Medical Studies

Student doctor numbers to rise by 25%

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The number of medical school places will increase by 25% from 2018 under plans to make England “self-sufficient” in training doctors.

The government’s plan will see an expansion in training places from 6,000 to 7,500 a year.

Ministers believe increasing the number of home-grown doctors will be essential given the ageing population.

There is also concern it will become more difficult to recruit doctors trained abroad in the future.

About a quarter of the medical workforce is trained outside the UK, but the impact of Brexit and a global shortage of doctors could make it harder to recruit so many in the future.

Prime Minister Theresa May told the BBC: “We want to see the NHS able to recruit doctors from this country. We want to see more British doctors in the NHS.”

The increase also comes after the government has spent a year at loggerheads with junior doctors over the pressures being placed on them to fill rota gaps.

Doctor workforce in numbers

150,000

doctors working in NHS

25% are foreign

9% due to retire in next five years

2% more needed each year to keep up with demand

7-10% of posts are vacant

Dr Daniel Bunce, 27, is in his third year of being a junior doctor after completing his medical degree. He is now working in a hospital in the south west in intensive care.

He says he got into medicine because he wanted to “care for people and make a difference”.

“It’s been difficult. There is so much pressure, particularly during winter. We just don’t have the time to spend with patients that we need to provide the care we want to because we are rushing around just trying to keep up.

“I’m now working in intensive care so the staff to patient ratios is much better than it was when I was on medical wards. But the workload is making people I work with think about whether this is something they want to do for the rest of their career.

“The increase in medical school places is a good move, but we will have to see what impact it has in hospitals in the long-term.”

Medical degrees take five years to complete, so it will be 2024 before the impact of these extra places is felt.

But Mr Hunt told the Conservative Party conference in Birmingham on Tuesday: “We need to prepare the NHS for the future, which means doing something we have never done properly before – training enough doctors.

“Currently a quarter of our doctors come from overseas. They do a fantastic job and we have been clear that we want EU nationals who are already here to stay post-Brexit.

“But is it right to import doctors from poorer countries that need them while turning away bright home graduates desperate to study medicine?”

Mr Hunt said the steps would mean that by the end of the next Parliament the health service in England would be “self-sufficient” when it comes to training doctors.

Analysis: Will this work?

There is widespread agreement that the NHS is facing a crisis when it comes to doctor shortages. It is one of the underlying reasons why the dispute between the government and junior doctors has been so bitter.

So news that the number of training places is to increase by 25% is certainly being welcomed by many. But whether it is enough is another matter.

The health service employs more than 150,000 doctors – a quarter more than it did a decade ago. But even that has not been sufficient – vacancy rates are said to be running at close to 10%.

This is despite huge numbers being recruited from abroad. In fact, the numbers registering to work in the NHS from outside the UK has been outstripping those graduating from medical school in recent years.

The future, of course, is fraught with difficulties. The impact of Brexit on EU doctors is uncertain, there are large numbers due to retire – a figure of 13,500 in the next five years has been suggested – and then there is the not insignificant numbers who leave the NHS for other countries or opportunities.

More doctors in training doesn’t necessarily translate to more doctors in the NHS.

The rise in training places will cost £100m from 2018 to 2020, but in the long-term the government hopes to recoup money by charging foreign students more than it does now.

Medical students will also be expected to work for the NHS for at least four years – or face penalties that could include them having to repay the cost of their training, which currently stands at £220,000 to the taxpayer over the five-year degree.

The details of how this will work have yet to be ironed out and, in particular how it will apply to doctors moving to another part of the NHS in Scotland, Wales and Northern Ireland. This announcement applies to England only.

At this stage it is thought unlikely that ministers would want to apply the four-year restriction to doctors wanting to move to other UK nations.

Doctor hands

British Medical Association leader Dr Mark Porter said the announcement “falls far short of what is needed”.

“The government’s poor workforce planning has meant that the health service is currently facing huge and predictable staff shortages,” he said.

“We desperately need more doctors, particularly with the government plans for further seven-day services, but it will take a decade for extra places at medical school to produce more doctors.

