December 31, 2011

Maharashtra University of Health Sciences to offer fellowships

Maharashtra University of Health Sciences will be partnering with private hospitals to offer fellowships to medical students in subjects that were earlier not offered in India

Noting that most medical students in the state prefer to abandon India for foreign shores to pursue subspecialty courses in medicine and surgery, the Maharashtra University of Health Sciences (MUHS) has decided to partner with the state's private hospitals to start fellowship programmes.

The MUHS has already identified around 25 subspecialty subjects -- including Endocrinology, Laparoscopy, Vascular surgery, Nuclear medicine, Geriatrics and Paediatric neurology -- in which the fellowships will be offered.

"Most students prefer to go to foreign universities to specialise in a certain field, after their completing their postgraduation studies. They do this because these subspecialities are not offered at recognised centres in India. Realising that a number of private hospitals in cities -- especially Mumbai -- have doctors practicing these subspecialties, we have decided to start fellowship programmes, which will be recognised by the MUHS," said Dr Arun Jamkar, vice-chancellor of MUHS.

The university has now created a fellowship board, with representatives of private hospitals on its rolls -- to draw up the course details. Dr Gustad Daver, medical director, P D Hinduja hospital, said, "All the courses will extend for a minimum period of one year and a maximum period of two years. The students will also receive a sum as stipend for the entire course period, in which they will get hands-on training. The university will conduct entrance examinations for admission. We are now busy working out the curriculum details."

"By this public private partnership, the untapped expertise existing in private hospitals will be tapped for the benefit of young doctors," he added.

At present, private hospitals only offer courses that are recognised by the Diplomat National Board (DNB). "The DNB norms are stringent, as a result of which we cannot offer courses in all the possible subspecialties. With the MUHS fellowships, students will be benefited by the wider variety of subspecialties on offer," added Daver.

Dr Anup Ramani, robotic uro-oncologist at Lilavati hospital, said, "When I completed my postgraduation in Urology from Sion hospital, there was no institution offering a subspecialty course in robotic uro-oncology. I had to go abroad for training. But today, there are surgeons in most private hospitals who have been received training in foreign universities and and are practicing here. They can turn teachers for our students pursing the subspecialties. These fellowships will help students save on money as well."

Link: Original Article

December 29, 2011

Accreditation boosts image of hospitals in India, say experts

At a time when healthcare seems to be a sort of money-minting business, experts feel that hospitals in India should go for accreditation like National Accreditation Board for Hospitals and Healthcare (NABH). They opined this at the 'Health and Hospital Conclave -2011' of Confederation of Indian Industry (CII).

NABH is a constituent board of Quality Council of India that aims at setting benchmark for progress of industry. One of the experts, Parag Rindani, emphasised that going for accreditation for hospitals calls for accountability and consistent excellence and also encourages healthcare organisation for quality healthcare measures.

Rindani was speaking at the second day of the CII conclave during the discussion on 'Changing Face of Indian Healthcare: The Game Changers'.

Dr Vasundhara Atre, a specialist in anaesthesiology from Mumbai, said that the main challenges faced in the healthcare sector in India are reducing maternal and child deaths, malnutrition-related problems, and infectious diseases. "Only seven countries in the world spend less money than India on public health. About70% of India lives in more than 600,000 villages across rural India, and not more than an estimated 30% have access to modern medicine. India needs more than one lakh doctors per year, but we produce 30,000.

The presentation on 'Preparing for NABH / NABL - Doing it the Right Way' highlighted the fact that any hospital should go for the certification not because it just wants the same, but as it is required legally.

Link: Original Article

December 27, 2011

IBM creates a doctor’s Watson

Doctors should be cracking difficult diagnoses with the help of a Watson in their hand.

This one is not about Sherlock Holmes' dear doctor-pal, but IBM's upcoming supercomputer.

Named after Big Blue's founder, Thomas Watson, the machine has been built to process complex language nuances, and later speech, almost like we do.

In three seconds flat, it can tell the doctor the nearest, if not the exact, disease the patient has, said Dr Manish Gupta, Director IBM Research-India and Chief Technologist, IBM India South Asia.

