MEDICAL FRONTIERS

Forensic Medicine
Medical Council of India (MCI) has developed a document, vision 2015, which proposes a radical change in the medical education in the country. The main components are the proposed UG medical education and proposed PG medical education.
There are several flaws in this document.I would suggest you to read the following article: http://forensicmedicine123.blogspot.com/2011/01/simlas-feedbackmemorandum-to-mci_14.html
My main objective of writing this letter is to express my concern about the future of forensic medicine in India.
There is a need for an explanation by MCI as to how will it produce forensic-medicine postgraduates in the country, when their vision is not going to attract anybody to take up this subject as a specialization following MBBS. In fact, the existing postgraduate students are seriously considering to move out, in the middle of their PG course, to search for other avenues.
Forensic Medicine has been predicted to have the highest shortfall of teachers in the future; this is as per the MCI’s very own controversial document-Vision 2015. On the one hand MCI knows about the current and predicted shortfall of Forensic Medicne experts; on the other hand, they are taking steps to worsen the situation.
Let me explain, how.
PRESENT SCENARIO:
As you must be aware,there are no job opportunities for forensic medicine experts, other than the teaching job in medical colleges. The medical colleges are employing the forensic-medicine experts, only because of compulsion. Having employed forensic medicine experts in their colleges, the colleges are allowing autopsies (Postmortems) and other medico legal services by these departments, which is benefiting the home department (Criminal justice system, etc). In some of the states of our country, the medical colleges are not carrying out all the medico-legal services, especially the autopsy, and the college managements are not bothered about this; after all, the autopsy needs to be conducted free of cost, and it costs some expenditure for the college. The main reason why college authorities are not insisting on the autopsies being conducted in their college hospitals is, there is no compulsion on them to do so; MCI is least bothered about the mortuary and medico-legal (especially autopsy) services in the teaching hospitals. Governments and the teaching hospitals, who were there in a win-win situation, as far their responsibility of getting done the autopsy services at free of cost (government’s benefit) and the availability of teaching material (benefit for the college, forensic department), were both co-operating very well in this mutually benefiting present situation.

Benefit for the Government (Home dept): Medical colleges do the PM examinations, free of cost.

Benefit for the college: They will get dead bodies to do the postmortem examinations, which can be demonstrated to the UG students. Presently, UG students are expected to mandatorily witness minimum of 10 autopsies in the II MBBS. Also useful for training the PG students, if PG teaching is there in that department. Their own Hospital deaths were autopsied there itself, and this would be welcome by the patients relatives as the process of shifting the dead body from place to place was not needed.
FUTURE SCENARIO (after vision 2015 is implemented):
If the subject of forensic medicine is made an elective subject, a medical student will not opt for this subject. If a medical student wants to opt for this subject, which is very rare given the fact that there will be strong contenders like ENT, Ophthalmology, Psychiatry, Skin, Orthopedics, etc., the college management will surely discourage the student from opting for forensic medicine; the reason for the college management to do that is, that forensic medicine is not a specialty which is required by the patients, neither is it profitable to maintain the department of forensic medicine, and most importantly, it is not mandatory for the medical colleges to show to the MCI, the medico-legal work load (autopsies in particular) during the inspections.
Having made the forensic medicine subject as an elective subject, it implies that the previous compulsion of demonstrating autopsies to all the MBBS students does not hold good. Even, if autopsies need to be demonstrated to the opted students, MCI will never mind if the colleges take their students to another hospital, to demonstrate the autopsies there.
It will, sooner or later, be made obvious to the Medical colleges that they can go ahead with their medical education, even without the department of Forensic medicine. MCI has not made it mandatory for Medical colleges to have a forensic medicine department in the vision 2015.
It will not be nice on the part of forensic-medicine expert to continue in that medical college, without any teaching work, as it is well known that the management does not appreciate the services by forensic-medicine department; it should be the home dept. (govt) who gets the benefit and not the college. If the staff wants to continue, management of the medical colleges know the methods to make him resign. So, the staff will have to resign.
Existing staff will have to resign and the new staff will not get the job.
MCI wants to produce Forensic-medicine experts in the country. With the present scenario of job opportunities in medical colleges, there is hardly any takers of this subject among the PG aspirants. It is a well known fact that capitation fee is zero or least for this subject, when compared to all other subjects.
Since there is no demand presently for doing post-graduation in forensic medicine, and the demand will be totally zero in the near future, the MCI’s VISION-2015 of producing forensic medicine experts will be not be possible at all.
No private medical college will retain the faculty of forensic medicine to provide the non-profitable ‘service’ of post-graduate teaching in forensic medicine. They will do it, only if there is a compulsion.
SUMMARY
The present scenario:
The Government (Home department and the Law department) needs forensic-medicine experts.
The health ministry/MCI wants to produce forensic-medicine experts.
Home ministry does not employ forensic-medicine experts
FutureScenario (after vision-2015):
Health ministry/MCI is taking away the job prospects of the forensic-medicine experts
Home ministry seems to be silent
Forensic Medicine experts cannot be produced by Health ministry/MCI, because nobody would want to specialize in this subject.
India will have no forensic-medicine experts in future. Crime rate will go up, as the conviction rate will decrease substantially.

Author is an Associate Professor in Department of Forensic Medicine, Toxicology - Yenepoya Medical College, Yenepoya University,Deralakatte,Mangalore

Comments

Unknown said…
Very well written. Focus is on core issues.
standford said…
great post, and currently I even have a brand new list of blogs to appear through! in the future i'd like to be on the same list!

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