@marimphil wrote:

Is Being a Doctor Reasonable Anymore? Is there a Better Option Out There?
I’m 27, a junior doctor from India here in UK, will be appearing for PLAB Part 2 exam soon, and will be appearing for the MRCS Part 1 & 2 exams in January 2006. I had a dream to become a great general surgeon. My dad is a great, great laparoscopic surgeon, and so was my grand-dad a doctor. But now due to certain circumstances, which I shall be mentioning in detail in this article, I want to be different, do different and step aside from "standard protocol". I want to end this pattern of "insult" to our once-upon-a-time GREAT profession. I am therefore looking at alternative career prospects, simply because of the following:

Two facts which I don't think any one will oppose

Medical Profession has lost its Glory

And so has all the professions.

Long long ago, so long ago, every profession was held with respect.........

You ask a bank manager or a lawyer about how they were treated 50 years ago.

Teachers used to come to class in Coats (Coat with Dhoti was a well known dress in Southern India those days).... Even their respect has come down.

This is the current state of lawyers, the profession of Gandhi and Nehru

The Madras High Court Advocates' Association (MHAA) has demanded that screening of Vijay-starrer 'Sivakasi' be stopped within a week, since it allegedly "portrays lawyers in a bad light".

In Sivakasi, Vijay's Diwali release that has been keeping the box offices ringing, the hero's friend, played by M S Bhaskar, is a lawyer with too many stupidities and too few cases. The lawyer is shown as using law books as pillows and serving tea to Vijay, who plays the role of a welding worker.

"Lawyers are portrayed as jokers and idiots in the film," said Praveen, a second-year law student in Madurai who filed the case against the makers of the movie last week.

looking at the situation we are forced to think that the medical profession has lost with glory n charm but trust me,when a patient looks at you n thanks you,all these feelings dissappear.

I agree with bruno that the respect has definitely gone down, take any profession. And also he thanks that nikhil mentions here, yup deinitely it feels great.

But its not so with payscales!! icon_smile.gif Doctors definitely dont get paid as much, if u consider the efforts they put in, esp if u look at their non -medico counterparts. IS it that we dont require money to pay for our roti, kapda and makaan??? then why this discrimination.

But then, inspite of all that, I think each & everyone is definitely proud to be a doctor & proud that he/ she has done his/her share to serve humanity.

as bruno said, the respect is gone down globally
and the reason we get frustrated is bcoz of our expectations
but if we tune down our expectations to a different level, then life can be easy

and payscales are down for dcotors all over the world, if compared to other professionals
dont know why
but most professionals take up the protest weapon to get their needs listened and done
some professionals, they cant take that route

but as everyone told we should be proud of what we are doing

here are two kinds of people: those who see reality and those who flee reality.

If professional waters are choppy, the realist takes note and adjusts the sails. Or chooses on an alternate way to reach his destination.

The escapist believes that knowing there is bad weather is of no use since it can't be changed. Members of this tribe often write in, accusing me of demoralising students by presenting a less-than-rosy picture of a particular career path.

So honestly, after the Doctors vs Engineers column, I was expecting some serious flak.

"The idea is not to give pros and cons and Budget analysis of various careers, but plain and simple education, and lo and behold you'll find people wanting to be a doctor even if they have to get by on Rs 2,000 a month", wrote Abheek Das.

The indefinite struggle

My question is why? Why should Medicine
school graduates be willing to watch others whiz past them while they struggle indefinitely?

Let's not compare apples with oranges by saying, "not all MBAs/ engineers get good jobs." Those who get into top ranking colleges certainly do, unlike their similarly brilliant MBBS counterparts.

Dr Shekhar's anguish boils over as he notes,"No one realises that the salary that a resident receives in Maharashtra
is less than what a sweeper in BMC recieves. After slogging for 24 hours on call, if u happen to have a stressful day, it does not make a difference to anyone."

For reasons such as these, doctors are dissuading their kids from the profession. And that's a fact.

Says a reader, whose dad is a surgeon but advised him to take up engineering, "I have a younger brother on the verge of making the 'ultimate' career decision: Medicine
/ engineering? The choice is clear and unambiguous now. Eight out of 10 folks today cannot avoid the temptation of the get-settled-quick draw of engineering/ The long course has no buzz

is evident from the fact that even a sneeze at the Indian Institutes of Technology or Indian Insitutes of Management reverberates in the national media. In contrast, Medicine
hits the headlines only in the context of exorbitant fees being charged by private medical colleges.

In the recent budget, a one-line mention was made of the government's intent to set up more institutes along the lines of All India Institute of Medical Sciences. A week has passed and no further details are known. Actually, the government is simply reviving a proposal made by the National Democratic Alliance while it was in office.

Two years have gone by since that earlier, unfulfilled promise.

Incidentally, the NDA proposal clearly specified it would not 'create' new hospitals, merely upgrade the existing setups in six locations. Lack of funds, perhaps?

No such constraints seem to apply for the seventh IIM, which is being set up from scratch, in the North East.

I bet it will come up long before any of the proposed AIIMS
campuses. Because IIMs 'sell'. And politicians, like channels, are always looking for ratings.

The strange bit is, medical education is the one stream where privatisation has flopped dismally. If an MBA
aspirant does not get into an IIM, Faculty of Management Studies or Bajaj, s/he would be reasonably happy with non-sarkaari alternatives like XLRI, S P Jain, MDI, Symbiosis, NMIMS, etc.

Of the 1,000-odd B-schools in India, though, a large number offer a dud education, a decent number of reputed non-IIM brands do exist. The same goes for engineering.

In Mumbai, Thadumal Shahani, VESIT, Sardar Patel and D J Sanghvi are just some of the private engineering colleges which students are satisfied with and clamour to join.

The Medicine

With Medicine
, however -- barring the odd exception -- government colleges rule. That's because a medical college must be attached to a good hospital in order to give students proper clinical exposure and experience.