Watson, Dr Gupta recently told Business Line, can search the equivalent of a million books or about 200 million pages of medical literature. It uses IBM's fastest tools and is not connected to the Internet.

If doctors tried to clear their doubts on the Web, it would take time and not yield a conclusive answer; much of medical literature is not on the Web, Dr Gupta reasoned. Watson would show similar cases; suggest treatment; or alert about side-effects of a prescribed medicine.

In the US, IBM has picked partners to commercialise Watson. Dr Gupta said the system should be available worldwide in a year or two.

One model was to offer it to hospitals on cloud. The doctor can tap Watson on a smart phone or a laptop. Other user industries could be customer care, stock exchanges and banks.

While IBM chose the healthcare industry as the first user, Watson would not jeopardise medical jobs.

Dr Gupta emphasised, “We are not at all talking about replacing the doctor.”

Nor would it increase the patient's spend as records would be available across the healthcare chain and reduce repeat-tests.

The first challenge was to increase the use of electronic health records.

Supercomputers have been used by the military, advanced scientific institutions, for weather modelling and drug discovery.

In February, IBM entered Watson into a popular and challenging US quiz show, Jeopardy – which it won over two human champions. And like humans, Dr Gupta said, it also erred on some answers.

Link: Original Article

December 25, 2011

India doesn't have even 1 hospital bed per 1,000 persons

Need admission in a hospital? Chances are that you might not get a bed, however unwell you are. Here is an example - the waiting time for a private ward under the neuro-surgery department at India's premiere All India Institute of Medical Sciences (AIIMS) is around four to six months.

However, if a patient needs to be admitted in the general bed for the same surgery, the waiting time is more than a year. And this, the Planning Commission says is because of India's acute shortage of hospital beds. The Commission's high level expert group (HLEG) on health says that when it comes to secondary and tertiary care, India lags behind most other countries in the number of hospital beds per 1,000 population, despite having a higher absolute number of hospital beds than other countries.

The World Health Statistics say that India ranks among the lowest in this regard globally, with 0.9 beds per 1,000 population - far below the global average of 2.9 beds. India's National Health Profile 2010 says India has a current public sector availability of one bed per 2012 persons available in 12,760 government hospitals - around 0.5 beds per 1,000 population.

Sri Lanka on the other hand has 3.1 beds per 1,000 population, China 3 beds, Thailand 2.2, Brazil 2.4, USA 3.1 and UK 3.9 beds per 1,000 population. Shakti Gupta, HOD of hospital administration at AIIMS said: "It was recommended in 1948 by Bhore Committee that there should be one bed per 1,000 population. However it's been 63 years since and we still haven't been able to reach that target. At present, India has around 0.7 beds per 1,000 population." Gupta added

The concept is that patients should be investigated on day care basis and if found fit for surgery should be admitted.

The average stay of a patient should be three to four days. Earlier, we would admit a patient, waste 7-10 days on diagnosing the problem and then take him for surgery."

Link: Original Article

December 24, 2011

Panel wants 187 new medical colleges

Aiming to bridge the medical education gap between the northern and southern states, a high-level expert group set up by the Planning Commission has suggested creation of 187 new medical colleges in the next 10 years.

Most of the medical colleges are currently located in the southern states of Karnataka, Andhra Pradesh, Tamil Nadu and Maharashtra with a very few colleges in large populous states like Uttar Pradesh, Bihar and Madhya Pradesh.

“We recommend setting up of 187 new medical colleges over the next 10 years in presently under-served districts with a population of more than 1.5 million,” the panel headed by K Srinath Reddy, president of the Public Health Foundation of India, said in its draft report, a copy of which is available with Deccan Herald.

The highly uneven distribution of medical colleges has resulted in skewed production and unequal availability of doctors across the country. For instance, there is only one medical college for a population of 11.5 million in Bihar, 9.5 million in Uttar Pradesh, 7.3 million in Madhya Pradesh and 6.8 million in Rajasthan.

