my note as a MBBS doctor - change the system EDIT

i am an indian doctor.

my journey so far:-

i spent over 10 lac rupees for my education just to get thru with my mbbs degree. WHY?

because of reservation i had to take up seat in a private medical college. my parents took loans and payed my fee.

during MBBS===there have been numerous instances where as an intern i have been on duty for more than 48 hours at a stretch (sometimes having the time to eat just one meal in the day ---- and this would happen atleast once every week!!) just at the age of 22-23... how many 22-23 year olds in MBA/engineering or other fields have to do that??? why are there NO RULES to regulate working standards for doctors while there are some guidelines for other professions???? Residents have it even worse.. i've seen residents in wards from 8 am in the morning-- first admitting then evaluating.. and managing patients till 5 am in the morning.. and then reporting for duty with grand rounds etc again at 8 am... 3 HOURS OF SLEEP?? SO MUCH STRESS--- AND YOU ARE DEALING WITH HUMAN LIFE---- what kind of work standard is that?????

now after just MBBS-- the pay i will get in mumbai to join any hospital is just Rs-18000/- per month. (BEST Opportunities) ... other wise it will be just RS16000 even less!! (getting job is difficult)

so why dont i study more and do postgraduation to increase qualification?


if i go for MD-- i will spend atleast 1 more year preparing for my enterance.. and there too due to a lack of seats.. it willl be difficult...

getting into postgraduation/residency ---- based solely on ONE test.. in which i have to mug things up by heart and then vomit it out on a paper! and based on that it will define my future..

and it has quite alot of stuff that is irrelevant to actual practice... how people prepare for it .. is take last 20 year question papers and LEARN THEM BY HEART!

i mean what kind of doctor does that make you --- one that can answer theoretical questions??? real life management of patients/concepts/ contraindications/ acute management... is very different for EVERY SINGLE PATIENT!

one might say --- OK you will learn with practice --- alright... so who should i practice on???

SHOULD i practice on actual LIVE HUMAN BEINGS in time of their sickness-- when i have limited knowledge about things (cos the current standard of education didnt require me to learn these skills)... should i learn things by trial and error on sick people?

(most other countries have interviews in addition to merit-- to judge your ability of acutal management.. to see what kind of person you are.. how you would deal with patients and people. their tests are concept based --- they ask you about stuff in various situations -- what is the next best step if this happens.. then what will you do... how will you diagnose? how will you change treatment for this special patient etc etc

basic interview day ----

1: interviewing by 4 different people in the faculty

2- actual case presentations with files of patients currently in the wards to see where you stand in managing cases

3- you views-- on what you want to do in the future -- do u want to teach? do you want to set up your own clinic? do you want to work in a hospital

and then keeping all this in mind.. your mentor during residency .. caters towards your specific needs)

when i do get in.. it will be another 3 years before i finish my MD..

during MD my stipend will be Rs-3000 to Rs-5000 per month! IS THIS A JOKE?

IN WHICH OTHER PROFESSION DO YOU GET PAYED ONLY SO MUCH THAT TOO WITH A MASTERS DEGREE?



i have spent 6 years in medical college + 1 year preparing for PG + 3 years of MD == atleast 10 years!!

so by the age of 28.. i might get a job!! and notice the word MIGHT (currently in delhi and mumbai and any city there are very few positions open in hospitals for people with just MD medicine.
if you have done only MD medicine.. you need to super specialize)

PERSONAL vs PROFESSIONAL LIFE
so at the age of 28 i will get my first salary... how much will that be???

by the time i have savings or i can think of being independent... i will be 30+

so when should i concentrate on my personal life?? marriage, family, vacation, parents, siblings??

but even then relentlessly we work.. every day and every night...

and yet baring criticism.. NON STOP and abuses from the general public.. due to a select few people that have some kind of ill conduct...

NO WHERE ELSE IN THE WORLD-- do doctors have such bad returns.

INDIA vs OTHER COUNTRIES

IN USA -- there is an excess of PG seats .. which foreign students can apply to. every year about 10,000 foreign students get in on MERIT! - and there are working laws for the limit to the number of hours you can work in a week or in a day!

if india has an EXCESS of workforce.--- why arent there better laws or solutions to employ them or organize them in a proper manner??

the starting pay for a resident is about 4000$ ---- convert that into indian currency and see how much that is!! even in $$ and living there.. it is enough to support a family of 2- rent an apartment -- and own a car!

NO wonder doctors go abroad... they pay nearly 5000$ for different exams/travel/interviews etc to get to usa.. to have a better life for themselves... and now what does the govt say??? THEY PUT A CLAUSE ON THE VISA FOR DOCTORS---saying you have to come back immidiately after residency there.

