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Medical colleges facing shortage of teachers in anatomy, forensic medicine

Chennai: The state-run medical colleges in Tamil Nadu are facing a 30 per cent shortage of teachers in anatomy. It’s worse in forensic medicine, with the 17 government medical colleges having only half the number of teachers they need.

“In some colleges in the south, students learn from specialists of other departments or learn by rote from textbooks,” according to a senior professor of anatomy. There is no teacher for forensic medicine in Government Medical College, Thanjavur, and Government Medical College, Trichy, he said.

Senior doctors suggest that MCI should relax the rules and increase the number of postgraduate seats as a long-term plan to increase the number of professionals from which teachers can be drawn. As a short-term measure, they say, MCI should permit qualified teachers of other medical subjects to teach anatomy and forensic medicine.

“Professors of general surgery, who are well trained in human anatomy, should be allowed to teach anatomy and professors of pathology should be allowed to teach forensic medicine,” said Dr S Vinayagam, former director of medical education. “We have raised this point several times with the MCI, but it has never been open to the idea.” [Source: ToI]

15 Comments

  1. nk nk Friday, June 27, 2014

    why cant the mci give permission for diploma doctors as faculties..if they are attached with academics the diploma courses will see a vast improvements..what the diploma doctors lack?? one year lesser time spent in the subject of speciality..so mci should make ammendments like delayed promotion for them..but surely it can help..

  2. Dr.Galeti Chandra Sekhar Dr.Galeti Chandra Sekhar Wednesday, June 25, 2014

    Hi,
    I am a 2nd year post graduate student in forensic medicine and toxicology from Andhra pradesh. I hav entered into the course immediately after my MBBS. I came here with lot of interest, but after entering into the course, so many people are speaking downgradely about the subject. I felt very bad(feeling still). We need people like u for strengthening forensic. Sir u said that atleast one district medicolegal expert is necessary, is it possible sir? If possible, probably when we r going to get those?

  3. Ravichandran Doraisamy Ravichandran Doraisamy Monday, June 17, 2013

    The idea of bringing in Clinical side people to teach basic sciences as a short term measure seems to be an irrational approach. The current scenario in clinical departments is that teachers are not found after 11 am owing to their private practice. The clinical students are left unattended in majority of the departments. The above statements will be vouched by their own conscience, students and the stake holder of the medical business-patients. If this is the situation where is the time for them to teach Anatomy, FM. Next how to solve the deficiency…..lucrative salary to govt college teachers, increase the staff strength in colleges as previously (2+3+5), provide super speciality courses in genetics, embryology, reproduction technology ,prosthetic designing etc. to attract fresh medical graduates to pursue the basic science courses. Short term policies or interim relief policies have not worked out in the past ….that’s the truth. Such short visioned comments are sure to destroy the long term benefits. I congratulate Dr. Hirak , Dr. Gaurav and Dr. Johnson and others for their prompt opposition to this idea. I in the capacity of Secretary of Society Of Clinical Anatomists , India strongly condemn the statements of such senior people. Dr. Ravichandran

  4. WMS Johnson WMS Johnson Saturday, June 15, 2013

    Its ridiculous to think of entrusting teaching Anatomy or other branches to others. The lack of importance given to basic subjects is telling upon the quality of budding Doctors. I am actually afraid of becoming a patient at the hands of such Doctors.

  5. Dr.Hirak Das Dr.Hirak Das Monday, September 10, 2012

    The statements made by some about replacing anatomy (or for that matter forensic medicines) by dozens of professionals from diverse branches only reflects their ignorance of what is Anatomy.

    Anatomy is not a subject that can or should be taught in such incoordinated manner. It is a highly scientific subject involving a close understanding and reference to diverse aspect including gross anatomy, microanatomy, embryology, genetics, osteology, imaging, physical anthropology, etc.

    Suppose we hire a surgeon to speak about the muscles of the upper limb. A student asks him how was the upper limb developed? The surgeon will say….OK dear, wait for an embrylogist who will explain the same next month…. The student waits………

    Next month, the embryologist comes and explains…. but suddennly another student asks a doubt about a particular bone in the limb. His teacher says… Pliz wait for the orthopaedician who will be visiting next month.

