Le Sourire....

A dream by the sea....

2011-12-06T00:28:00.001-08:00

On the salt trailed track
did it rain the sea,
Through the slit in the sky
the sailor says " are the gods angry at me?"

Through the solitary swirls,
did they dry the cracks...
Tearing as they went..
through the the watery tracks...

A sailor`s ode to the dream of the other side,
a strange paradise lurking about,
Altering scenery chilled by the storm
snapping away no matter how loud did he shout.

Within the corals did they sink
in it was voyage of the keel,
Pit of debris,everything fell into you,
standing was the sailor in the prow of the vessel.

Lying on the deck so did he dream,
of his hour of departure the hard and cold
Which holds fast to all the timetables.
he said would be at peace or so he told

Opend his eyes did he,
on the comfort the grass he dreamt of
Clouds moved in all directions, part blue part red,
thought at time did the sea let go

But the sea to its nature ,
did hold its belongings to the flow,
The spray, the keel, the prow,
in this land too did they follw....

Le Sourire....

2011-12-02T06:26:00.000-08:00

Its been quite a hectic phase on all fronts...so have been away for a days far too many.
Well a few days back one of my friends asked me why did i name my blog so strangely...well i guess that requires an answer.
Well the word is a direct double rip off of a word that's may be all i can say about it.
Le is intentional coz its " The " and that explains the magnanimity of the word that follows..
As for you my friend i hope you got my answer ...its a name..a noun

One for the one that sunk .....

2011-09-03T10:11:00.000-07:00

Opened my eyes
heard the dull platter outside
Smelt the damp
the burden of the heavy air,
Drifted back into the slumber
filled it all inside
Could run as much as i want
the longer night was here.

Felt the fresh beam
that glittered down the sail
One for the one that sunk
way below without a trace,
Wish some day it is to come
the day my eyes wont fail
Sleep shall i must then that day
without the rain but earth on my face.....

Inexprime...

2011-09-03T09:52:00.000-07:00

Through the bleary eyes
Fighting with a heavy soul,
There are volumes struggling within
but somehow i cant say any at all.

Middle of nowhere do here i stand
Vast stretch of nothingness to look ahead,
With all that clutter that is in hand
Have been lying but its still in my head.

Rumblings of the clouds do come to me
Wish the rains could wash it all away
The question that fights within to be,
All i can do is let it flow...
The Ghosts of the past are there to stay.....

Through the frosted glass window.....from love to phobia

2011-08-22T11:44:00.000-07:00

The thing about working at IGH is that it gives you a lot of time for yourself, not that it has reduced its working hours but you do save a lot of time that could have gone into travelling and pondering over what to eat and where and all stuff, but i guess staying at home has its own perks.
The other day Dr MS was there in his seat in his style was tossing a piece of paper up and down when i reached...
As soon as i sat down he showed me a paper that said "Youth Hostels India organises bike rally to Leh- Laddakh " and he asked " chalna hai ?"
As for me i at that very instant was taken by the seer number of random thoughts that sprang up at that very second......
Technically the mere idea of a bike trip should have got me going but for the first time in my life the word bike and my bike that has been with me through thick and thin been my partner in smiles or sniffles sounded alien to me....
I did realize that i hadn't been with my bike sice a long time, long drive in the rains is my idea of a perfect romance, a long ride could magically change all emotions into smiles...but somehow even the idea of a bike ride in Rourkela rains had eluded me.
I mean i have done around 5000 kms on my bike riding through unknown territory on a trot and my bike never gave up on me and not that i was scared even...cant say but it was something else..
All i can say that today my bike ( she ) is alone and my love for her for some reason changed to phobia....
I looked up to see Dr MS looking at me expecting an affermative but all i could say was " i cant " and continued with the days work...
Guess everything is just passe..somethings do change with time, somethings do come with age..
think i will figure it out someday or maybe i will never know...

Through the frosted glass window.....The slap that canged everything

2011-08-11T13:56:00.000-07:00

Well going on with my days at IGH casualty room, i would like to bring in my other friend Dr TP into the picture. Now to describe Dr TP, he is one hell of a person, someone you would not like to stand with when alone but someone you would hate standing without when facing a crowd. Heres why
A few days or rather nights back there was this talk about a certain Dr MS being frisked up by some local freak at night during one of night duties and by the tone of the stuff it did sound a lil serious, i mean the number of such incidents were rising. Me being from a govt setup had somehow taken it in a stride as a matter if fact kind of stuff...
Then on a "B" shift ie 2pm to 10pm shift it mas me Dr SK and Dr TP, the topic came up. Excitable as always Dr TP kept saying it should not be tolerated and all so just for the sake of it Dr SK said " for me i would close the door, lock the grill and keep banging the one who comes to assault till he is rescued. i wouldnt be a decent doctor like everyone to try and compromise and take it all "
I did never realise that the very same discussion had such an impact on Dr TP, all day on the next day he kept cribbing about the lack of security to doctors and how watchmen went to sleep while he was up on duty, frankly speaking i am sure he was shit scared..
A week later Dr TP , Dr MS and me were on night duty, Dr MS was sent off to take care of the 2nd half of the duty. I then started to poke some fun around TP telling what if a mob comes beats us up and all, cant explain the look on his face.
At aroound 12.30am there an ambulance arrived , a trolley came out with a boy possibly after a road traffic accident,Dr TP was doing the paperwork and i was with the patient when i heard a loud bang and thud....i rushed in an saw a guy lying on the ground near the ambulance...
Apparently the patient had met with an accident in a drunken state was was brought in by his friends and a local so called troubleshooter, he was pressing on sending the patient to the ICU to which TP said that the doctor will be the best judge for that, the troubleshooter ( read local self proclaimed goon) started niceties and TP asked him to get out. What really triggered TP was the line that sounded somewhat like this " Dr is a public servant, i am public, you are my servant. If you dont work as per my wish you deserve to be beaten up...doctors do get beaten up i hope you know this " and then rest all TP said he knew was that the guy was on the ground.
The patient was admitted and all the incident was hushed up...what was interesting is that the word spread like wild fire and from that day to this very day there have been no Dr MS like incidents, no one was ever beated up..
That was one slap that changed everything, that was one slap that made doctors and the staff believe that they were no at the receiving end always, that they could deliver....
What Dr TP did that day was what Dr SM always said " be the man, show me the solution...be the change you wish to see...."

And then it rained.....again

2011-08-11T13:09:00.000-07:00

"Sitting in this sea of people, the window by my side,
something was in tatters but i didnt feel a thing,
cold air just began to race in, some smiled,
some sighed, i didnt feel a thing...

I look out to the horizon,
the darkness was looming in,
something had just slipped out,
something, but i didnt feel a thing...

Came out to the open,
would walk back the way,
could feel something going on, something..
but the wind swept it all away...

The water started to pour in,
The world around seemed to blur,
Of all those feelings there is nothing left
but casualness interstratified only by
a drop of pain and a pinch of self-hate...

I only see the cold, nothing but the cold
water flows down my cold face,
into the void beyond me,
once more everything dissolved in the rain

Sometimes i feel immune,
anasesthetised to the core of my soul
nibbling away into the pain and the past
trying to hold on to a dream,
dream that wasnt ment to last..."

Through the frosted glass window.....A few lines

2011-08-11T12:56:00.000-07:00

Nothing much to pen..just would like to share a few lines that Dr SM said once..
the context was about a complain that went to the director regarding the state of affairs at the hospital...
Unmoved Dr SM said " its fun to criticize, easier to point out mistakes, even easier to be a part of the problem... don't show me the problem , show me the man you are, give me the solution. Be the change you want to see ".
Respect....

Through the frosted glass window.....Trolley Number Extra 03

2011-07-24T07:59:00.000-07:00

Going on with my experiences in the Critical Care and casualty here at IGH..here is an incident quite close to me....
Dr SM the man as a physician has not only inspired by his untiring approach to his job, duty, his patients but also his clear approach towards life and heres why. In the first few days of my stint in the ICU i used to be a lil restrained in my approach the reason...i dont know, may be my all beginners are meant to be tentative...on one of the night duty days we got a patient around 22-23 yr old , a female...ward attendents n the para-med staff with us are very skilled owing to their vast experience immediately announced the arrival n made it a point that it needs to be attended soon...
Apparently the girl had consumed something and was delerious, so a basic lavage was done, but the patient began to gradually sink...so we sent her to the ICU for better management..
She was our ICU EX TR 03, for the first 2 days no signs of improvement were seen but on day 3 the vitals seemed to improve and by day 4 she began talking in abbreviated words...
During one of the rounds Dr SM too notice of the girl, not that the t/t protocol was any bad but he just said a line " what a waste of life"
The girl allegedly had attempted to end her life following some altercations with her friend...
A lively discussion followed...there were a lot of talk bout improvements that could be made to the ICU n on how old are the protocols we were following to my recurrent mistakes in ventilator settings..but there was a part that i picked up and i would like to share..." what ever trolley No Ex03 did may sound logical to her and many of us in that position, maybe she will improve maybe not, we all go through such phases but analyse this, even if two people are together they are so for life, as human we have a fixed number of years at the end of which we must leave, leaving the counterpart alone...all alone for the rest of the duration of his/her natural life. alone we have to be someday or the other, why regret something which is inevitable...why die for it "
May be i was inarticulate i saying what he said ....but he meant something hope you understand.
The very next day EX TR 03 was discharged and she happens to be fine, as for the latest she told me, she got through some campus placement and seems happy though seems to brood . This post is especially for you TR EX 03, if you understood what he meant...we shall never meet again at least in the circumstances we met.....
till next time ...bye

