Saturday, November 28, 2015

AIIMS announces details for All-India Post-Graduate Dental Entrance Examination

AIIMS will conduct The All India Post-Graduate Dental Entrance Examination (AIPGDEE) on December 13, 2015. The exam will be conducted online by AIIMS, New Delhi for admission to its post-graduate courses.
The eligibility criteria for taking the exam (for the candidates who have applied for the PG course) is completion of the BDS course. Now, they will appear for MDS course under 50 percent all India quota on December 13.
The admit cards are yet to be issued and will carry all the important information including details of the examination centre, duration, roll number, and as required.
Admit card is mandatory to be carried at the examination centre-only then the candidates will be allowed to appear for the exam.
There is already an existing reservation policy to admit qualified candidates to Dental MDS courses. The qualified candidates will be classified in to an all India merit list and state wise merit list- to be prepared on the basis of the percentage of marks obtained in the exam.
As reported by on the further details of the exam:
Examination pattern
The exam will be held for a duration of three hours. The exam will be conducted in a single session from 10 am to 1 pm. The online question booklet of AIPGDEE2016 will have 200 multiple choice questions with single correct response. For each wrong answer, 1 mark will be deducted.
The exam will have questions from subjects taught during the MBBS course including basic sciences, para-clinical and clinical.
Important dates
The admit cards will be available from November 26
AIPGDEE 2015 will be conducted on December 13
The results are likely to be declared on December 21

Friday, November 27, 2015

Doctors Unhappy Over 7th Pay Commission


Doctors allege that their demands have not only been ignored but downgraded too. The objections are widely perceived to stem from the fact that the demands made by them have not been met genuinely. 
Government doctors have raised objection as implementation of the 7th Pay Commission is on the cards. The objections are widely perceived to stem from the fact that, as government doctors claim, the demands made by them have not been met genuinely.

The prime reason being their fears that they might have to see a fall in comparative salaries instead of the expected increase. Doctors attribute the fall to rising prices in the country.
Doctors constitute a sizeable part of the 55 lakh state government and 48 lakh central government employees.
Another reason for this is reduction in non-practising allowance (NPA), which has been cut by 5 per cent; brought down from 25 per cent of basic salary in 6th Pay Commission to 20 per cent of the basic salary in 7th Pay Commission.
“We feel cheated”, says Dr Pankaj Solanki, President Federation of Resident Doctors’ Association (FORDA) and add FORDA is trying to create awareness of this issue among doctors by holding meetings at various hospitals.
There is another rider attached to NPA – it will no more be treated as a component of basic salary, but as separate allowance. This has irked doctors who had rallied for an increase in NPA to 40 per cent.
“The reduction in NPA would mean a number of things; mainly it would mean cancellation of allowances and merger for DA such that there would be a difference in salary to the tune of Rs 12000 – 14000 on day one”, adds Dr Solanki.
Doctors allege that their demands have not only been ignored but downgraded too. The same is true for House Rent Allowance (HRA), the percentage of which has also been reduced.

Resident doctors unhappy with pay panel report

An association of resident doctors in government hospitals today claimed the salary raises proposed by the Seventh Pay Commission are likely to exacerbate the exodus of doctors from government to private healthcare institutions.

The Federation of Resident Doctors Association, a body of junior and senior residents in central government hospitals, said the commission's pay recommendations had done little to address the imbalance between the government and the private medical sector.

The commission, which submitted its report to the Union government last week, has reduced a component of the pay called the non-practising allowance (NPA) given to government doctors for not engaging in private consultations, the federation said.

The commission has proposed a reduction in the allowance to 20 per cent of the basic salary from the current level of 25 per cent, although representatives of doctors had sought a raise to 40 per cent. It has also proposed a drop in house rent allowance to 24 per cent, 16 per cent, and 8 per cent of basic pay from the earlier 30 per cent, 20 per cent, and 10 per cent in tier-1, tier-2, and tier-3 cities, the federation said in a statement today.

The recommendations will raise the starting salary of senior resident doctors from the current Rs 88,000 per month to Rs 105,000 per month, federation office-bearers said.

