then compares these lists using a computerised match algorithm. This results in successful applicants being matched into suitable residency programmes.

The process of entering a residency programme in the United States requires a high degree of dedication and fortitude. Matching into a programme in a truly international arena however, offers Indian trained doctors a new perspective to medicine, which can only complement all they have learnt in medical college.

(Dr Risheen Reejhsinghani)

(Courtesy: The Times of India)

Health Minister to conduct study to find spurious drug circulation

The Union Health Ministry has rejected the possibility of a large number of spurious drugs circulating in the country as suggested by some estimates, saying it would conduct a fresh study to find out the exact amount of fake medicines.

A recent study by ASSOCHAM had fixed the chunk of spurious drugs at 20-25 per cent of the total medicine circulation in the NCR region alone.

However, health ministry officials told that when asked to clarify as to how they reached the figures, ASSOCHAM said it had arrived at the figures after going through the amount of business lost by pharmaceutical firms.

The officials said that the only reliable study so far was the one conducted by the World Health Organisation (WHO) which pinned the counterfeit drugs at 3.1 per cent.

But in this study as well, the sample size taken was only 10,000 which is very low, which cannot give a true picture, they said.

The government's own data compiled over a period of 10 years shows that as many as 122 out of 150 samples were found to be normal.

The data compiled by the government is based on the complaints made by consumers following which inspectors pick up samples from various chemists to the tune of nearly 4,000 every year, they said.

The sample size for the new study would be minimum 31,000, the officials said adding that it would be conducted with a budget of Rs 50 lakh.

The study will begin in about three weeks time and will be completed in six months.

The Mashelkar committee, which studied various aspects of the growing threat from spurious drugs, in its interim report has recommended stringent punishment for offenders.

The case of an offender, according to the committee, should be tried by the court of the rank of a session judge or above whereas the extant provision provides for a trial by a metropolitan magistrate or a first class judicial magistrate or above.

The committee also noted that most cases relating to spurious drugs remained undecided for years, while suggesting a separate provision for speedy trials of such offences.

The Indian pharmaceutical industry has a domestic turnover of more than Rs 20,000 crore and exports over Rs 10,000 crore.

It has been growing at the rate of over 10 per cent for the last decade and is said to be the fourth in the world in terms of volume.

India’s first medical tech park in TN

The first medical technology park in the country will be set up at Irungattukottai, near Chennai by Trivitron, one of India's medical technology companies, in collaboration with Aloka, a well known international company.
The park to be set up an investment of Rs 250 crore would be spread over an area of 23 acres was aimed to develop high quality, cost effective medical technology products suited to the needs of developing countries, Dr GSK Velu, managing director of Trivitron told reporters here.
The park would also enhance the accessibility and affordability of medical instruments to the rural mass, he said. It would first focus on domestic market and then on emerging markets with particular emphasis on South Asia, West Asia and African markets.
At present most of the medical instruments were imported as hospitals were hesitant to use products without a brand name. When all other related fields related to medical technology had grown in the country, it was time the country started manufacturing medical technology products, he said.
The park would be built on par with international manufacturing standards and the company was also exploring the possibility of converting the park into SEZ after acquiring another two acre land in the same location, Mr Velu said.
Trivitron would focus on manufacturing of medical equipment in the areas of critical care, cardiac care, imaging and routine laboratory diagnostics. For the initial phase, it would manufacture products like X-ray machines, ECG machines and stress test systems.
About a decade ago, China was importing medical equipments and now it was one of the world's largest manufacturers and exporters, Mr Velu said and added that similar growth was expected in India also.

Canada regulator finds Ayurvedic products harmful

Health Canada, a drug and health regulatory body, has once again said some Ayurvedic products may contain high levels of heavy metals, such as lead, mercury and arsenic. Saying these medicines may pose serious health risks, the Canadian regulator has asked people to exercise caution while purchasing them.

The move is based on an article in the March 2008 edition of the British Columbia Medical Journal, detailing how an adult male had symptoms of vomiting and diarrhoea, believed to have been caused due to heavy metal poisoning by consuming one tablet a day of Puspadhanva Rasa, manufactured by Shri Dhanwantri Ayurvedic Pharmacy of India.

The patient purchased the drug from India and used it over a number of years to ‘increase vigour'.

Health Canada had advised consumers in March and July 2005 and later in June and September 2006 that some Ayurvedic medicinal products may contain harmful levels of heavy metals. The campaigns were based on a study in the December 2004 issue of the Journal of the American Medical Association (JAMA) on commercially available Ayurvedic medicinal products sold in Boston.

