Earlier this year, interns (house surgeons) from government medical colleges, went on a protest. With the medicos wearing black badges as they went about their work, the protest gained momentum towards the end of July and culminated in demonstrations by interns from government medical colleges across Tamil Nadu.
The complaint centred on the extraordinarily long hours of work and having to do jobs that were to be done by the paramedical staff, like administering routine injections and doing blood tests. They felt that this was taking away time which ought to be spent in learning how to diagnose, treat patients, understand them and so on, in effect, the doctor’s trade.
The protest had an immediate effect as the Tamil Nadu Health Secretary sent out a circular instructing hospitals to look into the matter. Here is what some interns have to say:
Praveen, intern at Madras Medical College, Secretary of Tamil Nadu Medical Colleges Interns Association
Things are going fine in the internship training. We see patients, write case-sheets, analyse the patients’ data, arrive at a diagnosis and prescribe medicines and counsel them too! After this, the first round is with postgraduates who teach us a few things, second round is with assistant professors and the third round is with the unit chief. So, for a single case three of them are teaching us. And one patient is seen by four doctors, so the in-patient care has improved now.
We learn procedures like lumbar puncture, tracheostomy, intubation, central line, conducting deliveries; surgeries like hernia, hydrocoele, appendectomy, caesarean; assisting in other major surgeries; elective and emergency management; community health programmes; and disease prevention.
Apart from this we learn imaging techniques. So, we actually learn medicine in the best possible way.
But we still continue to work 36 hours continuously in the name of admission days. We don’t even have a weekly off, which is a basic human right violation.
Kalaipriya, student of Madras Medical College, is an intern at the Institute of Obstetrics and Gynecology, Chennai
We went on protest against having to do continuous duty and paramedical work, but the problem is solved. We now get to examine the patients and learn to practise medicine. The Medical Council of India and Tamil Nadu Dr MGR University have outlined 300 skills that need to be acquired to become proficient, for example, conducting delivery, assisting in surgery, examining the patients, etc.
Earlier the work used to be mechanical and we would do routine duty. So, we did not get to know anything about the patients or their problems. Now we talk to them and get to understand how to diagnose and treat them. We go on rounds with our chiefs and assistant professors and get good exposure. There has been a good change in the last 10-15 days.
The Institute for Child health and Hospital for Children is like a role model, starting from seeing OP cases from 7.30 a.m. to 10.00 a.m., interns get to do a lot of work when they learn the practice. We had asked the other hospitals to follow this pattern. Now, Rajiv Gandhi Government General Hospital, Institute of Gynecology and Obstertrics and Kilpauk General Hospital have all started following the model set by ICH. I now get to assist in conducting delivery, surgeries, etc.
Ulageswari, student of Sri Ramachandra Medical College and Research Institute, is now interning in the General Medicine ward.
The protest by government college interns was reasonable. Interns are almost like doctors with not just the degree in hand. They should not be made to do the nurses’ work. Of course in the O.P. and clinic, the doctors give injections, but to make them do just that is really bad. In our college, interns are treated like doctors and the situation is generally good. The only annoying thing is that when it comes to blood transfusions, we see it as our duty to get it started and check for allergies and so on, but making interns run around for the blood packets is bad.
We learn a lot during our internship. While we get to learn about the basics of diagnosing and treating a patient, it is only during the internship that we get to experience, practise and apply our theoretical knowledge. So it is important that we focus and learn the maximum during this training period.