i n d i a n h e a r t j o u r n a l 6 7 ( 2 0 1 5 ) 4 1 1 e4 1 2
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/ihj
Musings
Government or private practice: Does it really matter in India?
No one saves us but ourselves. No one can and no one may. We ourselves must walk the path e Buddha “Should I start private practice or join a government institution after finishing my cardiovascular training?” This is a million-dollar question for cardiovascular trainees in India. Such thoughts loom in the mind of most of the young trainees in initial phase of their career. It is difficult to answer this question as individual priority may vary. In India, there is no compulsion for separate fellowships in interventional cardiology, electrophysiology or pediatric cardiology after completion of formal 3-years cardiovascular training. Moreover, the standard of cardiovascular training is variable. To begin the career in a government institution or a high volume private sector becomes more relevant as it is difficult to start practice independently immediately after completion of formal training. In the present scenario, new-comers in the field go through two different phases. First, fine-tuning their interventional skills and second, the implementation of the acquired skill in clinical practice. We feel that one should begin with a high volume center either a government or a private sector to sharpen interventional skills and enrich the experience. After gaining enough confidence in the first phase, one should enter the second phase. The second phase has three important aspects which may help to resolve the dilemma of government or private practice. 1. Academic aspect: Although it is a general belief that if one wants to pursue an academic career he or she should join a government teaching institution. Does it really matter in India? Here are some facts. Total number of institutions offering training of DM cardiology in this country is 75 (46 Government and 29 private or trust). Moreover, total number of seats per annum for this course is 269 (219 in government and 50 in private or trust). Whereas on the
academic front, the situation is altogether different. The total number of original articles published in Indian Heart Journal in 2014 is 52 (22 from government and 30 from private or trust). This data contradict the belief that to pursue an academic career one should be in government medical college. Although the number of private institutions running academic programs is limited but the number of publications coming out from the government institutions is also disproportionately low. So, for academic career what is required is a right mindset and a high volume center which may either be a government or private with or without teaching program. 2. Financial aspect: Most of the trainees while finishing their cardiovascular training are in mid 30s and have financial liabilities. There is a significant difference in the pay structure in private as compared to government institutions. It also differs significantly between government institutions in various states. This aspect is to be kept in mind by the trainee before taking final decision. 3. Social aspect: India is a large country with varied ethnicities. Being a cardiologist in your own state and society helps you connect better with the patient and his problems. As cardiology is an emergency branch and has great socio-economic impact on the society, it is always better to practice in a known environment. It also helps to maintain doctorepatient relationship and avoid unnecessary conflicts. It eventually earns respect in the society which can't have any monitory equivalence. All the three aspects have to be balanced in choosing the right path for future practice although there can be individual priorities. Whether one is in an academic institute or a private sector, it is ultimately the mindset and dedication towards the profession and society which may led to the path of success.
412
i n d i a n h e a r t j o u r n a l 6 7 ( 2 0 1 5 ) 4 1 1 e4 1 2
Conflicts of interest The authors have none to declare. Surender Deora* Assistant Professor, Department of Cardiology, PGIMER Dr RML Hospital, New Delhi 110001, India Tejas Patel Professor & Head, Department of Cardiology, Sheth V.S. General Hospital, Smt. N.H.L. Municipal Medical College, Ahmedabad 380006, India
*Corresponding author. Department of Cardiology, PGIMER Dr RML Hospital, Baba Kharak Singh Marg, New Delhi 110001, India. Tel.: þ91 9413063063. E-mail address: [email protected] Available online 3 July 2015 0019-4832/$ e see front matter Copyright © 2015, Cardiological Society of India. All rights reserved. http://dx.doi.org/10.1016/j.ihj.2015.05.011
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/ihj
Musings
Government or private practice: Does it really matter in India?
No one saves us but ourselves. No one can and no one may. We ourselves must walk the path e Buddha “Should I start private practice or join a government institution after finishing my cardiovascular training?” This is a million-dollar question for cardiovascular trainees in India. Such thoughts loom in the mind of most of the young trainees in initial phase of their career. It is difficult to answer this question as individual priority may vary. In India, there is no compulsion for separate fellowships in interventional cardiology, electrophysiology or pediatric cardiology after completion of formal 3-years cardiovascular training. Moreover, the standard of cardiovascular training is variable. To begin the career in a government institution or a high volume private sector becomes more relevant as it is difficult to start practice independently immediately after completion of formal training. In the present scenario, new-comers in the field go through two different phases. First, fine-tuning their interventional skills and second, the implementation of the acquired skill in clinical practice. We feel that one should begin with a high volume center either a government or a private sector to sharpen interventional skills and enrich the experience. After gaining enough confidence in the first phase, one should enter the second phase. The second phase has three important aspects which may help to resolve the dilemma of government or private practice. 1. Academic aspect: Although it is a general belief that if one wants to pursue an academic career he or she should join a government teaching institution. Does it really matter in India? Here are some facts. Total number of institutions offering training of DM cardiology in this country is 75 (46 Government and 29 private or trust). Moreover, total number of seats per annum for this course is 269 (219 in government and 50 in private or trust). Whereas on the
academic front, the situation is altogether different. The total number of original articles published in Indian Heart Journal in 2014 is 52 (22 from government and 30 from private or trust). This data contradict the belief that to pursue an academic career one should be in government medical college. Although the number of private institutions running academic programs is limited but the number of publications coming out from the government institutions is also disproportionately low. So, for academic career what is required is a right mindset and a high volume center which may either be a government or private with or without teaching program. 2. Financial aspect: Most of the trainees while finishing their cardiovascular training are in mid 30s and have financial liabilities. There is a significant difference in the pay structure in private as compared to government institutions. It also differs significantly between government institutions in various states. This aspect is to be kept in mind by the trainee before taking final decision. 3. Social aspect: India is a large country with varied ethnicities. Being a cardiologist in your own state and society helps you connect better with the patient and his problems. As cardiology is an emergency branch and has great socio-economic impact on the society, it is always better to practice in a known environment. It also helps to maintain doctorepatient relationship and avoid unnecessary conflicts. It eventually earns respect in the society which can't have any monitory equivalence. All the three aspects have to be balanced in choosing the right path for future practice although there can be individual priorities. Whether one is in an academic institute or a private sector, it is ultimately the mindset and dedication towards the profession and society which may led to the path of success.
412
i n d i a n h e a r t j o u r n a l 6 7 ( 2 0 1 5 ) 4 1 1 e4 1 2
Conflicts of interest The authors have none to declare. Surender Deora* Assistant Professor, Department of Cardiology, PGIMER Dr RML Hospital, New Delhi 110001, India Tejas Patel Professor & Head, Department of Cardiology, Sheth V.S. General Hospital, Smt. N.H.L. Municipal Medical College, Ahmedabad 380006, India
*Corresponding author. Department of Cardiology, PGIMER Dr RML Hospital, Baba Kharak Singh Marg, New Delhi 110001, India. Tel.: þ91 9413063063. E-mail address: [email protected] Available online 3 July 2015 0019-4832/$ e see front matter Copyright © 2015, Cardiological Society of India. All rights reserved. http://dx.doi.org/10.1016/j.ihj.2015.05.011