The study had alleged that 14 of these products, made by Ayurvedic firms, like Dabur, Zandu, Baidyanath, Himalaya and Jalaram, contained harmful levels of lead, mercury and arsenic.

Based on the JAMA study, Health Canada, the UK's drug regulator MHRA and Singapore's regulator HSA had issued warning against Ayurvedic products with high metal content.

The issue also caused India's ministry of health to make heavy metal tests mandatory for herbal, Ayurvedic, Siddha and Unani medicine exports from January 1, 2006. The exported products also have to display on the label whether the heavy metals are within the permissible levels.

In its reminder to Canadian citizens, Health Canada said heavy metals may be used in a detoxified state in these medicinal products because of their presumed therapeutic properties. However, improper manufacturing processes may result in dangerously high levels of heavy metals in the final product.

Meanwhile, Ayurveda industry professionals said Puspadhanva Rasa is a prescribed drug and has to be taken under medical supervision. Heavy metals contained in Ayurveda, a time-tested therapy for many centuries, are de-toxified and would not cause any harmful effects, they added.

Health Canada says high presence of heavy metals in the body pose serious health risks because they may accumulate in vital organs to create serious health problems in a later stage.

May 18, 2008

Unsafe abortions, a silent scourge

Savita Joglekar, a mother of two, didn't realise what she was getting into when she visited a local dai (midwife) in her village in Maharashtra, to abort an unwanted pregnancy. The dai gave her a bitter concoction and an abdominal massage and told her to return later.

The next day, after hearing that she had not bled, the dai inserted a stick into her private parts. Running a high temperature and crying out in pain, Savita had to be rushed to a hospital. The doctors were shocked to see her — her uterus was badly damaged and the intestines were punctured. Luckily, she was saved in time.

In a country where over 18,000 women die every year due to unsafe abortions, Savita is one of the few survivors. It's a sad reality that 8% of all maternal deaths are due to unsafe abortions. An estimated four million women undergo unsafe abortions every year in India — one-fifth of the global figures.

Abortion is still a dirty word and most women, especially in rural India, shy away from seeking legal medical help. As a result, most of them end up visiting the local dai.

"It's only when things get out of control that they visit a primary health centre. It's the last resort in most cases. By the time a doctor sees them, many of them are beyond help," says Elizabeth S Maguire, president and CEO, Ipas. The NGO works with the National Rural Health Mission to reduce maternal deaths due to unsafe abortions.

In a few cases, the women have been so badly injured that they have no chance of ever becoming pregnant again. Take Lily Toppo's case. When the 14-year-old schoolgirl became pregnant, her family took her to a local nurse in their village in Jharkhand for a secret abortion. While doing the procedure, the nurse perforated the rectum. And it was 48 hours before the girl was rushed to a hospital and operated upon. Three months later, the doctors are still not sure whether she can get pregnant again.

A study done by Ipas in 2007 in Jharkhand, found that 20% of the reported abortions were carried out at home through unsafe methods, of which 51% women had post-abortion complications. A similar study in Madhya Pradesh, conducted in 10 hospitals, showed that 29% women brought to the hospitals, suffered from post-abortion complications. In 67% women, complications included incomplete or failed abortions. Yet another study undertaken in 2000 by King Edward's Medical College highlighted that 67% women admitted to hospitals in Maharashtra, reported complications, of which 6% were life-threatening while 3% resulted in deaths.

In Puducherry, a survey done by Jawaharlal Institute of Postgraduate Medical Education & Research in 1999 found that 41.8% suffered from post-abortion complications and 24% had to be hospitalised.

Unfortunately, few women are aware that the quite common, but unsafe, method of dilation and curettage (D&C) is a big reason for complications. The WHO guidelines clearly state that this method increases the risk of complications. It advises that either medical vacuum aspiration or medical abortion should be followed.

Safe techniques not only save a woman's life but money too. It was found that after safe techniques were introduced in South Africa, deaths from unsafe abortions dropped by 91%.

But what stops most women from visiting a hospital is the lack of legal abortion facilities closer to their homes. "The government mandates that every primary health centre must provide legal abortion service but in reality, that doesn't happen," points out Vinoj Manning, country director, Ipas.