ARE THEY ASSURING US A JOB AFTER WE COME BACK--- NO

ARE THEY GOING TO FUND OUR STUDIES SO WE CAN GO ABROAD AND COME BACK AND SERVE THE PEOPLE HERE BETTER ---- NO!

why????




the amount of MBBS doctors our country generates is far in excess of the PG seats available.

when the govt knows that there are NO jobs available. for just mbbs doctors... WHY ARE THEY FURTHUR LIMITING PG SEATS? WHY ARE THEY PLAYING WITH OUT FUTURES?

it is very easy to be a non medico-- and say-- oh you can always do rural work..

RURAL WORK--

is good. giving back to the community.. that is why i chose this profession... to give back to the people...

but please tell me for how long can i survive on rural work???

let me ask you being a woman-- would you go to an interior place in india-- where you have never been before... where women are looked down upon because of their gender, there is no security.. and we all know about the increasing amount of sexual and other crimes against women

No electricity, limited water, varied food supplies.

you are away from family for 6 years of medical school and now you shud live furthur away ?

WHY?


YOU MAY SAY I AM DOING THIS BY CHOICE
when i chose to be a doctor-- i chose to serve people-- YES

i chose to not complain and treat people and be there for them during THE WORST TIMES OF THEIR LIVES.. (cos thats what sickness is right?) and i chose to listen to their complaints and criticism when they were well!

but i did not sign up to gamble my future or to be taken for a joyride by the govt. who can provide me with ZERO security when it comes to my future...

in this profession the INPUT is far in excess of the OUTPUT.

no wonder people in desperate need resort to other methods.

I agree they are wrong! but instead of blaming them --- creating shows to malign them etc etc---- ISNT IT BETTER TO DEAL WITH THE UNDERLYING CAUSE OF WHY THEY DO IT?????

i thought the whole idea of this show was to change peoples mentality ... and bring about a change in society... isnt that possible only by addressing the ROOT CAUSE of things?

** i agree that as a doctor i am not perfect, i may have alot of minus points. but i would appreciate not being bashed***

** TO CLEAR A FEW THINGS

1- i havent put up this post to whine about reservation or how bad my life was, its just my analysis of what the underlying thought process of the thousands of doctors out there might be. which might be eventually leading to the things shown on the show.

My point was that it is more than JUST GREED that is fuelling all this

2- my note on rural practice

and no where am i sayign that a doctor should say NO to going rural.. there is nothing wrong with it.. yes you should always give back to the less fortunate.. yes it might be difficult at times but you can deal with it. IM QUESTIONING THE RESON BEHIND THE PROLONGED AND MANDATORY RURAL PRACTICE ON THE NAME OF UPLIFTMENT...

and yes i did just attend a 2 month long FREE rural camp in the beginning of this year in gujrat (im not gujrati) it was organized by doctors. NOT GETTING PAYED. had everything from surgeries to obstetric procedures to eye surgeries.. to just simple medical diagnosis and prescriptions (can google it for the ones who think such stuff is not possible)

and yes my home medical college.. located in interior maharashtra.. holds WEEKLY FREE MEDICAL CAMPS (all specialities) in a 100km radius of its location... so almost all villages get covered. camps are 2-3 days long. take place in schools/temples. (we sleep with sleeping bags on the floors FYI) .. if something is found.. at the end of the day the patient is transported back to the hospital.. and treated.. he just has to pay the bed charges.. all diagnostics and medications are FREE.

the local ayurvedic/allopethic doctors are taken into confidence and the PRO staff from the hospital keeps a check on the locality for dire needs even after we leave.

just citing and example...

every week the camp staff changes. so different doctors go. it is not a bane to anyone.

healthy alternative??

all i was trying to say was.. that there are ways.. that are well sorted out.. to bring about a CHANGE in the entire system... and if it needs to be changed.. it has to be at a grassroot level.. which for any medico is the day he/she steps into med school

change is always met with resistance.. but if it is for the better it always shines thru!

and dealing with the underlying causes is far more important than just pointing fingers

(i am again not justifying what is wrong and not saying that anyone is entitled to mislead someone just cos he went thru a tough time)

but DONOT judge the entire practice.. based on a select few. Instead treat these select few as a warning sign for how bad things could get if the the infrastructure isnt worked upon soon. ***

Natasha, thank you for showing us the issues with the profession. Being a professional there are law and ethics that every one has to follow. Just because you spent so much time and money does not warrant you to do things that are wrong.

Originally posted by: BHAVI1972

Natasha, thank you for showing us the issues with the profession. Being a professional there are law and ethics that every one has to follow. Just because you spent so much time and money does not warrant you to do things that are wrong.

You are lucky that you will be getting 16000-18000 /month as your first salary. There are many professions who does not even hit 10000/ month as their first salary.

yup that is a good point.

and i agree.. that i am privileged and thankful to god for atleast having the chance to attain that much.

but the positions that give me such a salary are just 2-3 in every hospital.

(again its not an all or none rule.. there is a percentage -although small- that do manage this)

Also these positions are available only in selective hospitals.

for anything else -- either i would have to fund myself and build up the infrastructure to open a clinic.

