milee99
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Hi friends..
I like to read something distracting which when I think too much over petty issues (like the delay in score reporting for step 2 CK)  . These kind of write-ups remind me that there are more complicated issues than the ones I am stressing myself over. 
This was a post I found in other forum I would like to share with everyone. I first thought of posting it in the Indian IMG forum, since it addresses most issues in India, but then I thought that probably it could relate to issues from other countries as well. However, If the moderators find this inappropriate for this forum, I am sorry for the inconvenience caused to them.
I have translated 1 or 2 sentences that were in Hindi language. I hope It does not affect the original meaning..also taking advice from P4a99, for copyright and giving credit to the appropriate people, here's the original one : it is in four parts.
http://www.orkut.com/CommMsgs.aspx?cmm=22693680&a......
http://www.orkut.com/CommMsgs.aspx?cmm=22693680&a......
http://www.orkut.com/CommMsgs.aspx?cmm=22693680&a......
http://www.orkut.com/CommMsgs.aspx?cmm=22693680&a......
I might sound like a hypocrite struggling to get a residency in the US and then posting this write-up here, but I often like to challenge my own beliefs, so that I don’t forget the other side of the coin. And this side of the coin is hidden deep inside my heart.
It is a letter written by a senior doctor to his junior doctor from India, on:
WHY HIGHLY QUALIFIED INDIANS LEAVE INDIA
Dear PQR,
There is definitely nothing flawed in your Point of view .But there are certain other points of view which I want you to consider. I will write randomly -
excuse that.
In between XYZ had read in a journal, that in today's information age, even the doctors from the developing countries get exposed to the latest in medical care. The cream of the country manages to get aware of the very best in it. Then they find the gap between what they know, and the scenario in their country's medical practice to be too big - so they decide to go abroad and be a part of the very best and sensible medical practice. Nothing wrong, but because of this the developing countries are losing all their cream to the developed world. Rather than the developed supporting the developing, the developing are supporting the developed, by providing the best of their manpower!! And as a consequence, the developing countries don't seem to be making progress towards efficient medical practice, at any significant pace. One of the conclusions of the article was -- so we should stop educating the medical students of developing countries about things that are beyond, what can be implemented in recent present.
Of course, I disagree with this conclusion. But what do you think about this issue? What is the solution? Isn’t this brain drain bad for our country?
Of course there is madness in India and things are simply pathetic. ABC recently left her job as a Medical Officer after 3 months after becoming terrifically frustrated. The staff (equivalent of nurse in a rural health care setting) over there used to come in night-dress! And sometimes her hubby dear would come and ask, "Madam is it must for her to come. She is making food at present"?
Not denying it. Things are far far from ideal. But how will things improve, if even those few, who continue to harbor a passion for an ideal practice, leave the show.
Hearing Apte sir was such a big treat. There was so much dynamism and optimism in his voice. I am sure, that the scenario of hematology practice in Pune must have received a huge transformation because of him.
Good doctors need to make India their place of worship, not because they will get an ideal setup; but because there is no ideal set up; and because there is a need of creating one.
The things which motivate you are : when you see any form of exciting work you want to join in. I want to do something that’s really good. Its like if you want to do Psychiatry and if you are doing it at NIMHANS you are assured of something substantial.
Wouldn't being a pioneer, and setting up one ideal practice, be a very exciting and challenging job? Being good where everyone around you is good, is fine. But isn’t it more worthwhile to become good in India and prove that it’s possible.
It’s not necessary for us to become a part of a bad set up. Luckily, in XYZ college we were exposed to a couple of near- ideal set ups and we have an assurance, that though difficult-- it’s possible. Just that it’s very difficult, risky, and probability of success in an unsupportive environment is very less.
Yes, being abroad - these uncertainties won’t be there. It would quite certainly ensure that you will successfully be a part of something meaningful. But if you wouldn’t be there, somebody else would take your place and the show will go on.