On the contrary, in Kerala, Karnataka and Tamil Nadu, there is one medical college for a population of 1.5 million, 1.6 million and 1.9 million respecti­vely. The panel has recomm­ended establishing 49 medical colleges in UP, 27 in Bihar, 20 in West Bengal, 18 in MP and 17 in Rajasthan, besides 10 each in Jharkhand and Odisha. The experts also suggested mandating a substantial propo­r­tion of local student enrolment.

Recognising that establishment of so many medical coll­eges would pose a logistical problem for the state governm­ents due to faculty shortage and paucity of resources, the panel recommended linking the new colleges to district hospitals to overcome the shortco­mings.

At the same time, it advised the Plan panel to set up 58 new nursing colleges, 382 nursing sc­­hools and 232 schools for auxiliary nurse and midwives.

The proposals are aimed at improving the doctor-patient ratio besides doubling the nu­mber of nurses and midwives. Currently, one allopathic doctor serves 1,953 people, which can be brought down to 1,201 people by 2025, if the pa­nel’s recommendations are followed.

Link: Original Article

'Homeopathy fast becoming preferred mode of treatment in India'

Homeopathy is not a placebo but is effective in treating many serious diseases, including certain kinds of cancer, and costs just one-fifth of allopathic medication, say experts in the field of homeopathy that is fast becoming a preferred mode of treatment for many in India.

Homeopathic medicines, sourced from plants, "can cure cancer in the initial stages and can cure certain kinds of cancer completely, like breast cancer," said Sushil Vats, senior homeopathic consultant and one of the main organisers at an international homeopathy event in the capital.

In fact, at the 66th World Homeopathic Congress of Limhi (Liga Medicorum Homeopathica Internationalis) here, a case study of a double side breast cancer patient who was treated successfully with homeopathy was presented. According to Vats, the patient was a "Stage five" case.

"Homeopathy can effectively support ongoing allopathic treatment in all types of cancers, improve the quality of life of the patient and also the life span," Vats told IANS on the sidelines of the Dec 1-4 conference.

He said that homeopathy can effectively treat diabetes, thyroid, hypertension, AIDS, asthama, but the results vary from case to case. Sometimes a patient may take longer to show results, he said. "In cases treated for many years with allopathy, it becomes difficult to treat with homeopathy as the patients develop homeopathy drug dependency," he said.

Homeopathy is in fact the number two preferred mode of treatment, after allopathy, in India, as per the government of India survey, and it costs just a fraction, he said. Besides, homeopathy has no side effects or adverse effects, he added.

According to R.K. Manchanda, deputy director (homeopathy) in the Directorate of Indian System of Medicine and Homeopathy, government of NCT and Delhi, the Delhi government "is regularly opening homeopathic dispensaries". At present there are 92 homeopathic dispensaries in the capital, mostly in poor areas, which together see around 1.8 million patients a year.

"Mostly, the patients come to these dispensaries with difficult problems like arthritis, skin allergies and chronic gastric problem and with renal stone complaints," Manchanda told IANS.

Manchanda recounted a survey he and a colleague had done in 2005, which showed that homeopathy costs "just one fifth of allopathic treatment to provide day-to-day care".

The conference, attended by 2,500 delegates from 35 countries, was aimed to project India as a "hub of homeopathy in the world", he said.

If homeopathy is so effective in treating so many difficult diseases, then why was it described as a placebo in a study by Lancet?

According to Vats, the study by Lancet was "biased". He said in the UK, the National Health Service runs many homeopathy clinics and they get a "huge budget". During the recession, the allopathic companies were hit and they floated the theory of homeopathy being a placebo in order to get the government withdraw the budget, he said.

Eswar Das, consultant advisor to the government on homeopathy, said the Lancet study was "not based on homeopathy concepts and philosophy". Explaining, he said, homeopathy does not give one standard dose of a medicine to all patients suffering from a disease. Homeopathy studies the patient in terms of the symptoms, body type, nature, likes, dislikes, etc., and then prescribes the dose of medicine accordingly.

"In India, homeopathy has proper recognition. There is a believability and it is an effective form of treatment," said Manchanda.