Most private colleges don't fulfil that criteria. Their hospitals exist only on paper -- or function poorly. And students pay the price of the mismanaged hospital in many ways. Not only do they lose out in terms of learning, their fees are hiked to recover the losses the hospital is making.

After shelling out several lakh to study at a private college, what are the returns? Pretty dim.

Imagine students who have taken bank loans. How will these be repaid? The financial equation works out only if:

Your family already runs a clinic/ nursing home.
You manage to migrate to the United Kingdom or the United States of America and earn in pounds/ dollars.
As Jay Nitturkar wrote in to say, "I know some top IITians in America make lot of money being entrepreneurs, but that is probably 1% of them; among doctors of Indian origin in America, I can safely tell you the median annual income is over $350,000 (for over 50% of all Indian docs!) and for top 10%, it is even more."

The brighter lot gets the cheaper bit!

Great! But such opportunities are first going to be snapped up by the brighter lot. The ones who scored enough to make it to the government colleges where the annual fees are a dirt cheap Rs 18,000 to Rs 25,000 per annum (thanks to sarkari subsidy).

So the Maharashtra
government now wants students who are benefiting from this largesse to furnish bonds.

From this year, the state government has raised the bond amount from Rs 100,000 to Rs 500,000 to 'ensure' that students work in state-run hospitals for a minimum of two years after their MBBS.

What's baffling is that the bond has to be signed by a third party who cannot be a close member of the family. This guarantor should also own property valued at at least three times the bond amount. Not surprisingly, most students are unable to find such a benevolent guarantor. It defies common sense!

The government's contention is that 'bonds given by family members have proved to be unsuccessful'. Which is precisely why people unrelated to the student would also refuse to sign.

Subsidised fees and payback!

In a free country, zor-zabardasti cannot be the solution. And any policy based on 'we are subsidising you, so now it's payback time', can't be restricted to Medicine

What about government engineering colleges? Even with Medicine
, this rule currently applies only to state-run colleges, not those run by the Brihanmumbai Municipal Corporation.

A more viable alternative would be to charge higher fees from all MBBS students in state-run colleges (those who cannot pay upfront can avail of bank loans). After graduation, those who stick on to work at government hospitals can be rewarded with decent salaries, say Rs 25,000 per month. This will help take care of their bank loan repayments and, in a sense, reverse-subsidise their education cost.

I am sure many doctors who would otherwise have considered migrating or going to private hospitals would feel valued enough to stay on at government hospitals. Because the professional exposure -- and personal satisfaction -- at these hospitals is inherently greater than working in private clinics.

The long run equation

Yes, some will still be tempted to migrate. But in the long run, it doesn't necessarily hurt us. 'brain
drain' used to be an oft debated national issue. Now, we are reaping the benefits of having a large and cash-rich community of Indians worldwide. They have also created a global Indian brand: Every time you think of brains, think India.

Coming back to Medicine
-- yes, there is a need for young doctors to practice in rural India. And I think many fresh medical graduates would be willing to do so -- as a form of national service -- provided they were assured certain basic facilities.

Some years ago, when one year 'rural posting' was compulsory for those completing their MBBS from BMC-run hospitals, many a young doctor returned with horror stories.

We are willing to work, they said, but the primary health centres lack even the basic medicines. There are endemic problems -- like malnutrition -- which need to be tackled not just by a single, well-meaning young doctor, but the system as a whole.

The government wants doctors to be accountable because it subsidized their education. But who will the government be accountable to? Who will answer for the phantom medicines and foodgrains that are 'allocated' in the annual budgets but then 'relocated' by the forces of corruption?

Bottom line: Doctors still enjoy a great deal of 'respect' in society. But is that going to be enough to motivate future generations of bright young people to join the profession?

Not unless we put medical education under a scanner, diagnose what's ailing it and figure out a holistic form of treatment. In medicalspeak, "Case complicated hai..."

Just the right words to ignite a spark in doctors' eyes. And induce them, as a professional community, to rise up to the challenge?

I felt very sad reading ur msg. If you have already decided to do whatever u wanted to do I wish Luck. I hate debating especially on topics like these because debates are never conclusive. Everyone leaves the debate thinking he/she is MORE CORRECT or LESS CORRECT ,, nothing changes.
But here, its the risk you take, and how comfortable you feel taking that risk is entirely upto you. One thing, you shouldnt regret your decision in future.
Its sad state of doctors somewhat similar to state of God. Both wanted to serve people. But both are being less and less cared for as the ages passess by. Cant imagine what happens when God decides to change his profession.(I hate comparing things too so dont take offence)
As a human being we have the capacity to fight even the inevitable. For example Death. Not necessary that we win. Its in the spirit of being alive we fight till our last breath as if we will be living forever. But in your case either decision you make is not something unachievable. So don't loose spirit, you will succeed in whatever choice you make. Fight ;