    Orthopaedican comes and clears his doubt. Another students again raised a doubt about some nerves and its connections to the brain…He had to wait another month for the neurologist’s visit !!!!!! This will be the scenario of such an endeavour.

    The MCI is intelligent enough to understand this and has rightfully entrusted the job to the professional anatomists. This is true for any specialist subjects.

    However, a shortage is definately present. The question is…. what is the solution???

    1. Firstly, we have to understand the source of the problem. The root of the problem is the low esteem that some medicos view this subject and lack of adequate avenues available to rise upwards via this subject. For example, a medicine specialist can do a DM in Cardiology, Neurology, Gastroenterology, etc, etc. An surgeon can do MCh in Urology, CTVS, Plastic surgery, Paediatric surgery, etc. Similaiarly all clinical departments can do superspecialities. But an anatomist doesnt have this option. New avenues for higher studies (DM/MCh)must be opened up. Many options are available like Medical Genetics and Reproductive Medicine & Clinical Embryology. In INdia, only SGPGI,Lucknow are running a DM in Medical Genetics course but they do not allow Anatomists into it. Similarly anatomist are not being allowed for courses in Reproductive Medicine which are reserved for Gynecologists. It is this attitude that prevents fresh graduates from taking up anatomy. Authorities mus therefore ensure that anatomist must be allowed entry to such superspecialities. They may make modifications in the PG curriculum to make them fit for such roles.

    2.Lack of clinical touch. Anatomy nowadays have gone beyond the limits of gross anatomy. They have entered into fields of genetics, clincal embryology, prosthesis designing, etc. But these have not been regularized yet. They should be allowed more work in such clinical areas. They should also be allowed to do minor surgical operations (as done in Surgery Minot OT). They have already done it in graduate days. There is no reason to restrain them as post graduates.

    3. All clinicians need a brush up of their anatomical knowledge. They may not have enough time to go through the Gray’s Anatomy. Short term refresher courses in Anatomy for clinicians as part of Vertical integration will fulfill their needs.

    4. Non practice allowance given to teachers are nowhere near the income of the private practice of the clinicians. The NPA should be increasd to satisfactory n sufficient degrees so that we give them due honour for the sacrifice they have made in their medical practice for the sake of the students.

    Only if such steps are taken, medicos will take up anatomy eagerly as a profession. This is the best way to deal with the situation without compromising the quality of education. It will bring overall benifits to students, anatomists, clinicians and college employers as well. Besides it will promote healthy competition and increase job satisfaction.

  6. Dr. Hirak Das Dr. Hirak Das Monday, September 10, 2012

    The statements made by some about replacing anatomy (or for that matter forensic medicines) by dozens of professionals from diverse branches only reflects their ignorance of what is Anatomy.

    Anatomy is not a subject that can or should be taught in such incoordinated manner. It is a highly scientific subject involving a close understanding and reference to diverse aspect including gross anatomy, microanatomy, embryology, genetics, osteology, imaging, physical anthropology, etc.

    Suppose we hire a surgeon to speak about the muscles of the upper limb. A student asks him how was the upper limb developed? The surgeon will say….OK dear, wait for an embrylogist who will explain the same next month…. The student waits………

    Next month, the embryologist comes and explains…. but suddennly another student asks a doubt about a particular bone in the limb. His teacher says… Pliz wait for the orthopaedician who will be visiting next month.

    Orthopaedican comes and clears his doubt. Another students again raised a doubt about some nerves and its connections to the brain…He had to wait another month for the neurologist’s visit !!!!!! This will be the scenario of such an endeavour.

    The MCI is intelligent enough to understand this and has rightfully entrusted the job to the professional anatomists. This is true for any specialist subjects.

    However, a shortage is definately present. The question is…. what is the solution???

