A casual walk through the corridors of S.M.H.S. Hospital will drive you nostalgic, especially when you are working elsewhere.  It is here, you were grilled, groomed and made malleable, to fit into the demanding mould of a doctor.
As I was walking through its corridors sometime back, I saw a group of doctors, discussing what seemed to be a serious matter.  I did not find it proper to interrupt them but was curious to know as to how they are doing in their profession! This group represents our cream- a group of super- specialists, whose presence converts a general hospital into a tertiary care centre.  Glad to see them back in the service of their alma mater.  To get into medicine means overcoming tough competition, to get into post-graduation means surpassing a difficult hurdle and super-specialization means actually overshooting the mark!  These doctors must have dreamt big, maybe bigger, first to become doctors, then specialists and finally super-specialists. Can’t imagine the amount of oil they must have burnt to reach their goal!  Super specialists stand at the apex of the health care delivery system -making health policies, running health programs and assessing the system in its entirety.  But, what are our super specialists doing and what role have we assigned to them?
We have engaged half a dozen of them on an ad hoc arrangement at the prime hospital of the valley.  The arrangement is for one year and then it can be extended----I could understand now, what those guys must have been discussing in the corridors  when I saw them last---- Is it their future as adhoc consultants or what? Interestingly ! Gulf did not amuse them, West did not attract them, as they chose to be back home-as what, and for what, I don’t know? I am told PSC found them overqualified, rather over- smart as all of them were rejected with a clean remark, ‘specialists desired not super specialists? In such circumstances, this adhoc arrangement is all they can get.  This arrangement is also there, thanks to the people who have extended ‘contractual assignments’ from education to medicine everywhere, otherwise these poor fellows would be jobless!
There were times when specialists were sponsored to get advanced training in the institutions of repute so that there was no shortage of trained manpower in the state, who would provide quality care to the patients.  And these are the times when trained manpower in an accessory to be involved in a contractual assignment!
If this is the plight of super specialists, specialists are doing no better.  Our system has made a good useless lot out of a huge stock of intelligent minds and diligent workers.  Contractual assignments are a dream for these doctors, They are getting into a mad race for tenure appointments as senior residents and registrars. Only a few lucky ones make I to these-rest have no option but to rest!  With many dreams to chase and families to support, most of them head towards the unsteady destinations in Gulf and juicy options in America.  Survival, man! And it is here that it scores over struggle!  Every year hundreds of specialists leave their homes unwantingly - just to survive!
And then our graduates, 400-500 of them are produced every year from Medical colleges within and outside the state.  The best ones go to medicine, their mothers wanted them to serve the sick, their fathers wanted them to be the ‘Saviors of humanity’--- But, they have no jobs, their restless souls and inquisitive minds- better find a corner in their homes for further studies(this can at least assure them a temporary residency somewhere),otherwise they will end up as frustrated doctors who have to get used to carrying placards, ‘We want work’ or they might bid a farewell to the profession with no regrets after seeing the darker side of it, with all excuses to parents who cherished this profession for their children.  ‘Sorry! Mom! It did not fetch me a livelihood!” They will end up saying. Though,  people like Shah Faisal make the switch overs memorable!
Here is a paradox! Europe and America readily absorb our doctors, pay them better than other professionals and give them opportunities to excel. This poor State does not know how to handle the professionals and use them for the betterment of our ailing health sector! The doctor patient ratio in America and Europe is less than 1:300 whereas here it is more than 1:1500.So who should be utilizing the doctors more? Govt .spends 16 -17 lakh for producing a doctor and then dumps him in heaps of the unemployed! Crores are spent on post-graduation and post-doctoral programmes running within the State,but the end products are not utilized. How strange! With doctors sitting idle in such huge numbers and our healthcare system in shambles, how is it that we plan to revive it?
With available super-specialists shouldn’t there be another tertiary care hospital in Srinagar to distress the SKIMS and to meet the ever increasing demands of patients?  Super specialist services save state’s money from unnecessary referrals, the state cannot tread on the path of development unless quality care health services are provided to its people. . We need the super specialists to create departments, to train manpower and these responsibilities cannot be assigned to people on contractual arrangements.
With a large number of specialists waiting to be absorbed, why are our hospitals in peripheries defunct?  Specialists at the peripheries can greatly decrease the burden on tertiary care centers and improve the functioning of health care units there.We need to aggressively involve them to improve our peripheries.  Their benefits need to be enhanced and their working conditions in peripheries need to be improved.  If Government  Sector is saturated, specialists may be encouraged to set up private nursing homes and hospitals in remote areas on ‘public private partnership’ schemes.  Nonresident Kashmiri doctors can also be involved in such endeavors. Surplus doctors in the state should encourage the state to open a few more medical colleges in remote districts so that job opportunities are enhanced and health care is improved.
The growing number of medical graduates is our real potential.  They are the ones who need to be encouraged to stick to the profession and involve themselves in community service and devise innovative methods to help overcome the burden of diseases in our community.  Scholarships and fellowships should be there to encourage the best of the best! Let us know that these youngsters have the potential to reach the moon if not the stars-let us not throw them in wells where they spend rest of their lives creeping its walls!
India badly needs doctors-to provide basic health care  facilities to the large population of rural India.,  On a need basis a truncated course in medicine is being started to cater to the demand of rural India.  But with so many unemployed doctors in our state which way  are the health planners looking?

(Feedback at rumanahamid@rediffmail.com)

Lastupdate on : Tue, 15 Jun 2010 21:30:00 Mecca time
Lastupdate on : Tue, 15 Jun 2010 18:30:00 GMT
Lastupdate on : Wed, 16 Jun 2010 00:00:00 IST