thanks so much for writing in. i really appreciated the points you made, and most of all, i appreciate people who are honest in airing their true thoughts and opinions, like you. now let me tell you a few things.
firstly, i am not even close to have taken a decision. i am still in the uk, will be appearing for the MRCS part-2 exams this january, and most importantly of all, i am fascinated by the science of surgery, and i am sure that i will always want to learn more and more about the skills of surgery. and i'm sure i will. and how am i able to do that? simply because i have earned the right to hold a scalpel in my hand, or a suture & needle and use it to save someones life...and thats cos i have worked hard to become a doctor, without which learning surgery would have been a forbidden territory for me. and whats more...i will ALWAYS remain a doctor, no matter where i am, and what i do further on in life, and nothing on earth can change this fact, and neither will i let anything change this fact. and so, after completing my MRCS, fully, i will also become a qualified specialised surgeon...and so this is something i will do as well, cos as i said, surgery fascinates me, and i will not let go of it!
but what i wanna do here is break away, somewhat, from this closed bubble in which most doctors live for the rest of their lives, simply cos they think that they dont have other options as their field of study is too specialised. who said that a doctor HAS to spend the rest of his living days working as a doctor, or for that matter...an engineer has to be an engineer for the rest of his life...or a lawyer has to be a lawyer forever. we human beings are capable of remarkable things...and WE DOCTORS are naturally the more intelligent breed than the average population, arent we? then my whole point is that, why dont we expand our frontiers, and use this intelligence to greater use, for our self-improvement? thats all i am saying, and that is why, i am thinking on these lines. i as an individual, feel that, i am multi-talented...and i also feel that almost all of us out there, who have been able to see through the rigours, and processes of an extremely tough entrance exam, who hav seen through a 5.5 yr intense course at medical college, and who are still giving it their best, to move forward in their professions...well, i feel that, its not only me who is multi-talented...but its all these doctors out there who possess immense talents like myself. but due to the circumstances, and society issues, are unable to put these talents to use. plz read on...
my thoughts are like this. since i feel that, being doctors, we are multi-talented, i want to put these dormant talents to use, and feel that all doctors should, as well. my particular area of interest is setting up a business in property investments, and also starting a media group, and channel of my own, too, which will be exclusive to health, and medicine programmes. we have animal planet...we have news channels...we have movie channels...but do we have a medical channel out there? no and i intend to create one. big ambitions, one might say, but they are honest ambitions, i must say...and i want to see these ambitions turn to reality. i also realise that, in order to go about doing these succesfully, i will need some kind of education which is different from learning how to use a laparascope to perform a cholecystectomy...probably some kind of business/management related education. and thats why i have on my mind something on the lines of an MBA. but wait...remember that we are doctors! RIGHT? and what did i say we are, as a result of being doctors? MULTI-TALENTED. that means we can easily be and do 2, or maybe even 3 things at the same time...and unlike being a "jack-of-all-trades, master-of none", we can be a master of more than one, cos we are the breed the world calls DOCTORS!!! and just in case if anyone has any doubts about the abilities of us docs, well, i am then gonna prove it to you all out there that, we are capable, and the 1st step in proving that, would be to prove that I AM CAPABLE. so here's a thought which i have thought about...but which i havent worked on yet, in details, cos i am presently focussing on my MRCS exam on 16th january. after that, i will start my "homework" in this direction, FULL SWING!!! read on for the analogy...
have you guys ever thought of those guys who get top ranks in various exams like GMAT, etc, and in doing so, end up in some of the top institutions of the world, like harvard, stanford, or london school of business (and mind you...our IIM's dont even feature among the worlds top 20, and so i have not mentioned the CAT exams here...though no offence to our indian management guru's, cos i know a few IIM guys personally, and trust me, they are infinitely amazing and brilliant people, and equally capable as their foriegn counterparts...and so i personally feel its probably some worldwide ranking system which manages to get the better of us, and our IIM's )? well, there is this general perception that they are the "cream" of the brains, and due to this perception (which is largely true as well), they also demand some of the highest paid salaries, and some of the most resepectful jobs. citing an example here...the average annual starting salary of a person having completed his MBA from harvard, stanford, LSB, or the "top-10", is around £.110,000, thats Rs.88 Lakhs a year! and this is only the mean average salary i'm talking about. but mind you, its only people who pass from these worlds best business schools, who enjoy this kind of salary. there are thousands of institutions all over the world, and india too, mushrooming up, and offering MBA courses...but trust me, most are useless, as far as job prospects are concerned. the message is simple. if you wanna be paid £.110,000 a year for your efforts, you have to have an MBA from some of the world's best. even our IIM's are in the top bracket, as far a salaries in our country are concerned. read on to hear my idea...
...well, i got a bit distracted there for a while, and so lets get back to telling you what i was telling you...about us being muti-talented, our capabilities....and about the fact of me proving it to you guys, that we doctors are the BESTEST. so here's the point. whats so special about those guys getting their MBA's from the "top-10", and getting paid exhorbitantly? and why do we have to spend our living days hearing society talk about them big-shot MBA's being brilliant, super, talented individuals, when this so-called "society" actually benefits a lot more from us doctors directly, as far as themselves, and their biologies are concerned...and wen these MBA's play very little direct role in people's lives? well, enough of questions, now lemme tell you what i intend to do, or at least have thought about doing. read on plz...
...since my particular ambitions later on in life about property investments, and on owning a tv channel, will require a thorough learning on business and management...i have my eyes on an MBA. but here's the POINT. so all my mates here...take notice of this forum posting/article today, from just another one of you doctors, who calls himself simba_smiles. i am not going to sit and watch that "cream of brains" salutation go to the non-docs only...and so i am going to go on to get an admission in an MBA course from among the top-10 business schools in the world, and will do whatever it takes to top score in their qualifying exam, called GMAT. after that, besdies bothering about my property investments, i will get that international tv channel up and running (where as you might have guessed, there'll be lots of surgery shown!!!icon_wink.gif), just for us docs, and the rest of the world. and everyone of you guys out here, will be welcome to feature in the millions of programmes i will have lined up...in fact...all of us docs will deserve it. and moreso, cos i'll always be a doc after all, and you will all be my extended family in anything that i do, on that medical channel. at the same time, i will continue to learn, and specialize my skills in the practice of surgery, cos its something i love doing. now i know that all this sounds larger-than-life, and overtly-ambitious, and many of you might be saying that this guy called simba has gone crazy! but trust me, fellow doctors, i hereby declare to all of you out here...that i will prove it that i am capable of acheiving this...and more...cos after all, its all about self belief, and i know that i have an enormous amount of this self-belief. its just a matter of time before you all, and i myself see me making all this happen for real. so make sure you guys keep a really good track on what i'm upto.
well, thats a lot of details from my side. will write more later, after my MRCS exams are over. but i'd love to hear from you guys out there, and welcome any forms of support or criticism reagrding my view-points here. so please do make it a point to air your comments, docs, cos it will only help me see both sides of the coin more clearly...and i need to be able to do that, before i set foot on this adventure of mines. i call this an ADVENTURE cos of the following. i'm sure that our lives are long enough, and our minds are talented enough, to experience more than one adventure in life. we have all been fortunate enough to experience one of these magnificent adventures...in the form of medicine. (very few on planet earth are fortunate enough to experience this vast and immense adventure). i'm just trying to experience some more. well, thats all for now, and all the best to all of you, and keep the faith.
before i leave, i just wanna add a line which i had heard in a movie or something, and which really means a lot, if you look at it from a very strong and deep perspective....."What makes a man a man? Is it his origins, or the way he starts things, or where he lives, or what he does? No. IT'S THE CHOICES HE MAKES. Not how he starts things, but how he finishes them."
This doctor friend of your RxPG community, called simba_smiles, just wants to be able to make a choice.