    1. Firstly, we have to understand the source of the problem. The root of the problem is the low esteem that some medicos view this subject and lack of adequate avenues available to rise upwards via this subject. For example, a medicine specialist can do a DM in Cardiology, Neurology, Gastroenterology, etc, etc. An surgeon can do MCh in Urology, CTVS, Plastic surgery, Paediatric surgery, etc. Similaiarly all clinical departments can do superspecialities. But an anatomist doesnt have this option. New avenues for higher studies (DM/MCh)must be opened up. Many options are available like Medical Genetics and Reproductive Medicine & Clinical Embryology. In INdia, only SGPGI,Lucknow are running a DM in Medical Genetics course but they do not allow Anatomists into it. Similarly anatomist are not being allowed for courses in Reproductive Medicine which are reserved for Gynecologists. It is this attitude that prevents fresh graduates from taking up anatomy. Authorities mus therefore ensure that anatomist must be allowed entry to such superspecialities. They may make modifications in the PG curriculum to make them fit for such roles.

    2.Lack of clinical touch. Anatomy nowadays have gone beyond the limits of gross anatomy. They have entered into fields of genetics, clincal embryology, prosthesis designing, etc. But these have not been regularized yet. They should be allowed more work in such clinical areas. They should also be allowed to do minor surgical operations (as done in Surgery Minot OT). They have already done it in graduate days. There is no reason to restrain them as post graduates.

    3. All clinicians need a brush up of their anatomical knowledge. They may not have enough time to go through the Gray’s Anatomy. Short term refresher courses in Anatomy for clinicians as part of Vertical integration will fulfill their needs.

    4. Non practice allowance given to teachers are nowhere near the income of the private practice of the clinicians. The NPA should be increasd to satisfactory n sufficient degrees so that we give them due honour for the sacrifice they have made in their medical practice for the sake of the students.

    Only if such steps are taken, medicos will take up anatomy eagerly as a profession. This is the best way to deal with the situation without compromising the quality of education. It will bring overall benifits to students, anatomists, clinicians and college employers as well. Besides it will promote healthy competition and increase job satisfaction.

  7. Dr.G.S.Pawar Frme Medico legal Consultant and deputy Chief Forensic Pathologist Govt of Jamaica [W .I] Dr.G.S.Pawar Frme Medico legal Consultant and deputy Chief Forensic Pathologist Govt of Jamaica [W .I] Tuesday, August 28, 2012

    Dear Friends,
    We must appreciate and respect the comments made by such a senior medical teacher ,academician & former DME of Tamilnadu Dr.Vinayagam who is well known for his academic achievements. It only shows his deep concern and emphathy towards medical education and health care .Every one has got a right to comment on what he/she feels correct.
    The current crisis in Medical education is mainly because of wrong and bad government policies , commercialization of medical education.Medical colleges are mushrooming in our country curtsey government policies and MCI.Sudden increase in the number of Medical Colleges in our country without giving priority to the development of man power [ medical teachers] and infrastructure .Just like industrial revolution . During that time too there was man power deficiency and now we have excess man power.We must have patience .See what impatience has lead to – we all know the fate of many engg ,dental and pharmacy colleges .Many of them not getting candidates and some of them got closed and disappeared in thin air.I have not heard about Physio therapy college existing near by my place. Thanks to DCI and AICTEE who has stopped giving permission to new colleges .
    Coming to the matter of discussion- single teacher teaching [ may be great idea for private colleges as they may have pay him/her to the max s double salary ,in turn saving five teachers salary] many subjects is dangerous to the medical education and heath care system.In the era of superspecialities it is better to learn by a qualified and experienced teacher of that specialty.Any teacher who is good in English can teach any subject,medical /non medical but he can not teach the intricacies without having an experience in it.One man teaching is currently possible / acceptable only in play schools but not in medical colleges /Professional colleges.It is Myth that there is dearth of qualified Teachers.There are qualified persons available in Anotomy and FMT (Karnataka produces 30 P G ‘s AP produces 25 in FMT /year- .many do not get jobs in their states is a bitter truth ) who are underutilized buy the the govt and private sector.Govt not ready or not in a position to pay higher salaries and facilities like AIIMS as Health care is not the govt priority.
    If the same situation continues then what can happen 1] There may not be any students to take up medicine 2] Colleges may get closed 3] Country will be full of qualified quacks – this 100% sure thing to happen 4] Health care system will crash due to incompetent doctors .5] This will put the heath of citizens of India in jeopardy- what can happen to an unhealthy country every one of us can imagine 6]Overseas job ads state very explicitly” INDIAN MEDICAL GRADUATES NEED NOT HAVE TO APPLY TO THESE POSTS ” .It is high time that we must learn from others mistakes and think in the direction of proper utilization of man power,raising the standards of medical education and ultimately preserving the health of the country.
    TIME TO THINK AND ACT

  8. Dr neeta chhabra Dr neeta chhabra Friday, August 17, 2012

    I would like to know the names of colleges where there is shortage of anatomy teachers .