Through the frosted glass window....the introduction

2011-07-22T11:09:00.000-07:00

Its definitely been a long time since i posted, well a lot has transpired in between and i shall try my level best to bring it down in words.
Its been sort of a roller coaster, with all its its ups and downs. i have been working at this critical care unit at Ispat General Hospital, though i would say its not exactly state of art but is a great place to learn... let me begin by introducing the characters coz in my next few blogs i will be talking bout them and this is also coz they deserve a special mention due to their awesome skill levels that i came across and just by the virtue of the wonderful people they are.
To begin with i would like to name people with a brief description ..
Dr Sanjiv Mohanty(SM)...one of the very few people who can be but into the cadre of people who work by example, he has been one of those i have seen committed to his work and did inspire a lot. Taught me a lot many things not just about treating a patient but also bout being a doctor and more importantly being human.
Dr Uma Devi(UD)...wow a fire brand, at her age she has an awesome amount of energy, workaholic to the core. She has this nack of learning things but seldom learns ...always will you find her enthusiastically trying to learn something and right when you thought you taught her all and she got it all figured out, you would get a call..." arre its not working" . but an able and enthusiastic person who will pick up a point and will do all in her might to see you through. PS- code named "Bhalu"
Dr Saroj Mishra(Boss)...he has been the one i looked up to as the king of doctor i would like to become...am not qualified or apt enough to comment bout his clinical accumen but his interpersonal skill and his approach is something you would like to emulate...all in all a great person.
Dr Rajyavardhan Pattnaik(RP)...as per his name he walks into the ICU as a king, and king he is, a very lively personality, skilled and the smile he gives to the patient would light up the hearts of even the gloomiest patients.
Dr Narayan(N)...well an absolute gentleman, an anaesthesiologist, well the interactions have been limited but the level of his energy is infective. Always up to something and was an able guide, helped me learn a few things at the work place.
Dr Satish(SK)...our critical care specialist, communication was his strength and man mangement was his strong point, very friendly and more importantly obsessed towards radiodiagnosis.
Dr Kartik(KUTTU)...a friend, one of the coolest guy i have come across lately, post grad in pulmonary medicine and mba and our partner in crime on all such pursuits , be it impromptu trips in the name of lunch or the fights for a plate of mutton in a dingy hotel.
Dr X......well more bout doctor x when i write in next.....

Got this from sumwhere ...lol

2011-04-10T00:45:00.000-07:00

well i got this artilcle from somewhere, i hope it wasnt copywrited...funny i feel

Everyone out there must have been in relationship at some point of time…few good ones and few bad ones…this is my attempt to summarize how the relationships start and end….. I tried to use some of the famous dialogues girls and guys say in each phase…..This post is inspired by many relationships I have witnessed and heard about…I would like to know how many of you agree with me…

Phase 1:
This phase starts immediately after the initial attraction b/w two people, attraction can be physical (for most of the guys) or Intellectual . In this phase you have this curiosity to find out everything about the other person, their likes, interests, food habits, dressing sense, music sense….If the other person smokes or boozes (girls especially)…basically you show that you care about the other person in this phase…

Here are some of the famous dialogues

“Hey where did you go, I was worried about you”
“I was looking forward to talk to you the whole day”
“You sound low today, is every thing alright”
“I really like you”
“What do you do for fun?”
“What type of music do you like?”
“It was fun hanging out with you, we should do it some other time” “So what do you like about me?”

Phase 2:This is the most lovely phase…both people are happy that they are in a relationship and they have someone who likes them more than anybody….It’s the “love is blind , deaf, dumb and fuck the world I’m in love, I don’t give fuck about anyone…. I got my girl/guy” Phase….You start ignoring your friends…you dont look at your health, you start missing working out gym so that you can spend time with your love… You simply like what ever the other person does…their smile, the way they sleep, eat, dress up vagera vagera…

Here is some shit we all say….

“I luv u more than anything in life”
” I’m having headache. let me do choomantar(some voodoo shit) ” girl or guy kisses on forehead
“I’m really worried about you”
“Do you want to eat something, I will cook something for you”
“You are the only person that I’m close too in this world” “I know you will take care of me for ever”
“I will not marry anyone, other than you”
“Why didn’t we meet earlier”
“God I love you more than anything in this world”
“You are the most beautiful thing in the whole world” “Lets get married right now”

Phase3:
This is the most irritating phase for any two people who are in relationship…Once you got to know each other…you try to get back to your normal life (pre-gf/bf times), catchup with old friends, working out, hanging out with buddies, booze up…and the other person feel that you are not spending time with them (which is true) but that’s how it is…you take other person for granted and they think they are always there with you…that’s where things start to go wrong…

Here are few samplers…
“I think you have changed a lot”
“Why don’t you spend time with me”
“You get mad at me these days and you don’t like what ever I do”
“You are so cheap”
“I can’t imagine that you talk like this”
“You misunderstood me, I didn’t mean that”
“You dont to me, like you use to before”
“I’m don’t like the way you talk”

Phase4:After you get/give all sorts of crap in the last phase, you as a individual defend the allegations…this is the blame-game phase…you say things that you don’t mean…but you want to say…but you have to so that your ego doesn’t get hurt…It’s a cheap phase…this phase leads to the ultimate downfall in a relationship….Break-up

“Why are you behaving like this? ”
“I’m doing so much and you think that I don’t love you”
“I don’t think I can marry you”
“OK, you tell me what you want me to do”
“Wat else u expect me to do”
“I wish i can make you happy”
“I have doubts about our relationship”
“You are not happy with me anymore”
“I feel sad that we are going through this situation”
“I wish things were better”

Phase5:
In this phase You are being hit by a thunderbolt, If you are not strong enough my friend…you will be fucking yourself…you start being desperate to get other person…you start compromising on all the things that you were never comfortable doing with…you beg to get the other person back…

“I don’t think I can marry you”
“I know its not your fault, its just me”
“I don’t know why am i doing this 2 u”
“I’m sure you will find a better girl than me”
“I think this is the best decision for both of us”
“all I want is to c u happy”
“what if this thing happened after marriage, its good that it happened now”
“You are the only person that i loved”
“I don’t think i can love anyone else”
“Please don’t talk lovey-dovey things with me, It will very be tough for me to get out of the situation”
“You think I’m having good time…it’s tough for me too to get out of this situation”
“I don’t have anyone with me, not even you”
“You are a good guy, I’m the bad girl”

Phase6:
You blog about your past relationship or
You bitch about your Ex

PS - remember the he and she may be interchanged at anytime

Waiting For The End....

2011-03-10T10:18:00.001-08:00

A few times you get to hear things that make sense and even on fewer occasions do things strike a cord...
this one did....

Waiting For The End - Linkin Park
" This is not the end
This is not the beginning,
Like we're holding onto something
That's invisible there,
'Cause we're living at the mercy of
The pain and the fear
Until we dead it, Forget it,
Let it all disappear
(Holding on to what i haven't got!)
Though the words sound steady
Something empty's within 'em
Cause we're living at the mercy of
The pain and the fear
Until we dead it, Forget it,
Let it all disappear.

Waiting for the end to come
Wishing I had strength to stand
This is not what I had planned
It's out of my control....

Flying at the speed of light
Thoughts were spinning in my head
So many things were left unsaid
It's hard to let you go...

I know what it takes to move on,
I know how it feels to lie,
All I wanna do
Is trade this life for something new
Holding on to what I haven't got

Sitting in an empty room
Trying to forget the past
This was never meant to last,
I wish it wasn't so...

What was left when that fire was gone?
I thought it felt right but that right was wrong
All caught up in the eye of the storm
And trying to figure out what it's like moving on
And i don't even know what kind of things I've said
My mouth kept moving and my mind went dead
So, picking up the pieces, now where to begin?
The hardest part of ending Is starting again!!

Institutionalized....a thought

2010-12-09T03:33:00.000-08:00

hi
its been a long and tough year, years for the matter have always been a long time to look at but seem just a few events when they come to an end, but its really been a long year. Trust me fellows trying for a seat in the postgraduate discipline in medicine is really a tough ask, for all those who are going through know what exctly i mean, for all those who have been through successfully or unsuccessfully hats off....
But dont worry i am not here to discuss about how to prepare for a md ms course or how to spend a year preparing for it coz frankly i scarcely know, google it maybe you might find out.....on the contrary i could tell you how not to go about. Anyways few days back friend of mine came up to me and casually picked up a discussion and we spoke about a lot of thing one that struck me the most is what i am gonna vent out here, the movie was " the shawshank redemption" and the word was "institutionalized"
The question my friend asked me was " dont you think we are institutionalized ?" and that put me into a serious but viscious cycle of thought and i wonder even now arent we institutionalized?
We i mean not just me and my fellows in medicine, but everyone ? made to behave in a particular way like a zombie maybe. How many times have we actually thought of thinking out of the box and going for what we actually dream of actually want in the real sense? How many times have we been curbed down by friends, family, girlfriends, boyfriends, the system as a whole and how many times have you curbed your self down outright?
Its not a problem to be in the routine or being ordinary or average maybe but it that is the coccoon in which your life gets stuck up then maybe its a bit of an issue, getting stuck up on things , issues, relationships. The problem with being institutionalized is that it is too human to be ignored, we all have a tendency to get institutionalized and get cozy in whatever we are in but the day it gets over it the day we dont want to see....
Let me not be too cynical but analyze this....
As hard as some may try to clutch onto that little bit of individuality we’re slowly moulding into one big unit. We’re becoming clones, slaves to the ordinary. Different is scary. Society cannot handle it if somebody does something out of the norm, if they mess with the system. Everybody has to be put into a box and labelled so they can be understood and make people feel at ease. It’s easy to see an awkward kid with glasses and acne and call him a “nerd”, guy trying in for an mba after an mbbs is thought to be playing with his career or making thins difficult for others. That’s how we’re processed and kept in check. The hard thing to do, for a lot of people, is to squeeze through the narrow mindedness of the label and see every aspect of the person. Everybody has got good points, bad points, funny points, and interesting points to their character. To see them as one little thing is sad and insulting. People aren’t allowed to be anymore than a face attached to some sort of stereotype because society today can’t function on individuality.
Label me, I’ll label you it’s a vicious circle we all fall into.
Nobody on this planet is immune to pain, stress, worry, heart break, fear, disease.
Shattering the mould and really stepping out of the norm is quite a difficult thing to do. A lot of us know all this stuff already but knowing and doing something about it are two completely different things. It’s hard to swim against the current and be the sheep that doesn’t follow the others. There’s ridicule and scornful eyes cast upon you when you step out of the pack and take your own path through life. But the next thing that we know, but should really remember, is that what other people think doesn’t really matter.
"The world is like a ride in an amusement park. And when you choose to go on it, you think it's real because that's how powerful our minds are. And the ride goes up and down and round and round. It has thrills and chills and it's very brightly coloured and it's very loud and its fun, for a while. Some people have been on the ride for a long time and they begin to question, is this real, or is this just a ride? "

So whatever you are into just make it a point in your mind " nothing absolutely nothing in this world is indispensable" so go ahead follow your dream if that sounds too radical to start with go open your mind and feel happy for the ones who do.....that will take you a step closer to your goal.....