noone shud regreat for being a doctor... but wont doctors have dimensions too... varied interests... In our field, we doctors mask our desires deep within us and forget to know the happenings around us with involvement with our field, the edge that we slack.... we devote ourself to our field leaving alone the family and friends around, sooo engrossed into medicine and patients and with no entertainment and we neither go for the adventures we used to crave for as our profession never allow us to do..

we jus got to break ourself to set ourself free and the generation that wil follow us..

good to know that you are still an active member out here. yes, i know about your ealier post, and that u had written it ages ago...and since it was posted so very long ago, i didnt reply to it, cos i had considered that probably you had stopped visiting RxPG any further. but its good to know that you are back again...and that you liked my ideas.
so wat are you doing these days, where are u from, and wat exactly are you doing to make your plans turn to reality. i plan to giv GMAT in the middle of 2006. but still hav to do some more research regarding MBA's and i'll even check out wat the CAT is all about...but will do all this research after the 16th of jan, cos i hav my MRCS exams on that day. anyway, you keep me updated about details from your side...and by the way...i'm not the only bloke out here with similar interests. there are 3 more guys with whom i exchange a lot of posts, and who hav similar plans to taht of mines. they are "confusedashell", "dr_kunal", and "parikshit". you can hav a talk with em too, and if we see that things are going in the right direction, we can open another thread with the name "the origin", or "MBA dreams taking shape" or something like that, which will signify our first few steps in this direction. that'd be interesting...wud'nt it? and others could then join in, where the discussions wud be more focussed on the actual steps and decisions we are taking, in order to reach this goal. anyway, will be looking forward to hearin from u soon. take care, and best wishes.

yes i agree, i do lost track of rxpg for sometime now.. i have jus logged in after a yr r so...
good to know that there r few more ppl.... Im doing my post graduation in Neurosurgery in Tamilnadu.. Im 25 and come from tamilnadu.
hey, for me, i think u don need an MBA degree to do a business or u have to waste ur time again struggling and juggling for another competitive seat... u jus need the vision to do something and u got to learn by ur own.. when u can learn medicine, theres nothing more difficult in business... What they teach u in MBA i dont think will be of much help for u to do any business... Noone had an MBA til the last 3 decades.. May be if u have an idea to earn after an MBA , u need to get into business line totally then.. u wil lose the touch in medical field... what u have learn in the whole 5 yrs wil be wasted then.. And for u to get into top ranking universities, u just dont need scoring in Gmat, u need experience... they wont even consider u without 2 r 3 yrs experience.. i dont think u shud do all this.. Thats upto u anyway..
for me, i jus want to do business as an addition to our medical practise.. u can always have someone to carry out ur orders in business, but u need a doctor to give proxy to an operation...

i love to do shares, which im already doing. i have an interest to start something related to medicine like instrument manufacturing, automobile component manufacture and blah blah.. i jus have an idea.. all this can become real only with money power..

rest in next... wil post actively man...

Hi everyone....I highly appreciate the motivation of our young medical enterpreneurs....The article of Rashmi bansal quoted by organized_chaos and Shaunaq was highly thought provoking.....

What I feel is that it is not the respect for doctors that has come down but it the hunger of our patients for more information about their disease and tretment and their expectations for a miraculous cure that have gone up....they do not believe that still we do not have cure for more that 30% diseases and for rest we just have reassurance....The main purpose of other medicinal systems picking up is their more intimate contact with patient which our allopathic no-touch techniques have weaned from the patients...We the doctors, the knower of the prognosis of most of the diseases based on evidence-based medicine, often forget the pain of the patient....and here we lose actual ground inspite of putting our best on patient's front....

Coming back to business thing, I fully agree with Parikshit Bhattacharya that medical professional are very brainy people and we can be master of more than one....but our system has made us to run only after certain well trodden path that defies knowledge from any other discipline. I posted something on MRI in nagging questions zone. The things written in that were said way back in 1952 by Bloch and Purcell and did not even include the stuff that marks start of MRI era which was ushered by nobel winning innovation of Laterbur in 1971.....And after that post their seemed to be no response.... This lack of knowledge of basic technology that we use daily in our medical life is growing for now....

Let me quote an example... we all use surgical instruments...they are made of stainless steel...but during my surgical OTs I always wondered why do they get rusted at the jonits if they were truly stainless steel (of course sisters told me that it is due to autoclaving) ....And it would be a surprising to few of you that medical instruments are made up of stainless steel and still they are attracted by magnet...one of my house surgeons got furious on learning that the instrument, he was using in OT, was attracted to magnet and concluded that the manufacturer did fraud by selling iron and not stainless steel....but it is not so...stainless steel is of many types... the one used for utensils is austenitic type and that for surgical instruments is martensitic....this later variety provides hardness to the instrument and is attracted by magnet.....

Now coming back to that rust....martensitic form just provides hardness but it has nothing to do with rust.....Then fortunately (just six months before) I happened to go to a cluster development program seminar near calcutta... (Actually to best of my knowledge surgical instruments are mainly formed by two clusters in India, one is near kolkata and other is near Jalandhar in Punjab....) Now the people those who made the instruments were trained in the days of britishers and continued to work with the same hereditary knowledge.... They heated stainless steel in coal furnace for melting and casting.....The carbon in coal actually soaked one of the alloying element and the stainless steel changed to plain iron thereafter....They used to scratch the surface which turned to iron (and hence rusted) and then polish it before selling to market..... They could overcome this change of stainless steel to iron by just using electrical furnace heating.... and then they asked me what is wrong with the scissors...I said most of the time we need the tip to be sharp and that is never sharp.... Now it needs little metallurgical knowledge to unerstand this but in short their same coal heating process made iron out of stainless steel and that is why they could not heat treat it later to make it stable sharp as iron melts before stainless steel during heat treatment......