"This is much lower than what we had expected and much lower than the salaries that doctors with similar level of qualifications would receive in private hospitals," said Pankaj Solanki, a senior resident surgeon at Baba Saheb Ambedkar Hospital, Delhi, and the president of the federation.

The federation has claimed that an assistant professor in a government medical college would have a starting pay of about Rs 85,000 per month, while a consultant in some private hospitals with an equivalent medical qualification would receive Rs 2 lakh to Rs 2.5 lakh. India has over 400 medical colleges that produce about 56,000 MBBS-qualified graduate doctors and about 25,000 specialists with postgraduate MD or MS degrees. But many medical colleges, including government colleges, have long been dogged by faculty shortages.

The pay commission report has observed that the number of medical officers, teaching and non-teaching specialists and public health specialists in the central health services in 2014-15 was 2,942 against the sanctioned strength of 4,006.

But medical faculty in government healthcare institutions said there are certain advantages in working in such hospitals that cannot be measured quantitatively. "Yes, we're overloaded with patients," said a senior cardiologist at the Post-Graduate Institute of Medical Education and Research, Chandigarh.

"But we don't have commercial pressures, we don't have targets to meet, and we get to train the next generation of doctors - some of us see these as benefits," the cardiologist said.

Thursday, November 26, 2015

Bihar health minister asks doctors to be present on duty 24x7

Health, minor irrigation and environment and forest minister Tej Pratap Yadav on Tuesday asked the health department officials to ensure 24X7 presence of doctors in the emergency wards of all medical college hospitals across the state so that patients get all the facilities even in odd hours.

Presiding over a review meeting with health officials at secretariat, Tej Pratap asked the principal secretary (health) Brajesh Mehrotra to also ensure that the government doctors posted in district hospitals and primary health centres (PHCs) reside at their places of posting.

The minister announced he would make surprise visits to find loopholes in the functioning of medical colleges and government hospitals and ensure that doctors are on duty. Strict action would be take against those found negligent.

Yadav asked Mehrotra to keep the emergency wards of Patna Medical College and Hospital (PMCH), Nalanda Medical College and Hospital (NMCH), Indira Gandhi Institute of Medical Sciences and child ward of PMCH working round-the clock. He also issued instructions to make available all the life-saving drugs in hospitals so that attendants of patients are not harassed in getting the medicine.

The minister also instructed the principal secretary to keep monitor the government doctors' posting and duty hours and find out if any of them refrains from duty. He instructed the senior doctors to visit their wards twice at night.

To make government hospitals well-equipped, Tej Pratap reviewed the availability of CT-Scan, MRI, X-Ray and Ventilator machines and asked the officials concerned to get all the non-functional machines repaired. He ordered that cleanliness must be maintained in all the hospitals and agents of private hospitals are not able to misguide and lure patients.

He further instructed all the private hospitals and nursing homes to abide by rules and regulations. Expressing his gratitude towards the people of Bihar for supporting Mahagathbandhan, Tej Pratap said the government machinery would function for the benefit of common people. If anyone faces a problem, then s/he could give his complaint in writing.