“This initiative will not stop the NHS from needing to recruit overseas staff.”

  • Each year 6,000 medical students currently graduate after five years of study
  • There are a similar new junior doctors places open for them (although some students take gap years)
  • By the third year of junior doctor training they need to choose a specialism, such as general practice or a hospital speciality like surgery
  • That is where the shortages start to emerge
  • Latest figures from Health Education England show one in 10 places remain unfilled
  • The biggest gaps are seen in psychiatry (19%), GPs (17%) and paediatrics (7%)

Nigel Edwards, chief executive of the Nuffield Trust, said: “For decades, the NHS has failed to train enough of its own staff, so increasing the number of UK-trained medical staff is long overdue.

“However, if this new announcement involves simply replacing overseas doctors with UK-trained ones, that won’t increase the total number working in the NHS, and certainly won’t solve the agency staff crisis that is affecting the NHS right now.”

Chief Executive of Dartford and Gravesham NHS Trust Susan Acott told the BBC there were shortages in specialisms including Accident and Emergency, radiology and intensive care in her hospitals.

“An expansion of medical training is very desirable,” she said. “We’re a very under-doctored country compared to European levels.”

The idea that doctors could be retained in the UK once they had trained was an “interesting” idea, she added, but there were practical obstacles.

“Doctors go abroad to develop their training and experience different health systems and techniques,” Ms Acott said.

Source: http://www.bbc.com/news/health-37546360

Developing countries should enroll medical and nursing students from rural areas

Nearly one third of medical and nursing students in developing countries may have no intention of working in their own countries after graduation, while less than one fifth of them intend to work in rural areas where they are needed most, according to a new study.

Developing countries should enroll medical and nursing students from rural areas

Health workforce shortages have been a major factor driving the current outbreak of Ebola in western Africa. The disease initially spread rapidly in rural parts of three of the world’s poorest countries (Guinea, Sierra Leone and Liberia), where health workers are scarcest.

The study, which was published in the Bulletin of the World Health Organization today, provides new evidence supporting World Health Organization (WHO) recommendations on recruiting and retaining health workers in rural areas, including the targeted admission of medical and nursing students with rural backgrounds.

“Considerable investment has been made in recent years to expand health workforce training in low- and middle-income countries,” said lead author Dr David Silvestri from Brigham and Women’s Hospital and Massachusetts General Hospital in Boston, United States of America.

“Unfortunately, insufficient attention has been given to ensuring that the students who are enrolled are those most likely to work in rural areas, where health needs are greatest. As a result, a significant proportion of these increased investments may be spent training individuals who only aspire to emigrate after training.”

From 2011 to 2012, Silvestri and his colleagues surveyed 3199 first- and final-year medical and nursing students at 16 leading government-run medical and nursing schools in eight countries: Bangladesh, Ethiopia, India, Kenya, Malawi, Nepal, the United Republic of Tanzania and Zambia.

The study is important because it is a multi-country study (one for which data was collected and analyzed in several diverse countries) that suggests that there might be a similar pattern in the future career intentions of medical and nursing students across countries in more than one region for the first time.

When asked where they intended to work within five years of graduation, 28% of surveyed students expected to seek employment abroad, while only 18% anticipated choosing a career in rural areas.

“We found that students raised in rural areas were most likely to want to pursue rural careers, and were least likely to want to move abroad,” Silvestri said. “Our data suggest that students’ career intentions may be identified before matriculation, which means that countries could selectively admit those most likely to work in high-need areas.”

The severity of health workforce shortages in developing countries is a major barrier to global health advances, and was first identified by the World Health Report 2006. Sub-Saharan African countries have on average 2 physicians and 11 nurses or midwives per 10 000 people, compared with 30 physicians and 84 nurses or midwives in high-income countries, according to the World Bank.

To address shortages and maldistribution of health workers in developing countries, WHO established the Global Health Workforce Alliance in 2006, a partnership devoted to these issues. In 2010, it issued the WHO Global Code of Practice on the International Recruitment of Health Personnel, along with recommendations on health worker recruitment and retention in rural areas, entitled Increasing access to health workers in remote and rural areas through improved retention.