Stressing on purity of homeopathic medicine, the government has made manufacturers, who initially numbered around 200, comply with Good Manufacturing Practices (GMP) for quality assurance. With this coming into force, there are now only around 30 firms that manufacture homeopathic medicines in India, said Vats. The market in India is worth around Rs.1,000 crore. The homeopathic medicine market has grown manifold in last 4-5 years, he informed.

Eswar Das said though homeopathy was "born in Germany it has flourished in India". The system of healing was founded by German doctor Samuel Christian Hahnemann (1755).

Link: Original Article

December 22, 2011

Council of Indian Medicine sets deadline for MGR varsity on syllabus

The tussle between the Tamil Nadu MGR Medical University and the Central Council of Indian Medicine (CCIM) has got bitter with the council serving a deadline on the varsity to spell out its stance on the syllabus for students of Indian systems of medicine.

The council wrote a letter on October 5, demanding reversal of the university's decision to remove allopathic content from the syllabus for courses on Indian systems of medicine, within 15 days. CCIM, the apex body for Indian medicine had earlier threatened to withdraw recognition for all courses on Indian medicine being conducted by the university.

The university had promised to withdraw another of its controversial decision - to remove the 'surgery' part from the name of the degree - but has been silent on reinstating the removed portions of the syllabus.

The university had decided that undergraduate students of traditional medicine course will not study allopathic contents including surgery, pharmacology, ophthalmology, obstetrics and gynecology.

Following this, on August 17, CCIM secretary P R Sharma wrote a letter to the university stating that the university would be violating provisions of the Indian Medicine Central Council Act 1970 if it deletes contents from the syllabus fixed by the council. State health minister V S Vijay had held a meeting with the university officials, Indian medicine experts, students and health department officials and announced that the university will neither tamper with the syllabus nor change the nomenclature of the degree.

But the university registrar Dr Sudha Seshayyan in a reply to CCIM on September 14saidthe university has decided not to alter the nomenclature of undergraduate degree in Indian medicine and homoeopathy courses. In a letter dated October 5, P R Sharma has asked the university to inform the CCIM about the action taken on the issue of syllabus revision within 15days. ACCIM official said the council would derecogonise all Indian medicine courses if the university does not oblige. The university decision will be vital for the students, who have threatened to go on an indefinite strike on October 20 if the university does not invalidate its syllabus revision.

Link: Original Article

December 20, 2011

In a first, college to teach medicos with mannequins

COIMBATORE: A new methodology of using third generation robotic mannequins instead of patients in imparting medical education has come into being at PSG Institute of Medical Science and Research here on Saturday. This is the first in India, according to PSG medical college director Dr Vimal Kumar Govindan.

Addressing media persons here, Govindan said the innovative way of using 3G mannequins to teach medicos on how to treat patients would be accessible to all the 2,000 students of its group institutions from now onwards. The mannequins made of Norwegian technology would respond to medical care as the same way as that of an actual patient, said Govindan.

"The 3G technology will be enough to help students to learn the first lessons on treating patients. They can also get training on emergency procedures starting from injections to many of the serious cardiac and other health issues over the mannequins," he added.

The mannequins are being made in such a way to have practical training on accident care, maternity care and other medical emergency care. The students can conduct the procedures on these models and the teachers could comfortably explain the corrections, without having embarrassing them in front of patients.

"The major factor which comes as a relief to both the students as well as the patients is that, the students will not have to learn in front of the patients who definitely feel uncomfortable," said Dr S Ramalingam, the principal of the PSG medical college.

The whole idea according to Dr G Dhanabhagyam, the co-ordinator of the programme, is that they have great expectations on the output as they have methodologies to create and monitor the processes.

"From a nearby room, the faculties will be with the help of computers creating medical situations on the 'patient' models. The students will then have to respond with the right procedure. The monitor kept adjacent to the 'patient' connected with the wires will show the recordings as in actual situations. So students can easily understand the various situations they are into and later easily evaluate them," according to Dr G Dhanabhagyam.

The electronic models are equipped in such a way that 'emergency situations' can be created with the computerized mechanisms prompting students to respond appropriately. Mannequins to teach various usual issues were installed.