  9. Dr. Ramesh Vardhan Dr. Ramesh Vardhan Tuesday, July 17, 2012

    it is easy to appoint msc human anatomy graduates & msc forensic graduates ( criminology) . any way these are nothing do with treating the patients . there job to teach medical students. most of the post mortems are performed by mbbs doctors. all most all the specimens& samples are sent out the medical colleges mile away .. it is a common scene to see old hazy glass jars covered with dust in the so called labs.( that too borrowed from some other colleges. real forensic is a combination of law, toxicology , criminology , anatomy , pathology , with good acknowledge of english . majority of the medical students are poor at english( even the teachers for that matter) , we should thinks about it. according to me one must learn english at least for year with an intensive teaching by an expert. before taking admission to medicine. communication is most important thing in teaching .it is hard to find a good teacher now a days . teaching should be a full time job , one should confine to only teaching , instead of running around the nursing homes , labs & scanning centres after pressing finger on the biometric device\ signing in the muster. due to wrong govt.policies & greedy medical college managements the entire system going to the dogs. that’s why we see 60 year man as a tutor or as a residence ( at fag end of his carrier ) the lowest position as teacher , instead of teaching students he has to learn from them. (unfortunate & un fair ). please bear with me for being frank. dr ramesh vardhan.

  10. Dr.Laxman Kumar Karmi Dr.Laxman Kumar Karmi Monday, July 2, 2012

    Now there is shortage of teaching staffs in the departments like Anatomy/Physiology/Biochem etc.Why this is so ?we should try to know the cause first,then only we can find out away.
    the issue of job satisfaction- In common knowldge-Doctor means -dealing with the ailing persons and helping him/her to be cured off the problem/disease.Maximum medical graduate wants to be in this sector rather to be teacher,also the parents wants that.But till then there are people who will enjoy to be teacher rather then working 24 Hrs in the periphery with involvemnt in lot of govt.programmes rather then medical practice.In reality,now the govt.doctors in periphery became a medical manager rather then treating doctor,for which many people are not joining the Govt.Job now.So to deal with this we have to find out the suitable persons ,who really want to be teachers.
    The issue of Salary-In the medical colleges-the doctors are getting salary almost twice that in the periphery job ,to that with only 8 hours of job daily.So I think-Money is not a constraint.
    The third issue-Why the Graduates not opting for PG in this subject during counselling? I think-All have the aim to do PG in good clinical subject ,which is not possible.There are people to do PG in this subjects,but they need job security,as by this degee they can not practice anywhere,other then college.

  11. mrinal barua mrinal barua Sunday, July 1, 2012

    I agree with Dr. Adarsh here. I fail to understand how a patho guy could be specialist in forensic medicine and not vice versa. If this is the case then probably all the anatomists should be allowed to teach general surgery students. The basic problem here in our country is that all medicos believe that medical education is just a waste of time and all the people in pre-clinical and para-clinical subjects are good for nothing. The MCI only talks of improving standards of medical education but they do not do anything about it. The concept of interdisciplinary learning is completely non-existent.

  12. Smitha Hegde Smitha Hegde Sunday, July 1, 2012

    The alternative measure to teach Anatomy and Forensic Medicine as suggested by Dr S.Vinayagam,former D.M.E is dangerous to Medical education.Another suggestion to increase the number of PG seats in Anatomy and Forensic Medicine is not correct.When I was a medical student,these PG seats were not preferred and usually remained vacant.The working conditions and salary offered by the government was not satisfactory.Once you complete MBBS,you can remain without practice and if you choose to forgo private practice,you should have adequate compensation.Let government give attractive salary say Rs1lakh for assistant professor and 1.5lakhs for professor in all pre-clinical and para-clinical subjects,then everybody will show interest.Let state government announce walk-in interviews to fill vacancies in government sector medical colleges,there will be improvement in situation.Low salary offered by the state government to doctors who take up these non-practising subjests is the main reason and not shortage of PG seats.

