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Re: [iapsm_youthmembers] Re: Deabte on doctors serving in rural India: Should it be published in IJCM?

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  • nick carter
    Dear All,              I guess the whole idea of this debate is getting defeated, why we want to go back in time and look at the history when we
    Message 1 of 42 , Aug 1 4:07 AM
    • 0 Attachment

      Dear All,
                   I guess the whole idea of this debate is getting defeated, why we want to go back in time and look at the history when we are sure that we do not want to learn from it. My only suggestion is that there needs to be a Vision and Road Map. By Vision i mean " what we actually want Doctors like You and Me to do when we are posted in the Rural areas" by Road Map i mean there should be a time bound process for the career enhancement of the doctors serving in the rural areas. I really appreciate motivated doctors who are serving in the Rural Areas, but sir i wish to ask how many of motivated people like you are there across the country, had there been enough i guess we would not have been having  this debate.Sir it would be easy to bring in an amendment which would say " that MBBS Degree or Post Graduate Degree will only be granted after a compulsory rural posting" but will it be sustainable.One can sustain hardships for some period of time, hoping for the situation to improve, but if it is expected that people will hold the grounds forever whatever may come, I am sorry sir not even 1% will hold on because if even the basic amenities are not available how will one survive.
      The number of doctors registered with MCI currently is 696747
      The number of Government Allopathic Doctors is 76542
      Total number of Government Doctors at PHCs 22273  (No of PHCs:22669)
      Total No. of CHCs Specialist are 3979 (No.of CHCs: 3910)

      Under IPHS provision of additional doctor at PHC has been made, but unfortunately majority of places these vacancies are filled on contractual basis and the doctor is paid a salary of Rs15,000 per month.
      At the CHCs there is Requirement of 3 Specialists ( General Surgeon, Obstetrician and Gynecologist and Pediatrician) apart from 1 General Physician. Under NRHM , provision of Anesthetist is also there.If we exclude the Anesthetist we still require 3 Specialists and the numbers we have is just one third of required.
      I dont have the number of specialist currently working in the Government set up (the Breakup speciality wise) other wise i would have concluded in a more better way.

      I guess serving in the rural areas is not the issue, there have to some Road Map and Some basic facilities available, one can continue to cross swollen Ganges to ensure good quality immunization activity, or may be one can run a PHC in the Naxalite infested areas or may be go without food for one day, but WHAT FOR?? whats trh
       
       
       
       
       
      Regards & Thanks
       
      Dr. Aikant Bhatti 


      --- On Thu, 7/31/08, kash h <drkash11@...> wrote:
      From: kash h <drkash11@...>
      Subject: Re: [iapsm_youthmembers] Re: Deabte on doctors serving in rural India: Should it be published in IJCM?
      To: iapsm_youthmembers@yahoogroups.com
      Date: Thursday, July 31, 2008, 11:01 AM

      Respected members of the group
       
      How many you are aware of the the number of students appearing in this year's all india PMT???
       
      And goinh by thee result, as Dr. Niraj said that people who couldnt get through MBBS try for IAS. well thats absolutely wrong.. because the resulth of AIPMT  exam is itself very shattering
       
      where earlier the percentage used to go as high as 80 % , this time the 1st candidate has got around 55-56 % ...is that the best brains??
       
      i stll have to confirm this, but the overall result has totally gone down
       
      Medicine no more attracts the best brains in the country, and the best brains who are there, hjave already left for greener pastures abroad.....no matter peolpe talk of selfless sefive and all...but the fact is that good pay, better working conditions are important to retain doctors and attract the younger people..no two ways about it.
       