But over here, a system is not in place. And so success or failure is determined by the quality of the person. Jamkhed exists because Dr. Arole exists. Infant Mortality Rate in Gadchiroli has dropped by 100!! because Dr. Abhay Bang exists. I have not seen someone so strong academically and yet so well read about general issues also.
Another point to be considered is. As Dr. Arole said, "Repairing cleft palates is an important need and requires great skill. Someone doing it is doing a great service. But in our country where lakhs are dying due to diarrhoea, how smart it is to be busy repairing cleft palates?" Yes poor also get cleft palates. It’s just about prioritising and not grumbling that the work one is expected to do is below par.
If we have been educated beyond the needs of our circumstances, that should act as a disqualification. It should just help us do develop a good distant vision. This can be applicable in technical issues and in non- technical issues as well. i.e. if the circumstances I have to address, demand that I have to spend a large amount of time in addressing non-medical issues as well - then I have no other option. What is more important? What do I enjoy in giving? What is the need of the day?
Abhay Bang had said to Indians in US, “You are busy inventing microchips for your foreign bosses and earning them patents. But when would you do research about how to make the wheel of a bullock cart light? How can the water of a well be drawn out comfortably, who will do research over that? How to wipe the mucus secretions of an infant, without damaging his tender nose, when will you do this research? These are tiny problems, but if we can figure out creative solutions to them, then it would go a long way in making the life in Indian villages, more pleasurable."
I don't expect you to work in villages only. Establishing good practice in Indian towns is also a big need of the day. Most consultants charge 600-700 for just saying "hi, good morning. How do you do?" When will this scenario change?
When will patient-interest be the focus of the show, in India also? When will each accident victim's relatives, be counseled about organ donation in India also?
I very well know that what has drawn you there is not money, but that desire to excel. And that is what hurts me more. I can’t see my country lose
you. There are so few quality workers in India!!
I am in no position of authority and I am making no offers or suggestions. I myself don't know the road ahead.
I know only this much as of now, "whatever I have to do I have to do it well". I am not saying that I will surely be there with you to help you (though I will try my level best to work with you if need be). But still I request you to spend your life for your motherland. If you can’t see a way how, there will be many who can help you chalk out a way ahead. Though few, still that are enough number of people who are trying to change the way things are in India. They will guide you.
Things surely won’t be very rosy and easy; but I feel you will be able to make it happen. It’s more difficult and cumbersome than practicing or doing research abroad. But let’s try. The AIDS epidemic is staring bang on India's face. Let’s lend a hand in fighting it.
If you plan to return to India after doing the course, then all above arguments stand cancelled. But then my question remains - if you want to work in India, is it really necessary to go there? Isn't all the info available on net? If you do a course out there, wouldn't you find it impossible to find a work of your standard out here afterwards? I know that many people who have changed the state of things in India, have 1st got educated themselves outside. But in today's age, is that a must?
I have written freely as a friend. I know there are many factors, which have to be considered while taking decisions. This was just 1 angle of the issue. Let me know about what other angle you are considering.
Edited by milee99 on 07/20/08 - 03:03 PM
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| vector
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milee what you wrote is true.its not just india,its the same with most developing countries.if the same standard of living and organised rules and regulations we get to enjoy here are provided in any developing country why would we leave our home at the first place?
education is also really really good for postgrads in india, i myself being one of those trained in a premier institute,but biggest problem is is these no control over how much labor intense work they extract from you and treat you like a piece of crap.thats coz the consultanants themself are victims of abuse and the same system is continued for generations.plus added to that some times lack of resources,lack of monetary support.
in developing countires the doctors are as poor as some of their patients who cant afford treatment.solid 30 yrs goes into training and education and no money to even support himself.at the end of the day medicine is your passion,but we got to survive too right for which we need to make a living by earning.
in this country atleast the talent is well renumarated.there are disadvantages here too,do you think any one of us is happy being here away from family . no but humans have to grow and for that they make loads of sacrifices on their way.every single day each one us dreams of the day when we are content and wanna go back.most of us are doing for sake of quest and also for the sake of making our families proud.
hoping for the day when the whole world is one healthy place to live in .
