Rough Draft VISION-2015 IAFM Memo
1.The MCI in its proposed UG Medical Education 2010 in its introductory part had
highlighted “VISION – 2015” having the national goal Health for All by reforming
the medical training to produce capable physicians for first contact and to
provide basic medical services and quality health care both rural and urban
areas of the country. While the MCI expressed its concern about the burden of
diseases in India perhaps it has forgotten another kind of medical service which
is an obligatory duty of a registered medical practitioner towards the state &
society i.e., the medico legal service assisting the judiciary in preventing
crimes against human beings. To achieve that objective the subject of F.M. &T.
should be treated as a core subject and not an elective subject while imparting
training to the medical students. As per the prevailing law of the land a passed
out MBBS doctor must have reasonable knowledge of Forensic Medicine to render
the medico-legal services. This responsibility of a doctor cannot be withdrawn
without amending the current Cr.PC, IPC, & Indian Evidence Act. On the other
hand if that subject will be considered as elective (optional) the doctor will
have a right to refuse to attend medico-legal cases expressing his/her
incompetency pleading lack of training & skill in the subject. Hence Forensic
Medicine cannot be an elective subject and it must be in the core subject group
(compulsory).
2. The projected need and shortage of teachers as projected under Table 3
pertaining to Forensic medicine is nothing but a bundle of lies. The figures are
totally cooked-up. It is evident with the current need as per their own
guidelines and account the same can not be equal for departments like Surgery,
Pathology as well as Forensic Medicine since already the requirement for FM
teachers were least in comparison to other branches. The table shows all at 2000
each. Further the table shows the current shortfall as 1500; again it has been
goofed up completely. As per their own account (information available at
website) there are total 1493 forensic medicine teachers (1390+103) i.e. approx
1500 whereas the table shows only 500 teachers in place. Upon further scrutiny
it was also observed that names of so many faculty members are not appearing in
this list whereas they are very much working in various medical colleges.
According to rough estimate at least names of about 100 forensic medicine
faculty are not reflected on website. That means there are more than 1600
forensic faculty are in place. If one takes into account the current need; there
does not appear any shortfall as projected.
Similarly the projected need (2000) also can’t be same for all the subjects i.e.
Surgery, Medicine, Patho as well as Forensic medicine as per present
requirements of medical teachers. There are almost 100 seats of PG in forensic
medicine all over country so we can expect that 100 prospective faculty will be
added every year to present pool. In present circumstances when the opening for
jobs is meager (only in medical colleges); the students will be encouraged to
take only when sufficient opportunities exist. In fact by increasing the age of
retirement and by regular production of MD in forensic medicine, the additional
need which will arise in due course of time will be taken care of these MD pass
outs. So the additional need as projected (3500) appears to be absolutely
inflated.
3. The vision document-2015 which is advocating integrated teaching programme
contradicting its claim in disintegrating an integrated subject by fragmenting
the branches of Forensic Medicine & Toxicology. If the subject will be taught in
fragmentation there will be very negligible impact in the development of skill &
knowledge in the mind of the trainee & as such it will yield adverse result in
the interpretation of medical facts during the administration of justice. Hence
the subject of F.M. & T. should not be disintegrated rather recent advances in
the technology should be included in the syllabus to make it more useful.
4. We agree with the broad suggestion as per this document that the subject of
F.M. &T. should not be grouped under pre or paraclinical disciplines but under
clinical discipline because of acquiring inter-disciplinary knowledge. After the
students are equipped with pre & paraclinical knowledge & involving themselves
in clinical subjects like Surgery, Casualty (Emergency Medicine including
poisoning cases), Obst &Gynae, Ortho, ENT, Ophth., Anesthesiology etc; the
teaching of F.M.&T. will be more effective because the very definition of
forensic medicine (as accepted by law) is “Application of knowledge and
principles of medicine in the court room for administration of
justice.”Therefore Forensic Medicine should be taught from 3rd to 9th semester
and the examination should be conducted at the end of 9th semester.