      Regards
      Dr.Kashipa
       


      Niraj Pandit <drniraj74@gmail. com> wrote:
      
      Dear All
      I am reading our debate on issue of compulsion in rural posting. I think we should go in history of our medical education. As far as my knowledge many middle age associate prof and professors are the members of this group, one I know Dr Jugal Kishor. The history of our subject has shown that we never gave importance to this subject as whole. But all people who were with policy makers, they knew/know the value of this subject.
      Start form Bengal Famine Committee, Bhore Committee to last National health policy 2002 or NRHM and last Public health foundation birth. They all have given great importance to subject.
      But same time what was going on in medical education? I am giving one example, in one of biggest medical college of Gujarat, they had the subject PSM as part of medicine till 1991. there was separate department since long but people inside were not ready to give the importance. the department was in dark. Not only this, community medicine was taught and even today is taught in four walls instead of in community. Very few medical collages have community laboratory or field laboratory for teaching subject.
      We all should agree that students have some role models in their mind during their study days. Their behavior reflect according to their role model. Are we making real role model? Key question which needs introspection.
      Somebody has tried to make comparison with engineers, architects or IAS. Dear friends, please remove habit of comparison. what do we need is competition not comparison? One can not compare two profession in any means. Few years back these engineers were unemployed and even they are not getting job worth five thousand rupee. Many people in IAS are those who did not able to take admission in medical. So my point never compare just make competition within us.Competition will improve services. Here I like to point some thing about stock market. There is inverse relation between risk and sustainability. If u want to earn in short time u need to take risk and play gamble. But u want to be sustainable progress and gain u need to be in gradually growing companies, isn't it friends?
      Third point is on birth of Indian Public health foundation. After sixty years of independence and in presence of PSM department, why do national government need to start PHFI? The simple reason we could not able to diversify our subject. Till today, after six years of post MD, I feel that the degree of MD is like undergraduate level. There are some 10 sub specialties which we could make as super specialties or post doctoral level, but we lost that time, I think.
      Forth since independence government is asking for community physicians who can work in community. Our 74% of population still is living in rural area and they need the public health experts. We also know that 80% of curative work can be handled by even trained MPW or ANM. If so what is need of doctors? And u have observed that under NRHM they have started to appoint AYUS doctors at PHC level.
      Thus compulsion came out of whole long history not just over one year. And whenever change in system there must be turbulence and murmur. But history is witness that such turbulences are eliminated over a period.
      I am also sending on documents that is the draft curriculum of undergraduate for our subject. Hope many know about this. In this they have suggested to take exam for subject should be in 9th semester instead of 7th sem. R we ready for change?/???
      Its high time to introspect our selves rather blaming on anybody.
      Best of luck
      Regards
      Dr. Niraj
       
      ----- Original Message -----
      Sent: Saturday, July 26, 2008 7:36 PM
      Subject: Re: [iapsm_youthmembers ] Re: Deabte on doctors serving in rural India: Should it be published in IJCM?

      Dear all,
       
      We are debating compulsion- not the need for people to go to villages (which is proven beyond doubt).
      We have worked in rural areas and no doubt learned a lot and enriched our experience.
      The only submission is that we need to make it attractive and fulfilling with the career goals of doctors.
       
      Sex is good and enjoyable as far as it is consensual, there ceases the limit when it become rape and one enjoys at the cost of the other.
       
      We need to draw the line on compulsion. There still seems to be lack of consensus on rural allowance for doctors? The Health minister had mooted this proposal when NRHM was being launched, but some of our advisors have advised RAPE.
       
       
      Rajesh Sood


       
      On 7/26/08, omesh bharti <bhartiomesh@ yahoo.com> wrote:
      Dear Dr. vinod,
                           
                            it was pleasant to hear from your experience in rural areas and god must have given you the dividends for that, because what we learn in rural areas keep on enriching our experiences throughout life and gives us a holistic vision.
      With this reading I remember the book EVERY BODY LOVES A GOOD DROUGHT BY P.SAINATH, he vividly explains the difficulties and corruption in rural areas.
      We the doctors must volunteer to got to rural areas not as doctors but as fellow human beings to understand the causes of poverty and alienation of the villagers and think of ways to mitigate them.
      I only wanted to know from you the ultimate learning you had in rural areas and how it shaped your life apart from the noodle yarning!
      Thanks
      Dr. Omesh Bharti
      Himachal

      --- On Fri, 7/25/08, vinod Immidisetty <vinodivrs@gmail. com> wrote:
      From: vinod Immidisetty <vinodivrs@gmail. com>
      Subject: Re: [iapsm_youthmembers ] Deabte on doctors serving in rural India: Should it be published in IJCM?
      To: iapsm_youthmembers@ yahoogroups. com
      Date: Friday, July 25, 2008, 7:25 PM


      Dear Dr,
       
      Would you think, without facing the rural music anyone would come out so strong! I can tell you something... .... i still enjoyed my stint, i have hundreds of photographs of my work and i cherish my experiences.
       