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| P4a99
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Man, I have like 2000000 questions, comments, and points I would like to make.
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| P4a99
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OK, this is one of my favorite topics of discussion, hands down! Before sharing my thoughts there are a couple of things, Milee.
- I couldn't really recognize your thoughts, from the translation, from the article or letter or forum thread, ... because of the color and font.
- For copyright issues it is always better to leave a link, credit, courtesy, when you are quoting someone or copying from another website.
- I am glad you posted here. This is a global problem not domestic!
First, and before things get a bit messy, in my opinion, the cause of 99% of such problems is corruption, PERIOD.
Poverty, poor education, terrible health care systems, low wages ... can only be fixed by stopping corruption. No one physician is going to cure AIDS in Africa, no one professor is going to fix medical schools in Egypt, no one researcher is going to figure out how to provide food to a billion people in India, no one engineer is going to bring sewer system, clean water, and electricity in to houses of the poor villages in south America, no one wealthy guy is going to lift the beggars from the streets of Philippines and Thailand from poverty.
On the other hand if you ponder for a moment you will see that a lot of these problems can be fixed by stopping corruption. What brought these problems to these countries in the first place but corruption?
I am sure everyone has heard the news from Zimbabwe. What kind of health, education, infrastructure, and security would you suspect to find tomorrow in such a country? Haven't you watched the movie blood diamond? (I am not recommending education through Hollywood movies but the movie does make you pause and think for a moment) ... ... ...
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| bioguy
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when you board a flight, you are given instructions on what to do in emergecy loss of pressure.
what are you told to do? listen carefully -
- when the oxygen masks are deployed, secure YOUR mask first before you help others -
thats my motto. in other words - if someone is stuck in a quicksand I won't jump in to save him, instead i will secure myself safely on the bank and throw him a rope to pull him out.
in this dangerous world, if your generous soul is dying to help others before establishing its own security, it will die doing so without effect. my use of the word 'dangerous' is not an exaggeration. and according to me its made dangerous by of humans themselves.
don't ask me WHEN i will be satisfied that i am secure enough and WHEN i will start helping others. because if i am inclined towards helping others i WILL DEFINITELY DO that. and if i am not inclined towards helping others no amount of sentimental talk will move me. thats how i am. i am not foolish enough to jump into the broiling broth of ignorance, corruption and ineptitude with the inconceivable notion of transforming it into a haven. i CAN DO THAT without jumping into it too. i can stand aside and create opportunities providing financial support which is what i am doing right now. i support a group called ASHA FOR EDUCATION which is involved in providing eduction for underpriveleged children. We have raised around $15000 at our city chapter in the last 3 years and supported various education projects in remote villages in Tamil Nadu, Rajasthan and West Bengal. We made site visits to confirm that those funds were put to proper us and not corrupted. In course of these projects we have created job opportunities for teachers in those villages.
Coming to health care, it needs higher amount of investment, infrastructure and organization. And it is definitely in my agenda when I am capable enough to support it. I would absolutely not want to literally kill my life and go there and work in those remote villages. This might seem selfish and brash, but hey I am voicing MY opinion and isn't evolution about "ME" - i mean "my survival".
I can go on and on - as p499 said there are zillions of comments, zillions of problems and zillion other ways to help the needy.
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| P4a99
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Regarding the issue of: "oh my poor country, I want to go back and fix India, I want to stay and fix Pakistan, I do not care how tough it is to live in Indonesia I would rather live here in poverty than to immigrate and become a millionaire, ..."
