Flexner Model: Parliamentary Panel Advises NMC to Study International Best Practices

New Delhi: A Parliamentary Committee has recently recommended that the National Medical Commission (NMC) should undertake a comparative study of best practices of its parallel organisation in various countries.

Such a recommendation was given by the Department-related Parliamentary Standing Committee on Health and Family Welfare in its One Hundred Fufty Seventh Report, which was presented before the Parliament on 9th February 2024.

The panel, chaired by Shri Bhubaneswar Kalita, opined that such a study, if undertaken by NMC, can help the Commission to usher in best practices followed around the world and help make NMC an institution par excellence.

It mentioned in the report that countries across the world have adopted the Flexner Model changing it suitably whenever required. According to the USA’s National Library of Medicine website, Flexner’s report opines that all education should be utilitarian and should prepare the individual for the responsibilities of citizenship and for an occupation or a profession. It is a book-length landmark report of medical education in the United States and Canada, written by Abraham Flexner and published in 1910. The Report, also known as Carnegie Foundation Bulletin Number Four, called on American medical schools to enact higher admission and graduation standards, and to adhere strictly to the protocols of mainstream science in their teaching and research, as per Wikipedia.

After conducting a scrutiny of various governing authorities for medical education across the countries U.S.A, U.K and China, the panel observed that NMC meets international professional standards in medical education.

It was further observed by the panel that barring a few countries at the global level, the shortage of doctors at present or for the future seems to be an all-pervading problem. The developed countries are able to meet this shortfall by serving as attractive destination for medical graduates from the developing countries and by easing the process for the practice of medicine by the International Medical Graduates, noted the panel.

In the context of the standardised tests for medical education, the Committee noted the fact that behavioural and social sciences are also becoming part of the testing process of various countries to assess the ethics, integrity, etc. of the medical aspirants.

Therefore, the panel recommended in its report, “The Committee recommends National Medical Commission undertake a comparative study of best practices of its parallel organisation in various countries. The Committee feels that this measure can help NMC to usher in best practices followed around the world and help in making NMC an institution par excellence.”

Concerning the maintenance of a national database of resident doctors, the committee recommended that NMC should maintain a real-time national database akin to the GME Track of the USA.

This national database can allow access to multiple stakeholders such as the ministry, states, medical colleges and other concerned parties.

This database can also serve as a tool to decimate the limitation of resources in the newly-opened institutions and operate as a platform for experience and knowledge-sharing among the resident doctors, adds PTI.

Against this background, the committee also highlighted the issue of dual registration of doctors with the respective state medical councils where they practice and any other place where they may relocate subsequently.

This gives rise to multiple registrations of doctors with various state medical councils, making tracking difficult, it said, recommending the generation of a unique registration number for the doctors at the NMC level.

This move can also leverage the national database and usher in uniformity in the registration of practising doctors, the committee said in the report.

The committee also recommended that the ministry develops a robust medical education system and emphasises on evidence-based practices, critical thinking and continuous learning, ensuring that healthcare practitioners stay up to date with medical advancements.

In this way, quality medical education would not only secure the present generation’s healthcare needs but also be an investment in the future of healthcare, it said.

The committee noted that the importance of quality in medical education must be considered when taking into account its direct impact on the quality of healthcare services.

“High-quality medical education is the foundation upon which competent and compassionate healthcare professionals are built. It equips them with the necessary knowledge, skills and ethical principles essential for providing safe and effective care to patients,” it said.

It also recommended the government to chalk out a comprehensive India-specific approach that considers the nation’s healthcare needs in the next 20-25 years, identifies the categories of doctors such as pediatricians, ophthalmologists, neurosurgeons, critical care specialists and infectious disease specialists that the country would need rather than just randomly increase the general surgery, pharma and anatomy seats.

It said in the case of the current scenario, modalities for a fair distribution of doctors’ workforce across the country, especially in the underprivileged areas can be worked out by the NMC by offering incentives, monetary or otherwise.