OR start studying for MD as i have pointed up above...

the point of my post was not to say that i am ENTITLED to anything better...

i just put it up as an insiders view of the so called "system" in place.

and also a special thanks for putting forward your point so politely.. 😊

rather than the usual anger such posts have brought upon themselves

Originally posted by: natasha-remix

yup that is a good point.

and i agree.. that i am privileged and thankful to god for atleast having the chance to attain that much.

but the positions that give me such a salary are just 2-3 in every hospital.

(again its not an all or none rule.. there is a percentage -although small- that do manage this)

Also these positions are available only in selective hospitals.

for anything else -- either i would have to fund myself and build up the infrastructure to open a clinic.

OR start studying for MD as i have pointed up above...

the point of my post was not to say that i am ENTITLED to anything better...

i just put it up as an insiders view of the so called "system" in place.

and also a special thanks for putting forward your point so politely.. 😊

rather than the usual anger such posts have brought upon themselves

Thank you so much for taking the time to give us an insight into what happens when a career in medicine is chosen. I have the greatest respect for any level of medical personnel, be it a doctor, nurse, emt, lab person or even ward boy. Together they all contribute towards making a patients lowest time in their life better. That is ideally what should happen right? No doubt you guys have your struggles, obstacles and frustrations, but let's face it, what was shown on Satymev Jayate was also enlightening albeit from an emotional and sensational platform. We cannot deny the level of corruption prevalent and we cannot just play the blame game but look to see how to overcome these frustrations. The example of Dr Shetty on the show clearly shows that this can be possible. The show is not just showing the negative but also the positive like the good docs and pharmacists who are becoming trailblazers. Honest Introspection is necessary to bring about positive change.

the payment and MD degree issue is very relevent.

@ topic maker ...

even with the payment seats there is so much exploitation ...

Originally posted by: Chitrashi

But what the show was pointing out was something totally different and that was malpractices rampant in the profession. Surely you are not trying to say that the grueling life as a doctor entitles one to play with the lives of others?

i am in no way justifying what was shown. and being a doctor myself i am ashamed that a limited few are doing these practices and maligning the name of the entire profession.

but my basic problem with the episode was that the issue of WHY such practices are happening was not addressed...

labeling it as greed and then leaving it at that is very easy. addressing the underlying culprit in the whole issue.. is the crux.

thru my post i have just tried to bring to light the initial years in the life of a med student.

what it becomes after residency etc.. i still have to experience. .

and thus it is somewhere down this same road that the efforts donot even remotely equal the outcomes.. which results in the malpractice.

there is no doubt that multiple parts of this system need revising.

during the last 5-10 years.. the undergraduate seats have multiplied... multiple pvt colleges have come up along with deemed universities. this was all sanctioned by the MCI. most of these universities/colleges are under MPs and MLAs.

the MCI was abolished a few years ago due to corruption in the system that came to light.

(can you imagine.. the chief governing agency for health all across india just dissolved overnight. i cant help but wonder what extent exactly all this went to.. to demand such a drastic step)

as a result of this ... the only ones that have suffered are the students.

problem 1- ALOT of increase in UG seats was sanctioned.. but jobs/ postgraduate seats.. were not increased. resulting in a big bottle neck.

problem 2-- most colleges came under the scanner-- and now students enrolled in those colleges (for no fault of their own) are in danger of losing their recognition as doctors on the whole... and this applies to not just undergrad but even post grad students.

i know of atleast 3 colleges in my city itself --- who had residents pass out with MD and MS degrees. been practicing for 1-2 years.. and have now had their degrees brought under question. as a result of which they cannot use them .. till the air is cleared.

all this is just the tip of the iceberg.

there are selective laws in place for even doctors graduating from govt colleges.. where in now they have to do 1 year and 2 months of compulsory rural work.

which i guess is OK... but as long as it applies to all fields.. right? why the thing where only a doctor who is as is its passing out at the age of 23- 24 now has to spend one more additional year? if ministers are talking about rural development.. im sure it must be a holistic approach.. rather than just medicine.

and he or she can choose to break the bond.. by paying the govt lacs of rupees... what kind of uplift is that? and one might question what the ulterior motive is.

and now the rule where only doctors selectively cannot go abroad on a visa and practice there but HAVE to return on completion of their 3 years education.. after putting in all the time and effort from their own pockets.

i guess what im trying to get at .. is that somewhere at the base of all of this is the basic frustration and the feeling of being cheated by some.. which then comes out as malpractice towards patients... Obviously there are the true altruists out there too.. and the optimists.. who just take it as it is .. and move on to work towards the best that they can.. with the limitations that are imposed upon them. but there are others that let their gray sides shine.

i guess the topics can go on endlessly.. and every field has its pitfalls.

also i would like to thank you for understanding the point about why junior doctors go on strike etc .

frankly its a welcome relief to see people understanding parts of the issue and having an educated approach towards it, rather than applying the ALL OR NONE principle..and just branding everything as all good or all bad.