Also, very few trained service providers are available today, making it difficult for PHCs to provide services. Besides, while very few women (just 13%) are aware that abortion is legal, only 0.3% know that it's legal to abort up to 20 weeks of pregnancy.
Contrary to popular wisdom, it's the married women who opt for abortions. "In rural areas, most girls get married young and have children while in their teens. When they don't want more kids, they try to abort," says Manning. Despite all efforts, the problem still persists. As Maguire says, "Safe abortion is not just about health; it's a human rights issue. It's about women's empowerment." For women like Savita, it's more than that — it's their right to life. on Times of India

Now doctors jump into BPO bandwagon

In a BPO firm, the job of a doctor can include medical billing, transcription and coding for the US hospitals.

Medical transcription, also known as MT, is an allied health profession, which deals in the process of transcription, or converting voice-recorded reports as dictated by physicians and/or other healthcare professionals into text format.

However, some companies like the Patni also provides high-end knowkledge process outsourcing where a doctor is required to study the reports of elderly patients and do risk assessment and prepare reports for health Insurance companies in the US.

May 17, 2008

Free medicines for BPL families on the cards

After the Union Health Minister announced free medical treatment at RIMS for families belonging to Below Poverty Line (BPL) under the National Rural Health Mission (NRHM), the State Health Department has also started preparations to provide free medicines to BPL families while undergoing treatment in Government hospitals.

Speaking to some media persons at his office chamber today, Minister of Health Pheiroijam Parijat said that in accordance to the instruction of Union Health Minister Anbumani Ramadoss to implement NRHM properly and effectively, a joint meeting of Deputy Commissioners, Chief Medical Officers and officials of district Health Missions has been convened on June 2 .

Besides focus on effective implementation of the NRHM, the meeting would also study provision of free medicines to patients holding BPL cards while undergoing treatment in JN Hospital and other Govt hospitals, Parijat said.

To install a CT Scan machine at JN Hospital within a short time, necessary procedures have been initiated to issue supply order for the machine.

The CT Scan machine will be procured from Japan, the Minister informed.

Under the JN Hospital Management Society, essential drugs worth Rs 3 lakhs will be procured every month starting from June.

The Health Department has also started work on procuring drugs for Rs 10 lakhs.

Necessary preparations have also been made to stock drugs for Rs 5 lakhs each in every district hospital and drugs of monetary value Rs 2 lakhs each in every Primary Health Centre and Community Health Centre under the National Rural Mission, stated Parijat adding that these drugs will be made available free of cost to patients holding BPL cards.

Stating that adequate quantity of drugs will be bought and stockpiled in all the Government hospitals every year under the Rural Health Mission, the Minister informed that necessary works have been initiated to build a hospital having capacity of 50 beds each in Ukhrul, Tamenglong, Chandel, Jiribam and Senapati.

Estimating that each hospital may cost Rs 14 to 15 crores, Parijat said that the MPSC will be entrusted to recruit 60 doctors to ameliorate the problem of shortage of doctors.

If the recruitment process through MPSC would take much time, some doctors may be recruited on contract basis according to need.

May 08, 2008

Barring Indian doctors will put UK patients at risk: BMA

The British Medical Association (BMA) on Thursday supported the cause of overseas doctors, including Indians, saying the government's attempts to restrict their career opportunities could threaten hospital services and put patients' lives at risk.

Last week the House of Lords ruled as illegal a state guideline discriminating against overseas medical graduates for employment in National Health Services (NHS).

The government guideline was legally challenged by the British Association of Physicians of Indian Origin (BAPIO).

"Removing the pool of International Medical Graduates from the UK altogether will destabilise rotas," and this will "ultimately place patients at risk", Chairman of the BMA's International Committee Terry John said.

"International medical staff are keeping services running. Three in ten junior doctors are now working on an understaffed rota, partly a result of the fact that many of our overseas colleagues have already grown disillusioned and left the NHS," he said.

Under the new points-based immigration system, Indian doctors who already have Highly Skilled Migrants Programme (HSMP) status will be able to compete for training programmmes with their UK colleagues.

However, the Department of Health is still reported to be consulting on other proposals to manage medical migration, including charging Indian and other overseas doctors for their postgraduate training.

May 06, 2008

Uttar Pradesh: Private practice by medical college teachers contempt of High Court

In a significant order, a division bench of the Allahabad High Court today directed the Uttar Pradesh government that any Medical College teacher found engaged in private practice -- directly, indirectly or through proxy -- will not only be subjected to disciplinary measure, but also considered to be in contempt of the HC order of March 31, 2006.

Passing this order, a division bench, comprising of Justice Sunil Ambawani and Justice Dilip Gupta, directed the principal of Medical College (MC), Meerut to obtain fresh affidavits from the teachers of the MC for not doing private practice.

