Indian Medic

I have been working on creating this blog for about a week now. However, I haven't been able to come up with a fitting first post for the blog. There are a few unshaped ideas in my head but they will take some time.

So I was thinking, maybe, to start off, I'll write about medical studies in India.

Ok, so the journey of a typical medical student in India starts at the tender age of 17. If u want to be a pre-med you have got to decide so in your final year of high school i.e. HSC or Higher secondary certificate year also known as 10 + 2 STD in many states. A few states offer a choice of completely dropping mathematics in your HSC so you can concentrate on the three main subjects for being a Pre med i.e. Biology, Physics and Chemistry. Whether or not you get into medical school at 17 depends upon your score in the various PMTs (Pre-Medical Tests) conducted by all states and one by the central government. Here too there are exceptions in the form of states that prefer to conduct the admission process based upon your scores in the HSC exams without an entrance exam. It's difficult to say which is the better procedure, but the lack of uniformity most certainly produces discrepancies in the whole system. Add to it confounding variables like caste reservations, minority reservations and a lot many other reservations. There is much to be said about that facet of the admission process, especially the caste reservation, but that would be fodder for another post.

Once you enter into the medical field, you are one of the privileged, coz being a medical student is an honor in its own way, as I am sure it is in other countries. Medical school or medical college as it is called in India consists of four and a half years followed by one year of Internship. The four and half calendar years are divided into three academic years of one, one and half and two years each, coving pre-clinical, para-clinical and clinical subjects respectively. This pattern too is subject to much variation in the different states.

The first year of pre-clinical subjects is spent entirely in classrooms, laboratories and dissection halls, obviously in study of Anatomy, Physiology and Biochemistry. From the Second 'prof' or professional year starts the real fun. Mornings are spent in clinical rotations learning hands on clinical medicine. It might seem odd that students are exposed to real patients even before they cover in theory all the clinical stuff, but that's how it is. Second prof covers Pathology, Pharmacology, Microbiology and Forensic medicine. Final year is similar to the second, except that now there is sync between the classroom study and study at the 'Clinics'. All three 'profs' culminate in exams of their respective subjects. Moreover, if a student fails in any one of them, he is set back by six months and so on until he or she manages to pass the examinations.

Then it is on to internship, 12 months of total unadulterated clinical experience. The fledgling doctors are shunted from discipline to discipline and trained in the basic technicalities of practicing medicine. At the end of each rotation, there is a performance evaluation and if needed one might have to repeat the rotation or if lucky enough, get away with an extension. Even though internship is one of the most crucial elements of any doctor's education how much a person gains from it depends upon the individual. What I mean is that there are always a handful of students who manage to play hooky during their internship days and devote their time in the pursuit of activities, which will ensure their further ascent in the hierarchy of the medical world. They prepare for the Post graduation entrance examinations. We will get there in a bit…

After the completion of the compulsory internship and registration with the Indian Medical council or the State medical council where they plan to practice, students officially become doctors or RMPs - Registered Medical Practitioners. The degree bequeathed on them is MBBS, which stands for Bachelor of Medicine and Bachelor of Surgery. All this by the approximate age of 23 or 24.  We can practice basic medicine, have a family practice; work in hospitals and clinics or as Medical officers for the government in rural areas. However, for most of us that is not enough.

A couple of decades ago, when the onus was more on family practitioners and not on specialized medicine, MBBS was a highly honored degree. Now trends have changed drastically, so much so, that the MBBS degree is only considered as a checkpoint in the spectrum of medical education. If you want to be a successful doctor, you have to specialize. The catch however is that the transition to being a specialist is by far the most challenging task. Another series of Entrance exams need to be cleared and depending upon your performance you to get be a candidate for either an MD or an MS. MD covers all the non surgical specialties like Internal medicine, Pediatrics, Psychiatry, Anesthesiology etc and MS covers all surgical branches like General surgery, Orthopedics , Ophthalmology and Otorhinolaryngology.  OBGY however has the dubious honor of being an MD specialty rather than MS even though it is practically all surgery.  

Believe me when I say, the entrance exams are tough. Even though the pattern is multiple choice and the subjects comprise all subjects of undergrad, it is very difficult to crack it. The problem is lack of facilities for specialty training. There are far few seats and far too many candidates. And as the backlog keeps mounting so does the competition, and the exams only get tougher. So far, there is no solution in sight for this problem.

But for those who do make it, it's an unparalleled victory. Not matter how grueling you residency might be, only after setting foot into the sacred territory of post graduation does one feel that he/she has arrived in the 'Promised land of Medicine.' Three years of post graduation training and after that the sky is the limit.

This in a nutshell is the journey of an Indian Medical student from the age of 17 to being a fully qualified 'specialist' doctor. Could take from anywhere between 9 - 12 years. I have another 3-4 years to go before I set foot in the 'Promised land.'