Ps- if you had all the time to read all that i wrote you could better give that time to retrospect coz all that i vent is nothing you dont know, so go live full...

Close to me......

2010-10-19T12:04:00.000-07:00

New divide- linkin park. lovely lyrics

2010-10-19T11:55:00.000-07:00

New divide- linkin park. lovely lyrics

2010-10-19T11:51:00.000-07:00

I remembered black skies, the lightning all around me
I remembered each flash as time began to blur
Like a startling sign that fate had finally found me
And your voice was all I heard that I get what I deserve

So give me reason to prove me wrong, to wash this memory clean
Let the floods cross the distance in your eyes
Give me reason to fill this hole, connect the space between
Let it be enough to reach the truth that lies across this new divide

There was nothing in sight but memories left abandoned
There was nowhere to hide, the ashes fell like snow
And the ground caved in between where we were standing
And your voice was all I heard that I get what I deserve

So give me reason to prove me wrong, to wash this memory clean
Let the floods cross the distance in your eyes across this new divide

In every loss, in every lie, in every truth that you'd deny
And each regret and each goodbye was a mistake too great to hide
And your voice was all I heard that I get what I deserve

So give me reason to prove me wrong, to wash this memory clean
Let the floods cross the distance in your eyes
Give me reason to fill this hole, connect the space between
Let it be enough to reach the truth that lies across this new divide
Across this new divide, across this new divide

The night...

2010-10-13T22:23:00.000-07:00

Walking in the dark outside
breathing in the cold damp air,
well i was thinking how it must feel
to see the little light
and watch it disappear.

Disappear into the abyss of the night
so i know its getting over soon,
and strangers make their promises
you wont feel any pain.

The steets are jammed by cars
running like a damned races,
and people are racing away
into their dark recesses.

Thought i would forget all the past,
but guess i couldn run that fast.

Now i just wanna stand outside
to know what is the right,
and its true i would like to fade into
the abyss of the long dark night.

Dissection hall revisited...

2010-05-10T11:59:00.000-07:00

The first year of mine was really eventful especially the three hours we spent at dissection hall. Be it sneaking out on numerous occasions to play cricket or sleeping …I guess I did it all.
Here's a strange one. There's this girl who seemed a lil over enthusiastic. I knew she was pathetic!! She tried to catch the teacher's attention every time, and made a fool of herself. And that's just the beginning.

What really bugged me was the fact that she didn't feel the need to wash her hands after dissection. She used to dig up the structures with her bare hands , then casually scratch her head, or adjust her apron. What's worse, she doesn't wash up even after the class is over. Gross.

And the most irritating part :she used to run to the cadaver with her lovely set of teeth out as if she would never need the scalpel, and sometimes she suddenly would come up from behind after you have washed up, and grab your hand or any other exposed part of your body, giving you a mad desire to run out of the dissection hall.
That's intolerable.

After days of patiently enduring that behavior, I asked her at the end of class if she was going to wash up or not, to which she shrugged and replied,"Why? It's just a cadaver. No big deal."

The ease with which she said this she mitght have well said its just a pickle!!!!!!!

Last few days at burla.......

2010-05-10T09:31:00.000-07:00

Its almost become a rule a few posts and then a hell hectic life but amidst all of it i never realised that its time to say goodbye.
Seems funny but i spent all my days in the belief dat i wanted out of this place n wont miss it but i guess its a lil tuff not missing sum place where i spent a good half decade of my life...

Here on will follow with few visits down the memory lane.....

Doctors getting beaten up at hospitals

2009-10-20T00:10:00.000-07:00

This topic is something i have been troubled by since i was in my first year at the medical school and i saw all that goes at the hospital...here goes
Attacks on doctors and hospitals in Indian cities are on the increase. In around February 2006, an assault on resident doctors and a senior doctor (his hands were chopped off) even led to a strike by resident doctors from our hospital (V.S.S. Medical College).
I spoke to a few among the administrative staff, senior doctors, nurses, friends, class IV employees, guards stationed in the hospitals and patients in our teaching hospital. There in fact are a few questions that need to be taken care of and that might interest you.
What are the triggers to such violence and what are the underlying conditions that give rise to these patient-provider conflicts? What are the structural and organizational factors that contribute to these conditions? What steps have been taken to reduce the current hostility towards the public health delivery system and what needs to be done?

The following summary of the respondents' perceptions provides insights into the problems of public health services in teaching hospitals.

What triggers attacks on doctors?
The most common trigger of such incidents is a sudden death. Other triggers are denial of admission, a delay in providing care, an absence of equipment and drugs during emergencies, and abuse or so called negligence by hospital staff.

Resident medical officers (RMOs) that are us are usually entrusted with delicate tasks such as communicating the news of a relative's death, negotiating for permission to do a post-mortem and explaining what has happened inside the operating theatre or emergency room. This practice continues even though the public believes that RMOs and interns are young and inexperienced and therefore responsible for the patient's death. The presence of senior doctors can defuse the situation, but when sudden deaths occur after office hours few senior doctors are available for support. Nor are there social workers or counselors who might be better equipped to deal with such situations and address the relatives' anxieties and queries. Juniors must cope as best as they can.

Sudden deaths are most common following an accident. Crowds of people who interfere with the emergency treatment often accompany accident victims. We must resuscitate the patient while also managing the crowd and worrying about mob psychology. The attacks are often started by people, at times by a local leader, who are unrelated to the patient. When a relative starts an argument, others join in the fray. It’s nothing much of an ask they feel I know what it is coz I have been going through the ordeal lately.

Hospital staff also felt that relatives have a limited understanding of the patient's critical illness. They expect the medical staff to save the life of their loved one, regardless of the patient's condition. "A woman who goes for delivery is seen as basically healthy," said a resident of obstetrics and gynaecology. "Relatives cannot understand how she could become seriously ill all of a sudden, let alone die. The same applies to infants."

Many patients come to public hospitals desperate for help. I saw that patients are often referred to a government service after having spent most of their money in private hospitals. Private hospitals wishing to rid themselves of a bankrupt patient may have told the relatives that the patient is critically ill and should be rushed to a teaching hospital. This is their last resort and they want something done immediately. They are not necessarily convinced by a casualty our opinion that there is no emergency and what then follows is mayhem shouting and a few useful hours wasted.

Lets face a few underlying tensions and structural problems responsible for creating such situations.

Shortages of drugs, linen and other items are a major concern at a Government facility. I have seen patients and their relatives are often angry about having to pay for services that are supposed to be free, even life-saving drugs like adrenaline are often missing in emergency rooms and operating theatres (you don’t find an IV line at times, a pint of normal saline needs to be bought and the nurses behave like keepers of the treasure and need to be bribed for everything). Sometimes the drugs are just not available; at other times, adequate stocks may not be maintained in each ward or outpatient department. Then there are the administrators who stock maintenance at the cost of providing medical care.

This is how problems of supply irritate patients. The list of drugs in stock, displayed in the hospital out patient department (OPD), is not regularly updated and doctors in the OPD prescribe drugs based on the outdated list. At the dispensary patients are told that the drugs are out of stock; either they must be purchased from outside at their own expense or they must get the prescription changed, which means going back to the crowded OPD.

Further, diagnostic equipment such as ultrasound and X-ray machines are routinely out of order, forcing patients to get these investigations done at private centers for a fee.

It’s even important to know that staff shortages also force relatives to take on substantial responsibility for nursing the patient and loss of vital time. They are required to be present almost round the clock in the hospital. Yet there are no bathing, resting or food facilities for them.

Shortage of personnel – either because of under-staffing or because of rampant absenteeism among the support staff. Needless to mention that orderlies, didis(nurses) and ayahs are often on leave. We as always are compelled to do jobs like crowd management, pushing trolleys, getting drugs and equipment and escorting patients between departments. This affects their interaction with patients. Few patients also feel that such work reduces their status in the eyes of the relatives thus treating them at their whim. It does not help when we residents are bullied by ward staff who views us as novices.

The stress is compounded by the environment of the outpatient department, where crowds of patients, each pushing case papers to get the doctor's attention, surround doctors and nurses. If Class IV staff is absent there is no system to manage the stream of patients.

Then there is absenteeism is common among senior doctors (lecturers, assistant professors and professors) who may make cursory rounds of the wards and are often missing during duty hours when they are required. This affects the quality of care and dampens the residents' morale. "There are not enough role models among the senior staff," said one resident. "The government's recent decision to allow full-time professors and associate professors to practice privately has made the situation worse. Teachers rush to leave the teaching hospital and compensate their pay packets with a private nursing home attachment." Several doctors felt that senior doctors are not committed to patients in public hospital. A number of academic posts remain vacant and this overburdens the existing cadre of doctors.

Doctors feel they are under constant pressure to give special treatment to patients who have connections with politicians, senior government officials or senior doctors and administrators. It is common for patients to proffer a 'note' or letter of reference from an influential person. It is not rare to have politicians demand preferential treatment for certain patients.

Administrations need to be criticised for succumbing to pressure from politicians, local leaders and patients instead of standing up for doctors. The recent incidents of violence by patients have led a few among us to practice a kind of defensive medicine – doctors focus on avoiding an "incident" even if it is at the cost of victimizing innocent colleagues or some patient. Seniors do berate residents in front of patients, humiliating and demoralizing them.