  13. Chiranjeeb Kakoty Chiranjeeb Kakoty Sunday, July 1, 2012

    Interesting piece of debate. Till about mid 70s, the scenario was something like this. Primarily because the specialities / subb specialities did not develop or because we had less man power

    General Surgeons doubled up as ENT surgeons , some even as eye surgeons
    Medicine specialists taught physiology , some even pharmacology
    Community Medicine / SPM was under the domain of General Medicine
    Physiology and Bio Chemistry were a single subject
    Pathology and Microbiology were a single subject
    Some FSM chapters were taken by faculty of Pathology

    Though things have developed, rough edges and thorns are all over . MCI let us down many times – it had its own limitations within itself and outside. The government has not able to cure its myopia . And even if it got corrected , it was wrongly corrected that vision got worse. Now with the PM making a statement in the JIPMER convocation , lets see if we can , at all, change

  14. Dr. Adarsh Kumar Dr. Adarsh Kumar Sunday, July 1, 2012

    Dear Dr Tushar
    I agree with your observations about the causes of shortfall of qualified teachers in various disciplines; however I have strong objections to your views about teaching forensic science by legal professional and toxicology by others. The new curriculum which has been preapred after lot of efforts takes care of all issues in meticulous manner and hence revamping of MBBS curriculum was needed. Only qualfied teacher of forensic medicine can teach various intricacies of subject. it is wrong to suggest that any other person can teach the subject. Its a well known fact that private medical college is trying to moot this idea of shortage of fM tecahers and consequently trying to reduce the teaching strength.The obvious reason is they have to pay in full and dont get easily available faculty for small payment as in other branches. We have put in so many efforts over last 2 years or so to give it a proper shape.
    I request you to not misguide the readers about the reality. Rather every efforts should be to give the subject its proper due which has been neglected since decades. Only strengthening the subject at MBBS lelve as well mandatory creation of at least one post of district medicolegal expert for Forensic medicine doctor will gradually improve the system.
    Dr Adarsh Kumar
    Commonwalth Fellow, Scotland UK
    Hony.General Secretary.,Indian Academy of Forensic Medicine
    Associate Professor. Forensic Medicine & Toxicology
    All India INstitute of Medical Sciences New Delhi

  15. DR TUSHAR KANTI NAYAK DR TUSHAR KANTI NAYAK Saturday, June 30, 2012

    THE MEDICAL COUNCIL OF INDIA IS LACKING WITH INOVATIVE IDEAS AND SUFFERS WITH A SYNDROME OF CONSERVATISM.

    By : Dr Tushar Kanti Nayak. 30 June 2012.

    I had the opportunity to listen to a lecture given by Sir Adrew F Huxley, Nobel Prize winner in Medicine or Physiology, for pioneering work in nerve and muscle physiology. That was in 1983 when I was studying for my M.D. Degree in Biochemistry at the AIIMS,New Delhi. Dr Huxley died on 30 May 2012, exactly a month ago. It would be very interesting to read a little bit about the biography of a scientist who was telling in his lecture that most of his family members are working in muscle physiology and some other members have received Nobel Prize for specific research finding. Huxley was a graduate student in physics major with chemistry and mathematics. It was compulsory for students to take one more subject in addition to the PCM combination. With the advise of a faculty he took Physiology as an optional subject. Later he wanted to study medicine, but under circumstances due to the Second World War, he could not enter medical college, and he had to work for the defence department. From physics to biophysics to physiology was a tortuous journey for Huxley. He had innovated a differential microscope, microtome and other useful research tools as well. If one reads the story of top scientists with whose efforts science has advanced so much, it is common to notice that their working styles were not of the stereotype what we notice in institutions in our country. They were having plenty of freedom to work and this they had enjoyed due to the very liberal policies prevailing in the institutions in which they had worked. This is the way most western universities and other world class institutions work.