"There are models for delivery to all the usual everyday emergencies which a medical professional have to encounter routinely," told Dr P Jayakrishnan, an anesthetist. He accepted that the technology will be limited with many of the routine issues faced by the medicos.

Link: Original Article

December 19, 2011

Approve MBBS syllabus at earliest: CBSE to Min

Even as the Union Health Ministry deliberates on the fate of the All-India Common Entrance Test (CET) for MBBS courses, the CBSE has asked it to approve the syllabus at the earliest so that it can finalise prospectus etc for the examination scheduled for May 13, 2012.

The CBSE is entrusted with conducting the test for the largest entrance test for CET which is also known as National Eligibility-cum-Entrance Test for undergraduates (NEET-UG). The course which has been prepared and released by the Medical Council of India (MCI), however, still awaits nod from the Health Ministry in view of severe opposition from some states like Karnataka and Andhra Pradesh. These states have cited difficulty in holding the examination from 2012.

Racing against time as only five months are left for the CET for admission to all medical colleges across the country, the CBSE has shot off a letter to the Health Ministry saying that timing is crucial as it involves the fate of the lakhs of students.

“The Ministry needs to notify the NEET-UG at the earliest so that we can prepare the prospectus and other logistics accordingly. What if they seek last minute changes in the course. We cannot give wrong information in the prospectus?” said sources in the CBSE.

CBSE was zeroed in for conducting tests as it has the experience of conducing the largest entrance test in India - AIEEE for engineering entrance which close to 11 lakh students take every year.

The CET, since its announcement last year has been mired in the controversy with the MCI and the Health Ministry at loggerheads over its implementation. While the MCI claims the CET with one test for UG medical admissions would avoid stress to students, the Ministry has remained undecided about it citing opposition from the states.

Presently, lakh of students, sit for different tests, including the All India PMT which the CBSE conducts and various state-level medical entrance tests in over 300 colleges including 180 in private sector.

A common test will check private colleges from charging exorbitant sums for admitting students, says the MCI. One test will ensure quality students entering medical education because states would be obliged to fill seats in their respective jurisdictions with students who figure in the All-India merit list. They would be free to prefer students from their areas but they won’t be able to compromise on merit, says the medical education regulator.

Link: Original Article

December 18, 2011

Delhi gets first family clinic on Britain's NHS model

Family doctors might make a comeback in the country with Delhi chief minister Sheila Dikshit Saturday launching the first-of-its-kind family health clinic based on Britain's National Health Services (NHS) model. “Access to quality, affordable healthcare has been a huge issue in the country and there is a huge gap which the government alone cannot fill. Such projects will reach out to both urban and rural communities,” Dikshit said at the launch.
The clinic — set up by private firm Pathfinder — in Janakpuri area of west Delhi would work through a general physician and nurses in the clinic.

The low-cost primary health care provider will charge Rs 100-300 for the first consultation and is aimed at boosting the primary healthcare system at a local level where tertiary care centres may not be required.

"The centres will also focus on areas such as immunisation, cervical screening, minor surgery, family planning, integrated health-ayurveda, palliative care, district nursing, and diagnostics among others,” said Hardev Pall, director, Pathfinder Health India.

Link: Original Article

December 17, 2011

Plan to relax ban on sex determination tests draws sharp reactions

The Planning Commission’s proposal for relaxing ban on sex determination tests has evoked sharp reactions favouring and disapproving it. The proposal envisages relaxing rules for sex determination of the foetus but giving incentives to stakeholders and mothers, if it is a girl child, to ensure safe delivery.

The National Commission on protection of Child Rights (NCPCR) chairperson, Shantha Sinha, fully agrees that the government should ensure the safety of the foetuses through its network of anganwadi workers, anuxiliary nurse midwives, and accredited social health activists (ASHAs).

The question of adoption is to be interpreted as taking charge of the health of a woman, tracking every pregnancy from the time of conception to the time the child is at least two years old whether boy or girl child. The Pre Conception and Pre Natal Diagnostic Techniques (PC&PNDT) Act alone is not sufficient to combat foeticide.

