As the pandemic enters the second year, the surge steeper this time, over 4,500 resident doctors across Maharashtra government medical colleges (GMC), who have been drafted in the fight against Covid-19, have started complaining about losing out on academics.
Resident doctors at T N Topiwala medical college in Mumbai went on mass leave on Tuesday to protest against the conversion of the hospital into a dedicated Covid-19 facility. Except in intensive care units, the doctors did not report for work.
On Monday, the Maharashtra Association of Resident Doctors (MARD) had written to the Directorate of Medical Education and Research (DMER), warning that doctors who are not on Covid-19 duty would go on strike across the state if demands of those on pandemic duty are not met. The demands include allowing quarantine period post duty, roping in Ayush doctors for Covid-19 work, recruiting more medical officers, continuing with other routine surgeries and ensuring smooth supply of gloves, needles and syringes.
“Last year, resident doctors had agreed to work in Covid-19 wards because it was an unprecedented medical emergency. But if the same happens this year, they will lose two years of education,” said Dr Dnyaneshwar Patil, president of MARD.
Many young doctors, who have taken admissions in specialised postgraduate courses, have claimed that the emphasis on Covid-19 work has meant that they hardly got to interact or gain practical experience in treating patients suffering from other ailments.
Dr Abhijit Kulkarni, a third-year ophthalmology student, has conducted less than 20 eye surgeries last year. Usually, second-year doctor perform close to 100 surgeries. “These two years will produce a batch of incompetent doctors,” he rued.
The Medical Council of India (MCI) is mulling over solutions. Dr Avinash Supe, member of the expert group of MCI academic cell, said, “We have discussed whether we can add a year of paid residency for second and third-year students to compensate for their academic loss. In that one year, they will receive hands on experience in their specialty.”
Maintaining that the “fatigue is understandable”, he added: “Most doctors were getting ready to return to normal work. Nobody expected the second wave to be so strong. It is a difficult situation for doctors and the government.”
On April 3, The Indian Express spent two hours at Aurangabad GMC’s 12-bed Covid-19 emergency ward with two resident doctors, one ward boy and a nurse. Around 10 pm, 13 patients were sharing 12 beds. By midnight, 15 more patients had been admitted.
When the number of beds fell short, two patients shared a bed, some occupied benches. Their relatives followed a second-year doctor to arrange for a bed in the general ward, to get the oxygen tube fixed properly, to control breathlessness and for medicines.
“We have only 13 oxygen ports. When the number of patients increase, we split a port into two tubes, which reduces oxygen supply per patient. The patient load is high and difficult to manage,” the doctor said.
His personal protective equipment is drenched in two hours of duty and he has no time for a bathroom break in his six-hour duty. He alternates between conducting antigen tests to making space for new patients.
The Aurangabad GMC has over 120 posts for doctors vacant, MP Imtiaz Jaleel said. Of the 490 resident doctors, 150 are on Covid-19 duty, more are slated to join. Also, at least 25 are actively infected.
The latest rise in cases has skewed the doctor-patient ratio – until last year, there was one doctor for 20 patients in the GMC’s general ward, now there is one for 40, MARD doctors said.
T N Topiwala medical college exclusively treated only Covid-19 patients last year. “All pre-clinical, para-clinical, clinical, surgical and super-specialty resident doctors pursuing postgraduate programmes were roped in on Covid-19 duty for the entire year. If this continues this year, they will lose two of their three years of education,” said student president Dr Nilesh Kalyankar.
Dr T P Lahane, Director of DMER, said they are faced with limited solutions. “We are treating people with other ailments but have to limit the number of patients being admitted to prevent them getting infected with Covid-19.”
“Resident doctors are given six-hour duty, before pandemic it was 12 hours. They need to support the government at this juncture,” he added.