Here’s why foreign medical degrees are no longer fancy

As in most areas of the national capital, the plush and the pocket-friendly exist cheek-by-jowl in Gautam Nagar. If one lane is lined with sprawling commercial spaces, another has tumbling apartment blocks crowding its narrow, winding stretch. But what sets the area apart are the multiple training institutes for medical aspirants that have mushroomed there. Proximity to the All India Institute of Medical Sciences (AIIMS) always made Gautam Nagar a hub for young medical professionals. In the last decade or so, the coaching centres here have drawn another league of medical aspirants - Indians who have done their medical graduation from a foreign country and are seeking to clear the mandatory FMGE (Foreign Medical Graduates Examination) that will help them get the Medical Council of India (MCI) registration needed to practice in India.
According to data from the National Board of Examinations (NBE) - the organisation charged with the responsibility of conducting the FMGE - 62,934 foreign medical graduates have taken the FMGE in the past five years. Those who have studied medicine in the US, UK, Australia, New Zealand, and Canada, and are eligible to practice there are exempted from the screening. Of course, for the average medical aspirant seeking a primary medical qualification, these are hardly the port of call. “As per records, since 2011, China has been the most-preferred destination for obtaining primary medical qualification for Indian students travailing outside India,” said a source in the NBE. Russia, formerly the top choice, is now the second favourite. Ukraine and Nepal are the other popular choices. But unlike Indians shifting to the US or UK for post-graduate studies, the driving force behind a foreign admission for most of these students is economics, rather than the quality of education or opportunities offered by these institutes or countries. “I sat for the undergraduate medical entrance examinations in 2005. But compared to the number of medical aspirants in the country, there are very few government college seats. It is very difficult to get in unless you are among the reserved categories. Most private colleges ask for Rs 30-40 lakh just in donations. My family was unable to pay so much money. So I decided to study in China. The course duration is the same as in India, 4.5 years, plus a year of internship. But I spent less than Rs 20 lakh for my complete MBBS programme and stay in China,” explains Jatin (28) from Kerala.
Those who graduated from China in 2014 say they spent approximately Rs 25 lakh. For most students what also makes a difference is that - unlike in private medical colleges in India, where the entire sum of donation or capitation fee needs to be paid at one go - foreign universities allow you to pay the money in instalments over the years. However, tuition fees, living costs and air fare aren’t the only things that need to be covered. “Most students approach an agent to get them admitted. On an average, an agent charges approximately Rs 2 lakhs for the admission,” says Firdaus, a student who completed his MBBS from China in 2014 and is waiting to clear the FMGE.
While this will be Firdaus’s first attempt at the FMGE, Jatin is among the lucky few who managed to clear the screening at the first go and is now pursuing a post graduate degree in respiratory medicine in Mumbai. For most, though, the years in China or central Asia are followed by months or years of tuition classes, more money spent, and multiple attempts to clear the dreaded screening that will give them the license to practice in India. “I completed my MBBS from an university in China in 2012. But even after five attempts I have been unable to clear the FMGE. I have already paid Rs 1,35,000 in coaching classes. My father, 62, is a farmer. He can’t support my studies any more. He just wants me to get back home and work on the farm now,” says Avinash Singh.

The FMGE was introduced in 2002. Before that, like Indian medical graduates, foreign graduates too only had to complete a year of compulsory internship in India before getting their permanent registration numbers from the MCI. Rajesh Sharma, director of Delhi Institute For Advanced Medical Studies (DIAMS), which was opened in 2003 to coach foreign graduates for the FMGE, believes that the screening test was required at the time. “Back then, Indian medical students were mainly going to Russia or other central Asian countries like Ukraine. At the time, the quality of education there was not up to the mark,” says Sharma. “Today, 60 per cent of my students are from China. Philippines is also fast gaining popularity and offers quality education,” he adds. Students, FMGE coaching centres and agents who help place Indian medical aspirants in foreign universities point out the several advantages of studying in China instead of Russia. “For one, internship in China is recognised by the MCI, unlike that done in Russia. So one can start practising sooner on return,” says Sharma. Until recently, China was also cheaper. “In 2010, it was possible to complete one’s education there for Rs 5 to 7 lakhs less than in Russia. But since then, the Rouble has weakened and China has developed faster so it has become more expensive. Also, most Chinese universities have now put a restriction on the number of Indian students they are allowing every year,” says Sharma.

Students insist that, with an eye on the FMGE and to ensure a steady flow of Indian students, universities abroad have evolved an improved pattern of education. “The curriculum in India and these countries is similar. Indians and other foreign students such as those from Pakistan or Bangladesh are not taught in the same class as domestic students. We study Indian books and Indian doctors and professors come down as visiting faculty members,” says Rohit Singh, a medical graduate from China, who has been in New Delhi for a year now trying to clear the FMGE. Some universities have tied-up with coaching centres in India. Delhi-based surgeon Vineet Gupta, who opened the Medical Institute for Screening Test (MIST) in 2012, has tied up with three Central Asian universities. “When I was a senior resident physician, many of the graduates from Russia didn’t even know how to apply a catheter. That is not the case now. Most hospitals in India have foreign medical graduates working for them,” he says. He admits, however, that a small section of Indian doctors are still prejudiced against foreign medical graduates and prefer to work with those trained in India.

