Dr Shyam Singh
Government Medical Colleges came into being for three main Purposes:
One to teach and train future Medical Faculty, Medical Practitioners, Paramedical Personnel .
Two to produce research in field of Medical Sciences particularly on ailments prevalent in our set of population
Three for Patient Care
Jammu & Kashmir Union Territory with its difficult terrain, and multiple impediments has shown marked improvements in health indicators in the recent past due to dedicated efforts of central and UT dispensations. Sound health policies and good governance can lead UT to a faster development.
The trainees in our Medical Colleges need quality education and people need quality medical care.
A scientific human resource development program must be a top priority of the Government.
For quality medical education ,you need quality medical teachers.If you compromise on the recruitment of medical teachers you shall be destroying the medical education system of the country because medical teachers are responsible for guiding the undergraduate (M.B.,B.S.), postgraduate (M.D./M.S), Postdoctoral (M.Ch/D.M) medical students in their teaching and training. Besides a medical teacher in a medical college has to deliver quality medical care to the patients. Not only this ,he/she has to undertake research in the clinical and basic sciences and teach and guide the students under his/her care in research projects.
The recruitment agency for Government Medical Colleges in J&K , Public Service Commission had become a rehabilitation centre for retiree who were nearer and dearer to the corridors of political powers than having merit.Thankfully with formation of Union Territory the PSC has been bundled up but what is the roadmap ahead is still not clear whether the same corrupt set up will return in new avtar .
With amalgamation of J&K after abrogation of article 370 , it was expected that the rules and regulations of Union Territory will come into force but after even after 3 months the fog has not cleared from the hilly terrains of Union Territory of Jammu & Kashmir .The recent Government order on NEET 2020 specifying that the old set of scheme shall continue in Union Territory of J&K as was prevalent in erstwhile State of Jammu and Kashmir meaning thereby that aspirants of the Union Territory of J&K for Medical seats will not be allowed to compete for All India Medical pool raises doubts about change. Similarly Health & Medical Education Department Order on subject of Notification of minimum qualifications for Recruitment and method of recruitment for various categories of Gazetted level posts/faculty posts in the Superspeciality Hospital Srinagar , a week before order of Union Territory of J&K inspite of clear cut supreme court finding that a state cannot make rules which are in conflict with Medical Council of India Regulations on Minimum Qualification for Medical teachers, raises questions of malafide.
The best way to put a fullstop on these malafide actions is to implement Medical Council Of India, Minimun Qualification for medical teachers in medical institutions,Regulations which are to be mandatorily followed as has been envisaged in many Supreme Court and High Court judgements.
All the faculty vacancies ought to be advertised at national level so that we get the best lot of medical teachers.
The posts of Principals, Medical Superintendents/ Deputy Medical Superint-endents should also be advertised at national level so that the best ones are recruited for the jobs rather than handpicking without any transparency.
The problem of shortage of manpower should be addressed without compromising the quality and as per the Medical Council of India Rules and Regulations.
Transfer policy of doctors in health department needs prompt revision. Gandhinagar hospital & Sarwal hospital in Jammu and Gousia hospital and Rainawari hospital in Srinagar , and evening clinics in the twin cities of the union territory have traditionally been the places of postings for wives, sons and son -in-laws, daughters and daughter -in-laws of politicians and bureaucrats. These hospitals in the past had become centres for unnecessary referrals to Govt Medical Colleges, after 4 P.M.These hospitals need to be upgraded with 24×7 facility for emergency services .
There are doctors from Health Departments recruited for peripheral hospitals but are posted in Govt medical colleges Jammu & Srinagar for decades together on recommendations of Politicians.
New superspeciality hospitals should not be opened for the sake of cutting ribbons unless and until you have requisite trained and qualified medical professionals and paramedical staff in place and protocols in place.The supporting services of qualified engineers for maintenance of buildings and engineering services are must. An experienced, honest ,upright and dynamic administrator at helm of affairs who knows how to lead his team from the front, can make the difference. Superspeciality hospital should purely cater to patients who require superspecialist’s consultation or admission.Continued medical education for medical personnel should be made mandatory. In each department, the chair of the head of department must change every two years between the senior most faculty members.This will help implementation of new ideas /protocols for the betterment of patient care.
All the health professionals working in tertiary care hospitals need be in campus.For this proper accommodation and facilities must be provided A review committee must review the progress and achievement of set targets every month and pinpoint bluntly the shortcomings and deficiencies of all the departments involved and dissect out the causes and suggest immediate remedial measures. Quality assurance and Clinical Audit is a necessity for improvising patient care.
Doctors and paramedics must have regular Continuous Medical Education Programmes to enhance their knowledge and skills. Only proficient staff can provide quality care.Special attention must be given to the training of doctors and nurses in Critical care including Trauma management.
A Referral System must be in place to treat the right patient at the right place at the right time. The system needs regular monitoring with proper feedback from referral centres to the referring doctors.
Health Information System including Electronic Medical Records is necessity for continuity of health care, policy making and planning. Networking of healthcare facilities through Telemedicine is required.
Recruitment of faculty and paramedics on academic basis for new superspeciality hospitals and new Medical Colleges will create more confusion and chaos and will further decrease the medical teachers in GMC Jammu and GMC Srinagar.Already there are cases where the government has tried to shift faculty from departments of General Surgery, General Medicine to Superspeciality Departments of GMC Jammu and GMC Srinagar, thereby decreasing the faculty strength in the parent departments of General Surgery and General Medicine on the cadre of which they were recruited.This action is not only illegal but detrimental to the health of the parent and the new superspeciality departments.
Can a medical professional afford doing private practice while serving in a teaching tertiary care hospitals without compromising the quality of services ,he/she is recruited for delivering? I have no doubt in my mind on this subject, one cannot justify doing private practice, infact cannot have time to do so if one performs his services of teaching,clinical practice and research.
But they need to be compensated adequately . Their salaries and perks should be as per standard Medical Institutions. Sabbatical leave for one year after 5 years of regular service should be given to medical faculty .
Those who think they can flourish in private practice should go fulltime in private sector and help private medical sector to grow and progress as that is needed for competitive growth of medical services.
It is the clear conscience,zeal for selfless service to mankind which sets apart a medical professional from the rest .
I have a firm belief that the medical education and healthcare in the union territory is going to change, and change for the better.
(The author is Consultant Cardiothoracic & Vascular Surgeon Govt Superspeciality Hospital ,GMC Jammu)
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