Bridge courses

Bridge courses is an ill conceived idea. It will jeopardise validity of all systems of tt. To master anything we have to draw a boundary around it and do it repetitively. If I opt to limit my practice to, say , geriatric psychiatry only ; I get trained in it , attend CMEs on it , give presentations pertaining to it , hold workshops to disseminate my knowledge to my juniors and continuously practice this branch of psychiatry. In all probability, with passage of time I would be an authority on the subject, would be able to find my niche and people will come to know of my competence in the subject. It will be beneficial to me and the society I cater to. And if I hobnob with , not only general psychiatry, but with diseases of other organs then eventually I'll end up as a small time medical practitioner. Neither I'll have job satisfaction nor people will bestow upon me special recognition. And this phenomenon is very much evident. When specialised services are available for spine surgery or joint replacement surgery then people will like to go to the specialist of that area of orthopaedics. And for general bone and joint ailments will consult general orthopedician. This is the reason in modern medicine, a family physician to a neurosurgeon : all get their share of success. This doesn't happen in many other professions. Even very important field of law and judiciary doesn't have specifications. Lawyers have a broad category of civil and criminal. Many a times lawyers try to handle both. Consequent upon which some lawyers get very successful and others face difficulty even in earning decent living.
When it comes to different methods of treatment, issues are all the more complex. All have their own independent principles. Cross over is immensely tedious. Expediency may push one to feel happy about bridge courses.But It won't do good to either a practitioner or a recipient of the treatment.
Unfortunately such decisions are not taken by people who've practical and in-depth knowledge of the subject.
The bill has been prepared by Niti Ayog, the head of which is an economist. Advice of only one individual was sought, namely Dr Roy Chaudhari.
In such circumstances, in a democratic governance, we can't let the chosen few to take decision. We've to participate in it. If we're not invited for participation, we should descend on the roads and make powers that be listen to us. We can't afford to take things lying down.
To make my point more stronger , I'll give an example as to how governments work. It was traditional in medical colleges of Gujarat for clinical teachers to do govt job for few yrs, then resign and start full time independent practice. There was perpetual shortage of good teachers
It wasn't so in the adjacent state of Rajasthan, where no teacher ever resigns from govt job. The reason being they're allowed to do pvt practice after working hours . The govt of Gujarat decided to follow the suit. One fateful morning it was declared the teachers can do their own practice in extra time from the job. And non-practicing allowance was abolished. Fall out of this step was chaos. Non clinical teachers M.B.,B.S. and M.D. , who were teaching for fifteen twenty years were at a loss as to how to practice and from where to get patients. Clinical teachers were more than happy. They joined pvt nursing homes on part time basis or opened their own clinics. They had ready made clientele. Among people who were consulting them in govt hospital, those who were better off started showing them in their pvt clinic. But nonclinical teachers too were a big mass. There was fierce agitation. Eventually the govt had to roll back its plan.
Now the simple question is : the model which was working in Rajasthan , why didn't work in Gujarat.
The answer is ridiculous. In Rajasthan, clinical teachers are not not paid non practicing allowance but nonclinical are paid. In Gujarat, the allowance was abolished for all.
This lapse arouses feeling of bewilderment.
When the states of affairs of the State are such , how can we leave the decision in the hands of the State.
Let me give you one more example. I called upon the secretary of medical education to transfer me from Jamnagar to Surat on the ground that my teaching experience was getting wasted as there no post graduate training in Jamnagar while it was there in Surat. An IAS doesn't necessarily have to know everything. He asked me if psychiatry was a clinical or a non clinical branch. As the things turned out I wasn't transferred. I resigned and opened my own nursing home. I never had to look back.
Therefore friends, let's fight tooth and nail for what's right. Not only right but for larger and future good*

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