NEWSLETTER MAY 2007

Medical Education: Climbing costs and Stumbling Standards.

Of late, the entire field of Education starting from LKG to PG has been overexploited and overcommercialised. Medical Education is no exception. In fact it is an example of how mindless capitalism leads to limitless dangers to the society!

Every year, Private Medical Colleges have been mushrooming all over India, especially in AP. Most of these colleges are ill-equipped and understaffed.

First the selection process is itself mired in ruthless corruption. It is an open secret that several lacs are paid to get an MBBS/BDS seat in these colleges. As Capitation fees have been declared illegal by a court ruling, this amount is paid under the table in the garb of a “Charitable Donation” to a Trust.

And the Government has recently increased the “Management quota” to >50% in addition to approving >150 seats in colleges lacking basic infrastructure! So the brilliant students who got in by merit qualifying through EAMCET are clubbed with dimwitted morons, who became medicos just because their parents had deep pockets!

Though the College buildings are quite attractive, it is a well known fact that both doctors and patients are regularly shepherded every year to meet the minimal standards, whenever an MCI team makes the mandatory “surprise” visits. Once the team leaves, the buildings are empty once again…….with very few fulltime doctors and fewer  patients.

All of us know that Clinical Medicine is not taught in the lecture halls, it has to be learnt by the bedside. Short of clinical material and teaching faculty, it is the poor Merit Student who feels betrayed. After all, the dimwit donation candidate doesn’t mind anyway as he doesn’t need to know the answers, he only needs to “know” the examiner! The same situation obtains at the Post graduate and even at the Post doctoral level!!

The end result is this: We’ll have a multitude of below par doctors armed with degrees and diplomas from these Venerable Institutions, let loose on the unsuspecting public with license to practice medicine. We can imagine the type of standards we can expect from such doctors.

It is time to sit up and take notice. The remedy is not far to seek. Of course, we cannot ban Private Medical Colleges. Higher education has been taken up by the Corporate sector for good, as our Governments have neither the inclination nor the funds. The least any Government (represented by MCI) could do is to ensure that MCI Inspections are genuine and the needed standards are really maintained all round the year. Exams must be held under strict supervision. Otherwise we are going to witness a Medical Revolution of a different kind….People will prefer to go to practitioners of Homeopathy, Ayurveda and other unscientific alternative therapies. And Scientific Medicine as we know it will be put on  the  backburner!!

--A. Chalapathi Rao, MA (English), Retd Prof of English, SV University, Tirupati

• Routine use of Aspirin by normal individuals without risks has become a fashion among the elite. Now  latest news show that such use is not as useful as claimed and may even cause side effects like GI bleed, erosive gastritis and peptic ulcer (Health Behaviour News, April 2007)
• One EVEREST study dealt with the new drug Tolvaptan. Now another EVEREST study has been done (Endovascular Valve Edge to Edge Repair Study). In this study, percutaneous procedure called valve edge to edge repair using a Kitra Clip has been done in pts with Chronic MR of various causes. The results are comparable to surgical repair. (Circulation, April 2007)
•  Visceral fat close to stomach and intestines may have an active metabolic role in Syndrome X. Increased

• Good news to coffee addicts!! Coffee  has been shown to prevent SCD (Sudden Cardiac Death) in the elderly population, but only in those without Hypertension. (Am J  of Nutrition, Feb 2007). Also coffee and smoking have been proven to retard progression of Parkinsonism esp of the familial form. (BMJ 2006)
• Mini Robots are now being trained to do cardiac surgery! These prototype “Caterpillar” robots are designed to crawl over the heart and remove dead tissue, inject stem cells and do other procedures without opening the chest!! So the CT surgeon now has another instrument named after an invertebrate to add to the list of Beating Heart Surgery in addition to the “Octopus” and the  “Starfish”(New Scientist, April 07)