To be honest, I cannot talk much about this, because I do not find my self feeling this much connected in the first place and I think that is for a reason. My father is from a country, my mother is from another country, and I lived most of my life in yet another two countries. I absolutely wish the best for the 4 countries that I am or I was once a part of but no, I do not think I would feel that much sorrow If I traveled to the US and did not come back to the other 3.
Living in this period of time with the ever advancing communications, telecommunication, internet, and the increase of cross cultural marriages the world has never been smaller. One country being wealthy and advanced is not that isolated as it could have been a 100 years ago. For example, one day when a cure for cancer will be developed by an Indian in the UK a French guy in South Africa will benefit from the discovery too. Another example, when you become rich in the US you can send thousands of dollar back home to help out you cousins, siblings, or build an elementary school for the needy in Delhi.
Like so many others. If one of us travelled to the US or UK and got married to someone from that country and had children whom have both bloods running in their veins. Which country are you supposed to be worrying about now? Your wives’? Your children's? or the one that you left in the first place because you were afraid you were going to waste your talent, education, ambition, and the best years of your life there? ... ... ...
Edited by P4a99 on 07/20/08 - 11:05 AM
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| vector
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thats my motto. in other words - if someone is stuck in a quicksand I won't jump in to save him, instead i will secure myself safely on the bank and throw him a rope to pull him out.
bioguy i really liked this quote of yours.its true my dear doctor collegues.first we have to help ourselves to help others.every single person has soft corner for his mother land like as much as we are biologically programmed to love our parents no matter what.but one has to think of practicality as well.one has to do whats best for oneself so that he can later return the favour.one country is like the mother that gave you birth,but the other country that you lived in to have become what your are for having provided you opportunity is like another mother who nutured you .so you really cant choose.
but at the end of the day most of your final goal is the same better oursleves first and go back to your loved ones so as to give a helping hand when they are too old, plus also do some good to the country that provided the initial opportunity ie our motherlandand at the same be greatly indebted to the other country which has let us exel and reneder our services to this country as well.
do you think our countries would give a foreign students as much opportunity as this country does?no it dosent.definately agree that some places are in dire need of health care and we are being selfish for our own personal comfort.let the government or social organisations give same amount of renumaration and benefits who would not want to take such an offer.at the end of the day a doctor and his family have to not just barely survive for the life long effort that he put in,but atleast be content that he's able to keep his family happy and provided for.
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| P4a99
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The term "Brain Drain" is one that I do not agree upon. I know that there have been books written describing the "phenomenon" and calling out for caution in the Arab world. I was amazed when you used the same term describing the Indian "brain drain".
I think I could describe my opinion about this by asking a couple of questions. What is a Moroccan astronomer supposed to do in Morocco? What good is an Egyptian nuclear medicine professor going to do in Egypt? Should he wait another 40 years hoping change will come?
If your answer will be: (as the guy said in the letter regarding cleft correction) why study that stuff anyway? Study something relevant to your countries situation.... I will say: thank God we do not live in communist days anymore. Everyone has the right to choose what ever he/she finds his passion in.
Once a Cambodian uses his freedom and rights and chooses quantum mechanics as a career what is he supposed to do? Stay in his country and open a cafeteria, book shop, minimarket, work as an accountant, or teach physics to babies at an elementary school? because no one in his country appreciates or understands what he does. At this moment in life don’t you think it is his right to go to the country that most appreciates him and fulfills his dreams and provides him with everything he needs for his work and research? And as I said above the entire world would benefit from his discoveries on day or another one way or another. Isn’t that better than REALLY DRAINING HIS BRAIN IN HIS HOME COUNTRY??!
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| Jackofknives
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P4a99 wrote:
The term "Brain Drain" is one that I do not agree upon. I know that there have been books written describing the "phenomenon" and calling out for caution in the Arab world. I was amazed when you used the same term describing the Indian "brain drain".