      I can tell you i was a brave, dedicated country loving person who joined in a contractual role in the Community Health Centre in the district of Keonjhar in Orissa in contractual basis. I felt i will change the country. I would do this, that...what not. Then finally have ended in Delhi.
      The CHC was Salania, where i joined 1st in contractual role.
      (My partner was Dr Prakash Rana who has completed his Medicine PG after that )
      I also worked in Orali for some time, got permanent posting in KBK area of Orissa.
      Worked in rural Jajpur district for 4 years but not in PHC. Stayed in Sukinda, in Sukinda Block with a private company those 4 years.
      Instrumental in starting a PHI, with public private partnership. ( Tata Steel and CDMO Jajpur, RNTCP) The microscopy centre is still working in Kalarangiata.
      Streamlining the immunisation with public private partnership. ......... .Tata Steel provided the Electricity and infrastructure for the ILR's, in Kalarangiata.
       
      Guys! rural interior Orissa : plight of doctors, heavy politics, villages with no electricity, malaria endemic area, high prevalance of TB in mines, unsafe sexual practices by Handia sellers( local alcohol brewed by tribals), villages on top of mountains, unmotorable villages, Naxalite prone areas, no public service( 1/2 buses per day), no proper schools , no proper teachers in schools,no blood bank within 80 kms, no proper referral hospital within 60 kms, no ambulance service, snake infested area, high poisoning cases, no banks, no newspapers, no internet, no proper mobile coverage, no clubs for family, no proper friends for wife, no sports activities,no proper restaurants within 50 kms area, no choice of channels in cable etal were some of the problems i faced between 2002 and 2007 at different places where i stayed, worked in rural Jajpur, Keonjhar and Dhenkanal and the same with all the rural doctors i had befriended. Luckily i was part of the private company most of the part but other scenarios were same for everyone.
       
      If someone wants to write stories i have thousands to narrate!
       
       Eg : Trip to 30 kms ahead town for a Thums up!
       Eg : How i craved for one plate of chinese noodles!
       Eg:  Trip to the nearest railway station to recieve my parents! ( my mom vomitted twice when i took her through the bumpy road)
       
      If some of the facilities have improved by now i will be thankful for the Doctors who are still working!
       
      It is not that what i had been through or people who have done more, it is more what we can do.......nothing will happen with compulsion and negative energy!
      So i shared some views how it should be for fellow doctors, juniors.
       
      with lots of love,
       
      Dr I.Vinod


       
      On Fri, Jul 25, 2008 at 6:27 PM, omesh bharti <bhartiomesh@ yahoo.com> wrote:
      Dear All,
                 I am serprised if anyone of those who are debating the issue tooth and nail is practically doing something in support of his arguments, only e-mail activism would not suffice!
      Thanks
      Dr. OMesh bharti

      --- On Thu, 7/24/08, nkyuth@yahoo. com <nkyuth@yahoo. com> wrote:
      From: nkyuth@yahoo. com <nkyuth@yahoo. com>

      Subject: Re: [iapsm_youthmembers ] Deabte on doctors serving in rural India: Should it be published in IJCM?
      To: iapsm_youthmembers@ yahoogroups. com
       
