Genetics: Naming Genes

"...a misleading way of talking about genetics that involves tagging genes with the problem that accompanies their dysfunction - genes "for" obesity, aggression, dyslexia, and addiction, and their more obviously medical cousins, the genes "for" cancer, Alzheimer's, and high cholesterol - and you get a world where people begin to think that their genes hold road plans for their lives. That their nature controls them"

Names do matter




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Medical Advances Vs Health Insurance

"Since insurance depends on mutual ignorance, then any advance in medical science, which pushes back the boundaries of ignorance—whether for the insurers, the insured, or both, will weaken the basis of insurance. The more we know, the less we can insure."


This is from New York Times bestseller "The Undercover Economist" by Tim Harford.

A major part of the chapter "The Inside Story" is about the shortcomings of the US and UK health care systems. The health care system of Singapore, with out of pocket spending for regular doctor visits and health insurance covering catastrophic expenses, is held as the solution.

If you are a econo junkie like me then put this book on your must-read list.




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Patient Care: Protocol Vs Clinical Judgement

Commenting on the procedure to be followed by physicians in treating any patient in Columbia Hospital in Bangalore.


"It is devising an “integrated critical care pathway, a specific flow of events which needs to be followed by every physician for the treatment of a given symptom.”

If a doctor deviates from this standard for whatever reason, he has to document the reason for doing so"

This might be the sweet spot that we are looking for between the so called impersonal, rigid, inhumane, medicine-as-a-system type of standardized, protocol based management of the patients and the each-patient-is-unique type of care.

This allows for standardized and efficient management of the patient based on a protocol while allowing lee way to the physician, based on his clinical judgment, to tailor the treatment to the needs of a particular patient.

Trying to have the best of both worlds.

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Medical PG KCET 2007 Rank Cut off

Getting a good rank in any entrance exam is half the battle.

Making sense of what the rank means and what seats will be available for that rank is the other half of the battle which only the fortunate deserving few will get to fight.

On the RGUHS website, at this page

http://www.rguhs.ac.in/student/newcollegelist.php?fcode=01

you can find the number of seats alloted to each college , classified into subdivisions to be filled up though KCET, COMEDK, Management quota, NRI quota, All India Quota.

But the best part is that there in also information about the name of the person who took up a particular seat in 2007, his rank, the category (GM, cat II/III, SC, ST) and other details.

So you can sort of compile a list of the seats chosen by the first 100 or 200 rank holders in KCET 2007. But the list wont be complete as a few of the colleges have not put up this information (?yet). You can know the general pattern in which seats of different specialties and colleges are taken up in each round and what the likely choices that you will face during counseling.

It is cumbersome, but it can be done.

Others who are preparing for the next KCET exam can do this to get an idea about the ruthless competition that is out there to get you.

What rank do you need, to get into the seat that you want ?


Postscript: If any of you have such lists for previous entrance exams (All India, KCET) about which seat will be available for what rank under which category, please mail it to netmedico@gmail.com

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Part 1: How to study ENT ?

Recently one of the readers of this blog asked me "How to retain what is read in ENT?".

One easy way to understand any subject and retain it is to visualize what is being read.

Knowing the anatomy and functioning of the ear is essential.

Here are few videos that might be of help.

This is a short animation to know the basics of Ear anatomy.


This is a 5 minute didactic video of ear anatomy.




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Funny Condom Song from India

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Fake US Medical School

This is the weirdest this I have come across in a while.

A fake medical school in US is trying to lure students.

I had heard of fake doctors. But a whole medical college ?