I think I could describe my opinion about this by asking a couple of questions. What is a Moroccan astronomer supposed to do in Morocco? What good is an Egyptian nuclear medicine professor going to do in Egypt? Should he wait another 40 years hoping change will come?
If your answer will be: (as the guy said in the letter regarding cleft correction) why study that stuff anyway? Study something relevant to your countries situation.... I will say: thank God we do not live in communist days anymore. Everyone has the right to choose what ever he/she finds his passion in.
Once a Cambodian uses his freedom and rights and chooses quantum mechanics as a career what is he supposed to do? Stay in his country and open a cafeteria, book shop, minimarket, work as an accountant, or teach physics to babies at an elementary school? because no one in his country appreciates or understands what he does. At this moment in life don’t you think it is his right to go to the country that most appreciates him and fulfills his dreams and provides him with everything he needs for his work and research? And as I said above the entire world would benefit from his discoveries on day or another one way or another. Isn’t that better than REALLY DRAINING HIS BRAIN IN HIS HOME COUNTRY??!
this argument only applies if it is your intent to dedicate your career on research that would benefit your home country the most. Thus, if you come from the third world, what would make the most sense would be vaccination development for diseases that plague certain endemic areas for which developed countries feel more or less callous about. That is what these countries need the most in the medical field, not brain surgery, not open-chest heart surgery and all that fancy stuff.
Self-justification may provide some temporary virtue but what’s wrong with I just don’t give a ****.
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| milee99
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WOW!
I did not expect so many replies in a day!
@P4a99 - I did not leave a link because I replaced the true names for XYZ, ABC etc to preserve the anonymity of the people mentioned.. some of those I know personally. However thanks for bringing out Copyright issues and Credit and also the discrepancy that may be created because of me translating some sentences.. I have edited the post to include the link, I hope the forum is public.
All the reasons that everyone has discussed above stand true and practical.. those are also the reasons I left my country. I was just a medical grad when I left it, and there was no way I could be of any good use to my country until I atleast settle down myself - At that point, the issue becomes more of personal choice than professional.
The problem arises later - 25 yrs from now - when I may reach or even surpass my career goals - when children are also old enough to care about themselves - then I probably would want a different purpose - that is where these kind of issues should serve as an eye opener for me.
Of course the same kind of service can be rendered in USA, all human beings are equal.. it is not less rewarding to serve a country other than your own.
The question arises of unfulfilled needs. And I wish that in my whole lifetime, I should do atleast one thing that caters to the medical needs of my country.
About issues like corruption etc - most of us have given up on it. But it is rewarding to fight it - I wish that atleast once in a lifetime, let me be courageous enough to stand up and fight against it - at a time when that fight is not for my own benefit.
The problem is that to make even a small change, it is important to be in the system.
There are doctors who after being educated here, go to India and try to maintain the same standards of ethics, behavior and care there - not because someone will sue them if they don't, but because it is the ideal way to do it.
Currently, only the financially well-off can afford that kind of a care - yet, it is one baby step to prove that it can be done in India also.
Can I join them? Probably.
Can I go one step forward and make it available to not so financially well-off? I would like to try.
I can't change whole of India, but I can create a 10 bedded ICU with the best standards, quality of care within the principles of ethical practice, and make it so enviable that atleast 2 other future doctors in my town try to do it as well. I don't have to go to the village or sacrifice my life for that.
As for now, I had better get back to studies. Otherwise all these dreams will remain only dreams :P
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| new_n_lost
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milee99 wrote:
I can't change whole of India, but I can create a 10 bedded ICU with the best standards, quality of care within the principles of ethical practice, and make it so enviable that atleast 2 other future doctors in my town try to do it as well. I don't have to go to the village or sacrifice my life for that.
As for now, I had better get back to studies. Otherwise all these dreams will remain only dreams :P
+1
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| bioguy
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Jackofknives wrote:
Self-justification may provide some temporary virtue but what’s wrong with I just don’t give a ****.
