Thread by @dralokshah

I was planning not to say anything on the whole NRS Medical College incident. Public apathy toward doctors is at an all time high.

Also, I’ve realised that, whenever I would share any such incident with my non medico friends, some are indifferent, some would say you knew what you were getting into when you got into this profession, and some would make outrageous remarks like-this is due to pharma kickbacks

To the politicians, we are not a vote bank - and hence not important. But the reason I have chosen to comment is this - MB says “The state spends 25 lakhs on each doctor...” the full article is here: google.com/amp/s/m.hindus…

Now let’s get a few things clear for politicians and “concerned” tax paying citizens out there regarding this sum of “25 lakhs”.

The state doesn’t spend money on doctors. It spends it on public healthcare. A fundamental responsibility of the government. Medical education are a byproduct and necessity for the deliverance of govt health care services

While during the first 4.5 years of MBBS course students do not directly contribute to public health care, they do so as interns - the last year after final MBBS.

Since interns were involved in this case, a few points on internship - Interns have no fixed working hours (I’ve myself done 56 hrs continuous on calls), no fixed duties - from performing minor surgeries in outskirts, to pushing trollies in tertiary public hospitals when reqd

It is before graduation itself that MBBS students, as interns, form an important cog of public health care - with no fixed hours (none have been officially set), and a pay which would barely cover travel expenses

Moving on, it is from amongst these MBBS graduates a few (un)lucky ones, thru entrance exams get, on their merit a seat in a public hospital. Excessively long working hours, subhuman living conditions - you have it all. These resident Docs are the backbone of public healthcare

Interestingly, the Central residency scheme has set a limit of 48 hours/ week and no more than 12 hours/ day for resident doctors. Resident doctors routinely work >24 hours on emergency days and >120 hours/ week.

Interestingly, despite today’s era of digital governance, the document on the Central Residency Scheme is not (for obvious reasons) available on any govt website or portal.

Here is a version of CRS I found on Scribd - scribd.com/doc/63162413/R… I cannot confirm the authenticity of the same because there isn’t any official source to compare with. However you will find multiple RTIs confirming the working hours mentioned

India spends very little on healthcare. Here’s an article I found google.com/amp/s/www.firs… which says we spent even lesser on healthcare than countries such as Sri Lanka, a country with comparatively lesser resources and a smaller population

One can therefore see, that there are multiple systematic issues with public healthcare in India. The fault lies with the government - not one but successive governments, who have not failed to improve public health care

To my resident colleagues/ intern I can only say keep doing your best because you’re the only thing keeping up a failing system - but don’t do it at the cost of your life. Be aware of your surroundings. Save your life first. You owe it to yourself and your family

To the Indian public - understand that resident doctors/ interns are working toward your well being. And usually the only ones who will attend to you at your hour of need

To the government I can only say this - if you continue down this road of targeting Doctors for your the failure of public healthcare (which is your responsibility) - students will (and this has started) stop taking medicine as a profession. Those who have will leave the country

Change is necessary. Because an attack on doctors, ultimately will be detrimental to healthcare.

*failed to improve public healthcare