So this examle shows how a very simple amendmend could soar the profits from medical instruments very high and earn high profits in foriegn markets because it is almost impossible to make such quality instruments with machine (thankfully due to craftsmenship of those people)....

This was just one example, we still need good casting procedures to be followed in India for titanium prosthesis....we Indians have different built and biometrical stats but still we follow everything that is deduced from westerners.....we made nuclear missiles but still we do not have CT machine of our own....This is not because we do not have brains in India, or this is not because government does not support that...its just for the lack of enthusiast enterpreneurs.... Medical instrumentation is a field which is difficult to flourish without a medical brain behind it ....

So medical line has lots of hidden potential in India and we need more of Tatas among our medical breed to come forward and take the cause of self reliance to new heights.... Earning money through such efforts of course brings money in addition to fulfillment of ones zeal for patriotism...... and of course I need not mention how much that would boost the enhusiasm of a common doctor towards the technology that he uses knowing that it is made by one of his own brethren and is well within his/her understanding....

well being a doctor reasonable it is for sure is but maybe no the "IN THING" right now is all i can say.its like a new fad mba now itll pass .whn my dad was n his engineering days it was upsc ias and the likes.so i guess its another of those phases.as for us well its like u know whn u have something u dont realise its value.pple just count doctors in one of those things.i too did till i became one.well u know after all the frustration of reading etcmy achievement of getting the gilded "DR" INITIALS before MY NAME r acknowledged each day i when i see my patients getting cured and thanking me.in my rural posting some of them just would show me alone and no other colleagues.im not trying to be proud of that but u knowits worth the effort.and if u go by the money part of t its true it comes in late ad probably not regards to the efforts etc.its wrthwhile and resonable definitely .if the engineerig guys can harp on about their fatter paypackets maybe we shuld too .
and nevr look for pple for approval.chancs r ull never get it
we are in it .the onus is us to make it look reasonable. im sure we all knew the terrible amount of hard work theres in it.i knew it even thoughi have no no rlatives even long lost ones nthis profession.so it was achoice we made
so now isthe sticking part to it
andwe can either make we living his life of a doctor a heaven or hell THE AMOUNT OF WORK WILL BE THE SAME----its a choice again WE MAKE

thats a whole lot of info you hav given out here regarding the medical instruments scenario...especially the huge lack of proper knowledge so many people unknowingly have! anyway, considering the intricate details u hav given about so many different aspects about these instruments, one would assume that you deal with such stuff, or at least plan to do so. is that true? if so, could you plz share with us the details...as i'm sure many out here would be interested in knowing. i myself am personally more inclined towards investments, and entrepreneurship in the near future, and in media related things...so dont think i'll end up doing anything on these lines, but even then, i'd love to hear the details, cos there is never an end to learning...and i may very well pick up an idea or two from wat u hav to say. anyway, thats all for now...and keep up with great write ups like this, which are really wat u call "eye-openers"!

Thank you all for showing interest. The things mentioned about medical instruments in my previous post were part of a lecture by a Professor from IIT, and Chand, at a training course organized by cluster development program, to the craftsmen at Berhampore (a small place 10-15 km from Calcutta, it is different from the one in Orissa). These things are very basic in metallurgy and Chand acquired them through his education in IIT, KGP.

My endeavor was not to guide you to a particular business but just wanted to divert your attention to something different from what you all have in mind. Actually the world's richest economies have slowed down. A big reason for that is that the youth there have taken up white collared jobs like management as their source of income. The main manufacturing units are shifting to developing countries in want of labor. With their own population almost on decline due to over jealous growth control and their old age populations increasing, the attention is therefore being shifted to south east Asia (India being prime), which has huge resources, cheap labor and above all that a huge consumption unit. The outsourcing business supports this view. So for now India is using the things provided by foreign lands but still lacks the indigenous things, more so in the field of medical instrumentation.

Now the main problem with medical instrumentation development in India is lack of a common platform for the high tech engineers and our talented medical pioneers. I can quote many examples and let me start with a very tiny one.

This image shows segmentation of heart from chest X-ray film. This was done by Chand with the help of computer programming. This simple thing if developed properly can automate the rheumatic heart disease diagnosis (by taking different ratios of different transverse, vertical and oblique dimensions). Now I do not deny the fact that there would be thousands in India who could write a better and more efficient C program for this thing, but then does any professional C-programmer know where the heart is?? Same is true for digital image processing of MRI images and CT images... Mass tuberculosis screening is our problem and it is we who have to develop a program for its automation but instead of doing that our image processing laboratories are working on mammography which is a routine somewhere else just because information about that is more easily available. This is where a common platform is needed and here we need doctors to change the scenario....

well its strange but I also got some interest in Management and Marketing. I even did a 2 yr course in Sales and Marketing parallel to MBBS. Everythimg in that field is amazing. It got creativity, practicality and much more. But I wanted to be a doc so i kept my other interests aside and sunk compltely into medicine. My fav passtime is to read buss mags. Just a weird thought why not we start a thread related to bussiness in this forum. It can be anything and can discss anything which makes sense. I have a gut feeling that it will be great fun and at the same time can be very educating 4 ppl like me. Oh I need to check first if such thread already exists in rxpg.

I just have the simlar thoughts of sonia... i totally agree with what she says... We must be involved in making medicines, instruments and software. there are few docs who have migrated into software field during the software boom n have gone to US for work.
Just tht i need some time and proper planning.. may be interested docs collectively can work into it, whoever interested can join in. Its just teamwork including all specialities and multiple brain work, though decision making is simple.