The Court in its order said, ''' Any MC teacher, who does not comply with the orders and candidates of undertaking, shall be taken to have committed contempt of the court.'' On March 31, 2006, the HC had issued directions to the teachers of the MC, Meerut, bound by their service rules, not to engage in private practice and attend the duties assigned to them in the hospital by the principal of the College.

They were also directed to declare whether they, their spouse, their parents, children or other close relatives own hospital, nursing homes, diagnostic centers, clinics of medical facilities at Meerut.

The Court had also directed that if such affidavits were not listed, the principal of the Lala Lajpat Rai National (LLRN) MC shall personally present self in the Court on May 12, 2006. However, when the case was taken up on April 25, 2008, the state government counsel informed that these affidavits were given but could not be filed.

The Court will now hear this case on May 16, 2008. The Court has also directed chief standing counsel M C Chaturvedi to file affidavit of compliance on the fixed date. The Court passed this order on a writ petition filed by Dr V K Goel, who had challenged the order on March 20, 2006 by which he was suspended for doing private practice.

May 04, 2008

Most consumer disputes relate to medical insurance claims

Complaints relating to settlement of medical insurance claims constituted the bulk of petitions coming up before consumer redressal forums in India, according to National Consumer Disputes Redressal Commission Chairman, Justice M P Shah.

In most cases, the problems concerned delay in giving discharge summaries by hospitals, Justice Shah, who was on a private visit, said during a chat with reporters.

If hospitals gave all the documents without delay and insurance firms processed them in time, such grievances could be avoided, he said.

In a state like Kerala, where awareness about the legal rights was high, the number of cases coming up before consumer redressal forums was larger than most other states, he said.

If the state government provided necessary infrastructure and staff, the Commission would consider setting up a bench in Kerala, he added.

From Economic Times

May 01, 2008

Tamil Nadu immunisation drive in trouble

The polio programme in India has suffered due to lack of awareness and ignorance. Many parents have kept their children away from the drive due to misplaced fears of their wellbeing.

After the death of four children in Tamil Nadu, another immunisation progarmme could be in trouble.

Ironically, this is happening in a state that has the best record in the country for immunising its children.

Jayamala is so relieved her 11-month-old is alive. Baby Kalaiyarasi got her anti-measles shot on Wednesday and the same day four other babies died in Tiruvallur district soon after being vaccinated.

''They said four babies had died. I just couldn't take it. I started crying. We took her to hospital at 1.30 in the afternoon and they gave intravenous glucose,'' said Jayamala, mother of Kalaiyarasi.

The vaccine vials had come from Karchur Primary Health Centre. Though it was administered from a separate vial by a different village health nurse.

When asked if she will give her baby the second shot of vaccines, Jayamala replied, ''No, I will not. I don't want to lose my baby. I am too scared of getting my children vaccinated now. Even if the child is unwell, I am afraid to take the child to hospital.''

This is unfortunate because Tamil Nadu has the best track record in the country with immunisation coverage at 95 per cent.

Public health observers say that the big challenge for health authorities is to get to the root cause and restore public confidence so that years of work is not undone.

''The government has to build confidence, show this is a anomaly, a rare case. Otherwise people may not take immunisation because of fear, insecurity,'' said Dr K Shanmugavelayutham, child health activist.

More people use public health services in Tamil Nadu than anywhere else in the country.

No polio has been reported in the last four years

There's been no incidence of diphtheria and whooping cough and

WHO has declared Tamil Nadu a neo-natal tetanus-free state

Questions are now being raised about a possible break in cold chain and contamination due to official negligence.

Besides, public health observers say, protocols are routinely followed, like checking indicator and health workers discard the vial whenever there is a colour change.

''We have a very good system of cold chain. We want to ensure and emphasise that don't mind the wastage. We want every child immunised, taking care of child health and child safety,'' said Dr Saravana Kumar, PHC duty doctor, Maraimalainagar.

Interestingly, used vials are kept in the same ice-lined refrigerator for a week for testing in case some allergy or adverse reaction is reported. Health centre officials say it is marked and always stored separately.

''It's not just the public that is afraid of getting vaccinated. Even nurses are scared of administering the vaccine now,'' said K Komathy, President, Village Health Nurse Association.

Public confidence is obviously shaken when a life-saving vaccine is perceived as something that causes death. Locals say the death of the four babies should not go in vain. For that, the inquiry should focus on correcting the wrongs rather than making scapegoats.




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