While mindsets may change with time, it is less easy to ignore the NBE records. In the past five years, the percentage of foreign medical graduates who have cleared the FMGE has varied between 13.09 to 26.9 per cent. “The suboptimal performance by foreign medical graduates in the screening test is related to the deficient level of training and teaching at institutes from where these graduates are obtaining their primary medical qualification. Besides variance in course curriculum and syllabus in foreign medical colleges vis-a-vis the curriculum notified by the MCI in Graduate Medical Regulations, there is less clinical exposure for foreign medical graduates, which is one of the most important reasons for poor performance in subjects like community medicine, obstetrics and gynaecology and paediatrics,” says a source in the NBE. “The absence of entrance tests in foreign medical institutes is also a key factor”. The NBE says that, between 2005 and 2013, the Ministry of Health & Family Welfare sent delegations to countries like China and Russia to analyse the quality of medical education there. They found the result to be far from satisfactory. It is ironical then that the MCI, on its website, puts up a list of available colleges in China every year.

Most foreign medical graduates admit that their practical knowledge and clinical exposure is less than what is given at Indian institutes - government and public. Language is a challenge. “While most Chinese institutes have English medium classes for Indian students, in Russia the course includes a year’s training in the local language. That is not enough to give the students a good enough grip to study in the language. Even when classes are held in English, Indian students, who have studied in vernacular medium schools find it difficult to keep up,” says Sharma. The alien language is especially a hurdle when it comes to practical study or clinical duties. “Most patients, whether in China, Russia or Ukraine, speak the local language,” says Dia (25), who is preparing for her second shot at the FMGE.

The students and coaching centres accuse the NBE of being high-handed and uncooperative. “They ask post-graduate level questions in the FMGE,” says Jatin. Adds Sharma, “Results are not declared for more than a month. Calls to the helpline go unanswered or generate no satisfactory answers.” Some, like Rohit, accuse the NBE of being hand-in-glove with privates colleges in India. “The poor show at the FMGE is just to give out the message that it’s better to study in India. Not just foreign graduates, students of private Indian colleges too should have to clear the screening “ he says. Others smell a money-making scheme. “Every time a candidate sits for the FMGE, he or she has to pay Rs 5,500. It’s a lot of earning for the Board,” says A Najeerul Ameen, president of the All India Foreign Medical Graduates Association.
The additional expenditure definitely makes a difference for aspirants. “If a foreign graduate takes two years to clear the FMGE, that comes to about Rs 7-8 lakhs in tuition and FMGE registration fees,” says Sharma. DIAMS charges Rs 55,000 for a six-month training programme. “The total is still less than what one would have had to pay at a private college in India,” he says. But families, who have already spent lakhs on foreign education, are often without the means to pay Rs 7-8 lakhs more, or to wait until the students can begin practising. “There is now pressure on me to get married,” says Akansha, a graduate from Russia, who will be attempting the FMGE for the third time when it’s held on December 9-10.
At preparatory classes in Gautam Nagar, students busily answer mock tests and pore over books. Conversations are all about possible questions. Perhaps this time, some of them will manage to crack the FMGE and get that coveted license.
(Names of foreign medical graduates have been changed to protect their identities.)

Wednesday, November 25, 2015

India's first MRI machine to be out in market by 2018

The department of IT's R&D laboratory SAMEER will soon bring out India's first MRI machine in the market by 2018.

SAMEER is an R&D Laboratory set-up in 1960s for research, design and development of products in the field of RF and microwave systems. In a recent presentation to the Telecom Minister Ravi Shankar Prasad, Director-General SAMEER said the R&D laboratory was already in advance stages of product development of the machine which would enable use of imaging in medical diagnosis.

Prasad asked the organisation to revisit the mandate and explore more medical equipment which could be indigenously developed by the lab. "Prasad said that healthcare was a major focus area of the Modi government and encouraged the team to focus more on field," a senior officer said.

Prasad also asked the the research institute to work towards potential solutions to cyber security issues.