5. Forensic Medicine is not a theoretical subject it is very much practical
oriented, unless a student have practical knowledge he/she cannot meet to the
expectations of the investigating agencies & judiciary who mostly depend upon
the medical opinion to deliver the justice. Therefore it should be made
mandatory for exposure of the students to practical medico legal problems like
Postmortem examination – Forensic Pathology, Examination of Injury cases
including examination of weapon of offence – Forensic Traumatology, Examination
of Sexual Assault (RAPE-examination of victim as well as accused) cases – Sexual
Jurisprudence, Estimation of Age, Disputed Paternity cases- Clinical Forensic
Medicine, Suspected Poisoning cases including alcohol intoxication-Management,
Documentation, Preservation & analysis of poisons – Forensic & Analytical
toxicology. Therefore for the interest of the students (would be doctors) & for
the larger interest of the society before giving permission/approval for opening
of new medical colleges; the MCI should insist upon the prospective institutions
for a functional unit in this regard like functional mortuary to conduct
medico-legal autopsy (after getting the due notification from concerned state) ,
functional Casualty under clinical forensic medicine, separate toxicology unit &
required laboratory facilities to start or continue medical education, just like
requiring no. of beds/ units/ dept. in the clinical disciplines.
6.While the MCI & IMA are pressing hard for inclusion of a man of medicine to
the tribunals like Consumer Courts dealing with cases of alleged medical
negligence apprehending miscarriage of justice due to misinterpretation of
medical findings , suggestions of VISION Document reg outsourcing to a lawyer
for teaching forensic medicine to the medical students appears totally
unjustified and ridiculous. Just for the information of the BOG-MCI we want to
point out that the forensic medicine experts are taking orientation classes for
judiciary and police officers in their respective training schools/academies
during their re-orientation/induction programs as per the current national
programme suggested by Hon’ble Supreme Court.
7. It is our experience that the clinicians are invariably overburdened with
patient care and so neither they want to be involved in medicolegal work nor
like to be even approached by police for various queries & subsequent deposition
for giving the evidences in the court. Since they are not tuned to handle this
part it will again be a futile exercise of course compromising with the quality
of medicolegal work. So many times the courts have even taken cognizance of it &
has been adversely reflected in the verdict of judiciary.
Last but not the least everybody knows that MCI is a professional body
constituted by the representatives of RMP either elected or nominated. The
members are not the representatives of the Govt. but advisors to the Govt. A
slightest wrong advice will not only affect the medical profession but may cause
severe damage to national health programme. Therefore before suggesting any
reforms in the medical education the BOG-MCI should not only consult with all
the streams of medical sciences especially affected ones but also each and every
dept. (Health, Home & Law) directly or indirectly involved in this reformation
process. We would like to submit that present duration of 4 ½ years has worked
very well and as a result India has produced quality doctors over the years. Any
dilution of subject of forensic medicine and toxicology will only be detrimental
to quality of medical education imparted as well as affect the society if the
medicolegal cases are not investigated properly. Yes we do agree that the
present curriculum needs be restructured for its adequacy, effectiveness
commensurating with incorporation of recent advances as mentioned before
according to need of country; not to forget of the fact that what is expected
from MBBS doctor.
You may add more inputs at your end.
At this stage If we can just spread this messsage it will be of great help. Most
important thing to be atken on priority is seeking the extension of dates. Of
course simlutaneously everybody has to file his own suggestions with a copy to
me as mentioned in the tips.Please act fast.
With warm regards
Dr. Adarsh Kumar
General Secretary, Indian Academy of Forensic Medicine(2010-2012)
Faculty, Forensic Medicine & Toxicology
R.No.315, 2nd Floor, New Forensic Wing
All India Institute of Medical Sciences
Ansari Nagar, NEW DELHI- 110 029, INDIA
Ph: 09868438856, 0120-2462449 (Res.)
0091-011-26546467(Off);0091-9868397146
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