Understanding student motivation to work in rural areas and strengthening the rural pipeline of health workers is part of ongoing collaboration between the WHO, the World Bank and the International Labour Organization.

The study is timely because the WHO Global Code of Practice is due for its first review at the Executive Board in January 2015, and its findings have policy implications for countries that are striving for universal coverage of health-care services, according to James Campbell, Director of the Health Workforce department at WHO headquarters and Executive Director of the Global Health Workforce Alliance.

Health workforce retention is vital in emergencies – as we have seen in the current Ebola outbreak in western Africa. We need to rethink some of the policies aimed at attracting the best of the best to train and prepare them to serve where they are most needed,” Campbell said.

“Without a rethink of education, deployment and equitable distribution of health workers, many health systems could be at risk of providing little or no care to rural populations,” Campbell said.

Source: medical xpress

Top 10 Mistakes Made in Clinical Rotations

Arguing with a patient:
This is an exercise in futility, and is very unprofessional.
“One of your role’s as a physician is to invoke a shared decision making process with your patients who have decision making capacity.”

Top 10 Mistakes Made in Clinical Rotations

Reporting a physical finding without actually observing it:
I’ve even seen a student get in trouble for documenting a physical finding on a patient who had been discharged already.

Berating (aka “pimping”) your resident or attending:
Med school is similar to the military when it comes to respecting your place in the chain of command. Attendings “pimp” residents and med students. Residents berate med students. Thou shalt not berate up the chain. That said, the institutionalized nature of “pimping” does not absolve the word of its offensive and unethical practice. Eradicate it from your vocabulary and practice.

“Most of the time it is to show power, how smart they are and embarrass those lower in the “Hierarchy”. If residents and attendings really want to teach, than have a real discussion of the issues. Yes, ask questions but don’t berate someone if they don’t know the answer. Good attendings approach it like that, and if a student or resident doesn’t know the answer, they are told to look it up.

A few times, when I was a student, a hotshot resident would try to “pimp” me and they had the wrong answer and tried to correct me. I looked up a relevant article and proved my position. There is nothing wrong with that, as long as it is done respectfully.

Medicine is a life long learning experience. Everyone can learn something new including residents and attendings. Don’t automatically discount someone’s opinion because they are lower on the hospital chain. A student might have a Ph.D. or master’s in some field and truly knows more about a subject than the resident or attending.”

Disrespecting the nurses:
Seriously, this is a huge no-no. If you want to make your life miserable, make the nurses hate you. If you want to enjoy your time at the hospital, befriend every nurse you meet.

Dressing inappropriately:
Dressing appropriately is important, and applies to men as well as women. For example, no sandals, no jeans, no T-shirts (unless they’re under scrubs), a mohawk wouldn’t go over well, nor would wearing 4-inch stiletto heels, or a need to exhibit one’s cleavage. There’s a time and a place for everything, and the hospital is not a place to dress provocatively.

“Include personal hygiene. Use your dental floss and brush your teeth. Patients do not deserve a doctor with bad breath. Poor personal hygiene raises doubts in the minds of all about whether you are scrupulous about everything else.”

Documenting an important positive finding without alerting your resident or attending:
If you discover that a patient has rebound tenderness, or a temperature of 103.7, don’t write this in a note and walk away. You must always alert your higher-ups to significant findings, or else you will find yourself getting chewed out for a good while.

Showing up late:
This is a particular pet peeve of mine, and one that some students seem to think is insignificant. People notice when you’re late. It’s unprofessional and disrespectful to the rest of the group. Traffic is not an excuse. Leave your residence early enough to get to the hospital with plenty of time to spare.

Performing a procedure without having been authorized to do so:
If the resident walks in on you placing a central line on a patient without their authorization, you will find yourself in deep trouble with the doctor, hospital, and potentially a courtroom.