      Date: Thursday, July 24, 2008, 3:30 PM


      Dear all
       warm regards
      i would first like to congratulate all who have participated in this debate and generated lot of interest and heat both ways.
      this topic deserves to be discussed, also at much higher platforms so as to bring binding changes in the health policies being framed in this country.
      one of the solutions can be like starting md courses in Primary health care as distinct speciality just like the western countries and setting up of rural medical colleges under public private partnership.
      this would not only fill the gap of lack in man power but also provide tertiary level care at the grassroot level.
      Money is not the only issue involved. we also need to focus our efforts on the quality of services being provided to the most deserving. a judicial balance has to be deployed between financial compensation/ quality of life for a health care professional in rural area and compulsory postings.
      compulsory posting can be a short term strategy but cannot yield long term benefits unless a thoroughly well structured plan on infrastructure n services development is under place.  
      For the same we need to have a long term plan say 25-30 yrs focussed primarily on improving service sector in rural areas comprising all facets of life be it health or water supply or managers.
      Bcos health status of population cant be improved in isolation.
      Literacy,povert, unemployment, social stigmas etc all need to be tackled in conjunction with health.
      so not only doctors but teachers, engineers computer professionals etc are all required in villages.
      i hope the debate continues until it has achieved its ultimate objective i.e meaningful change in the system and policies.
      looking forward for everyone to participate
       
      Dr Neelesh Kapoor
      2nd yr resident
      NSCBMC Jabalpur. 
       
       
       
       

      --- On Thu, 7/24/08, Anil Kumar <dr.k.anil@gmail. com> wrote:
      From: Anil Kumar <dr.k.anil@gmail. com>
      Subject: Re: [iapsm_youthmembers ] Deabte on doctors serving in rural India: Should it be published in IJCM?
      To: iapsm_youthmembers@ yahoogroups. com
      Date: Thursday, July 24, 2008, 10:05 AM

      One could also think of a formal study, analyzing the following variables (for example) to see if there is any difference between physicians serving in rural areas versus urban areas:

      - Perceived job satisfaction
      - Perceived hardships
      - CME frequency
      - Availability of a medical library or internet at home to study medical literature
      - Average monthly salary
      - Education level of their children, wives
      - Percentage of salary accrued as life savings
      - Adverse health episodes in the doctor and/or his family members
      - Distance to nearest other doctor (in case the doctor needs medical care for himself)
      ...
      ...

      Such a study, if conducted, has a potential to serve as an evidence-based eye-opener for the government I believe.

      Additionally, I posted about the same issue in my blog (in Hindi). The user comments are especially interesting. It's in three parts:

      Part 1: http://xn--l1b4e4a1 c.blogspot. com/2008/ 07/blog-post_ 11.html
      Part 2: http://xn--l1b4e4a1 c.blogspot. com/2008/ 07/blog-post_ 8406.html
      Part 3: http://xn--l1b4e4a1 c.blogspot. com/2008/ 07/blog-post_ 20.html

      Anil

      http://photographyb yindians. blogspot. com

      On Wed, Jul 23, 2008 at 11:04 PM, Chandrakant Lahariya <youth_iapsm@ yahoo.com> wrote:
      Dear Drs Clarance and Sood,
      I would like to thank two of you for moderating one of the best topic dicussed on this forum since the inception. You and all other people who participated in this debate need to be congratulated for this activity.
      As Dr Kishore had suggested, I would further improvise that a debate may be planned for Indian Journal of Community Medicine on Should doctors go to serve in Rural India? where Dr Clarance writing for and Dr Sood Against? It will be a great service to the medical fraternity to publish this debate and begin the changes...
      I would say more such topics need to be debated on this forum for the grerater benefit of us all.
      Thanks and best wishes,
      Chandrakant 


       





       




      --
      Dr RK Sood
      FETP Scholar (NIE, Chennai)
      drrksood@gmail. com
      +91 9418064077, +91 9445157327


      Connect with friends all over the world. Get Yahoo! India Messenger.