Also Read: Need to increase MBBS, PG medical seats in India: Parliamentary Panel

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FDA approves budesonide oral suspension for treatment of eosinophilic esophagitis

The Food and Drug Administration (FDA) has approved EOHILIA (budesonide) oral suspension for treatment of eosinophilic esophagitis among adults and pediatric patients 11 years of age and older.

It will be available in 2 mg/10 mL convenient, single-dose stick packs by the end of February.

EOHILIA is a corticosteroid indicated for 12 weeks of treatment in patients 11 years and older with EoE.1 Developed specifically for EoE, EOHILIA’s novel formulation of budesonide confers thixotropic properties-flowing more freely when shaken and returning to a more viscous state when swallowed.

“Various formulations of corticosteroids have been used in the past to manage EoE, but in an off-label capacity and using multiple delivery options. With EOHILIA, it’s gratifying to now have an FDA-approved treatment specifically formulated for a consistent dose delivery with demonstrated ability to address esophageal inflammation and EoE dysphagia symptoms,” said Ikuo Hirano, MD, professor of medicine and director of the Kenneth C. Griffin Esophageal Center in the Division of Gastroenterology and Hepatology at Northwestern University Feinberg School of Medicine. “As the treatment needs and goals of patients with EoE can vary, I welcome the flexibility that EOHILIA offers as an oral medication.”

The FDA approval of EOHILIA 2 mg twice daily is based on efficacy and safety data from two multicenter, randomized, double-blind, parallel-group, placebo-controlled 12-week studies (Study 1 and Study 2) in patients (ages 11 to 56 and 11 to 42, respectively) with EoE. In both studies, patients received at least one dose of either EOHILIA 2 mg twice daily or placebo orally twice daily. Efficacy endpoints included histologic remission (peak eosinophil count of ≤6 per high-powered field across all available esophageal levels) and the absolute change from baseline in patient-reported Dysphagia Symptom Questionnaire (DSQ) combined score after 12 weeks of treatment. The DSQ measures how often a patient with EoE has trouble swallowing and the behavioral adaptations they subsequently use, as reported directly by patients.

Significantly more patients receiving EOHILIA achieved histologic remission vs. placebo in Study 1 (53.1% vs. 1%). In Study 2, 38% of EOHILIA patients achieved histologic remission vs. 2.4% of those in the placebo group. Absolute change from baseline in DSQ combined score in the EOHILIA vs. placebo groups in Study 1 was -10.2 (1.5) vs. -6.5 (1.8) and in Study 2, -14.5 (1.8) vs. -5.9 (2.1). During the last two weeks of each study, more patients receiving EOHILIA experienced no dysphagia or only experienced dysphagia that “got better or cleared up on its own” as compared to placebo, as measured by the DSQ. EOHILIA has not been shown to be safe and effective for the treatment of EoE for longer than 12 weeks. The most common adverse reactions (≥2% of patients receiving EOHILIA and at a rate greater than placebo) in Study 1 included: respiratory tract infection (13%), gastrointestinal mucosal candidiasis (8%), headache (5%), gastroenteritis (3%), throat irritation (3%), adrenal suppression (2%) and erosive esophagitis (2%). The safety profile of EOHILIA in Study 2 was generally similar to Study 1.

“For most of us, eating is a simple experience. But for people living with eosinophilic esophagitis, sitting down for a meal can include painful and difficult swallowing, chest pain and a choking sensation,” said Brandon Monk, senior vice president and head, U.S. Gastroenterology Business Unit, Takeda. “With EOHILIA, patients and their physicians now have the first and only FDA-approved oral treatment option for EoE that was shown during two 12-week clinical studies to reduce esophageal inflammation and improve the ability to swallow.”