The conditions of medical students

Many of our demands are related to their working and living conditions. "We do not have regular duty hours. We are not even assured of a day off following a 36 hour shift forget a night on call. We work all day and attend calls through the night. So patients coming in through the night assume that the doctor on duty is sleeping and get angry," said an associate professor. Sometimes we never get a break to eat. All this takes a toll.
Add to it the meager stipends we receive its like adding pepper to the wound(salt mite even soothe). Although medicine is a lucrative profession in the long term, our their peers and frenz in engineering and management already earn a lot more. Many view the three years of residency as something to survive before they can start their practice. They feel that they are being made scapegoats for all the problems at the hospital.

A senior once told me that we are at a stage in life where we have many other personal preoccupations and no support system. Most of my friends also start with the preoccupation that medicine is an exalted profession and they, as doctors, should be treated as important people. They become disillusioned when their colleagues or patients don't reciprocate this belief.

Class, culture and medical education

"There is a class difference between doctors and the patient community they serve," noted by my professor. "By the very nature of the medical entrance system, it is the elite upper middle class which makes it to medical colleges, either through merit driven by tuition classes and intensive coaching or simply by way of capitation. The usual fees in medical education have been hiked, even in state-run medical colleges." Those waiting for a post-graduate seat are likely to prefer studying for competitive exams rather than take a house post. Hence, when they start working as residents, they have very little practical experience and knowledge about the background of patients, their problems and their expectations.

"Today's doctors do not connect with patients who are the indigent poor and live in slums," an old family doctor uncle once told me. "Patients are routinely subjected to comments about their character, community, religion, education and upbringing. Doctors are unaware of the conditions in which their patients live, their social problems, and the kind of difficulties they face in accessing care. This affects their communication and interaction with patients."

Its noted that "uneducated" patients and relatives are responsible for the violence. If that were true, such incidents should be occurring daily because most of the public system's patients are poor and uneducated.

Public opinion about government health services

Patients were angry that doctors had gone on strike. They felt that the behavior of a few patients should not become the reason to inconvenience so many others.

The most common grievance of patients was the hospital staff's rude behaviour.
Patients were also angry about the constant demands to pay for services or to purchase materials from outside. Other major grievances were delays, being shuttled from department to department and poor communication about the patient's condition. Patients were not too concerned about the lack of nursing care; they were more upset about the constant demands to buy drugs and supplies from private pharmacies. In general, patients and their relatives felt helpless. They felt that the system is not responsive to their needs and they cannot exert any control on their own treatment. One common complaint was that doctors and nurses did not respond to calls from patients.

Patients had no understanding of the complexities of the hospital system. They just wanted to be examined and treated by a senior, experienced doctor, not by "novice" doctors (residents and interns).

Views about the measures taken to prevent such incidents

Hospital managements respond to a violent incident by temporarily enhancing security, usually with the help of the police and by constructing a few barricades. One municipal councillor has even suggested that doctors carry pistols to protect themselves.

Since the attacks were largely spontaneous, there was little that security personnel could do. Moreover, in many instances, the security personnel were often missing from their post or unwilling to intervene when called upon to do so.

What should be done?

Junior doctors believe the primary problem is a high patient load and adverse working conditions, which make it impossible for residents to provide adequate care and also communicate with patients and their relatives.

Senior doctors felt the need for more than one doctor – especially a senior doctor – to communicate with aggrieved relatives. There may still be heated exchanges but the situation may not turn violent. When a patient dies the relatives often blame junior doctors for their "inexperience". But they are likely to accept the same explanation if given by a senior colleague.

It may also be suggested suggested that counsellors or social workers should talk to the relatives while we deal with the medical aspects of care.Seniors should deal with serious issues, such as breaking news about death and seeking permission for post-mortem.

We have no training in handling crowds and aggression so punishment to those who assaulted them would be a deterrent against such attacks. Many welcomed the government's announcement that assaulting a healthcare worker would be made a non-bailable offence but was it implemented ?.
Many issues do exist but only time will prove if they are ever taken care of or where it leads to..
But what it has done is pretty evident …Medicine as a preferred profession is slowly fading out into the oblivion….Its high time we actually made an effort to set things right else…..you know .

My first day at the hospital

2009-10-17T00:37:00.000-07:00

Hi , its been a long break from blogging that is...as otherwise life has been pretty hectic and happening.Exams got over and we went over on bike road trip that covered around 6k kms but more details on the stuff later.
Here i am today to share bout my 1st day as a doctor in practice. Well my 1st posting was that of Casualty and Emergency Care. The work here is to put it simple " to stabilize the patient before the other specialties take over" basically it is to keep the patient alive till we are sure he can actually be saved or cured for the matter.
Trust me my friends its easier said than done...we live by a doctrine that is to keep ABC fine and the patient is going to be fine, here

A= airway that is your breathing tract clear
B= breathing - keep the patient breathing
C= Circulation that is keep your heart beating anyways

God believe me its quite an ask....k but thats what we were all trained for but then you have all stuff coming your way like non cooperative or sinking patients...friends and family who are ready to beat you up at the drop of the coin...bullying and every thing but wait were we trained for all this stuff? Wait someone told me that a docs job is a royal job then how come???

Forget it practically the real world is always different from theory they say....
So the 1st day....
My alarm clock rang at 6 am. I automatically slapped the snooze button...the day before was a celebration in the true sense coz we got registered as licensed medical practitioners and that was what we has slogged for during the better half of over a decade….
Ten minutes passed and the dreaded alarm went off again. I lay there for a few minutes thinking; I had put work and medicine to the back of my mind, but reality started to kick in. I felt my heart rate go up and I got a burst of adrenaline that made my stomach feel like it was doing cartwheels or rather butterflies; it was the same feeling I had before finals. I thought about what this day meant—the first day as a doctor, the first day of my career, the first day of not being able to say, “I'm just a medical student.”
I got out of bed, had a shower, and got ready. I didn't eat any breakfast Burla can be real pathetic at times you know. Our hospital isn't exactly a stone throw from our hostel yet I decided to take a walk….
The first part of the day was all bout paperwork, I located the house officer and filled in the take over form , so I got into the hospital finally registered and got my working hours that was like 24*7 so it finally began…..all this ended with the assigning the concerned postings…went back early and took the day in getting stuff ready….
The Casualty Medical Officer was due to start the following day with a brief briefing. So I got my allotted chair for the intern .After I had written up all the notes and ordered bloods, several nurses approached me in turn with requests, “Doctor, we need fluids for Mr. B.”

My mind went blank—all those lectures on fluid balance and I still couldn’t think of what to give. I froze for a few seconds until the nurse suggested I prescribe normal saline. I then had a moment of genius and decided to check the patient’s urea and electrolytes, which were normal, and hey presto I wrote my first prescription. The rest of the day was hectic—as soon as I finished one job, I would get calls from a nurse requiring a IV line to be sited or a drug chart to be rewritten. Better still the nurses at a govt setup are nowhere to be found when you need them or at night for that matter.

The next phase didn’t go smooth as well …there was a patient who fell into the people who drank like fish and he had a bad bad ascites that is a swollen abdomen due to a failing liver……it is really tuff to tell people that nothing can be done and nothing can be more killing to a doctor than knowing the patient is sinking and still not being able to do anything about it.

A doctor at a government setup I got to understand a few stuff, I was going to face them all, agitated patients, mayhem , non cooperation, non availability of even simple stuff as syringes or iv lines, but I gotta live through it all the pricks while suturing and all.

The day was hectic and cant go into details …got a call from the casualty some one needs to be attended to….

But at the end of it all what I learnt was that it’s a thankless job you get all the brunt when things go wrong…and if a doctor feels so how bout the nurses so the next time you see a nurse thank her even if you forget the doctor….

Journey of a lifetime...The beginning Random shots

2009-09-04T08:12:00.000-07:00

Well am writing this up at kodaikanal at some internet parlour...Tell you what its damn tiring butr its been fun the ride the trip the road and climbing the ghats at nights and tall eucalyptus or pine forests.

but to start am just gonna add pics

wil get back the full text as soon as am done with the trip..til then ciao

The Escape from Burla

2009-08-14T03:51:00.000-07:00

Exams have been on since the last 3 months....and burla seems like a rat trap.

Medicine exams were like marathon like any other mega exam stuff we faced… but like everything else it got over …..

With Surgery and Paediatrics already over it’s a kind of a relif that almost a major chunk of the exams are over. But with the baap or rather maa of exams here obs and gyn ( arre wo bacche paida karne wali exam ) is still to go , havnt got the dates for it though.

So without any idea of how may days of break I got I set out for home……

Took my bike, filled it and hit the road… burla is 240kms around from Rourkela and people have taken care that the highway keeps u on a high while riding.The roads got the river and a few rivulets along its way and lil hills .All together it’s a pleasure to both the eyes and the mind. So it was for my sore body crying out for a break.

Got out from the hostel perfect sunshine at around 11am, filled up at Sambalpur and got a bite or two. The journey thus began …trucks goin by …quaint lil haats ( weekly markets ) by the villages nearby.

Stopped over at the chaiwalla along the way ……watched icing being put on the perfect cake, clouds on the perfect day…..

What followed was nothing but devine….the feel of rain on your face as if a songs playing, someones touchin you, you feel that mushy thing inside, its like love you can just know when you feel it ……

Felt the old days coming back….back in Rourkela maybe in class 8-9 when we went over to tutions on bicycle or school and it rained.There was this habit take your raincoat off and get wet…go to some puddle and splash yourself all over…wait for some bus to give you a shower…and then when you are all done go in for a few hot samosas. Alls over 100 mts from home put on your raincoat and tell mama I got a lil late wearing it and got drenched.

The love for the rains has lived in me since then…it still lives and will be there till the day I go up in smoke and water….

Thank you God ….guys take time to live all the moments around you coz theres no fear greater than “ being afraid of the unlived life “

Live Full

I got home………

Final Exams at a Medical College

2009-08-11T04:22:00.000-07:00

Hi
well after a long long time final MBBS exams seems to be coming to an end....
Though technically there's a Obs and Gyn exam still left to follow but a 14 days gap is welcome is still welcome in any case.
So i ventured out for a break, a break from the monotony of burla...
But before i get to the escapades let me get to the exams........