    The objective of writing the story above is to highlight the way behind at which the top guiding institution in medical profession (MCI) functions. The MCI has specific guidelines/requirements for setting up various departments in a medical college; about the faculty strength, their qualifications and experience etc. Before permission is given to start a new medical college, or at the time of renewal of permission given to existing colleges, the MCI inspectors are asked to use slide callipers to measure the infrastructure and faculties and these measured data are compared over the template (the prescribed guidelines). If the data do not match over the template, then the MCI starts creating a havoc with the concerned college. Compromise and corruption has well creeped into this system of conservatism. The dissolution of the MCI in 2011, through a Government order, is a story that was evolved with this defective system, therefore lessons must be learnt, and steps must be taken to find a way a out to getting rid of the conservative ideogy in running medical institutions and hospitals in the country.

    This report indicates that there is a shortage of teachers in Anatomy and Forensic Medicine in several medical colleges in Tamilnadu. This is perhaps indicating the tip of the iceberg. In reality there is a shortage of teachers in most departments especially in the foundation subjects. This is there just not in Tamilnadu but also in all other medical colleges across the country.It was only recently revealed in a programme produced and anchored by eminent film personality Amir Khan, the way the private medical colleges play gimmick and work hand in glove with the MCI inspectors during inspection time. Starting from hiring books for the library to parading hired faculty, and even hiring normal people to occupy hospital beds as patient are some exposers which show medical education system in the nation in very poor light.

    A crippling health care delivery system, and conservative medical education system are both responsible for shortages of teachers/consultants, in medical institutions and general hospitals. The shortage of experts in forensic medicine may be taken as an example.

    Currently a M.B.B.S. graduate enters into the M.D. programme in FMT not out of choice, but only when no other clinical subject which is having prospects for practise is not available; this is only done with the objective to earn a PG qualification for career promotion in government non-institutional service. The state governments do not appoint forensic medicine experts even in district headquarter hospitals for looking after medico-legal cases and to perform autopsy examinations. What is happening therefore : a general physician performs these duties. In many situations where an expert report could have helped in the case with the right legal perspective, the report prepared by a general physician fails to provide important clues required by the police and court of law. A post graduate in FMT if not given an opportunity to work as a consultant in the subject, works as a general physician in the general hospital all through his career. The lack of job opportunities is one major reason why medicos shun subjects such as FMT.

    The matter could be discussed with a different perspective.In FMT, students are taught 1. Forensic science, and 2. Toxicology. Forensic science is also called as Legal Medicine in which Medical jurisprudence is taught. This area could well be taught by somebody from the Legal Profession with a sound knowledge.

    It may be suggested that Lawers having good exposer and experience in the subject could be appointed as visiting Faculty in the medical college to teach this area. The Legal professional cum faculty could also help students to visit real court proceedings which shall help students in achieving a good understanding in the subject and also might stimulate some student in doing specialisation in legal medicine. The subject has great perspective in the 21st century civilisation, however the potential has not been explored by the medical professionals.

    The area of Toxicology could well be taught by a specialist in medicine. Faculty members from internal medicine department should be invited to give lectures in this subject. Students should be encouraged to visit clinical wards with the faculty concerned to see patients with poisoning getting treatment. This would help students getting on hand experience in the subject. In the FMT department students use to learn the theoritical aspects but do not receive any practical training in toxicology. How many medical colleges take their students to state forensic laboratories to observe how toxic materials are analysed, or how DNA finger print assay is performed? Students are shown poisonous snakes preserved in chemicals inside glass jar, or shown malathion label over a bottle. However they are not taken to the clinical wards to see how stomach wash is performed and how a malathion poisoning is managed.

    I am in full agreement with suggestions given by Dr S Vinayagam. The Anatomy teaching should ideally be multidisciplinary. Apart from full time faculty with PG qualifications in the subject, faculty members in other departments such as General Surgery, Orthopaedics, Neurosurgery, Histopathology and Cytology, should be invited to give theory lectures and practical demonstration in anatomic science which is the core subject in their respective disciplines as well. Dr Vinayagam’s observation about the MCI’s hard shell guidelines are quite right.

    The shortage of faculty in medical institutions is more of artificial nature in many instances. The human resources are available in abundance. What is required at this moment is to open up the (closed) mind and find ways to make use of it. The conservative ideas are outdated and remain hurdles for the future.

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