    • omesh bharti
      Dear Friends,                    Here is a doctor who opted for a tribal posting: see the link below  
      Message 42 of 42 , Aug 19 7:28 PM
      • 0 Attachment
        Dear Friends,
                           Here is a doctor who opted for a tribal posting: see the link below
         
         
        Let's learn from him as he is a statement in action !
        Dr. Omesh Bharti


        --- On Mon, 8/11/08, vinod Immidisetty <vinodivrs@...> wrote:
        From: vinod Immidisetty <vinodivrs@...>
        Subject: Re: [iapsm_youthmembers] Re: Deabte on doctors serving in rural India: Should it be published in IJCM?
        To: iapsm_youthmembers@yahoogroups.com
        Date: Monday, August 11, 2008, 10:33 PM

        Dear Dr Omesh,
         
        Very good stand indeed!
        I appreciate your thoughts and fully understand what you say!
        Good, keep up the good work!
         
        Dr I.Vinod

        On Sun, Aug 10, 2008 at 5:02 PM, omesh bharti <bhartiomesh@ yahoo.com> wrote:
        Dear Vinod,
                        It is not that I hit an idea, but I practically persuade my Tribal friends to go to their brotheren and help them alliviate their suffering.
        I am the president of Himachal Medical Officers' Association, Shimla and have done a lot of work on this.
        I am myself visiting remote schools of mine and sponsor poor students'  fees ranging from RS.35/- per month to Rs.350/- per month.
        Yes, I agree we must serve our fellow beings and should make a bigining in this direction, especially I appeal to all the group members who contributed to the discussion to go to their village and find out the people they can be of great help!
        LET'S GO TO THE ROOTS !
        Thanks
        Dr. Omesh Bharti
        Shimla, Himachal


        --- On Sun, 8/10/08, vinod Immidisetty <vinodivrs@gmail. com> wrote:
        From: vinod Immidisetty <vinodivrs@gmail. com>
        Subject: Re: [iapsm_youthmembers ] Re: Deabte on doctors serving in rural India: Should it be published in IJCM?Date: Sunday, August 10, 2008, 3:24 PM

        Dear Dr Omesh!
         
        ha ha ........what basis you told this? ( I can tell you that you hit the bull's eye)
        but no one talks about these things, no one raises these things?
        You are absolutely correct if we give back to the place we come from something it is very awe inspiring, what wrong??
        It is upto these doctors what they think about this?
        But a very good pertinent topic raised by you?
        Same way what is wrong in serving the people and area where we come from? When we are priviledged out of the whole population?
         
        That is what is nation building. I always personally think that inflation and price rise is being churned by us.
        Eg: We go for green apples, australian grapes, pears, peaches, kiwis, california oranges etc!.
        What is wrong in eating delicious indian grapes, Shimla apples, Nagpur oranges and mangoes?
        We pay more for those things and run after many things which are un-necessary!
        Cosmetics, imported branded clothes, shoes, soft drinks, confectionaries etc etc
         
         
        But this may be sensitive to many people and i think these are my personal views put to this group  and not to hurt anyone.
        Very good question raised by Dr Omesh thou!
         
        And one more thing, i will surely read this book: EVERY BODY LOVES A GOOD DROUGHT BY P.SAINATH and give you my thoughts on that.
         
         
        Dr I.Vinod

        On Sun, Aug 10, 2008 at 8:01 AM, omesh bharti <bhartiomesh@ yahoo.com> wrote:
        Dear Friends,
                           Let the tribal doctors selected from that area in P.M.T. serve their area for initial three years, if they are not willing to serve the area they have been given reservation who would go there?
         
        Dr. Omesh Bharti

        --- On Sat, 7/26/08, omesh bharti <bhartiomesh@ yahoo.com> wrote:
        From: omesh bharti <bhartiomesh@ yahoo.com>
        Subject: Re: Deabte on doctors serving in rural India: Should it be published in IJCM?
        To: iapsm_youthmembers@ yahoogroups. com
        Cc: vinodivrs@gmail. com
        Date: Saturday, July 26, 2008, 10:19 AM