The exams .....
Exams at this great institute of B*r^in as called by one of our very eminent physician and teacher last for almost a lifetime.........
dreary red eyes, pounding hearts....sleepless nights.
they build up like a Mexican wave
come at you like a pack of hungry starved rabid dogs ( with the fangs )
" i literally got up at nights with these nightmares"
and when the day finally comes you are in a fix.
The walk to the examination hall seems " the longest mile"
The invigilator seems like a herculean guard
and for a second Albert Einstein seems true " for a second is not a second but it stretches for an eternity "
and then when u raise your head and look around it seems that all heads around you have turned into lice(wild)life sanctuaries....scratching......... scratching........... scratching.
and in three hours the guard puts an end to our pain, takes away whatsoever we wrote ( that is if we wrote anything sensible).Trust me med school guys answer sheets do make volumes ....

So you guys think that's the end to it... letss party.......?
Noooooooooooo

whollla....
there are practical exams to follow.....
i wont go to the build up of it
lets reach the dooms day proper, the exams start at 7 am in the morning,and you got spotters ready ( u see the specimen and answer three ques about them all in a minute).
The code goes that once an examinee is inside the examination hall he/she cannot leave till its all done.
And it start

A long case
Two short cases to present
Seven vivas
Two people grill you over instruments( which you saw once or twice and didn't use even once).
Once grand vivas start at 8:30 pm .

Mind you my friend its evening not the morning the guy or the girl hasn't had had a morsel and the well replenished examiners charged up go on grilling , stewing and roasting away.For my friends who know the place well there's another great man who goes by the name of Dr Harrison making life even more hell.

Tell me my friend at 11 pm at night,
The guy or girl is without a bite,
Does he or she not have any human right,
Take a pause and think of his/her plight,
Really makes me question myself..." how much wrong to face to do a right?"
Now a passer by calling him/her a "Sadha Daktar" is it really in his might?

P.S - and you have practicals for all exams you face in your theory.

Missing life AKA school......

2009-07-28T13:58:00.000-07:00

Hi
well final MBBS exams are on .....
am done with the theory exams and practicals are on....a lil tuff a lil hectic but i like the taste of it.
Pediatrics just got over and Surgery follows in a day....
Its half past 3 in the morning , raining and load shedding is on here as usual....the day was hectic books, wards and then books again....
Got a mail from a few friends santosh , joshi, pani, ponds ...guys it feels great to still be in touch and yeh a good deal of time has gone by......almost around a decade......
So as i said final MBBS makes you seem a lot mechanical......you study for 16 maybe 18 its bound to happen.....but its friends and memories that come like a breeze and do make me realize that am still human and not some data crunching machine
cut the crap this is for all you wonderful people......

life AKA school days

All the days that spent,
would i change i would really repent.

the day when I cried at the primary,
and I pleaded to be released of the misery.

the day when I was smacked for my results,
I kept wondering what was wrong with the adults.

the day I was punished
for not wearing a tie or dirty shoes,
i kept praying these people
would someday pay for their dues.

the day I sneaked out of the class to see a friend,
or the independence day parade when it rained.

and the day when I finally got out of school,
having the only thing in mind that now life was gonna be cool.

Looking back I realise how wrong was I, how wrong am I,
but all that I can do now is let out a deep sigh.

i miss you guys.....

do keep in touch ...........
bye

If Solitude could speak…………

2009-06-11T22:44:00.000-07:00

Tell you what final MBBS can get you real cranky at times.....

At least thats what has done to me, made me write things i never did belive i could. In a way its nice lets me vent out whatever has been lying hidden somewhere deep inside.

So to make you a equal partner in crime am sharing this stuff.....

Here goes....

If Solitude could speak…………

When i pass the silent corridors

I see you walking by me,

And I pretend that I am happy and painless

When you say Hello or some meaningless words.

But when I am all alone

A strange world opens up in-front,

Because I did believe strongly

That things could never be gone.

You probably would think I am

Doing so good without you,

But oh how I long

you could see the other side of me,

beyond the masks I put on

Because this pain is endless inside of me.

I wish you could ever know the truth about

what I hide from you inside of me,

I cant eat...

I cant sleep...

Nothing means anything to me,

Somethings lost in my heart

Because your not next to me.

And when I return to my solitude after the day

I sit alone in my room and…..

and pray to God ……..

with no hope or desire what so ever or whatever you say.

But I cry because you will never

be next to me

Because I hurt you,

and let you go,but then you

wish you had turned back and held me tight…never let go,

If my solitude could talk

it would tell you how much

i long for you,

and how my life is not the same

because i dont have you.

If my solitude could talk

it would tell you how much

pain that lives inside of me,

because you were my first love

moving on is easier said than done

and i will never forget the pain

that’s left inside of me!!!

On a Different note

2009-06-09T22:26:00.000-07:00

hi,

well its been long since i did post anything,

Have been into this final MBBS examniation stuff, a lil tuff and a lil hectic.Medicine is a little funny of sorts right at the time you think that you have got it a bit even, it comes right back at you and hits right back.

Since a few days it has been like a few random thoughts going through my mind apart from a few volumes of surgery,paediatrics etc flying here and there.

So i thought i would rather vent it out.

it goes like

Silence

Silence is what is all that is left for sure

sounds of loneliness and the unending void,

dark hours haunt and torment and torture

here i stand stricken and destroyed.

no shread of laughter or happiness exists

nobody to shout over the phone,

Somber, melancholy moods and decay persists

now it is just slogging through the nights alone.

Confusion feeds like a savage inside

Leaving nothing considered worthy persists,

Destined to walk through life alne till i rech the other side

Alone, exiled, different and and still i continue to exist

its silence that prevails...

only silence that prevails.....

What not to do at a medical college - Ten Commandments for All Fresh Medics - " Eager young minds"

2009-05-06T12:07:00.000-07:00

Hello this post goes out to all those who intend to join into this wonderful stream....well almost wonderful stream.

But before you set out in this journey of a lifetime there are a few words of caution which i would like to add as " The Ten Commandments "

Forget your past - your past laurels, achievements, PMT or CET rank do not matter here. It’s a clean slate from day one and the last laugh belongs to the consistent hard workering and not the talented hardly working class.
Don’t be overwhelmed by the course, size of books, big talk by seniors. Before you, students of all backgrounds, intellects, I.Q.’s and E.Q.’s have sailed through this ocean called MBBS. You too will reach the other side. Just keep up your efforts and sprits.
Don’t believe every word your seniors tell you. Empty boxes make the most noise.
Don’t spend the year with question banks and guides. It will serve you better in the long term if you start with a knowledge based attitude, rather than a marks based attitude.
Don’t be repulsed by the library, if you want to be a knowledgeable doc. You can go through different books on a subject, before deciding which one to invest in. A good rapport with the library staff is invaluable.
Don’t while away time when you are supposed to be dissecting. There a lot to see and learn, when the air is heavy with formalin vapour and odour of cadavers. ( I realized this, albeit a too late)
The microscope in histology is not to be used as a telescope. ( Many realize this folly in second year, when they find that all pathology slides look the same,).The word’s in I.B. Singh’s histology textbook bears an uncanny resemblance to Grays Anatomy, at a fraction of the cost and weight. A good option for the Gray’s fanatic.
Don’t Ignore Guyton, else your fundas in many aspects will be perennially weakened. Guyton’s textbook of Physiology is very much readable and the book that could make a difference in your goal towards a PG seat if read and assimilated properly in the first year.
Ditto for biochemistry. Chose the book that suits you, there are many good ones out there.
Don’t just creep into books. There’s a new and exciting world out there. Be there and join the fun. These coming five years will be the best of your life. (I know it now, as I am the other side)

I would just like to add a line that my teacher told me during my college call days, her words were like " why do you want to understand everything, just remember whatever written. To get through MBBS you dont need to be talented or smart you just need to pull up your socks and read read and get things by heart. Its hard work which will get you through coz you cant draw conclusions as there is no therefore and logic in medicine...its like garbage in garbage out. All you read is all you know , just facts "

ARMY-DEFENCE Services after MBBS, a career option

2009-03-11T12:14:00.006-07:00

The other day round a few of my frenz and me sat for a party and fun stuff and then followed an animated discussion.
A discussion that is pretty common among almost all thinking MBBS undergrad junta.....What to do next?. Am pretty sure that if you have been through MBBS and through THE FINAL year you know exactly what i mean.
Anyways let me get to one of the few options that we discussed....the defence.
Had a chance to interact with quite a few seniors in the Army/Navy and Air Force.I just wish that this post helps you descide....
As someone once said being in the right profession is like being in love....all seems fine and the same to the world but the same mushy sweet and lovely feeling is something that one feels inside.Itz the same for a life well lived and a job well done.
All fingers arent alike neither are all medics the same...everyone has his/her own way of studying and that applies to the way of life as well.If it were to be judged academically you may have a good academician or a not so good academician mind you itz academician not a good doctor or a bad doctor.
Those preparing for all India Entrances are mostly average or above average. Otherwise the really brilliant ones are already in AIIMS, PGI, JIPMER, CMC VELLORE, USA, UK etc etc.......
So what happens to all the other above average doctors who are very hard working but still lose out in the highly competitive rat race of today or an average doctor who has lived his life along with studying for his degree. Will you expect all of them to spend the next few years trying again and again to get into the PG courses at elite institutions even as some of them have aged parents to support and responsibilities to shoulder? State entrances are wrought with quotas.....
Its just an opinion but thinking otherwise is an option too.....
The Indian Defence sector may be an answer we are looking for....at least it sure maybe for a guy like me....
Serving in the armed forces needs a different bent of mind, a cosmopolitan outlook, and open mind, the desire to do something different, and not just remain a clinician. If one wants to be a hardcore clinician alone and make waves, then one has to be very very very good nowdays to forge ahead in the present compettive atmosphere. But in a class of 100 students in Final MBBS, only 15 to 20 students( apna wo dash,moda,agarwal etc kind) will have that kind of abilities. What about the 60 % of average guys( like us me, apna gang, upadhyay,behera etc) and the 20 % of really medicore doctors remaining. Don't we deserve a decent life and a way to survive and lead a productive life without having to resort to unethical medical practice in civilian life (kidney-hint). I say this because I have seen both sides of the fence and know that medical practice in the civilian sector in India today is pure business (Rs 20 for the rickshaw-walla who brings the patient home, Rs 5000 from a patient for a cartract surgery at a government medical colleges which provides for all lenses,sutures and the doctor`s salary - no my friend everyone does it is not an alibi) .
Itz for those who dont have a medical background in the family, no clinic etc...want to do things other than medicine alone in your life...not very serious about PG...want to settle in life fast...aim to get into permanent commission ...do not mind the rules and regulations of armed forces...want to get married early ...looking forward to a laid back lifestyle with a decent pay without working too hard at academics.
Dont even think about it if
You think they are academically superior to other fellows and feel that they can get themselves into better positions in life either abroad or in corporate hospitals in India or cant conform themselves to the rigid discipline of the forces...