However, the All India Democratic Women’s Association (AIDWA) has strongly condemned the Planning Commission’s proposal to promote the “adoption” of unwanted female foetuses in a bid to stem the continuous decline in child sex ratios.

It should be noted that the ban on sex selection was achieved after a long struggle by women’s and health rights organisations, in the face of stiff opposition from certain sections of the medical profession who have utilised existing son preference to earn huge amounts of money by indulging in sex selective practices, a statement issued by the president Shyamali Gupta and general secretary Sudha Sundararaman said.

The Planning Commission’s regressive move, made in the name of “flexibility and choice” tantamounts to accepting the argument that sex selection is a matter of “freedom of choice”, which has already been struck down by the courts while upholding the PC&PNDT Act. However, both the 2001 and the 2011 Census reports have clearly shown that the implementation of the Act has been tardy.

It is most unfortunate that the Planning Commission is actually proposing to undermine existing legal safeguards, by making this preposterous proposal that will only encourage the virtual abandonment of a large number of girl children. It is well known that conditions of most orphanages and remand homes are insecure and deplorable, and innumerable cases of physical and sexual abuse, trafficking, etc. have come to light. The solution is not to “incentivise” the adoption of female foetuses, but to encourage the birth of girls with a slew of economic and social measures that will help to root out the discrimination faced by them.

We demand that the proposal should be immediately withdrawn. The AIDWA plans to petition the Planning Commission and the Ministries of Health and Family Welfare, HRD, Panchayati Raj and Information& Broadcasting in this regard.

The Human Rescue Team (a live knowledge network for human rescue from institutions from India and abroad) on Saturday said it was “legally opposing” the proposal of relaxed sex determination of foetus as it violated the medical ethics and reasonably endangered the girl child.

In a petition filed with the National Human Rights Commission, the National Commission for Women, National Commission on Protection of Child Rights and the Prime Minister’s Office, the team said it found the idea erroneous. “We are also afraid that an arbitrary relaxation in sex determination tests and attached incentives may cause a tremendous increase in female foeticides and even run the risk of projecting girls as a money earning mechanism that may be an uncalled burden on national economy.”

Link: Original Article

December 16, 2011

Superbug scare meant to hit Indian medical tourism

The scare abroad over the superbug or NDM-1 (New Delhi Metallo beta lactamase) last year was deliberately created to tarnish India's image as a medical tourism destination, says VM Katoch, director general of the Indian Council of Medical Research (ICMR).

"A hype to create some kind of a scare about superbug theory obviously helps some countries," Katoch, who is also secretary in the department of health research, told IANS.

He said there was nothing unusual. "The superbug has been known for years. The scare obviously suited some interest groups abroad. We have always stressed greater precautions and care in levels of hygiene and sanitary conditions in our hospitals."

Katoch was in Agra to attend a conference on advances in molecular techniques and their application in health and diseases.

The conference was jointly organised by the Indian National Science Academy (INSA) and nature, life sciences department of Agra College and the National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra.

Katoch did not see any new threat or condition to raise an alarm on the superbug issue.

"Health facilities and treatment in India are fairly good and affordable and there has been a discernible interest in citizens of several countries to take advantage of available medical advances in our country," he added.

The director general of ICMR informed the conference that work on the malaria vaccine was in an advanced stage of trial.

In October, Delhi Health Minister A.K. Walia downplayed the threat of the superbug in the capital and said the prevalence of the infection was "very low" and could not be termed "alarming".

"There is a very low prevalence of NDM-1 infection which exists as confirmed in tests conducted in the ICUs of a number of hospitals. It is between the range of 0.04 percent to 0.08 percent which cannot be stated as alarming," Walia said.

Reports from a British Medical journal had earlier alleged the presence of a bacteria with multi-drug resistant gene NDM-1 that was resistant to almost all antibiotics.

The journal later reported in a study that the NDM-1 was found in Delhi's sewage and drinking water. Scientists feared the spread of the enzyme worldwide due to its high antibiotic resistance, to fight which nothing has been developed so far.