Headquartered in IIT Powai, SAMEER also focuses on interdisciplinary research initiative addressing broader spectrum of electronics areas like optoelectronics, Digital signal processing, Navigational aids, radars, atmospheric remote sensing systems and Linear accelerators.

Nivolumab and cabozantinib outperform everolimus in advanced RCC

Nivolumab and cabozantinib, used separately as monotherapy, offer a survival benefit over everolimus in patients with advanced renal cell carcinoma (RCC) after failure of first-line anti-VEGF therapy, according to the results of two late-breaking phase III trials presented at the European Cancer Congress (ECC) 2015 in Vienna, Austria.
The CheckMate 025 study randomized 821 patients with advanced RCC, who had failed one or two previous anti-VEGF therapies, to receive nivolumab or everolimus until disease progression or intolerable toxicity. [ECC 2015, abstract 3LBAN Engl J Med 2015, doi:10.1056/NEJMoa1510665]
“This is the first phase III study to demonstrate a survival benefit with an immune checkpoint inhibitor vs current standard treatment in previously treated advanced RCC,” said lead investigator Professor Padmanee Sharma of the MD Anderson Cancer Centre, Houston, TX, US.
“Importantly, the primary endpoint of overall survival [OS] met the prespecified criterion for superiority, leading to premature termination of the study,” she highlighted. “The median OS was 25.0 months in the nivolumab group vs 19.6 months in the everolimus group [hazard ratio (HR), 0.73; p=0.0018].”
“The survival benefit with nivolumab was observed irrespective of programmed death-ligand 1 [PD-L1] expression,” added Sharma. “The median OS was 21.8 months with nivolumab vs 18.8 months with everolimus in patients with PD-L1 expression level ≥1 percent, and 27.4 vs 21.2 months among those with PD-L1 expression level <1 percent.”
The objective response rate (ORR) was also higher with nivolumab vs everolimus (25 vs 5 percent; p<0.0001), but the median progression-free survival (PFS) was similar between the two arms (4.6 months for nivolumab vs 4.4 months for everolimus; p=0.1135).
“Overall grade 3/4 adverse events [AEs] were less frequent in patients receiving nivolumab vs everolimus [19 vs 37 percent],” reported Sharma. “Quality of life of patients in the nivolumab group improved over time and differed significantly from those in the everolimus group at each assessment.”
Meanwhile, cabozantinib was compared with everolimus in the METEOR (Metastatic RCC Phase III Study Evaluating Cabozantinib vs Everolimus) trial of 658 advanced RCC patients who had progressed within 6 months after receiving VEGF receptor (VEGFR)-tyrosine kinase inhibitor (TKI) therapy. [ECC 2015, abstract 4LBAN Engl J Med 2015, doi:10.1056/NEJMoa1510016]
After a minimum follow-up of 11 months, the primary endpoint of PFS nearly doubled in patients receiving cabozantinib vs everolimus (median, 7.4 vs 3.8 months; p<0.001).
“The PFS benefit offered by cabozantinib was even more prominent in patients who received sunitinib as their only prior VEGFR-TKI [9.1 months vs 3.7 months for everolimus],” reported lead investigator Professor Toni Choueiri of the Dana-Farber Cancer Institute, Boston, MA, US.
“Similarly, the ORR was significantly higher with cabozantinib than with everolimus [21 vs 5 percent; p<0.001],” he added. “The interim OS analysis demonstrated a strong trend favouring cabozantinib [hazard ratio, 0.67; p=0.005].”
The most frequent grade 3/4 AEs for cabozantinib were hypertension (15 percent), diarrhoea (11 percent), fatigue (9 percent) and hand-foot syndrome (8 percent), while those for everolimus were anaemia (16 percent), fatigue (7 percent) and hyperglycaemia (5 percent).
“The OS benefit of 25 months offered by nivolumab sets a new benchmark for advanced RCC patients previously treated with anti-VEGF therapy,” commented discussant Dr. Cora Sternberg of the San Camillo and Forlanini Hospitals, Rome, Italy. “The impressive efficacy of cabozantinib as shown in the METEOR trial makes it a potential new treatment option for these patients.”