        Dear Dr. vinod,
                             
                              it was pleasant to hear from your experience in rural areas and god must have given you the dividends for that, because what we learn in rural areas keep on enriching our experiences throughout life and gives us a holistic vision.
        With this reading I remember the book EVERY BODY LOVES A GOOD DROUGHT BY P.SAINATH, he vividly explains the difficulties and corruption in rural areas.
        We the doctors must volunteer to got to rural areas not as doctors but as fellow human beings to understand the causes of poverty and alienation of the villagers and think of ways to mitigate them.
        I only wanted to know from you the ultimate learning you had in rural areas and how it shaped your life apart from the noodle yarning!
        Thanks
        Dr. Omesh Bharti
        Himachal

        --- On Fri, 7/25/08, vinod Immidisetty <vinodivrs@gmail. com> wrote:
        From: vinod Immidisetty <vinodivrs@gmail. com>
        Subject: Re: [iapsm_youthmembers ] Deabte on doctors serving in rural India: Should it be published in IJCM?
        To: iapsm_youthmembers@ yahoogroups. com
        Date: Friday, July 25, 2008, 7:25 PM

        Dear Dr,
         
        Would you think, without facing the rural music anyone would come out so strong! I can tell you something... .... i still enjoyed my stint, i have hundreds of photographs of my work and i cherish my experiences.
         
        I can tell you i was a brave, dedicated country loving person who joined in a contractual role in the Community Health Centre in the district of Keonjhar in Orissa in contractual basis. I felt i will change the country. I would do this, that...what not. Then finally have ended in Delhi.
        The CHC was Salania, where i joined 1st in contractual role.
        (My partner was Dr Prakash Rana who has completed his Medicine PG after that )
        I also worked in Orali for some time, got permanent posting in KBK area of Orissa.
        Worked in rural Jajpur district for 4 years but not in PHC. Stayed in Sukinda, in Sukinda Block with a private company those 4 years.
        Instrumental in starting a PHI, with public private partnership. ( Tata Steel and CDMO Jajpur, RNTCP) The microscopy centre is still working in Kalarangiata.
        Streamlining the immunisation with public private partnership. ......... .Tata Steel provided the Electricity and infrastructure for the ILR's, in Kalarangiata.
         
        Guys! rural interior Orissa : plight of doctors, heavy politics, villages with no electricity, malaria endemic area, high prevalance of TB in mines, unsafe sexual practices by Handia sellers( local alcohol brewed by tribals), villages on top of mountains, unmotorable villages, Naxalite prone areas, no public service( 1/2 buses per day), no proper schools , no proper teachers in schools,no blood bank within 80 kms, no proper referral hospital within 60 kms, no ambulance service, snake infested area, high poisoning cases, no banks, no newspapers, no internet, no proper mobile coverage, no clubs for family, no proper friends for wife, no sports activities,no proper restaurants within 50 kms area, no choice of channels in cable etal were some of the problems i faced between 2002 and 2007 at different places where i stayed, worked in rural Jajpur, Keonjhar and Dhenkanal and the same with all the rural doctors i had befriended. Luckily i was part of the private company most of the part but other scenarios were same for everyone.
         
        If someone wants to write stories i have thousands to narrate!
         
         Eg : Trip to 30 kms ahead town for a Thums up!
         Eg : How i craved for one plate of chinese noodles!
         Eg:  Trip to the nearest railway station to recieve my parents! ( my mom vomitted twice when i took her through the bumpy road)
         
        If some of the facilities have improved by now i will be thankful for the Doctors who are still working!
         
        It is not that what i had been through or people who have done more, it is more what we can do.......nothing will happen with compulsion and negative energy!
        So i shared some views how it should be for fellow doctors, juniors.
         
        with lots of love,
         
        Dr I.Vinod


         
        On Fri, Jul 25, 2008 at 6:27 PM, omesh bharti <bhartiomesh@ yahoo.com> wrote:
        Dear All,
                   I am serprised if anyone of those who are debating the issue tooth and nail is practically doing something in support of his arguments, only e-mail activism would not suffice!
        Thanks
        Dr. OMesh bharti

        --- On Thu, 7/24/08, nkyuth@yahoo. com <nkyuth@yahoo. com> wrote:
        From: nkyuth@yahoo. com <nkyuth@yahoo. com>

