The “now or never” situation

Through Murtaza Ahmad Shah

WCHICKEN a very small change in the initial conditions, such as the flapping of butterfly wings, creates significantly large changes in the outcome, such as the causation of tornadoes several weeks after the flapping, this is called “the butterfly Effect”. And yes, it is a real phenomenon that occurs in our everyday life. Simply put, “small, unnoticed actions with serious and significant consequences” is what it all means. And this phenomenon is all at work in our healthcare system these days – the “butterfly shutter” being a recent notification by the Medical Advisory Committee (MCC) and the predictable result being a disastrous tornado for the healthcare facility. of UT health. The ongoing protests in recent days by MBBS students from various UT medical schools are aimed at preventing the potentially destructible and irreversible chain of events. , try to understand in detail why this is a “now or never” situation for the J&K healthcare setup.

According to said notification, J&K is likely to participate in the All-India (AIQ) quota for NEET-PG seats this year and beyond. This means that 50% of the PG seats of GMC Srinagar and GMC Jammu, and 100% of the PG seats of SKIMS Srinagar will be bundled into AIQ, which will make very few seats reserved for local aspiring PG doctors of J&K. If the decision had been made for another state or UT, it would not have mattered and would rather have been successful. Because after all, that is the reason for competition – to let all competitors fight for the same opportunities and ensure the highest quality of skilled minds to cross. Law? Wrong!

For J&K, the equation is not that simple. It has many variables which all complicate the picture.

MBBS undergraduates, like other J&K students, suffer academically most of the time due to frequent problems and shutdowns of the Internet and other communications. This is a direct consequence of the inevitable fact that ours is a politically unstable region. We recently experienced the world’s longest Internet shutdown in a democratic country after the repeal of section 370. It lasted for 213 days of continuous Internet blackouts. Before that, we experienced the internet blockade of 2016. According to Internetshutdowns.in, Kashmir accounts for nearly half of the 413 internet outages India has experienced since 2012. This is compounded by the fact that almost all of the preparation for NEET-PG is done online.

As a result, students here, compared to the rest of India, have inequitable access to resources. Our students do not have access to the same learning and educational resources that students outside of J&K enjoy. How can we ignore this? How can policy makers completely forget about this variable?

The direct consequence of forcing us into such unequal competition would be that our UT would lose its large number of local specialist physicians trained as physicians in our own medical schools. What a huge waste of resources, both human and material, that would be!

Physicians trained in their own state / UT should preferably serve that state / UT because during the training they get to know the pattern of diseases in a given population (epidemiology). Medical experts know that such a pattern varies from place to place. So when physicians serve the area where they were trained, their training would be more cost effective and people would be served.

Therefore, pouring non-locals into our healthcare system would negatively affect patient care here due to one peculiarity: our population is predominantly rural and rarely knows non-local languages. The resulting language barrier between a non-local physician and a local patient would impact patient care, as the diagnosis is directly dependent on the clinical history extracted by a physician. Some would argue that compromising on the language barrier for better competitive doctors is not such a high stake, but you forget to factor in the already low doctor-to-patient ratio in J&K. According to a 2019 report, it is 1: 1880, one of the lowest in the country. It is even lower in the peripheral areas of UT. Add to that the compromise you made in patient care at tertiary institutes on language, epidemiological training and local specialists, it translates into the literal demise of the system.

Our healthcare system has had the experience of suffering irreparable damage due to the same decisions when they were implemented in super-specialty courses (DM, MCh). We are facing a serious shortage of super-specialists in J&K for the same reason that we allowed the pooling of super-specialty courses in AIQ earlier, and now the same is being done with specialty courses (courses PG).

The solution of this abused equation is therefore quite simple. Unless the ruling is overturned, that would be the last nail in the coffin of our already crumbling healthcare system.

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The opinions expressed in the article are those of the author and do not necessarily represent the editorial position of Kashmir Observer

• The author is a final year SKIMS MC student

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