Forgetting you are in a hospital:
This is something that is easier said than done. We spend so many hours in the hospital that it’s easy to forget that we are surrounded by very ill, helpless, and frightened people. It’s not a high school football game; it’s a hospital. Patient’s lives are in the hands of the healthcare workers surrounding them. We are each one of the healthcare workers.

Being a slacker:
We all have seen students who try to get by with the bare minimum in everything they do. If you want to throw away a ridiculous amount of money, not learn anything, and end up being a crappy doctor, then by all means slack off during your clinical years. If you want to learn a lot and become an incredible doctor, then put in the time and effort.

Source: Einstein

Black armband silent protest on Doctor’s Day by UCMS doctors

Black armband silent protest on Doctor’s Day by UCMS doctors

As India celebrated Doctors Day on July 1, doctors at the University College of Medical Sciences (UCMS) here sat quite gloomy while trying to find out reasons to celebrate.

“This observance is a way to show the society how important doctors are in our lives but has everybody thought how, even, we are denied our basic rights by the autocratic Delhi University administration,” said the aggrieved faculty members in a statement.

“Being doctors, we realise our duty towards patients and that’s why we deliberately avoided the options of strike and disruption of OPD and emergency services. We only wore black bands to raise our issues. In the evening we once again gave our representation in MHRD,” said Dr Satendra Singh, assistant professor of physiology at the UCMS.

According to the statement, the UCMS doctors are under the University of Delhi and henceforth the University Grants Commission (UGC) and the Ministry of Human Resource Development (MHRD), while other sister medical institutions like Maulana Azad Medical College (MAMC), Lady Hardinge Medical College (LHMC) and even all other state run medical colleges are under the Centre or State run Ministries of Health and Family Welfare (MOHFW). There the faculty can concentrate on quality of medical teaching and patient care as the promotions and pay scales of teaching medical faculty are determined by the Dynamic Assured Career Progression [DACP] scheme as laid down by the 6th Central Pay Commission Report, i.e. time bound promotions.

“The terms and conditions of DACP were brought into enforcement vide notification to UGC gazetted on 18th September 2010. The notification categorically directed UGC under clause no 1.1.1 that all medical faculties appointed medical teachers in Central Universities shall be governed by the norms of MOHFW i.e. time bound promotions. This was to be made effective for medical teachers of UCMS, AMU (Aligarh Muslim University) and BHU (Banaras Hindu University) from 31st December 2008. However, the dictatorial administrations of DU have not taken any heed to this constitutional right of medical teachers of UCMS,” it said.

“Being under DU, no pay protection is given to doctors who have to join at salaries lower than what they were given under the residency scheme of MOHFW. Unlike medical colleges under MOHFW which safeguard the financial and promotional interests of medical faculty, DU equates medical faculty to any other faculty in colleges under DU,” according to the faculty members.

“The VC of BHU provided pay protection to medical faculty in BHU, but the VC of DU even denied that. Faculty members having completed even upto eight years of service are given salaries less than resident doctors. This has made UCMS one medical college with the highest faculty attrition rate. In the last three months, 17 permanent faculty members have left UCMS and joined as assistant professor by sacrificing their current experience on which they should have been either associate professor or professor. In the past three years, almost 25 faculty members have left for Centre or State run MOHFW medical institutes like MAMC, LHMC, new AIIMS, state medical colleges and even private practice,” said the faculty members.

“The university system focuses purely on research for promotion of their faculty, while as medical teachers, faculty at UCMS and all medical colleges should be focussing on teaching medical students and patient care. Lack of transparency in the promotions in DU has made it one of the worst career options for medical faculty, who quit UCMS for greener pastures which offer them time bound promotions and better salaries. Every doctor is under the Hippocrates Oath, swearing for patient care and teaching his peers and juniors. But we are humans too and not demigods. Denial or delay of our constitutional rights has forced many to seek judicial help and tangent us away from the oath,” they added.

Source: India Medical Times

TAU School of Education Program

school of education

TAU’s School of Education helps to create eminent educationist who can create and enhance curriculum and education policies, improve the existing teaching methodologies using latest technology and maximize the learning capability of students by understanding their skills, background and needs.

