Dr Shakti Kumar Gupta
It is a matter of pride that in J&K two AIIMS like institutions are going to come up. The legacy and the value that it will add to the existing healthcare infrastructure makes it a momentous phase.It is important to think big and act big. Building AIIMS-like institutions in Jammu and Kashmir is undoubtedly a great initiative. These would help provide the latest medical facilities to common citizens at their doorstep. They would not have to rush to Chandigarh, Amritsar or Delhi for treatment of serious ailments. That the proposed institutes of higher learning and services would be a little away from winter and summer capitals, which have comparatively better Government and private amenities, is a thoughtful decision. The one at Awantipora in Pulwama district of the Valley would provide the population of south Kashmir quick access to ultramodern care. Likewise the other in Samba would bridge the existing gap in the Jammu region. A sum of Rs 3000 crore has been allocated for the construction of these institutes. Gradually similar institutes could be built in other parts of the State including the Ladakh region. The job should be taken on a priority. It is equally relevant to remember that an institution is as good as the people running it. Huge infrastructure has to be run by public-spirited men of talent and vision and they should be selected with proper care and scrutiny. It is important to provide right mentors so that they could be the best in the country.
However, any comparison with AIIMS New Delhi is misplaced at this stage. AIIMS New Delhi is a saga of hard work. It has earned its current status and reputation on the strength of its faculty and professional management.
It is imperative to understand the hard work and commitment that has gone into raising AIIMS New Delhi to the present level. Indeed, it is credible that it has maintained its zeal for research for the sake of achieving its excellence. Its name evokes global respect. One has to see to believe how its staff — both academic and non-academic — burns midnight oil to ensure timely delivery of services. Many doctors from the State who have served short stints at AIIMS would vouch for this. Millions have received quality healthcare over the last five decades and have invariably given a good chit — a matter of immense satisfaction for any institution. Primarily the credit goes to the faculty and other staff for carrying out sustained quest for excellence. The political leadership too deserves kudos. Jawahar Lal Nehru had thought about a medical institute par excellence as one of the temples of modern India. His Health Minister Rajkumari Amrit Kaur took over this challenge and the foundation of AIIMS was laid with the clear mandate that it would be an institute of global repute — a cradle for medical research and training. She was the first chairperson of the Institute of which the earlier years bear a stamp of her selfless service. To the credit of political parties that came to power at the Centre subsequently they showed keen interest in maintaining its high standard.
The current enthusiasm of spreading “AIIMS-like” organisations all over the country is in tune with the existing realities. First, the country has the necessary resources to steadily achieve the objective. Secondly, there is realisation on the part of everyone concerned that the benefit of medical advancement has to be shared with the people at large. Sustained effort is the key to success. AIIMS has set a pace for others to emulate. It leads with more than 2000 research publications by the faculty and researchers in a year. It enjoys autonomy including in planning curriculum, selects the best students of the country and trains also those from friendly neighbouring countries. Small class size, excellent library facilities, liberal clinically oriented teaching and research exposure are its other strong points. Relevant systems and processes have been firmly established to attain thetrinity of Mission of AIIMS which is Training, Patient care and Research.
The existing Medical colleges in the state are doing an excellent job but we can’t draw any comparison with AIIMS and I think that is not your intention either. Our State has produced brilliant medical practitioners and administrators who have excelled not only in the country but across the globe. As a State subject, I too share this pride. It is a pity that most of them have found their worth outside because they believed in themselves.Our colleges have adequate infrastructure and facilities. It seems nevertheless that their hospitals are being overburdened with heavy rush of patients. That is a different subject. We need to usher in our colleges the capacity to think global. For this it is necessary that there is serious academic interaction at various levels: (a) among teachers; (b) between teachers and students; and (c) between teachers and students together on one side and highly qualified professionals from outside on the other. It has to be a constant exercise. In case of a seriously ill patient, such interactions should go on till a cure is found. It may require the availability of the latest equipment which must be ensured. This will provide the requisite practical experience. Infrastructure, human resources and equipment are three pillars on which an institute stands. All of them should be all the time honed to keep pace with the fast-moving times. There is no full stop in this regard.
Mentoring of AIIMS in J&K is of paramount importance. Selecting and nurturing the proper human resource is a Herculean task.It concerns faculty development which is an essential component of reforming curriculum. A student learns what a teacher practices and not just what a teacher teaches. That explains the crucial role of mentors whose grasp of the subject, knowledge of the current developments in their field and experience hold the key to the faculty capacity building. They have to steer away from the conventional track of traditional and rigid methodology to remain in touch with the latest developments and explore new avenues. In fact, this is applicable to all in the medical sphere. They are dealing with human lives and their confidence born of genuine ability serves the cause of humanity. To ensure the healthy quality of human resource I may venture to suggest the following measures to be taken with respect to AIIMS-like institutions in Jammu and Kashmir:
a) At the recruitment stage the experts from existing autonomous institutes of excellence in the country should constitute selection committees;
b) After selection the recruits should be trained under the mentorship of selected doctors from respective specialties;
c) Doctors from the institutes like AIIMS, New Delhi and Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, should be sent on deputation to oversee the incubation period of various departments and their faculty;
d) Faculty from AIIMS, New Delhi and PGIMER, Chandigarh should be sent on 3 to 5 years’ deputation to establish department and create same working culture and they should be paid a dignified deputation allowance. While on deputation they should be allowed to maintain liaison with the parent institute and their research activities should go on unhindered. This would help evolve a work culture and ethos apart from augmenting skill base;
e) The faculty should also have the option to retire from parent organization and take on the challenge of establishing a startup organization.
f) The training calendar should have common entrance test, common curriculum, and uniformity in training calendar and student exchange programmes.
g) There should be common capacity building programmes for faculty and the same can be carried out centrally at Dr K L Wig CMET (Centre for Medical Education and Training), AIIMS, New Delhi. This can also be extended to residents, nurses and other paramedics;
h) There should be provision of joint research programmes and multicentric studies;
i) Besides AIIMS and PGI, the institutes like JIPMER (Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry), Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow and NIMHANS (National Institute of Mental Health and Neuro Sciences), Bengaluru, could be asked to extend the benefit of their advice from time to time;
j) The use of ‘telemedicine’ to conduct lectures, seminars to impart training to doctors and webinars to update on the existing scenario should be planned; and
k) ‘Centre of Excellence’ for clinical and scientific research should be developed for the benefit ofskilled professionals.
If developed in a planned manner the two AIIMS-like institutes in the State would gain in stature and reputation. The Government has supported the growth and mentoring of institutes. Jammu and Kashmir could also benefit from this. It always pays to be mentored by those better qualified and more experienced. The two institutes would open the floodgates of medical knowledge in the State.
(The author is Medical Superintendent, All India Institute of Medical Sciences, Dr R P Centre for Ophthalmic Sciences, New Delhi)
Dr Shakti Kumar Gupta