EoE is a chronic, immune-mediated, inflammatory disease localized in the esophagus. Although the exact cause is unknown, it is believed to be triggered by a variety of stimuli including certain foods and environmental allergens. The chronic inflammation of EoE can lead to a range of symptoms, which can vary by person and age, and include difficulty swallowing, vomiting and pain. Identifying EoE can be complex and delayed diagnosis is common among patients. If left untreated, the inflammation of EoE can worsen and narrow the esophagus, which can lead to food impaction (when food becomes stuck in the esophagus). In fact, EoE is the leading cause of emergency room visits for food impaction.

Takeda is assessing the financial impacts of the approval, including a reversal of impairment loss for intangible assets, on the fiscal year ending on March 31, 2024 (FY2023), but does not anticipate the impact to be material.

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Vacancies at JIPMER For Assistant Professor Post: Walk In Interview, Apply Now

Puducherry: The Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) has announced vacancies for the post of Assistant Professor on a contract basis in different departments.

JIPMER became an institution of national importance under the Ministry of Health and Family Welfare, Government of India in the year 2008. JIPMER offers various undergraduate and postgraduate medical courses. Located in Pondicherry, JIPMER is also a fully functional hospital that provides medical treatments to patients from all over the world. It has about 200 faculty members 3,000 staff and 360 resident physicians.

JIPMER Puducherry Vacancy Details:-

Total no of vacancies:- 11

The vacancies are in the Departments of – Cardiothoracic & Vascular Surgery, Forensic Medicine & Toxicology, Microbiology, Nephrology, Obstetrics & Gynaecology, Paediatrics, and Urology.

The last date for submission of the online application is 15th February 2024.

Date of interview: 16th and 17th February 2024.

For more details about Qualifications, Age, Pay Allowance, and much more, click on the given link:

https://medicaljob.in/jobs.php?post_type=&job_tags=JIPMER&location=&job_sector=all

Eligible Candidates (How to Apply):-

Applicants fulfilling the eligibility criteria shall report for Walk-In interview as per the schedule given below with his/her duly filled in application in the prescribed proforma (as listed in annexure) available on JIPMER website appending therewith self-attested certificates and all other relevant documents for verification on the day of interview.

Note: Candidate reporting after 9.00 A.M. will NOT BE CONSIDERED.

The last date for payment of application fee through SBI Collect is 15.02.2024 till 4.30 PM. The application fee once remitted will not be refunded.

LIST OF DOCUMENTS TO BE SUBMITTED ON THE DAY OF WALK-IN INTERVIEW FOR VERIFICATION:

a) Duly filled in application form in the prescribed format – 2 Sets

b) Hard copy of e-receipt for application fee paid through SBI collect should be submitted along with application. In addition to the above, the following certificate & documents have to be submitted in original with two sets of photocopies

c) Proof for Age

d) All educational qualification certificates

e) Registration certificates, Renewal of Registration certificates (If applicable)

f) Experience certificates

Experience certificates should be from the competent authority of the institution/organization for the entire experience claimed, clearly showing the duration of experience i.e., to , nature of experience i.e., either teaching and/or research etc.

The applicants should mention only those teaching experiences which are recognized by MCI/NMC/DCI/recognized teaching institutions, wherever applicable, and after obtaining the requisite educational qualification for the applied post.

g) Recent caste certificate SC / ST / OBC (Non-Creamy Layer) / EWS (If applicable, as per GoI norms)

h) No Objection Certificate (If applicable)

i) Any other relevant documents j) Brief resume of the Candidate in the prescribed format

k) Five (5) best publications (Not more than 5 publications must be attached)

Also Read:GB Pant Hospital Vacancies: Assistant Professor Post In Various Specialties, Apply Now

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Health Bulletin 13/February/2024

Here are the Top health stories for the day:

NEET 2024 eligibility criteria released

Inviting applications from the aspirants seeking admission to MBBS, BDS courses, the National Testing Agency (NTA) has released the information bulletin for the NEET 2024.

