Dr Shakti Kumar Gupta
The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) was announced in 2003 with objectives of correcting regional imbalances in the availability of affordable/reliable tertiary healthcare services and augmenting facilities for quality medical education in the country. The PMSSY has two components – the setting up of AIIMS-like institutions and the upgrading of Government medical college institutions.
Under Phase-I of the PMSSY, six AIIMS-like institutions were set up one each in the States of Bihar (Patna), Chhattisgarh (Raipur), Madhya Pradesh (Bhopal), Odisha (Bhubaneswar), Rajasthan (Jodhpur) and Uttarakhand (Rishikesh) at an estimated cost of Rs 840 crore per institution including nursing colleges.
The setting up of four new AIIMS-like institutions was announced in the 2014-15 Union Budget speech -one each in Andhra Pradesh, Maharashtra, West Bengal and Poorvanchal in UP.
During the 2015-16 Union Budget speech six new AIIMS institutions were announced – one each in Assam, Himachal Pradesh, Jammu and Kashmir, Punjab, Tamil Nadu and Bihar. The Government has also announced the setting up of two All India Institutes of Medical Sciences – each in Jammu and Kashmir as part of the Prime Minister Development Package for J&K.
Presently the cost of setting up a new AIIMS is approximately Rs 2,000 crore and there will be 960-bedded hospitals with Colleges of Nursing and Dental and AYUSH training facilities. Each institute will require about 250-300 acres of land.
It is heartening to note that the Government is striving hard to extend the facility of quality care rendered by the AIIMS in Delhi to other States. This is a welcome move as it will also help in decongesting the AIIMS and providing more time for every referral case.
It is very important that the new institutes, which have been opened, are provisioned with quality doctors to render training and healthcare. This aim can only be achieved by mentoring from the existing institutes of excellence like the AIIMS, New Delhi, the PGI, Chandigarh, the SGPGI, Lucknow and the JIPMER, Puducherry.
ROADMAP FOR MENTORING
The development of the medical facility is an essential part of reforming the curriculum. It is imperative to understand that the student learns what his/her teacher practises and not just what the teacher teaches and faculty capacity building is a low-cost investment. In order to build strong foundations of the faculty mentoring has to be customized to the existing needs of environment. The medical fraternity is now looking for a need-based curriculum and wishes to shed the conventional track of traditional and rigid methodology.
The following measures are suggested to be taken by authorities:
* At the recruitment stage experts from existing autonomous institutes of excellence should be there in committees for the selection of members of the medical faculty.
* The freshly recruited doctors should be trained under the mentorship of selected doctors from the respective specialties.
* Doctors from institutes like the PGI and the AIIMS can be sent on deputation to oversee the incubation period of various departments and their faculty.
* Members of the faculty from the AIIMS, New Delhi, and the PGI, Chandigarh, should be sent on three to five-year deputation to establish departments and create the same working culture there. They should be paid a dignified deputation allowance. While on deputation they should be allowed to maintain liaison with the parent institute and their research activity should go on unhindered.
* The faculty should also have the option to retire from the parent organization and take up the challenge of establishing a startup organization.
* It is important to devise a training strategy on the Development of Work Culture and Ethos and the augmentation of the skill base which can only be shared by expert mentors who are ingrained in the existing philosophy.
* The training calendar so planned should have a common entrance test, a common curriculum, and uniformity in student exchange programmes.
* There should be common capacity building programmes for the faculty and the same can be carried out centrally at the Dr K L Wig CMET, AIIMS, New Delhi. This can also be extended to Residents, nurses and other paramedics
* There should be a provision of joint research programmes and multicentric studies can easily be carried out.
* Regionalization of institutes can be planned. Institutes like the JIPMER and the NIMHANS can be mentor institutes which are being developed in South India. The AIIMS and the PGI can be mentor institutes in North India. This will help the system as local mentors have an indepth knowledge about the demographic needs and healthcare systems which have been successful.
* The use of “Telemedicine” to conduct lectures and seminars to impart training to doctors and webinars to update on the existing scenario can be planned.
* There should be virtual teaching in various network medical colleges with the AIIMS, the PGI, the SGPGI, the JIPMER and other similar institutions.
* Creating a conducive environment to encourage a reverse brain drain is the need of the hour.
* A “Centre of Excellence” for clinical and scientific research can be developed to make India lucrative for skilled professionals.
It was high time we appreciated that the 80 per cent of healthcare expenditure in India is out of pocket expenses. Hence the idea to give right impetus to various AIIMS-like institutes is very relevant in the present times. Making all efforts to support futuristic healthcare development is the need of the hour. If corrective measures are not taken right now, then these huge institutions may well run into a point of no return.
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(The author is the Medical Superintendent of Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences.)
Courtesy: Breaucracy Today
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