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Fellowship Programs at TAU

fellowship program

The fellowships provide an opportunity for clinicians and others to return to the University setting in order to explore further in the specialties concerned.

An effective Physician/Surgeon is dedicated to lifelong education and inner growth. Too frequently, traditional training programs have concentrated on high volume and long hours, while “educational care” for the trainee is neglected.

Salient features of the programs

  • Knowledge, competency and research based customized programs developed by TAU.
  • Students acquire clinical skills through exposure and training in Hospitals.
  • Students review contemporary articles and publish in international journals.
  • Students have the option of selecting the programs of duration from 1month – 1 year, depending on their qualification and specialties /programs chosen.

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Study Master of Medical Science (MMSc) in Texila American University

mmsc

A unique program which helps to attain the Masters in a span of ONE year. Students with basic Medical Education is inducted into this program.

Eligibility:

  • Bachelors Degree in Medicine.
  • Registered with the respective Medical Council of India or the State Medical Council.

Salient Features

  • Students will be able to procure a world class Master’s degree in a span of one year.
  • Work in hospitals or attend hospitals/clinics to acquire necessary clinical skills.
  • Students have the opportunity to attend CME programs to gain more credits.
  • Students are exposed to Article Reviews and Publications to understand the contemporary innovation and research in the concerned specialty.
  • Support to students by giving access to e-books of the concerned specialty.
  • Weekly MCQ’s assessment are given, which would facilitate continuous learning.
  • Q and A Session to facilitate student faculty interaction
  • The MMSc programs are also offered in the form of diplomas for the students to get benefitted in various aspects.

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Online Psychology programs

behavioral science

Texila American University (TAU) combines effective theoretical and practical experience in Master’s and Doctoral programs in School of Behavioral science. TAU offers these programs adapting to current technology and standards to meet everyday
challenges in the Psychology.

Our advanced online learning system provides you with the flexibility and support to study anytime, anywhere to balance work, life and study. You can achieve your fully accredited Degrees in Information Technology at a time that suits you.

Texila American University (TAU) combines effective theoretical and practical experience in Master’s and Doctoral programs in School of Behavioral science. TAU offers these programs adapting to current technology and standards to meet everyday
challenges in the Psychology. To know more details please register here:
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Doctor of Medicine 5.5 Years

5.5 md

The Doctor of Medicine (MD) is a four-year full-time course designed for students who have completed their undergraduate studies with Science background. The curriculum is structured after the best US and Caribbean Medical Schools, the MD delivers outstanding clinical and academic training, ensuring you are well prepared for the challenges of internship and future professional training.

Overview The 5.5 years Doctor of Medicine program is divided into 3 Parts. The Pre Medical Part: Duration 18 Months The Pre Clinical { basic Science } part: 2 Years Clinical Part 2 Years in Guyana (or) 2 Years in USA for US track

Eligibility: Students from 10 to 12 years of Education or Equivalent Student with NON – Pre medical College Credits Students who have earned 90 college level credit hours from undergraduate institutions or concurrently during the completion of secondary school are encouraged to apply to the 4 years MD Medicine Program, where the student will join the program at Pre-Clinical phase since those science based 90 college level credit hours will be considered in the admissions process. For more details please register here

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Medical Graduates Should Be Offered Diploma Courses To Make Them Specialists

To tide over the acute shortage of medical specialists in India, the country needs medical educational institutions on the line of the College of Physicians and Surgeons (CPS) in Maharashtra which would offer diploma courses in fields like anaesthesia, gynaecology, and paediatrics to medical graduates, according to experts.

Talking about the acute shortage of medical specialists in the country, Dr Devi Shetty, founder and chairman, Narayana Health, recently pointed out that while the US has 19,000 undergraduate medical seats and 32,000 postgraduate seats, in India it is the opposite – the country has close to 50,000 undergraduate medical seats but only 14,000 PG seats.