I hate passimism, having worked so hard for years and now bowing down to tough circumstances. Ha Ha ha, look at that thay are doctors who want to run away because the cases are hard.
Fight man fight. *when any one can do it Y can't I..
It is no doubt hard but not impossible, coz' sombody is already there, and has left his foot prints.

glad to know that you hav your own opinions about being a doctor, and doing wat you wanna do in life. BUT, am not at all glad to know that you are trying to shun, and discourage your fellow doctors out here...and that in fact, you have the audacity to say that they are pessimistic, that they are bowing down to pressures, that they are running away! that wasnt very polite of you boy...and i'm sure that you hav noticed, one of the primary things followed by every member on RxPG is that, they are courteous to one another, and they certainly DO NOT try and show their fellow doctors in poor light...the way you are trying to ridicule them here.

if you dont have any words of encouragement for them, for the ideas, and ambitions they hav in mind, even if that is something not to do with medicine...i feel that you just keep quiet about it, and stay out of forums such as these, instaed of coming here and jeering and making fun of them. and if at all u come here, make some constructive posting, where if you think that wat they are doing is not a good option, explain it to them why. you simply do not jeer at them, and say things like they are running away. highly unacceptable and unprofessional behaviour from you, dr. suryavanshi, i must say.

hav you ever heard of the word "diversifying"? i hope you understand wat this word means, although i can make out that your english knowledge is pretty poor, considering that you hav used words liked "passimism", in your posting....whatever that might mean. syndrome_xy thinks you tried to mean "pessimistic"! anyway, coming back to that word called "diversifying". its something a lot of multifaceted and multitalented guys do. and so thats simply wat out doctor friends in this forum are talking about doing. no doubt that they hav studied & worked hard for 6 yrs and become doctors. well, they hav done that on their own choice. havent they? so now if they also want to do something else which interests them, and think they hav the talent to do that, there should be no stopping them, and we all think that we should be proud of those doctors who also shine in other fields, instead of saying that they are RUNNING away from medicine because it is difficult. do you feel that other fields are easy? i hope i hav made my point clear to you. i believe you are in india now. let me giv you an example then. i am sure you hav heard of dr. palash sen....the lead singer of euphoria. well, i am not asking you whether you like his songs or not. i am just asking you whether you go about telling everyone that he has "RUN AWAY" from medicine. well, just in case you wanna know, he has "diversified" into another field which he is passionate about, and which he loves, i.e. music. and i am sure we indians, including us doctors are proud of him, for making it big. similarly, a lot of our doctor friends here hav similar visions, dreams, and ambitions...and they hav chosen this forum as a friendly place to share their thoughts, and try to turn them into a reality. i'd say that it takes a lot of guts and courage for a doctor to take an unconventional route, to do something he loves and is passionate about, but which might be seen in a negative way, by the community at large...and in such circumstances, the least we can expect is that, he gets whole-hearted support and encouragement from his fellow doctor mates, instead of the behaviour which you hav shown.

i hope you learn to respect these facts which i hav put across to you here, so that you dont inadvertently hurt or upset the sentiments of the doctors in this forum. however, as i said earlier, any healthy discussion on this topic about "alternative careers for doctors" will be highly welcome by you. till next time, take care, and all the best in whatever you do.

I highly appreciate your gesture to come openly and support our profession. I regret the kind of response meted to you by some of my friends. I have heard similar tones from my parents, from my best friends, and above all my teachers during my graduation years. My teachers were really great. I graduated from a college which was of not so high ranking then, but the people there were really good clinically and they were very sincere. My head of the department of Surgery used to come on foot and used to work late night on admission days. He is a wonderful surgeon and he used to reach the wards early morning and started doing the work even if house surgeon or others were late. He never used to go home without seeing that each patient has voided after laparotomy. This is just an example. There were many other like him who used to work so hard at their age of retirement, I being a young blood felt short in front of their dedication. But then to some reasons I came back to my home state (which is one of the richest in India). I do not know whether it was due to change in place and culture or due to change from a student to becoming a doctor, the scenario changed. The things that I had learnt were altogether different from the things being practiced. The doctors in the medical college would not pass a student, how so ever good he/she is until given some money. There was commission fixed for medicines, radiological investigations and lot more than that. The post graduation for which I had dreamt something great was in worse state. The PGs were required to bring the children of the department head, they were there for reserving tickets, bringing cooking gas cylinders and worse was when they acted as middle men for the commission exchange. The worst situation I faced was when one of my junior medical student died in his own home medical college waiting for a surgeon to do pericardiocentesis for his pericardial tamponade after an accident. Not even a single post graduate turned up for three hours because there was a party arranged by head of the department and they considered it an ill manner to annoy the boss. Such was the state of that ill-fated guy, then you can very well recognize the state of affairs of normal person. This was not all. I did house job in surgery for a year. In that one year in spite of my utmost dedication what I learnt was just how to make a case of IPC 323 look IPC 326 and so on. The government hospital, which I worked in, was the best in that one of the richest state of mine. The senior doctors never bothered to teach anything academic because they were too busy. They left OPD for private practice with a warning to us that they would not sign for my meager pay if I left the OPD. I being from a well to do family never bothered for money but always had an urge that may be I would be able to help somebody with little knowledge of mine. With most of my co house surgeons leaving jobs for their PG preparation I used to work 16 hrs a day to keep the things intact. But more I worked more the other people seemed to enjoy their leisure. I was so well tuned to the needs of my ward that I could very well predict the death of some patient and I used to wake up in the nights at the exact time when the patient was gasping even before the patient party could know that the patient was going to collapse. But my shortcoming was lack of expertise. In spite of working so hard none of my senior doctors did teach me anything and they got respite for doing more private practice. Some well to do person was given a visiting card and other not so well to do was treated in lieu of some money. What about the poor people? I remember an incident which is going to stay in my memory till I die. There was a laborer who had electric shock and his arm was developing gangrene. He was given TT on admission but he managed to run from the hospital as he was afraid of his arm being amputated. After one week when he returned he had that sardonicus smile on his face. In spite of all revolts from the operation theater staff and lack of cooperation from anesthetists we managed to amputate his arm in dressing room under kitamine. You know, this disease is too dreadful. But more dreadful was the treatment met by him from us. In spite of being prescribed, the nursing staff never gave 2 hourly sedation. He was prescribed IgG and his father was a real poor man, with just one dirty white cloth on his body. God knows how he managed those costly injections and to my utmost remorse those were not given to the patient and I came to know only after three days when he showed me the four injections he had brought lying in the drawer. “Doctor saaheb inka kya karna hai?” Since that day whenever I entered that tetanus ward I used to feel hurt when the patient’s risus sardonicus went straight to my heart questioning me the efficiency of the system I was working in……

