letter to MCI by DHO Bijapur, Karnataka

To,

Dr SK Sarin

Chairperson, Board of Governors

Medical Councilof India                                                                              

Pocket - 14, Sector - 8

Dwarka Phase - 1

New Delhi – 110077

Phones: 011-25367033, 25367035,

                     25367036,25367037

14 Jan 2011

Dear Sir,

            I am writing this letter in the capacity of - District Health and Family Welfare Officer, Bijapur ,  (Karnataka State).

            This is with reference to the proposed new curriculum for undergraduate medical education as outlined in the document “Vision 2015”.

In India 80 to 90 % of Medico legal Autopsy cases are done by Medical Officers with only MBBS qualification with meager knowledge gained during II phase MBBS with no medico-legal training during internship. Most of the new recruits to rural health services have fear of Medico legal work because of inadequate training at UG level which is the main reason for dislike / discontinuation of the service.

I have been working in Rural Health since last 27 years as a District level health officer in various capacities & according to my perception working at PHC/CHC involves lot of application of Forensic knowledge in day today practice of medico-legal cases, especially conducting ML – Autopsy. I find almost every new Medical officer joining into health services lack basic knowledge about in handling Medico-legal cases & issuing of various medico legal certificates.

These doctors are not facing any problem about pathology, microbiology, pharmacology or any clinical subjects but they are afraid of Medico legal cases. When any Medical officer encounter a Medico legal case he panics and tries to contact any person who know something or to department of forensic medicine & toxicology. I have seen many Medical officers going on long & un-authorized leave whenever they are summoned by court in any medico-legal case because being harassed by defense-lawyers due to their inadequate Medco-legal knowledge.

From day one on the duty he/ she has to perform autopsy, alcohol case examination, sexual offences cases, injury reports, age estimation etc. but not the investigation like microbiology or pathology or any other subject.

Presently teaching of Forensic Medicine & Toxicology has been neglected at the UG level, as a result of which a basic doctor with an MBBS degree has very little idea about practical aspects Medico legal cases.

Same problem exists with knowledge of Toxicology, as it is not a significant component of UG teaching. So a basic physician has very little inkling about effective handling and management of poisoning cases, leading to high mortality (the highest in the world), as well as miscarriage of justice in fatal cases with criminal overtones.

I feel that the MCI must develop Forensic Medicine as a Clinical subject with One month compulsory training during internship in the department of Forensic Medicine, so that there would be proper assistance to physicians managing Medico legal cases at peripheral levels.

If the subject made non-core it is going to affect quality of Medico legal Autopsy as well as issuing of various ML-certificates as required by the Law of the land (which in fact is in a very bad condition even with present full-pledged teaching of forensic medicine).

Unfortunately, I feel that the document “Vision 2015” is retrogressive with regard to Forensic Medicine & Toxicology and  this will further dilute the importance of this speciality among students and faculty of medicine leading to even more neglect.

            These are a few suggestions that if implemented effectively, will enable even a basic doctor working in a peripheral hospital like PHC / CHC work more effectively & efficiently.

1. Forensic medicine teaching in the final MBBS with One month compulsory training

    in Forensic Medicine during internship.

2. Before allowing a basic doctor to conduct an independent ML-Autopsy, he/she 

    should have personally conducted minimum of 25 autopsies ( As similarly done   

    with abortion in MTP Act).

3. Every District hospital should be attached with a teaching Medical college, with    

    all medico-legal cases being handled by department of Forensic Medicine.

           

With regards,

Yours sincerely,

District Health and Family Welfare Officer, Bijapur

Copies:

1. Dr SK Sarin

D-I/187, Chanakya Puri

New Delhi 110021

2. Prof Ranjit Roy Chaudhury

Y-85, Hauz Khas

New Delhi 110016

3. Dr. Sita Naik

J-708, Wembley Estate

Rosewood City, Sector-50

Gurgaon 122001

4. Prof RN Salhan

C-1/1233, Vasant Kunj

New Delhi 110070

5. Dr Devi Prasad Shetty

Narayana, 393, 3^rd Block

Koramangala, Bangalore – 34

6. Prof Gautam Sen

51, Jupiter Apartments

Cuffe Parade, Mumbai 400005