“The low number of PG seats results in a shortage of specialists. This can have terrible consequences on the ground. For example, India has one of the highest maternal mortality rates in the world and this is unrelated to the amount of money we spend on healthcare. The reason is that we have created a regulatory structure where only a specialist can perform certain tasks, and the country simply doesn’t produce enough of these specialists,” he said.

Dr Shetty suggested that to tide over the problem, the country needs medical educational institutions on the line of the College of Physicians and Surgeons (CPS) in Maharashtra which would offer diploma courses in fields like anaesthesia, gynaecology, and paediatrics to medical graduates.

“This can convert the entire 50,000 medical graduates produced in India every year into specialists who can then help reduce maternal mortality in India,” Dr Shetty said, adding, “If we want to deliver better healthcare outcomes, India doesn’t require money. We only require policy changes. This will not happen till the Government looks at medical education as integral part of the country’s development.”

Dr Shetty was speaking at ‘The Future of Healthcare: A Collective Vision’, a global healthcare conference that was held here on March 3-4. The event, hosted by The Healthcare Alliance, witnessed the participation of thought leaders, policy makers, senior government officials, and business and health leaders from over 15 countries.

Calling for major changes in the existing health system, Dr Naresh Trehan, chairman and managing director, Global Health (Medanta-The Medicity), said, “Healthcare is basically disease management. We should build our system from the ground up to create a new blueprint of India’s healthcare.”

“We have over 800,000 ASHAs (Accredited Social Healthcare Activists) in India but they are ill trained and don’t have any medical skills. Their costs are a huge burden on the exchequer and nothing gets accomplished in return. All we have to do is to upscale their skills so that they can be the eyes and ears of the healthcare system on the ground. They need to monitor hygiene and find out who in the community needs medical assistance. This will be a big help in ensuring quick diagnosis of diseases and reducing the incidence of NCDs (non-communicable diseases),” Dr Trehan said.

Outlining his views on the role of technology in ensuring greater access to quality healthcare, Shivinder Mohan Singh, executive vice chairman, Fortis Healthcare, said, “Technology has played a vital role in healthcare in the last 30 to 40 years, whether it is diagnosis or treatment. Going forward it is going to trigger more changes in healthcare than any other factor.”

Singh said, “Healthcare access will get radically transformed with technology whether it is in terms of proximity through devices planted in our bodies or by low-cost healthcare using innovative technological solutions or the speed with which information is shared.”

“A healthcare ecosystem would be created in future where different silos begin to talk to each other about patients and exchange information. Healthcare delivery is going to become more personalized in terms of tailor-made treatments for an individual,” he added.

Talking about the need for better integration of different systems of medicine, Singh said: “Allopathy has taken a predominant share of the existing market in healthcare, but I think we can’t avoid for too long the benefits that other health sciences bring to the table. Some kind of integration of different health disciplines is bound to happen in future.”

He also emphasized that the onus of taking charge of one’s health has to rest on the individual. “We need to be more concerned for what we do to our health rather than what healthcare would do to us. We need to take ownership of our own bodies and mind and not outsource these to healthcare providers. People need to focus more on preventive care rather than just landing in sick care – this is going to the mantra of healthcare in future,” he said.

Dr Shetty expressed concern about the nursing profession in India, which he said would die down in a few years if urgent measures were not taken.

“There is zero career progression for nurses. Nursing is now considered a dead-end career. Admissions to nursery colleges in India have come down by 50 per cent. Half of the nursing colleges in Karnataka have shut shop. In the years ahead, there will be an acute shortage of nurses in the country,” he said.

Dr Shetty further said, “There is a critical need to empower nurses by offering them a path to upgrade their skills and become specialists. About 67 per cent of anaesthesia in the US is given by nurse anaesthetists. In India, we don’t allow a nurse who has worked in critical care for 20 years to even prescribe a Paracetamol tablet!”

Dr Shetty also highlighted the need to look for alternative ways of funding healthcare, such as by a surcharge on mobile phone bills, to bring down the cost of building hospitals, develop patient management software, and establish one or two health cities with 3,000 to 5,000 beds in each metro where cutting-edge work can be done.

Source: India medical times