I write all this to remind you of the legacy, some of us have got, from your generation. I fail to understand why do we talk of the respect of profession when a government doctor can not restrain himself from private practice. I can not understand why a private practitioner puts brain dead patient on ventilator for days till the patient party is totally bankrupt. Is it just to recover his sunk cost on the hospital and that ventilator? There are innumerable such examples which make my teachings in graduation year and my practice stand in conflict with each other. Before I have studied more I feel myself incapable of treating patients adequately and for that study I need to clear some random test set under dictates of our so called senior doctors who themselves could not give anything useful to my generation except this beeline legacy. The state government of that richest state of mine was always bankrupt and therefore has not created any vacancies since 1998. The doctors who become post graduate just work day and night, of course not for the patients but to earn enough to open a hospital of their own. I do not smell anything called service to mankind in them. It is like our army people, they get paid throughout their life for remaining prepared for a war and if actually war arises then they need compensation for getting killed. India produces huge number of doctors that has saturated even the developed countries like UK and USA. They are real quality people as compared to the peer group there. Has somebody ever questioned why can not enough opportunities be created in our own land? Why the people with the highest education gracefully accept racial discrimination to work at foreign rural areas and not accept serving their own people? The government in India has its own populist policies to put forth to stay in power. Then who is going to do think of the so called ‘falling reputation’ of our profession??

It is we, who has to enter some new areas. Excuse me for saying this, but centuries of slavery has brought an inertia in us. We can take lives in name of religion but we can not risk ourselves into something which could provide some relief to other people too. We love to follow the well trodden path. Do you know that return ticket to Japan costs one fourth of one servant’s monthly wages in Japan, but it costs two pays of class I officer in India. So here is the difference where we are suffering. We with our orthodox nature have not deviated from our age old loyalty to our profession and have created a mess for our own selves. The price that a foreigner pays for same titanium prosthesis is similar to what we pay because it comes from their land. We forget that like that air ticket it costs lot more heavily on our people. This is just one example, you can very well site hundreds of such examples in your OT. So don’t you feel it is our duty to create same thing in India with a cost that is suitable to Indian condition. A UHMWPE prosthesis costs Rs 80,000 if it is swiss made, and it costs Rs 30,000 if it is Indian made. The polymer mesh you use for hernia repair costs nothing to the manufacturer. We, due to our inertia, are paying hefty amounts to recover their already recovered sunk costs. Don’t you feel that we as doctors have some duty at this end too. If the government is unable to create opportunities then I think we should be capable enough to create opportunities for our own.

I have tried to be as courteous to you as I would have been to my teachers. I do not want to hurt you in wildest of my dreams. But sir don’t you think the dissatisfied lot is increasing. Don’t you feel it is a duty for you and me to give a better working environment for our next generation? You yourself a practiced a lot and now you want to shift to Canada for reasons I don’t know. But don’t you feel if everybody starts fleeing this land then they would be deceiving the people on whom they learnt their skills. Has the honor of my countrymen gone so low that they would like to end up sitting in beeline in front of some temple in a foreign land and not take up the massive task we already have in front of us???.....

I sincerely apologise for any misgivings here, but I sincerely hope some of the people reading this would agree with me and I am sure those are enough to make the things look different…….

I have no words to say, I am sure many of us had similar experiences. I have many heart pinching and soul wrenching stories that are buried deep in my heart. But like many others I too buried them deep under to make sure it doesnt affect me now and live to fullfil my fase dreams may be by standing in a queue before a temple. I appreciate whole heartedly few brave souls like you for your determination to change something.

Hey crab I am really sorry if any of my statements have hurt you. Dreams are dreams, there is nothing true or false in them, they are always sweet because they are the hope to live. I wish you success in your endeavors, wherever you may be pursuing them. But I just want to convey that if ever in life you have to come back to India then do not take it as a failure, make that home coming a happy home coming and don’t wait for opportunities to knock at your door, create them on your own!

Thanks Dr Vimoj, Mallu, and kalakauaa. I think so many people favoured my views in the post because the post reflected their own views. Excuse me for saying this, but Britishers left a legacy to Indians, "Indians have been called good servants but bad masters". We usually need to be told the way to success but I think that we should carve out that for our own, and this is the first thing that we doctors need to learn.....

Hey Mallu last line of your post just strengthens my conviction that everything is so relative, I mean there is nothing good or bad actually, all is relative and depends on the situation where that thing applies. I believe in this strongly because among the first lessons of morality I got in childhood was "Always speak truth. But you can tell a lie if you do no harm to someone and by that lie you can save someone"......

Dr Vimoj himself has wrote wonderfully well in another article, nothing more to say to him. Dr Kalakauaa bhai, I am also a struggling PG aspirant for now... I wish to be a good doctor in future. what future has in hold for me is not so sure but I plan to manufacture some medical equipment so that things become cheaper and could reach more people. I surely can not change the system but if I could rope in few doctors into enterpreneurship then I hope it would be beginning of a new trend where doctors would not wait for the examiners to become generous on them and enter biomedical instrumentation field where they would collaborate with Indian engineers to launch some of their own products. The need for post graduation is stressed by lack of proper education at graudation level. It is not a secret that some of the top most cardiothoracic surgeons on India are just MBBS. So if people can stand on their own monetarily then they could learn whatever they wish to practice..... PG does not give some magic key, it is only a three year guided practice.... So why not do that guided practice in some other way. Creating a supply to rural areas with cheaper equipment would automatically generate more jobs and doctors would not be harassed to work at village level for lack of technology. All this is distant dream though but not an impossibility.... Every country rose like this only and our doctors go and work in rural reas in US and UK only because those places have better infrastrucutre. The high cost of medical equipment is the main bottleneck for development of infrastructure at our rural areas.........