        Subject: Re: [iapsm_youthmembers ] Deabte on doctors serving in rural India: Should it be published in IJCM?
        To: iapsm_youthmembers@ yahoogroups. com
        Date: Thursday, July 24, 2008, 3:30 PM


        Dear all
         warm regards
        i would first like to congratulate all who have participated in this debate and generated lot of interest and heat both ways.
        this topic deserves to be discussed, also at much higher platforms so as to bring binding changes in the health policies being framed in this country.
        one of the solutions can be like starting md courses in Primary health care as distinct speciality just like the western countries and setting up of rural medical colleges under public private partnership.
        this would not only fill the gap of lack in man power but also provide tertiary level care at the grassroot level.
        Money is not the only issue involved. we also need to focus our efforts on the quality of services being provided to the most deserving. a judicial balance has to be deployed between financial compensation/ quality of life for a health care professional in rural area and compulsory postings.
        compulsory posting can be a short term strategy but cannot yield long term benefits unless a thoroughly well structured plan on infrastructure n services development is under place.  
        For the same we need to have a long term plan say 25-30 yrs focussed primarily on improving service sector in rural areas comprising all facets of life be it health or water supply or managers.
        Bcos health status of population cant be improved in isolation.
        Literacy,povert, unemployment, social stigmas etc all need to be tackled in conjunction with health.
        so not only doctors but teachers, engineers computer professionals etc are all required in villages.
        i hope the debate continues until it has achieved its ultimate objective i.e meaningful change in the system and policies.
        looking forward for everyone to participate
         
        Dr Neelesh Kapoor
        2nd yr resident
        NSCBMC Jabalpur. 
         
         
         
         

        --- On Thu, 7/24/08, Anil Kumar <dr.k.anil@gmail. com> wrote:
        From: Anil Kumar <dr.k.anil@gmail. com>
        Subject: Re: [iapsm_youthmembers ] Deabte on doctors serving in rural India: Should it be published in IJCM?
        To: iapsm_youthmembers@ yahoogroups. com
        Date: Thursday, July 24, 2008, 10:05 AM

        One could also think of a formal study, analyzing the following variables (for example) to see if there is any difference between physicians serving in rural areas versus urban areas:

        - Perceived job satisfaction
        - Perceived hardships
        - CME frequency
        - Availability of a medical library or internet at home to study medical literature
        - Average monthly salary
        - Education level of their children, wives
        - Percentage of salary accrued as life savings
        - Adverse health episodes in the doctor and/or his family members
        - Distance to nearest other doctor (in case the doctor needs medical care for himself)
        ...
        ...

        Such a study, if conducted, has a potential to serve as an evidence-based eye-opener for the government I believe.

        Additionally, I posted about the same issue in my blog (in Hindi). The user comments are especially interesting. It's in three parts:

        Part 1: http://xn--l1b4e4a1 c.blogspot. com/2008/ 07/blog-post_ 11.html
        Part 2: http://xn--l1b4e4a1 c.blogspot. com/2008/ 07/blog-post_ 8406.html
        Part 3: http://xn--l1b4e4a1 c.blogspot. com/2008/ 07/blog-post_ 20.html

        Anil

        http://photographyb yindians. blogspot. com

        On Wed, Jul 23, 2008 at 11:04 PM, Chandrakant Lahariya <youth_iapsm@ yahoo.com> wrote:
        Dear Drs Clarance and Sood,
        I would like to thank two of you for moderating one of the best topic dicussed on this forum since the inception. You and all other people who participated in this debate need to be congratulated for this activity.
        As Dr Kishore had suggested, I would further improvise that a debate may be planned for Indian Journal of Community Medicine on Should doctors go to serve in Rural India? where Dr Clarance writing for and Dr Sood Against? It will be a great service to the medical fraternity to publish this debate and begin the changes...
        I would say more such topics need to be debated on this forum for the grerater benefit of us all.
        Thanks and best wishes,
        Chandrakant 













         






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