For more details, check out the link given below:

NEET 2024: Here Is Eligibility Criteria For MBBS Entrance Exam


AIIMS Delhi introduces Mohs Micrographic Surgery for skin cancer

Our skin serves as the body’s protective barrier, yet without proper care, it can become susceptible to serious conditions like cancer.

The global incidence of cancer, including skin cancer, is on the rise. Every month, the All India Institute of Medical Sciences (AIIMS), Delhi treats 5 to 6 patients with skin cancer.

To address this growing concern, AIIMS Delhi has introduced a new surgery for skin cancer treatment. Inaugurated by Professor M Srinivas, Director of AIIMS Hospital on Saturday, this new facility ensures that patients no longer need to seek treatment abroad.

For the full story, check out the link given below:

Delhi AIIMS Introduces Mohs Micrographic Surgery For Skin Cancer Treatment

Registration mandated for doctors in Bengal; deadline set by Medical Council

The medical practitioners who are employed in any capacity in West Bengal, those involved in private practice, or the Postgraduate students in any medical college in the State will now mandatorily require registration with the West Bengal Medical Council. This includes the doctors who have registrations in other states and are currently working in the state.

Issuing a notification in this regard on 09.02.2024, the Council further clarified that those who do not have registration with the West Bengal Medical Council will have to obtain the same within the coming three months.

For the full story, check out the link given below:

Registration Mandatory For All Doctors Practising, Studying In Bengal, Medical Council Gives Deadline

AIIMS Implements Cashless System

Union Minister for Health & Family Welfare and Chemicals & Fertilizers, Dr Mansukh Mandaviya has launched the AIIMS SBI Smart Payment Card. The AIIMS SBI Smart Payment Card will ensure hassle-free payments for treatment in AIIMS New Delhi.

Speaking on the occasion, the Union Health Minister highlighted that the “AIIMS Smart Payment Card will resolve the long pending issue of patients from far-flung areas carrying cash with them to the hospital.” He added that patients or their caretakers can get the card easily from the facilitation centres across AIIMS, New Delhi and thereafter use it for payment at various counters.

For the full story, check out the link given below:

One AIIMS, One Card: Union Health Minister Launches AIIMS-SBI Smart Card For Cashless Payments


Atlantic diet linked to reduced belly fat and cholesterol

The European diet scene is abuzz with attention, but this time it’s not the Mediterranean regimen stealing the spotlight. Instead, focus has shifted to the Atlantic diet, also recognized as the Southern European Atlantic diet, which draws inspiration from the culinary customs of northern Portugal and northwestern Spain. Numerous studies have highlighted its health advantages, with recent research indicating a notable reduction in the incidence of metabolic syndrome, a condition associated with heightened risks of heart disease and stroke. Additionally, adhering to the Atlantic diet has shown promise in diminishing the likelihood of depression and overall mortality rates, while simultaneously enhancing cholesterol levels and reducing abdominal fat.

So, what exactly does this diet entail? Well, it begins with a foundation of fresh produce and a touch of wine, resembling the renowned Mediterranean diet in its emphasis on minimally processed, fresh foods like vegetables, fruits, and whole grains. However, the Atlantic diet distinguishes itself by placing greater emphasis on fish, seafood, potatoes, and dairy products. Moderate consumption of both red and lean meats, alongside eggs and wine, is also integrated into the regimen.

Reference: Cristina Cambeses-Franco, MSc; Francisco Gude, PhD; Alfonso J. Benítez-Estévez, PhD; et al Traditional Atlantic Diet and Its Effect on Health and the Environment, JAMA Netw Open. doi:10.1001/jamanetworkopen.2023.54473

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New study finds roughly 1 in 10 pregnant people will develop long COVID

While there is a growing body of research about the long-term effects of COVID in the general adult population, little research has been done on the long-term impacts on those who get COVID while pregnant.

