Background: In India, there is a large gap between the mental health morbidity in society and the availability of psychiatrists. However, the latest Indian undergraduate medical curriculum does not require any competency in psychiatry to be fulfilled for certification of medical graduates as doctors. Thus, the role of Indian psychiatry teachers is quite challenging. Interestingly, there has been hardly any effort to understand the felt needs of psychiatry teachers that may further improve the quality of undergraduate training. Methods: We used a survey questionnaire that was both qualitative and quantitative, with questions on topics such as years of psychiatry training and experience as a psychiatry teacher. Do they feel the need for training in undergraduate psychiatry teaching? Do they require training in teaching psychiatry theory or clinics or both? What are the specific areas where they want training? What more should be planned for psychiatry teachers? Based on an online survey further steps in the direction of psychiatry teachers felt needs were initiated. Results: Around 55 responses with a response rate of 37% were received. More than 50% were working in medical colleges for the last 5 years. About 80% felt the need for further training to teach medical students while 97% felt that additional training is required for handling theory as well as bedside clinic. More than 60% were keen to attend a 1-day workshop to upgrade their teaching skills. A majority wanted to have a forum to share their experiences and to learn from others. Based on the felt needs of psychiatry teachers from the survey, a 1-day workshop was carried out and a forum for psychiatry teachers was inaugurated. Conclusion: Training of psychiatry teachers is an important felt need for the challenges that are unique to Indian medical education. The outcome from the Karnataka survey is a progressive step in addressing this challenge.
Background:
India has one of the largest numbers of doctors in the world. It is estimated that more than 1 million doctors are in India. Every year more than 80,000 medical students graduate as doctors from 529 medical colleges in India. Medical profession is considered as more stressful, but mental health is still a subject of taboo in medical profession in Indian context. Doctors have higher suicide risk, 2.5 times more than the general population. In the United Kingdom, 430 doctors committed suicide between the years 2011 and 2015. Even though suicide among doctors is reported in Indian media, there is hardly any scientific study that has looked into the suicide among Indian doctors because of many hurdles in the collection of information.
Materials and Methods:
All the Indian newspaper that are published in English and are available in the online platform were scrutinized on doctors suicide report from the year 2016 March to 2019 March.
Results:
Thirty suicides were reported between 2016 March and 2019 March, out of which 18 were female and 12 male. More than 80% were younger than 40 years. Twenty-two were from medical education institutions. Seventeen were from south India and 13 from North India. Eight were MBBS students and ten were postgraduate students. Among subspecialties, six doctors were from Anesthesia. Seventeen used hanging as a method for suicide, eight used medications, and five jumped from building to end life. Nineteen of suicide reports about doctors mentioned that they were depressed.
Conclusion:
Suicide among Indian doctors is concern. Majority are young undergraduate and postgraduate medical students. Female doctors were more than male doctors. Most doctors were reported to be depressed and used lethal method such as hanging and medications.
Abstract:Psychosocial risk factors significantly contribute to the morbidity and mortality of patients with cardiovascular disorders. The present study explored the anxiety and depression status of patients with coronary artery disease and evaluated the effect of deep breathing exercise on these psychosocial variables as well as physiological variables like heart rate variability and blood pressure. A randomized control design was adopted for the study. Out of 65 clients eligible for the study, 45 were selected based on inclusion criteria. Patient were trained in Deep breathing exercise (DBE)for 2-3 days, were instructed to practice the exercise twice a day for 10 min for a period of 2 weeks, further instructed to come for follow up to cardiac OPD after 2 weeks. The study findings revealed that majority of the cardiac patients were anxious 39 (86.66%), 23(57.5%) had mild depression and 3(7.5%) were with severe depression. Fischer's exact test revealed a significant association between depression and occupation (p=0.051), monthly income (p=0.031) and co morbid disease (p=0.006, p<0.05). Karl Pearson's correlation coefficient revealed significant positive correlation between anxiety and depression i.e. (r = 0.414, p <0.01). DBE was found to be effective in reducing anxiety and diastolic BP of clients with CAD. But there was no significant reduction in HR, SBP and depression after the intervention.
The COVID19 pandemic is an unprecedented disaster. In India, the spread of COVID19 infection and the subsequent lockdown coincided with a crucial period of the annual examination in almost all educational institutions. The pandemic has created hurdles in the conduct of examination due to many reasons, some of which are spread of infection and associated safety issues, lack of public transport for patients as well as the postgraduates in outstation and examiners, and lack of workforce due to round-the-clock service for rendering health services leading to difficulty in arranging logistics at the examination center. Currently, there are no guidelines or policies on how examinations need to be carried out during such a pandemic. Hence, there is an urgent need to look at solutions within the profession for the completion of examination. Teachers of psychiatry play an important role in the national mental health services. Their expertise can be valuable for finding solutions that work. This article has compiled suggestions from Indian teachers of psychiatry.
Varied presentation of infectious diseases like the rheumatic fever is on the rise especially in rural areas where a great proportion of communicable diseases are undiagnosed and untreated. Keen clinical examination and early treatment with minimal laboratory aid reduce healthcare expenditure in low socioeconomic regions. An 18-year-old adolescent girl presented with acute onset of motor tic for 2 weeks which progressed to vocal tic in a span of 6 weeks. As per the initial presentation, the patient was worked up as a case of Transient Tic Disorder and later as Tourette Syndrome. All the test results including Rheumatic Heart Disease workup were negative. But the patient developed Pure Chorea 2 weeks after this. The patient was treated on a presumptive diagnosis of Rheumatic Chorea and is now in remission for 6 months. Even though tics and other movement disorders can be associated with Rheumatic chorea, it is seldom to present as pure tic disorder at the first encounter and in relatively uncommon age group making this case special. Rather than early referral to movement disorder center, detailed observation of disease progression can prevent unnecessary work up.
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