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Cost of Creating a Doctor in a Private College

Let us see how much it costs a young person in time and money to become a fully minted doctor from Kasturba Medical College, Manipal, one of the best medical colleges in India. This is a private autonomous college and the full cost is borne by the student. (i.e no subsidy by the government)

This is the college fees for a General Category student in the year 2008 .
( Does not include accommodation, food and other expenses.)
( Foreign national/NRIs/Management students have to pay more)

MBBS Degree ( Under Graduate)

• First Year --- 1 year -- Rs 4,00,500
• 
  
• Second Year --- 1.5 years -- Rs 4,06,000
• 
  
• Third Year ----1 year -- Rs 4,30,000
• 
  
• Fourth Year ---- 1 year -- Rs 4,56,000
• 
  
• Internship ---- 1 Year -- Rs 2,42,000

Total Time : 5.5 Years College Fees: Rs 19,34,500


After spending 5.5 years and paying Rs 19, 34,500 you are awarded a MBBS degree. If you join a top end corporate hospital you can expect a salary between Rs 15,000 to Rs 20, 000 a month. (Roughly 8 to 11 years to earn the 19 odd lakhs paid as college fees).

But most people view a MBBS degree as inadequate to set up a private practice and treat in as a ticket to pursue specialization in some field of their interest by taking up a post graduate course.


MS/MD ( Post Graduate Degree)

A top rank in a competitive exam will grant you an entrance into any of these courses.

This is a three year course and the fees varies depending on the subject chosen.

MD Radiology (X ray, CAT Scan)-- 3 year course -- college fees: Rs 22,45,500

MD Pediatrics (Child Specialist) -- 3 year course -- college fees: Rs 18,31,500
MS Orthopedics(Bone Specialist)

MD General Medicine --- 3 year course-- college fees: Rs 16,09,500
MS General Surgery
MS Obstetrics & Gynecology (Ladies Specialist)

After spending 8.5 years, assuming you get a Post graduate seat in your first attempt, and spending a total of Rs 35,44,000 - Rs 41,80,000 you are certified as a specialist in your field and you can start a private practice and/or join a uni/multi specialty hospital.

Most people settle down at this level of specialization. But this may change in the future due to increasing competition and the demand for super specialists by patients in corporate hospitals.

The pressure to super specialize is already present to some extent in General Medicine and General Surgery.

Super Specialty Courses
Again , a top rank in a competitive exam will grant you an entrance into any of these courses.

If you want to be a Cardiologist(heart), Nephrologist (kidney), Neurologist (nerve), you have to complete a 3 year course after MD General Medicine or MD Pediatrics

Similarly if you want to become a Cardio-thoracic Surgeon, Neurosurgeon , Urologist, you have to complete a 3 year course after MS General Surgery or MD Pediatrics.

Duration: 3 years Course Fee: Rs 22,45,500

So after spending a total of 11.5 years, Rs 57,89,500 and countless exams, you are a super - specialist in your chosen field from one of the best medical colleges in India.

To put this in another way, a 18 year old student entering this end of the tunnel in 2008 will come out of the other end as 30 year old super - specialist in the year 2020.




Post Script: For the sake of simplicity, I have willfully turned a blind eye to the trend of exponentially increasing college fees. I have assumed that college fees will be frozen at the 2008 level till 2020.

I have also assumed that you will get your desired seat in the various entrance exams in your first attempt.

You will have to throw in a few more lakhs for the hostel facility based on the creature comforts you cant live without.

I have not considered Non clinical branches like Pathology, Anatomy, Biochemistry and 2 year diploma courses.

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Eradicating Waves of Malaria

Commenting on the undulating nature of Malaria

"The best-known example of defeat snatched from the jaws of victory is Sri Lanka, which went from one million malaria cases in 1955 to a mere 18 in 1963. Spraying was cut back, and cases surged to 537,000 by 1969. By 2005, the country was again down to 1,640 cases.

The civil war’s cease-fire of 2001 has broken down, and the disease could surge again."

Bill Gates has called for the eradication of malaria. He has been investing a lot of money on this through the Bill and Melinda Gates Foundation.

Just to place this audacious goal in perspective consider this.

A vaccine, considered an essential weapon for eradication of any disease, for polio was developed more than 50 years ago.

Efforts to eradicate polio have been going on since 1985.

There were less than 800 cases of polio in the whole world in 2003.


Yet we are years away from wiping out polio from the face of earth.



In contrast, there are around 500 million malarial infections every year, spread across 107 countries.

And a vaccine for malaria is nowhere in sight.

Can we or should we even aim to eradicate malaria in the near future ?

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