There is nothing wrong in saying 'i don't give a damn'. But just because you don't give a damn its too immature to think that some who gives a damn is trying 'self-justification for a temporary virtue'.
('you' doesn't mean you, jack. its just an addressing term)
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| paheli
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Well said, bioguy.
No offence, jack.
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| toolazy2study
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wow, thanx for sharing this, it's like p499 said, there's so many thoughts n opinions...n' u can see this is so many views....
here are a few frm me....u can't keep doctors frm leaving...it's their choice n' also it's their choice to go back as well...it's an individual choice...a few solutions... or for those who aren't seeing it already....india (btw, i'm not frm there, but i'm frm the indian subcontinent) has so many of their citizens going back, compared to the generations before...why? coz as far I see, India has taken small steps socially, & economy wise to improve....but no one can see it, coz it's all baby steps....my hubz is frm India n' I was so suprised to howz it advanced in so many ways when I visited there....n' I hear more & more citizens of our generation actually wanting to go back bcoz the life over there has improved....u'll never see a mass movement of ppl going back, it's always gona be gradual, something u can't capture....
when conditions improve in developing countries you'll automatically see more citizens going back...but the question is how to make conditions improve? or will they ever improve? this can't be changed just by medical doctors,...it has to be done by the government as well as the people of the country....I do believe that one person can make a difference, enough to see big changes... but who will that person be? I know I'm not the type, in fact I know I'll never be...it all depends on the person as an individual...takes courage to fight....do I have it? I know I don't....but I know there are others who are tougher to make a change....
but I know the only way I can help is as-is, status quo...meaning...I've made a promise to myself to try to the best of my ability to give back, esp to ppl in third world countries, n' not just my country of origin..... I hope I can...inshallah, one day....I may never be able to go back to my country of origin n' live there 'coz I never actually lived there ever....but this is MY OWN most IDEAL way "to give back"....going for summers n' giving free consulatations & treatment....
Edited by toolazy2study on 07/20/08 - 05:33 PM
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| milee99
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BTW, I must admit that I can dream of the things I mentioned, because I don't have to worry about the monetary part much, since my husband is not a doctor and so there will be an alternate source of income - always..
Also I don't have any family responsibilities. Nobody is dependent on me.
I don't think I would have thought the same way as now, if I had financial or family responsibilities.
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| milee99
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@tollazytostudy-
Yes, that is also a way of giving..
Also, in a debate that took place back in college had pointed out that some of the ambitions about bringing about a change require money and power (like political relationships). So if a person contributes financially to causes in India, or even if he can influence political opinion for a cause that is still a contribution to development.
There are many research projects that when collaborated with research in USA, the US pays for half of the expenses for the research in India - this cannot happen unless Indians doing research in the US also take efforts for it.
I remember of a village development project by Germany few years back - It paid for the expenses for all the material needed for one village in India, the villagers were supposed to volunteer for labour.
So, even Indians who may not return to India can contribute to the country's development.
When a an Indian surgeon in USA conducts the first surgery of its kind in the world - it is an inspiration for doctors back at home.
One more way could be to take free lectures at nearby medical colleges in the field of our specialty when we go back to India for vacations.
I AM SAYING INDIA ALL THE TIME BECAUSE I KNOW OF THE SENARIOS THERE - IT COULD APPLY FOR OTHER COUNTRIES TOO.
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| P4a99
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Only 8 people are interested in this topic? Then, I am glad I did not go on and on
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| genbot
Easy...
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Life is a crazy deal between what you want, what the ideal wants, and what everybody else around you wants from you.
I'm too tired to think about all the details right now but i'm sure one of the three keeps winning for most of us, most of the time.
Will talk more sometime.
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| bioguy
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what do you do about this -
http://www.nytimes.com/2008/07/23/world/asia/23in...
Indian Politicians are notorious for corruption.
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| bioguy
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it makes me SICK!!!!!
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