Here are a few pros and cons that might help you out..
ADVANTAGES:

1. The pay at junior ranks starts at 30k/pm(i think) which as all of you know is fantastic, you cant expect the same for any fresh doctor anywhere in India.

2. You get highly subsidised accomodation ( single & married), free rations for yourself which are sufficient for 2 persons....wherever you are posted you will e living in a secure residential complex, with all modern amenities, shopping complexes, and bank/ATM and other facilities nearby.

3. You get LTC, Train travel concessions.....club memberships, access to excellent sporst facilities like tennis courts, swimmimg pool, gym, indoor badminton, indoor games, and service run movie theatre.

4. The SSC is a secure job.... you join for an initial tenure of 5 years , automatically extendable by the President of India for another 5 years till a maximum of total 10 at the discretion of the MOD...unless you opt out at the end of 5 years.

5. The pay at the end of 5 years will be around 65k/pm gross...take home pay after tax deduction and PF is around 25,000/pm. You get the best interest rates for your PF savings.

6. If you opt out at 5 or 10 years you get a gratuity.( calculated according to your last basic pay and a formula)

7. The life at least in the defence is good.....good people, respect for you both as a doctor and as an officer.

DISADVANTAGES:

1. The life is totally different from civilain life and requires a different attitude to get adjusted to. There will be transfers every 3 years.

2. After front base posting, you may get posted to either a base unit or to a base hospital. Hospitals are great ...but the base units are a little like periphery.

3. At all times, except in a hospital posting you will be under the authority of a non medical commanding officer ...who may or may not be good to you. Almost certainly he /she will not have any idea about medicine and will depend on only you to sort out all the health related matters. It may give you an advantage sometimes , but might also a headache at times.

4. Once you join and your Joining Signal ( something like a joining confirmation leter fromyour unit) is sent to the Headquarters, you cannot quit at any time according to your whims and fancies. REMEMBER the commission is given to you by the PRESIDENT OF INDIA and that means that it is a honourable post which you cannnot resign at your fancy. If you opt out, you must send an official application it may take upto a year to process...at the end of which you may or may not be relieved off your duties.

5. You get to apply for a permanent commission interview board after finishing 2 years of service.Itz a little difficult to get permanent commission because not only is it dependent on a good Annual Confidential Reports sent by your commanding officer ...but it also becomes a matter of "PUSH AND PULL" with the bigwigs in the Selection boards. So no gurantees there.

6. Only if you get a permanent commission are you eligible to take up the PG entrance ( in service) in the 4th year of your service. If you get this then, post graduate training is like any other government hospital in india...with the difference that it is more regimental, and the hospitals are better equipped than most of the state government run hospitals. Infact the Command level hospitals are as good as some of the Private corporate hospitals in chennai and mumbai.

7. In the permanant commission you are bonded for at least 20 years of total service from initial commission as SSC...after 20 years you are eligible for a very good pension, and all other exservicemen benefits.

8. If you are unlucky enough to spend the entire of 5 years away from a service hospital...then invariably unless you are highly motivated, all your medical knowledge and acumen will be washed away in the interim period (Those were the exact words i heard)

so i gave it all i knew itz your life now make it large.........
live full

MEDICINE - CAN GET FUNNY TOO

2009-03-10T02:57:00.000-07:00

Well in a movie there was a line by Amitabh Bachan " i can talk in english, walk in english , laugh in english because english is a very funny language"
Medicine is taken as the pinnacle of all forms of learning and at times even i have found it to be funny in its own ways.....
this was probably an incident that i heard during my 3rd year.
the third year comprises of Pathology,Pharmacology,Microbiology and Forensic Medicine+Toxicology
Well its quite evident among us guys how we pass our examinations.....
It was one of those examination days.....the final university examination.
With exams starting at 7am it took pretty half an hour to actually get your brain to switch on.So eventually when it did start we discovered that it was Microbiology paper 1.
The first question was
Q1.Write a brief note on Robert Koch-the germ theory?
and so on and so forth.
I just am gonna mention a few lines of the answer....it goes like
India is a spiritual land,a land where religion and diversity have reached their culminating point.Hinduism is one of the major religions here....
Hindus have two sacred books Ramayana and Mahabharata.Mahabharata is a story about five brothers.The eldest was Yudhisthir and the most powerful was Bheem.
Bheem married a demon called Hidimba.Hidimba had two sons Ghatotkach and the other Robert Koch...................
medicine gets funny sometimes you know
and the guy passed and that too with good grades.

The joy of being a Doctor - an insight

2009-01-12T08:12:00.000-08:00

For centuries, the physician has been one of the most respected members of society. The leader of his pack, the king among all indigenous tribes revered for their knowledge of the healing arts. The family doctor often treated patients for their entire lives and was called upon not only to assist in births and deaths, but for advice and guidance as well. That seems to be changing somewhat in the litigious and all knowing society of today.

For most of us medicine is a "calling" much like priesthood something you are destined to do. To large extent I find it true. You must have a great desire to become a physician. A driving passion to help people, to be challenged, and to learn and slog throughout your life. You will sacrifice your time and energy for the care of your patients, often forsaking your family and yourself just to see a smile on those lips below the eyes that look up to you. Most doctors will tell you they can't imagine doing anything else, and today I can`t imagine myself doing anything else. Being a doctor is simply who we are, not just what we do, its me, its a part of me . The desire to help others a need within them, like breathing, or hunger.

Once you have made the decision to become a doctor, you must pursue it whole-heartedly, all through your mortal existence. Demystifying the process and the profession is only the first step. The rest is up to you.

"It concerns us to know the purposes we seek in life, for then, like archers aiming at a definite mark, we shall be more likely to attain what we desire." -- Aristotle

As a physician you will enjoy not only monetary rewards, but humanistic rewards which are priceless. We can all imagine how painful it must be to tell a family that their loved one has just died, but can you imagine how amazing it must feel to repair the defective heart of a tiny baby? Or to remove a malignant tumor from the brain of a young mother? Or to help an injured man to walk again, thereby giving him the gift of dignity, the ability to support his family, and the freedom to play catch with his son, watching them spread a painless smile. ISN`T IT WORTH ALL THE PAINS?

(But the predicament today is that distraught families no longer blame God or fate for the death or disability of loved ones, they blame the doctors who treat them. As in any profession, there are certainly some who deserve such blame. However, careful, caring physicians are more and more often finding themselves fighting legal battles for their right to continue practicing. In what other profession can a simple mistake cost a life? Doctors are not heartless, their failures weigh heavily on them. Yet neither are they perfect nor GOD, and often isnt too much expected from us)

IIT AFTER MBBS---A SECOND CHANCE

2008-08-17T09:51:00.000-07:00

Well this blog is aimed at all those who did dream of getting into the IITs but due to some unavoidable circumstances, family pressure and all other factors could not make it this is your second chance.Well its also a chance for all those who want to break out of the box and think the other way just out of the box.

But as it is with all second chances this wont be a cake walk either....all those MBBS junta who would like to get into the brand IIT there is a hope called MMST or Masters in Medical Science and Technology.

This course is run at IIT Kharagpur by its School of Medical Science and Technology.

A lot of details in this blog are just compiled by me from various sources-sites-people-seniors.As far as i remember there is just one senior of ours from orissa studing there.

So thats how it goes...

School of Medical Science and Technology

With the advancements in the realm of medical science & technology our globe has witnessed in the recent decades a sort of marriage between medicine & technology. School of Medical Science and Technology (SMST), Indian Institute of Technology Kharagpur was set up to provide a platform of interdisciplinary teaching and research in the field of medical science & technology, which would lead to a better integrated healthcare delivery system in India.

The next breed of doctors would not thus be technology hating geeks but a seer amalgamation product of both technology and the human touch.

As per the facilities are concerned you need to be assured that this is IIT you will find all you could ever dream of as a research fellow still here is the list that i could make...

