23, February 2010
By Umesh Isalkar & Swati Shinde
MCI says it has sanctioned the course, but colleges say they lack infrastructureBe it the earthquake at Killari in 1993, frequent bomb blasts in Mumbai or the recent terrorist attack in Pune, medical emergencies are not new to Maharashtra. What is surprising to know is the fact that despite being faced with such pressing situations at regular intervals, there are very few doctors in the state who specialise in emergency medicine.
Emergency medicine is the medical speciality dedicated to diagnosis and treatment of unforeseen illness or injury. The practice of emergency medicine includes the initial evaluation, diagnosis, treatment, and disposition of any patient requiring expeditious medical, surgical, or psychiatric care.
The Medical Council of India (MCI) recognised the need for emergency medicine in July 2009. However till date, not a single medical college in the state offers a speciality post–graduate programme in the said discipline.
“The state of emergency medicine in Maharashtra is miserable. Despite being recognised by the MCI, it is true the post–graduate programme in emergency medicine has not been taken up by any medical college,” said Arun Jamkar, dean of the B J Medical College, Pune.
Jamkar further said, “Blasts and other emergencies place severe demands on the hospital system. The resulting surge of victims can overwhelm the resources of any facility not prepared for such an event. The recent terrorist attack underscores the need for preparedness in terms of capacity–building in emergency medicine.”
“At most hospitals, emergency department and casualty wards are left to the knowledge and expertise of interns. It is true that MCI recognised MD in emergency medicine, but it is up to the colleges now to start such a course,” Jamkar said.
“As for our college, a full–fledged trauma centre is likely to come up in the next six months. The process of starting a post–graduate programme in emergency medicine will be initiated soon after,” he said.
Prasad Rajhans, chief intensivist at Deenanath Mangeshkar Hospital, said, “Since there are no specialists – except a handful who have studied abroad – emergency medicine department in most hospitals is manned by MBBS doctors who have certain degree of experience in handling emergency cases.”
“The emergency physician requires a broad field of knowledge and advanced procedural skills often including surgical procedures, trauma resuscitation, advanced cardiac life support and advanced airway management,” said Rajhans.
W B Tayade, state director of medical education and research, said, “To start a new course in a medical college, the concerned university has to forward a proposal to us. The academic council of the university should ideally discuss this and forward a proposal to the government. Accordingly we will decide the number of seats, eligibility criteria, faculty among other things and give approval.”
Mrudula Phadke, vice–chancellor of Maharashtra University of Health Sciences (MUHS) said, “So far, we have not received a proposal from any medical college. The Board of Studies (BoS) at the university is studying the possibility of starting a course. Already, there is a certificate course at MUHS. The BoS will recommend if such a post–graduate course is required in the state.”
When contacted, Vedprakash Mishra, chairman of MCI’s Academic Cell said, “MCI notified two courses–MD in emergency medicine and MD in infectious diseases in August 2009. The next step was notifying the teachers’ eligibility qualification. The MCI notified that in November 2009. That’s what we could do to initiate the process of starting the course. Now it is up to the medical colleges and state government and respective university to initiate and expedite the processes.”
“Medical colleges attached with hospital set ups need to have a full fledged trauma care unit in place if at all they want to run a special–ity programme in emergency medicine. Since most of them do not have the basic infrastructure in place, they can not run the course,” said Brigadier Amardeep Singh, dean of Padmashree Dr D Y Patil Medical College in Pimpri, adding that their college will soon have a superspeciality unit after which a course in emergency medicine may start.
The Story so Far
- The Society of Emergency Medicine, India, held its first meeting in May 1999 during the first ever conference in emergency medicine held in India, at Hyderabad
- The then cohesive body gave its first recommendation to the MCI to include EM as a specialty in postgraduate medical education in June 2000, which was turned down
- Exactly nine years later, the need is felt after efforts put up by EM pioneers
- MCI recognised emergency medicine as an independent speciality in Indian healthcare system in July 2009
- MCI notified MD in emergency medicine and MD in infectious disease in August 2009
- MCI notified teachers elegibilty qualification as faculty for MD in emergency medicine in November 2009