The "now or never" situation
By Murtaza Ahmad Shah
WHEN a very small change in the initial conditions, such as the flapping of butterfly wings, creates significantly large changes in the outcome, like the causation of tornadoes several weeks after the flapping, it is called "the butterfly effect". And yes, it is a real phenomenon occurring in our everyday lives. Simply put, "small unnoticed actions with serious large consequences' ' is what it all means. And this phenomenon is all in operation nowadays in our healthcare apparatus - the "butterfly flap" being a recent notification by the Medical Counselling Committee (MCC) and the predictable outcome being a disastrous tornado for the UT's healthcare setup. The ongoing protests for the past few days by MBBS students of various medical colleges of the UT are meant to prevent the potentially destructible and irreversible chain of events to take place. I, here, try to provide a detailed understanding of why it is a situation of "now or never" for the healthcare setup of J&K.
According to the said notification, J&K is likely to participate in the All-India Quota (AIQ) for NEET-PG seats this year and onwards. This means that 50% of PG seats each from GMC Srinagar and GMC Jammu, and 100% of PG seats from SKIMS Srinagar will pool into AIQ, rendering very few seats reserved for the local doctor PG aspirants of J&K. Had the decision been for any other state or UT, it wouldn't have mattered and would have rather proven to be fruitful. Because after all, this is what competition is all about - letting all competitors compete for the same opportunities and ensuring the best quality of skillful minds to get through. Right? Wrong!
For J&K, the equation is not that simple. It has many variables which all complicate the picture.
MBBS undergraduate students, like other students of J&K, suffer academically most of the time given the frequent internet and other communication gags and shutdowns. This is a direct result of the inevitable fact that ours is a politically volatile region. We recently experienced the world's longest internet shutdown in a democratic country post-Abrogation of Article 370. It was 213 days of continued internet blackout. Before that, we experienced the 2016 internet blockade. According to Internetshutdowns.in, Kashmir accounts for nearly half of the total 413 internet outages that India has seen since 2012. This is worsened by the fact that almost all of the preparation for NEET-PG is done online.
Therefore, students here, compared to the rest of India, have inequitable access to resources. Our students don't have access to the same resources of learning and education which students outside of J&K enjoy. How can anyone ignore that? How can policy makers completely forget this variable?
The direct consequence of forcing us into such an unequal competition would be our UT losing its large chunk of local medical specialists who were trained as doctors in our own medical colleges. What a huge waste of resources, both human and material, that would be!
Doctors trained in their own state/UT should preferably serve that state/UT as during the training course, they get to know the pattern of illnesses in a given population (epidemiology). Medical experts know that such a pattern varies from place to place. Thus, when doctors serve the region where they were trained, their training would pay off more aptly and people would be served.
Consequently, flocking non-locals into our healthcare setup would adversely affect patient care here because of one peculiarity: our population is mostly rural who rarely know non-local languages. The resulting language barrier between a non-local doctor and a local patient would impact patient-care, as diagnosis directly depends on the clinical history a doctor extracts. Some would argue that compromising on language barrier for better competitive doctors isn't that high a stake but you forget to account for the already low doctor-patient ratio in J&K. According to a 2019-report, it is 1:1880, one of the lowest in the country. It is still lower in the peripheral areas of the UT. Adding to it, the compromise you did in patient-care in the tertiary institutes over language, epidemiologic training and local specialists, it translates into literal demise of the system.
Our healthcare system has had this experience of suffering irreparable damage due to the same decisions when they were implemented in the super-speciality courses (DM, MCh). We are facing a serious dearth of super-specialists in J&K due to the very same reason that we allowed pooling of super-speciality courses into AIQ earlier, and now the same is being done with the specialty courses (PG courses).
The solution to this abused equation is, therefore, simple enough. Unless the decision is revoked, it would be the final nail in the coffin of our already crumbling healthcare system.
Views expressed in the article are the author’s own and do not necessarily represent the editorial stance of Kashmir Observer
- The author is a final year student SKIMS MC
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