Medical Imaging & Image Processing Lab

• Ultrasound scanner & 3D & 4D (with Colour Doppler)

• Fluorescence Microscope

• Atomic Force Microscope

• Digital CR

• Picture Archival & Communication System (PACS)

• Optical Microscopes

• Scanning Electron Microscope

Embeded Systems Lab for Medicine

• Micro Controller

• DSP trainer Kit

• FPGA based Medical Chip design facility

Medical Instrumentation Lab

• ECG and EEG recording systems with test probes

• PC based Spirometer

• Phono Cardiogram

• 8 Channel Biopotentials Recorder

• Automated peritoneal dialysis machine

• Pulse oximeter and blood gas analyzer

• Electro-Acoustic Transducers

• Fetal monitor

Bio-material, Tissue Engineering & Translational Wound Research Lab

• Universal testing Machine

• FTIR

• UV Spectrometer

• Surface Profilometer

• Viscometer

• Ultrasonic Bath

• Drying Oven

• Vacuum Pump

• Ball Mill

• Furnace

• Contact Angle

• Extruder

• Isostatic Press

• Internal Mixture

• Electro Spinning Setup

• Freeze Dryer

• Water Bath

• Diamond Saw

• Laminar Flow Unit

• CO2 Incubator

• Centrifuge

• Vacuum Oven

• Shaker

• Weighing Balance

• Microtome

• Inverted Microscope

• Autoclave

• Deep Freezer (-80oC)

• Liquid Nitrogen Can

• Polisher for Metallographic

Cell and Molecular Biology facilities

• DNA finger printing

• Electroporator

• Hybridizer

• Horizontal gel electrophoresis systems

• Gel documentation set-up

• Southern blotting apparatus

• PCR machine

• Sequencing facility

• Fluorescence and inverted microscopes

• UV cross linker

• Dark/cold room/radio-isotope facilities

Bioinformatics and Proteomics facilities

• Silicon graphics workstation

• Various softwares for protein analysis (RASMOL; RASWIN)

• HPLC

• Sonicator

• Western blotting apparatus

• ELISA reader

• Scintillation counter

• Vertical gel electrophoresis systems

• Lyophilizer

• Sequencing gel apparatus

Telemedicine

• Server and terminals

• Video conferencing unit

• Telemedicine software supporting live medical teleconsultation related to cardiology/radiology/pathology/oncology/ tropical diseases over ISDN and lease lines and integration with various medical instruments for diagnosis and treatment

Shared Facilities at Central Research Facility (CRF)

• MALDI-ToF Mass Spectrometry

• Automated DNA Sequencer

• Real Time PCR Machine

• 2D Gel Electrophoresis

• Fluorescence Activated Cell sorter

Some other Lab facilities of the School are:

• Clinical Skill Lab

• Medical Statistics & Informatics lab

• Herbal & Eco-friendly Medical Research Lab

The Course

The School of Medical Science and Technology (SMST), Indian Institute of Technology Kharagpur offers a 3 years post graduate program - Masters in Medical Science and Technology (MMST) for MBBS graduates. This programme imparts engineering skills to medical professionals and train them for the state-of-the-art medical research in frontier areas of

Medical Imaging
Molecular Imaging and Image Analysis
Biomaterials and Implants
Biophysics
Medical Statistics
Telemedicine
Biomedical Instrumentation
Early Detection of Cancer
Immuno-technology
Recombinant DNA Technology
Biomedical Simulation
Wound research and so on

There is also a Diploma program and a M-Tech program in Medical Imaging and Image Analysis (2 years).So the programmes broadly are....

Masters in Medical Science & Technology(3 years).
MS (Medical Science & Technology)
M. Tech Medical Imaging and Image Analysis (2 years).
Ph.D. (Medical Science & Technology)

The college in fact has link ups with a lot many prestigious institutions (its the IIT remember) like

Duke University Medical Centre, USA
University of Fukui, Japan
Brain Science Institute, RIKEN, Japan
National University of Singapore, Singapore
Scuola Superiore Sant' Anna, Pisa, Italy
United Bristol Healthcare, NHS Trust, UK
All India Institute of Medical Sciences, New Delhi
Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow PGIMER, Calcutta
Sree Chitra Tirunal Institute of Medical Science & Technology, Trivandrum

Eligibility

Although other streams are eligible but the primary focus of the course is on MBBS graduates.The criterion for admission to MMST students is MBBS Degree (recognised by Medical Council of India) with a minimum of 55% marks in aggregate and having studied mathematics at +2 level (even as additional subject) or from any recognized Open University. Seats are reserved for SC/ST candidates and persons with disability as per Govt. of India rules

The Scope

This is one part am not really sure about but during MMST you are paid a stipend of Rs 10,000 pm and you get in touch with all those real cool technology that you only heard of. After you are done with your degree as far as i have the idea about the placements its basically tech companies based abroad take you away as R&D associates with cool whopping salaries of around 1.5 lakhs per month. Well thats a dream as a fresh medicine graduate.So if research is your calling or R&D is where you think you belong this is the stuff for you.

The Exam

An objective type of written test of 2 hours duration.
Total of 120 questions of one mark each (no negative marking) out of which 75 questions are from MBBS syllabi. The remaining questions are equally distributed to cover the syllabi of +2 level Physics, Chemistry and Mathematics.
Candidates qualifying in the admission test are called for counseling at IIT Kharagpur before final selection

The Syllabus

Physics -Newton's Law of Motion, translation and rotation, energy and power, conservation of linear momentum, simple harmonic motion, Hook's law, First law of thermodynamics, expansion of solid, Gas laws, Maxwell distribution of velocity, waves, interference of two waves, total internal reflection, Coulomb's law, Ohm's law, Magnetic field due to current, Faraday's law of induction, Photoelectric effect, Bohr model of atom, Radoactivity.
Chemistry Chemical equilibrium, chemical and enzyme kinetics, Nuclear chemistry, Enzyme catalysis, Coordination Chemistry - preliminary concepts, Bonding, Strong and weak interactions, Inductive and resonance effect on acidity and basicity, Characteristics reactions of alcohols, aldehydes, ketones, amines, carboxylic acids and their derivatives, Optical isomerism of compounds containing two asymmetric centers, Aromatic and heterocyclic compounds (one hetero atom), Carbohydrates, Amino acids, Nucleic acids and proteins: general structure and physical properties. Mathematics Algebra of complex numbers, Theory of quadratic equations and quadratic expressions, relationship between roots and coefficients, Arithmetic, geometric and harmonic progression, Equation of a straight line in various forms, angle between two lines, distance of a point from a line, lines through point of intersection of two lines, Limit, continuity and derivatives of a function, limit, and derivative of sum, difference, product and quotient of two functions and composite functions, Integration as the inverse process of differentiation, integration by parts.
Medical Sciences- Anatomy - gross and applied Physiology, Biochemistry and genetics, Pharmacology: emphasis on clinical pharmacology, Pathology including microbiology and parasitology - emphasis on microscopic structures. Social and preventive medicine : emphasis on infectious and communicable diseases, immunization and family planning, Medicine including Pediatrics, Surgery including Orthopedics and Urology, Obstetrics & gynecology, Ophthalmology and ENT, Anesthesia and oncology, radio-diagnosis

The Test Centers

You can appear for the MMST entrance exams at

Bhubaneshwar
Chennai
Kolkata
Mumbai
New Delhi

What all can you work on

Reproductive Biomedicine
Internal Medicine
Pediatrics
Nutraceuticals & herbal medicine
Diabetology
Medical Statistics
Medical Expert System
Pattern Recognition in Medicine
Bio-medical Imaging and Image / Bio-signal processing
Retinal prosthesis / neural prosthesis
Visual Evoked Potential Response
Implantable electrical System
Bio-medical Instrumentation and Bio-sensors
Bio-materials
Medical Imaging
Wound & Cancer Biology
Radiation Biology
Eco-friendly Medicine
Hard Tissue Engineering
Near Net Shape Fabrication of Ceramics & Metal for Implant Applications
Biomimetic synthesis or surface modification of materials
Cancer Biology
Oxidative Stress in infertility
Proteomics in Reproductive Health
Male Contraceptive Development

The Catch

Like all good things come with a catch this thing too does ....

Only 10 seats all india plus quotas
You need to serve as a medical officer there

That was all that i could help you with you can go through the search yourself or visit their official website.

OVER WITH MBBS?...WHATS NEXT.......

2008-08-16T10:43:00.000-07:00

Hello friends since the very time I joined into MBBS I had a few questions about what was in store for the future…a professional point of view shows that it isn’t rewarding enough in terms of input to output ratio.

Well if it wasn’t for the job satisfaction a smile on the lips of a patient offers this isn’t worth the hours put in and the stress levels involved.

So my friends who have been looking for alternatives to going for a career that helps you both reach your dream to be a doctor, get the job satisfaction and make moolah too…( and a chance to get beyond the bulkiest books you would ever find in any curriculum or stream).

Here are a few options for those who have always believed in thinking out of the box…

Ø Work as a junior resident and remain soo for life ( yes get paid anything in between 7k to 18k)

Ø You can try for entrance exams where thousands, if not lakhs of other equally competent docs try to get handful of PG seats.

Ø After PG, if your dad or family doesn't run a hospital, sit in a small time clinic and try to earn your bread. else join a 5 star city hospital for a lowly wage (15-22K INR in Delhi)

Ø Go to the village and be GOD there. You can earn plenty as long as you are ready to spend the major part of your youth phase at some place where you fight to get to the civilized world and as long as you can sweetly but surely murder your ethics yet feel real good about it.

Ø Try to go abroad if u have loads of money to invest.
USA - if u can get visa to reach US soil and can get good MLE scores.
UK - if u already r in UK and working there. all gates to UK r now officially shut.
Australia - if u r ready for bad racism and working in their peripheral units for few years.
Canada/South Africa/Malaysia are other options which I have not practically ever met people going to.

Russia well the poor mans paradise but the credibility of doctors returning from the region has always been under suspicion by the society.

Ø Medical informatics (a lesser heard field)

Ø Medical IT and software programming

Ø Pharmaceutical management

Ø MBA and hospital management or general management.

Ø Health insurance work.

Ø Public health and WHO/UNICEF ( go to Congo ,Zaire on foreign trips)

Ø IAS - very very difficult option and even more difficult to stay honest after joining it.

Ø Open a shop(your apna clinic) and use ur brain to run it successfully.

Ø Politics - join local politics. doesn't pay much till u r corrupt.

Give it a thought....

2008-08-14T01:59:00.000-07:00

The recent controversy regarding the village posting of doctors has put the medical community on one side and the whole world on the other side. I remember, 4 years ago, when I was selected for medical college it was all joy and celebrations. But as a family i found it all right but going out into the big space i found ideas about doctors a little different..."charging exorbitantly","chor hai" and an and on....

The problem possibly lies with the doctors. They work for money, they do not bother about the society, they can kill female fetuses for a few bucks more, and they can refuse treatment for want of money; they are not up-to-date with knowledge, they do unnecessary tests to get a share of the booty. Most of the complaints are probably true. I have seen ultra-sonologists giving shamelessly false report to assist another shameless gynecologist in going for an unnecessary surgery, and I have seen many more un-parliamentary linen that I should not wash in public. All are true and more.