Rest all of you are torchbearers yourselves, you all have your own dreams to fulfill and therefore you have your own ways......

"Money is not everything. Make sure you have lots before you say that."
"Money is not everything. Only ones who has lots would say that."

Members, this is not a post by mistake. It belongs to this very interesting thread.

I appreciate the both the wisdom of some members and the honest confessions of others.

It is sad that the so called wise, respected/respectable doctors are sometimes forced to be at the bottom of the heirarchy. I have done my UG from one of the best Govt medical colleges in the country and believe me for some of the medical students/doctors - all this philosocphical stuff/ upliftment of society etc doesnt sink in. Its not their fault. They are at level one or two.

My sincere request to those at the top:
Please understand the plight of those at the bottom/below you.

Please note:
When I say the lower levels, I am not talking about examiners who take money but poor doctors who have to support a family with 3000-6000 Indian Rupees. Inspite of all this, a few enlightened souls(probably equatable to God), still help improve health conditions in the country.[/b]

First, I want to thank simba_smiles for THE article which lead to this thread.

I am happy for those who still feel very respectable and happy about how things are. I appreciate their dedication to medicine, country etc. I am happy with my situation and what I am doing. But, But, But, But I am not happy with the situation of the doctor community.

No matter how respectable some doctors(members) might feel, they have to agree that the profession is losing respect and so are other professions - like Bruno pointed out early in the thread. I have friends who have quit medicine and in IIM, IAS, B.Tech etc. There is increasing dissatisfaction among all professionals but doctors seem to bear the brunt. To point a few - doctors rate very high on suicide rates and divorce rates. Now what is that due to? Is it the obsessive nature? Is it the loss of family life? Is it lack of money? Is it because a student didnt pay him for passing out? Is it just biologically determined which we have no control over?

Rather than debating about the respect, the money, the dedication, the poor, the medical instruments, the examiners touts, PLAB and the likes, I would concentrate on "Why did all this happen? What can be done now? How? Where? etc".

Is there a solution we can think of?

Not all doctors have come to the profession with a good thought about the future. Barely eighteen and without any guidance of what is in store 10 years later - you dwell into this journey.

The reasons being:
pressure from the family
thinking medicine is the best profession
thinking doctors can make money
hoping to serve mankind.
to lead a decent life with a wife and a child.!!
do research.
lose social life and family life?
many others.....

My solution:
Very much like primary, secondary and tertiary prevention:

Primary: During the 10th to 12th standard.
I would suggest that all students betwen the 10th and 12th std be given career counselling as part of the curriculum. Starting from how long he/she might take to settle to the money, respect earned, kind of service that will be delivered, family life, social life, chances of death/suicide/accidents...... ..list goes on. But it could all be discussed at that stage where one can choose a profession and hope the counselling/discussions helped him choose a profession. Atleast one wont blame others for it. Agreed sometimes teh inevitable happens which we all have to face.

Secondary: Those who have doing UG/PG and are beginning to feel disappointed ..
Look into long term consequences of changing profession or newer fields in medicine which might interest you and give you what you expected. Again, a career counselling might be required if the person cant do it on his own by talking to relatives, friends and colleagues.

Tertiary: Those who are doing PG/ done PG and then realize that the 10-15 year long journey is not what they wanted to travel...
What can I think of? nothing. What kind of rehabilitation would work? I dont know.

Criticisms are readily accepted and suggestions are welcome.

Note to RxPG team: I am unable to use formatting with bold/italics/colors etc. Please give me a solution.
You all must be aware of the fact that a simple strip of cetrizine of a very famous pharmaceutical company in India is sold at Rs 2 at a wholesale shop and same thing is sold at Rs 27 on a retail shop just 100 m away from that. So you can very well estimate the actual manufacturing cost. Same is true for every household item starting from harpic to coca cola. Now the point is, the foreign investment in India has definitely brought a revolution but in some different aspect. Good marketing can make the same strip sell at Rs 40 but then we can not help our people that way... The already existing high price is of that strip is just to keep it at par with the foreign brand…. I understand that the foreign companies spend huge amounts on scientific research and product development but I hope that you would not deny that the same things can be done in India at far less costs…

So here is the place where the Indian entrepreneurs have to make a dent. The Indian made titanium prosthesis is not accepted because of small lacunae in the manufacturing process and so the patients are bound to buy a thing that is double the cost. I wish the things to be developed in our land so that the drugs become cheaper, the lacunae in prosthesis should be improved upon so that our material sells more... The lacunae are simple and well known. The medical instrument itself may not be costly but then value addition occurs by the software which are added later. So why not develop our own software??... Do you think we have dearth of people who can develop information systems for hospitals??... Simply selling that coming from abroad would fetch far less profits than selling something of our own made. We need to sell something which is cheap and of more utility to our doctors and this would also add to the service of the nation. This was the quality that made Jamshedji Tata unforgettable in Indian history. Further, with India progressing towards development the days are not far when insurance sector will takeover the medical scenario and then the effect of utility and quality would surpass the effect of publicity.

You people are masters of your own medical specialties and have enterprising attitude, so why not help our patients in a way that has more far reaching consequences than a mere three day prescription.... The beginning has to be made by making a platform where the technical people and your demands as medical specialists can collaborate… The initial investments may be at stake but then harvests would be huge if direction is right….be it software, be it metallic implants, be it polymers, be it anything…..

PS: I tried to be as plain as possible but excuse me if I sounded chauvinistic. I could not help that because like many others I also want to see India back to its glory of 'golden bird'.

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