Dear Sir,
I would like to point out that certain annexures to the Vision 2015 document are missing from the MCI web site. It would have been desirable to make them available openly.
My views regarding Vision 2015 are as follows:
1 It appears that the MCI has taken a view that forensic medicine is a minor subject and emphasis on it can be curtailed, particularly at the undergraduate level. This is evident from the reduction in teaching hours and required faculty strength.Forensic medicine is an extremely important subject and needs to be strengthened. Any decision to further curtail the already inadequate infrastructural facilities as regards faculty strength in the departments of forensic medicine would be certainly harmful and undesirable. Besides the Vision 2015 document, this is also clear from the Notification Nos. MCI 34(41)/2010-Med/29127 & MCI 35/(1)/98-Med (ii)/29127 dated 17th Sep. 2010 pertaining to staffing pattern in Forensic medicine. The guidelines in the notification reduce the faculty strength by one third to one half. It is crucial to keep in mind that any dilution of standards, emphasis and facilities and faculty in forensic medicine is not only against accepted principles of medical education but is also against the interests of the society at large. The services provided by the forensic medicine specialists in the medico-legal field are crucial to maintenance of law and order and peace in the society and for assisting the judiciary in administration of justice. The need for medico-legal expertise has increased all the more with the general increase in crime, including newer types of crime calling for latest forensic techniques and related research, but also the recent spurt in medico-legal / medical negligence cases subsequent to the Consumer Protection Act, 1986.
2 The importance of forensic medicine is further highlighted in the report, dated 2007, submitted by a committee chaired by Former Chief Justice of India Mr. Justice Venkatachalaiah. The Committee prepared a draft on “revision of undergraduate medico-legal curriculum”, which stressed the need for giving more importance to ‘forensic medicine’ in the training of a medical graduate. The report can be viewed at--http://medind.nic.in/jal/
3 If any further evidence for the crucial role of forensic medicine for the society is needed, it is worth pointing out that proper forensic investigation results in a marked increase in conviction rate. Available data shows that the conviction rate in CBI cases is 60% compared to merely 6% in those investigations by various state police. The difference is basically because the CBI utilises expert (forensic) scientific evidence which is neglected by the state police. The neglect of forensic medicine by the MCI is bound to deteriorate the situation further.
4 It appears that the Undergraduate Education Working Group 2010, which is part of the Vision Document 2015, convened by Prof. George Mathew is of the view that the forensic course need not be taught separately and may be combined with other subjects. This suggestion is difficult to support.
5 Forensic medicine concerns either live humans who have suffered injury or those who have died as a result of injury in spite of treatment. In both situations, it is clear that the forensic medicine deals with patients, living or dead. It is worth pointing out that there is even an important branch of forensic medicine known as clinical forensic medicine. It is thus necessary and appropriate to teach forensic medicine during the clinical semesters / final year of MBBS. This is especially important because toxicology is coupled with forensic medicine.
6 In view of the importance of the subject, a case can even be made out the number of examination marks allotted to forensic medicine should be 200 like any other major subject.
7 Since MCI is the body that grants recognition to medical colleges, it is absolutely essential that recognition should be given only when the medical college has necessary infrastructure for a mortuary and autopsy facilities and has already secured permission from the government authorities for conducting autopsies and is actually conducting medico-legal autopsies. This should be treated on the same lines as a working hospital with minimum standards is a must for granting recognition to a medical college. As a matter of fact, conducting autopsies on patients who have died as medico-legal cases should be considered an essential part of a hospital’s functioning and a teaching hospital should not be considered as complete if autopsies are not being conducted in it.
8 Forensic medicine stands at a different footing than other subjects in a medical college. While other subjects are concerned only with imparting knowledge and skills and doing research, the forensic medicine departments / specialists perform the crucial function of providing valuable inputs for criminal investigation as also for criminal adjudication by acting as expert witnesses in medico-legal cases. The Supreme Court and several High Courts have emphasised the need for adequate forensic support in investigation of crime. The recent examples are the Nithari case where high quality forensic evidence was collected by experts and the culprits were brought to book. On the other hand, sloppy investigation / autopsy in the ‘Aarushi murder case’ by mere MBBS non-experts resulted in a situation where the CBI could not trace the culprits.
9 A time has come when super-specialties of forensic medicine need to be developed by designing DM / DNB / PhD courses in areas like Forensic Pathology, Forensic Radiology, Forensic Anthropology, Forensic Toxicology, Clinical Forensic Medicine, Forensic Dentistry, etc. This can be possible only when forensic medicine is given adequate emphasis at undergraduate and MD level. The Vision 2015 document seems to have ignored this aspect.
10 It is also necessary to provide for at least 15 days’ compulsory posting during internship in the department of forensic medicine. It must be mandatory that during the course of MBBS studies, including the internship, a student should have actually observed / assisted in a minimum specified number of post mortem examinations. It is surprising that the Vision 2015 document for undergraduate education finds no mention of autopsy at all. It is well known that probably 90% autopsies in India are conducted by MBBS doctors, particularly in the rural areas.
I hope the MCI will view my comments in the proper spirit in the over all interest of medical education, as also the interest of the society with which the specialty of forensic medicine is intimately connected through its linkage with investigation and containment of crime.
Thanking you,
Sincerely
Mukesh Kumar
A133 UCMS and GTB Campus
Delhi 95
Ph – 9810635717
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