Is General Surgery as Specialsed Medical Branch Getting Extinct in Country?

Naveen Kumar
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Abstract

Today, in India, there are about 12,780 post-graduate seats in Master of Surgery of which there 1600 seats are in General Surgery offered by various Government and private medical colleges in India. There is a matter of grief situation that each year less number of undergraduates opting for the General Surgery branch. The foremost reason of it is that the amount of hardwork and stress which a trainee undergoes is incomparable to any other branch. Practicing General Surgery is not an easy job to have for anyone especially in an overpopulated country like India. Secondly, it is not a terminal branch as super-specialization in various disciplines is being offered after completion of postgraduation in General Surgery. So, again toiling for straight 3 years in General Surgery, a fresh Post Graduate (PG) has to again prepare hard to get into any Super-Specialty (SS) branch of his interest as only about 200 seats are being offered in various surgical super-specialty branches across the country. Finding General Surgery a hard road to walk, most undergraduates opt for less tiring branch which may also happens to be a terminal branch. The higher education in medical field is quite a costly affair owing to a few number of Government colleges offering the PG and SS seats. They may cost up to or more than one crore in many of the private medical colleges. To add to this is the ever increasing caste based reservation policy of the Government which is not doing justice to many according to many of the experts and educationists. All these factors result in many seats remaining vacant in the mentioned branch especially in SS across the country. Though the Government has established a new commission i.e. National Medical Commission (NMC) to look after the lacunae in the country’s medical education system, still there is lot that has to be done in this field. There aren’t sufficient faculty posts in the department of General Surgery and surgical super-specialties bearing burden over the system to look after increasing patient burden. General Surgery is the backbone of every institution and hospital which at present is overstressed thanks to the laid-back approach in policy making. Surgeon also has to face burnt of medico-legal proceedings every now and then in our country. Government is thumping it's back of opening more number of medical colleges in different states across the country but the fact is that nothing is on their agenda to improve the actual quality of medical education whatsoever is there. There is no concept of wet lab in surgery department even in various premium institutes of the country. There has not been any mentioning of arranging cadaveric dissection courses in the curriculum of post graduation. No fruitful research has come out from ages in the said department from so called research medical institutes. System has made the PG students to think each second about finishing off with their mandatory thesis work and pass the final exit examination without giving any attention to improve their clinical skills. And once they pass their examination, they start preparing for the entrance examination to get into SS branch of their choice. If this trend continues to work, time will come that patients will find it really tough to get well qualified surgeons for getting them operated in the country. Those who can afford will fly outside the country to get their ailment treated where better facilities are available as done by various dignitaries and politicians even now, whereas those who cannot afford to do so will ultimately succumb or may fall prey to the quacks. There is urgent need of revamp of the system where some better policies are being formulated to save this branch of medicine in our country. There is a need to ignite the interest among the medical undergraduates towards this branch so that more and more students should take up the General Surgery as their choice in future.
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作为专科医学分支的普外科在我国正在走向消亡吗?
今天,在印度,大约有12,780个外科硕士研究生席位,其中有1600个席位是由印度各政府和私立医学院提供的普通外科。有一个令人悲伤的情况,每年越来越少的本科生选择普通外科分支。最重要的原因是,实习生所承受的辛勤工作和压力是任何其他部门无法比拟的。对于任何人来说,从事普通外科手术都不是一件容易的工作,尤其是在像印度这样人口过剩的国家。其次,它不是一个终端分支,因为在普通外科研究生毕业后,还提供各种学科的超级专业。因此,在普通外科连续三年辛苦工作后,应届研究生(PG)必须再次努力准备进入他感兴趣的任何超级专业(SS)分支,因为全国各外科超级专业分支只提供约200个席位。发现普通外科是一条很难走的路,大多数本科生选择了不那么累的分支,也可能碰巧是一个终末分支。医学领域的高等教育是一件相当昂贵的事情,因为一些政府学院提供PG和SS席位。在许多私立医学院,他们的费用可能高达或超过1000万。此外,根据许多专家和教育家的说法,政府基于种姓的预留制政策不断增加,这对许多人来说并不公平。所有这些因素导致上述部门的许多席位空缺,特别是在全国各地的SS。虽然政府设立了一个新的委员会,即国家医学委员会(NMC),以处理该国医学教育系统中的空白,但在这一领域仍有许多工作要做。普通外科和外科超级专科没有足够的教师岗位来承担系统负担,以照顾日益增加的患者负担。普通外科是每个机构和医院的支柱,目前由于政策制定的宽松方式而压力过大。在我国,外科医生也时常要面临一系列的医疗法律诉讼。政府正在努力在全国不同的州开设更多的医学院,但事实是,他们的议程上没有任何东西可以提高现有医学教育的实际质量。即使在国内的一些高级机构,外科也没有湿实验室的概念。在研究生的课程设置中并没有提到尸体解剖的课程设置。多年来,在这个所谓的医学研究机构的部门里,没有任何有成果的研究出来。系统使得PG学生每一秒都想着完成他们的必修论文和通过最后的毕业考试,而没有注意提高他们的临床技能。一旦他们通过了考试,他们就开始准备进入他们选择的党卫军分支机构的入学考试。如果这一趋势继续下去,患者将发现很难在国内找到合格的外科医生为他们做手术。那些负担得起的人会飞到国外去治疗他们的疾病,那里有更好的设施,就像各种政要和政治家现在所做的那样,而那些负担不起的人最终会屈服或可能成为庸医的牺牲品。迫切需要改革制度,制定一些更好的政策来拯救我国的这一医学分支。有必要激发医学本科生对这一学科的兴趣,使越来越多的学生将来选择普外科作为他们的选择。
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