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Data-driven app results in 25% fewer emergency hospital admissions from care homes

The use of a digital remote monitoring technology in care homes has been found to reduce hospital A&E attendances by 11% and emergency admissions by 25% in a new study from the Health Data Research UK (HDR UK) Better Care program, published today in Age and Ageing.

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Plant-based diet tied to improved sexual health in men treated for prostate cancer

A diet that limits meat and dairy but is rich in fruits, vegetables, grains, and nuts is linked to less erectile dysfunction, urinary incontinence, and other common side effects seen in prostate cancer patients, a new study shows.

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Quality of care for patients who call 911 varies greatly across the US, study finds

Emergency medical service (EMS) systems are not consistently providing optimal care based on new national standards of quality to patients who call 911, according to a new study from the Icahn School of Medicine of Mount Sinai.

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Interferon-gamma drives brain pathology in a mouse model of multiple system atrophy

Multiple system atrophy is a rare and fatal neurodegenerative disease, where insoluble inclusions of the protein alpha-synuclein appear in oligodendrocyte cells of the brain. The resulting pathogenesis features neuroinflammation, demyelination and neurodegeneration. Oligodendrocytes produce myelin, an insulating sheath on the axons of nerves.

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Intrauterine vacuum-induced hemorrhage control device controls bleeding for vaginal and cesarean deliveries

PPH causes 70,000 maternal deaths annually and 12% of U.S. maternal deaths (2017-2019). Obstetric hemorrhage affects physical, reproductive, and mental health.

The application of an intrauterine vacuum-induced hemorrhage control device resulted in rapid and effective bleeding control for both vaginal and cesarean deliveries, as demonstrated by a real-world study’s findings published in the journal Obstetrics & Gynecology. The FDA cleared the JADA system in August 2020 for managing abnormal postpartum uterine bleeding.

A team of researchers led by Dr Goffman and colleagues assessed the real-world effectiveness and safety of a U.S. FDA-cleared intrauterine vacuum-induced-hemorrhage control device for managing PPH (postpartum hemorrhage).

This study was conducted at 16 American centres between October 2020 and March 2022. The primary outcome was evaluated based on treatment success, which was defined as controlling bleeding without additional treatment or recurrence. The study also examined other outcomes, such as blood loss, time to device insertion, indwelling time, bleeding recurrence, and time to bleeding control. The study evaluated treatment success and severe maternal morbidity by assessing blood loss before treatment and collected data on serious adverse events and adverse device effects to assess safety. The study summarized all outcomes by mode of delivery and treatment success by bleeding cause.

Key findings from the study are:

· 800 individuals were treated with the device ( (530 vaginal births, 270 cesarean births)

· 94.3% had uterine atony (alone or in combination with other causes).

· Median total blood loss at device insertion in vaginal and cesarean births was 1,050 mL and 1,600 mL, respectively.

· Across all bleeding causes, the treatment success rate vaginal and cesarean births was 92.5% and 83.7%, respectively. The Median indwelling time was 3.1 hours and 4.6 hours, respectively.

· In vaginal births and cesarean births, 14 SAEs (13 individuals) and 22 SAEs (21 individuals) were reported.

· Three SAEs were deemed possibly device or procedure-related.

· No uterine perforations or deaths were reported.

The FDA-cleared intrauterine vacuum-induced hemorrhage-control device effectively controlled bleeding in real-world settings for both vaginal and cesarean births. The safety profile was consistent with the registrational trial (NCT02883673), and no severe adverse device effects or SAEs were observed. This device serves as a crucial tool for managing life-threatening obstetric hemorrhage and may improve outcomes with timely utilization.

Reference:

Goffman et al. Real-World Utilization of an Intrauterine, Vacuum-Induced, Hemorrhage-Control Device. Obstetrics & Gynecology 142(5):p 1006-1016, November 2023. | DOI: 10.1097/AOG.0000000000005366

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