While the health ministry has not admitted on the impact of the NDM-1 on public health, it has been mulling over an antibiotic policy that will also address the issue of hospital-acquired infections (HAI) in the country.

Officials from the health ministry had said the naming of the enzyme after 'New Delhi' was an attempt to malign India as the superbug was found in many countries, not just India.

Link: Original Article

December 15, 2011

40% medicos fail first-year exams

CHENNAI: From topping exams to failing, it has taken them less than a year. Months after acing their 12th standard exams, nearly 40% of all first-year medical students in 27 colleges across the state have failed. They will take the exams again in February 2012 to be promoted to the second year.

This year, the failure percentage has increased by 3-11% in anatomy, physiology and biochemistry, the subjects that first-year students are taught.

The increase is largely attributed to changes in exam and evaluation policies. Unlike in previous years when students would get 40 marks as grace, this year not more than five grace marks were awarded as per Medical Council of India guidelines. Some 221 students benefited from the grace marks this year.

Also, in 2011, a student had to pass all the theory, oral and practical exams. Earlier, a student only needed a combined score of 50% from the two anatomy papers, but this year he/ she had to get 50% in each.

Earlier this year, the academic board of the Dr MGR Medical University fixed the passing minimum in each component of the examination, and this came into effect from August 2011. Deans and principals of all affiliated colleges were informed eight months before the examinations. "We had to do this to build better doctors. Medicos can't afford to leave out portions in choices. They can't say I failed in anatomy first paper but scored high in the second paper. It does not work," said university vice-chancellor Dr Mayilvahanan Natarajan.

Changes in exam and evaluation rules have led to this year's increase in the failure percentage of first-year medical students, academicians say. While these procedural changes may have contributed to this year's spike, a high percentage of first-year students fail every year, they add.

The dean of Madras Medical College (MMC) Dr V Kanakasabai agrees with the medical university's examination reforms, such as awarding fewer grace marks, but insists on better school education.

"We get the cream of students into our college. The quick dip in academic performance has something to do with the quality of students coming into medical colleges. They probably are so used to rote-based learning that they simply can't adapt themselves so quickly to concept-based learning," he said. At MMC, where seats get filled hours after counselling for admissions begins, nearly 17% of students failed in anatomy this year.

Every year, the fight to enter medical colleges gets tougher with more and more students scoring better in their class 12 examination. Unlike other states, students in Tamil Nadu are admitted to colleges based on their score in class 12. The state government feels eliminating common entrance will give rural students a chance to get into medical colleges. Senior doctors like Dr Rajasekaran feel that it's important to test students' aptitude before they are admitted to medical colleges and that can be done only through a common medical test. Among the 2008 batch of students who appeared for the break batch exam in February 2010, only 45% of the students passed in physiology. "We really don't know if they even like to study medicine or if they are pushed into it by parents," he said.

The reasons could be systemic, too. First year courses are considered non-clinical and the faculty of these courses is in short supply. For instance, there are less than 10 forensic experts for 17 medical colleges across the state. "Students are used to being spoon fed. In many medical colleges, they would only brief students on topics in almost all non-clinical subjects," said Dr G Ravindranath, who heads the Doctors Association for Social Equality.

Added to these are the new challenges of a professional education. From being school students, they are suddenly considered adults and thrown into a high-pressure environment of long hours, late nights and unsupervised lives. Living in hostels could add to the suddenness of the change that's taken over them. "Many students are forced to move to cities. Some come from villages and small towns. They have to adapt a lot. They tend to miss out on academics while they are adapting," said Dr Ravindranathan.


Faculty and eminent doctors are not surprised that students with near-perfect scores in class 12 do poorly in the first year medical exams. Inching up, the failure rate stands at 40% this year. The current increase is attributed to a change in exam rules which gives fewer grace marks and requires students to pass all subjects. But the problem is deeper and systemic. The failure of students exposes the limitations of the school education system. Toppers coming from TN are reared in rote-based learning whereas professional education requires conceptual learning. School education is clearly in need of an overhaul

Link: Original Article



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