My worry is about the ways the society is trying to go about solving the problem. The society is trying to find a solution without assistance from doctors. It was the same when the consumer protection act came. Most of the sane doctors protested, some insane ones also did. No one listened to us. I remember being told at one gathering of legal experts, that they were putting the patients from the frying pan to fire; from doctors clutches to lawyers. I asked them, why did they want consumer protection act for the medical community, to improve services or getting compensation, or did they want just to teach a lesson! I assured them none of these would be possible. People refuse to learn from history. Has the road accident compensation policy improved the quality of drivers? It has only raised the insurance rates and probably helped the family of the dead. If consumer protection act implementation for medical community was intended for compensation, it was good, but if it was meant to improve services, it was useless. People gave us funny looks, thought we were 'so bad'.

Now the great thinkers of the nation are again at it. They want doctors to go to villages, and because the so called anti-social doctors do not want to go to villages and move abroad or at least posh locations, they'll have to be forced. I am surprised at the cerebral quality of the people who rake up such ideas. Has any one tried to find out why doctors are not interested in going to the villages! (try visiting any and you will get at least a part of the answer) Is it only money! By the way, one of the lowest paid employees in

India

is a junior doctor. As a junior doctor we are paid a princely sum of Rs. 2860/-PM(now 5000 I suppose minus all bills), while the ward boys are paid Rs 9000/-(the pay scale revision on the cards). Their duty was 8 hrs, ours 24 hrs; they have one weekly holiday, we have none. They have time for lunch; we do not. we survive because the 'sisters' are real sisters. If the barber fails to turn up, we have to 'prepare' the patient for surgery; the ward boy would not even have a nightmare of doing it (enema ,stomach wash( look up in the dictionary) and everything) . If the ward boy is absent we have to 'ensure' that the patient reaches the OT on time, riding on the trolley, guess who pushes it through the corridors of the hospital! But I tell you; we enjoy our stay as a house surgeon. We are still proud of what we do Because that was when we learn. That is what prepares us for the future. That is where we learn how to give a painless suture, how to tackle a violent patient, how to tackle grief. I do not think an able beurocrat or a trained babu (our undersecretaries) will ever understand that, they do not have the training.

Look at the position of medical education today. MBBS is a five and a half years course. Already the longest course in the country. But an MBBS degree is truly nothing today. At one time an MBBS degree was equivalent to an M Sc degree. One could become a lecturer after MBBS, could do a MD, or MS after MBBS. But no more, now MBBS is equivalent to B Sc. MD is a doctoral degree, Doctor of Medicine(DM), now a postgraduate degree, a three years postgraduate degree. A two years postgraduate diploma is not equivalent to MD. Even the MCI( Medical Council of India) is trying its best to degrade the status of medical degrees.Medicine has moved forward in leaps and bounds and we havnt had had a syllabus revision in the last 50 years?

I invite the society to understand the problem first. Force should come as the last option, not the first. Today an MBBS degree holder is a pariah in society, to be accepted by the people he has to have a postgraduate qualification. 'Only MBBS', or 'simple MBBS', or worse 'plain MBBS' are terms we hear often, but do not understand the agony of it all. MBBS entrance is one of the toughest in the country,add to it the great the heavier than yourself load of books and out very own time crunched and probably the toughest exam the final MB but let me introduce you to a tougher entrance, the PG entrance. The number of seats for PG is one third or even less that of the total MBBS seats, so in any case two thirds of the MBBS shall remain 'plain and simple'. This cutthroat competition has prompted the students to treat MBBS degree as a qualifying benchmark for PG entrance tests. They prepare for the test rather than trying to become doctors. This one entrance test would make or break their career. It is better to be a simple B Sc then to remain a simple MBBS. There are instances where MBBS students are paying smaller hospitals to get internship certificate without going to the hospital so that they can utilize the time studying. What is the result? They do not become a 'doctor' after MBBS; they remain students. One third of them get into PG, two-thirds fail, add to them that fraction who are at a even worse condition ,these are people who get a rank all right but not good enough to get the desired speciality so they have to decide between the fire and the frying pan ie to join in a job specialization that doen not interest or appeal to them stay there as under performers for life or play the gamble of appearing once again and again means you never know. No, not because they are stupid, because the know-all government has put a rationing in the number of seats for PG. Imagine the fate of these students, they are plain MBBS, did not spend time learning during internship, now they are out in the open, no respect, no knowledge, official quacks. This is the most serious wastage of trained manpower the country is facing today, all because of our policy makers.

Take a case of a young student probably 17 years old driven by all kinds of forces parents, society, personal interest goes into this noble profession ...by the first few weeks that aura around the job fades but we wont discuss that here. Lets get into the duration first, six years of bone crushing studies.Then comes the biggest and merely the first hurdle, the post graduate entrance.If he gets through in the first attempt itself which is rare adds another three years to your career (18 hours of hospital job and 3 hours of study).Then you get into the big world but not before you have debated enough with yourself to enter the business or get to a super-specialization. But it takes more than marketing skills to get your shops running 5-10 years maybe before you get a decent enough name for yourself.Still theres the major test if you do not fare well you get to hear words like "uska haat set nahi hai" "doesnt have a healing hand" is this what you we are running after?.Trust me there are thousands of unsung dashs,pradhans,rays,upadhyays,sahus,nayaks,and ranjans before you get to see one Dr Rao,Dr Raila or a Dr Trehan.I am sure all our friends out there at the elite institutions would agree that if we got through our PMTs we were at par even if not better than them....then why is there such a sky difference in the end result? (sky rocketing salaries after a 4 year course!!!)

A friend once told me that you could make as much moolah as a techie if you go out to the villages.Stay there and you will be GOD (ask them to do so carrying their ethics alongside).Well we all gotta have a family some day,your genius then would require schooling,haven't you as a young ambitious guy/girl dreamt of riding your dream machine or leading your dream life.Well at the place where the government sends you better dream of getting your cell phone charged...

Who is responsible? There was one know-all TV talk show, which said if you cannot become a doctor in five years, you could never be. So very sick! These are the people who control the society, God help us. One does not become a 'doctor' immediately after passing MBBS; it takes at least 2-3 yrs of fulltime work under supervision to be able to work independently. That was what interships are. Practicing MCQs without a adequate field experience does not prepare a doctor well.

Is there a solution to the problems in villages? It is there, if our great parliamentarians bother to listen to us. By the way I have a few more proposals. I want to make it compulsory for the parliamentarians to stay in a village for one year as MP and fulfill all promises made during election campaign otherwise their Membership would be cancelled. Make it compulsory for IIM graduates to stay in a village for one year to work for betterment of rural finances, before they get their degree. I want an IITan to go to the villages and get the taste of real India and deal with itz basic infrastructural problems,maybe encourage a few ignited minds there.I want High Court judges to stay in villages at least 2 months a year to help solve the pending cases in the villages to be eligible for promotion to Supreme Court. I want the IAS officer to be posted in a village for one year before they are confirmed in their jobs.They can all stay in the excellent accomodation provided in the villages for the doctors. Sounds funny? Who started the jokes!

Here is what I suggest.

The entire medical course needs to be revamped. Instead of hundreds of confusing degrees there should be one degree, MD. It should be a 7.5 years integrated course, equivalent in status to a MD. All students,after four years of pre-clinical basics get to apply for a stream of their interest and get selected on grounds of merit, then get a provisional registration to work as doctors under supervision in respective departments. They would select their specialty at this juncture, depending on the merit and other government policies of the time. Even a surgeon would be MD. All the diploma courses would be abolished. There would be specialties in family practice, clinical medicine, hospital based internists, surgeons, ophthalmologists, and all other specialties that we have today.

One year out of this course will be a village posting (field practice in SPM -Social Preventive Medicine) where they can learn the problems of the villages and unlearn some hi-tech solutions to simple problems. There would never be a shortfall of doctors in villages, happy doctors and not frustrated ones. I do not think there would even be a murmur of protest from anywhere. No forcible "Cultural Revolutionary" tactics would be needed. The GPs-General Practicioner that we get would be trained ones, not untrained ones as we get now.

How does a patient differentiate between a physician MD and a general practitioner MD. The same way they do now, between MDs in Medicine, pharmacology, biochemistry and pathology. In any case, government can recognize certain associations, memberships of which can be made compulsory. (For example, MD, Member of Indian College of Pharmacology, or MD Indian College of Physicians.). This way every doctor that comes out of the college would have some special skills,and have worked independently for at the least 4 years before being released to the society. There is no wastage of doctors as 'simple MBBS'.

The super-specialties should be limited to a few, the brightest ones.There should be no further confusing degree like MCh, DM. The super-specialists would be offered fellowships of the college, e.g. MD, Fellow of the Indian College of Cardiac Surgeons, equivalent to postdoctoral degree, MCh.

By the way this does not solve the problem of the bad guys in the profession as mentioned in paragraph two of this article. I'll share a bitter truth with you. The patients are as much responsible for this situation as the doctors. The ratio of good doctors and bad doctors is exactly the same as the ratio of good guys and bad guys in the society, not more, not less. There is something very wrong in the way patients select their doctors. Name and fame does not depend on skill, knowledge and sincerity. Sound business tactics, sometimes not so ethical, makes one doctor more popular than the other.

But let me tell you theres nothing like seeing a smile on a kids face after he/she gets well,the glitter in the eye of a healed patient or his/her attendant or the job satisfaction that you get after even a 36 hour long shift ..thats what i and thousands of doctors and budding doctors are here for....next time you see one think of the ordeals we go through to stand before you and to get you to smile...

Tell me you must have always heard that people say that the society needs more doctors, there in no filling up of vacant posts at hospitals, acute shortage of doctors in the society but have you ever heard of a new AIIMS in your vicinity. Leave AIIMS aside how many times have you seen the government set up a new medical colleges instead we have 8 or is it 10 new IITS being set up.Anyone in the vague idea of sending IIT graduates to the village to deal with problems there. Infact they are the best and we are not the only ones on whom the government spends its billions.

This article is aimed at sensible people who want a solution, not revenge. The next doctor could be your son; the next patient could be you-your son-your brother-me anyone. THINK ABOUT IT!!

Sujay Pradhan

Vss medical college burla