Vipin is my very dear friend. He always goads me to write something for his brain child – “The Pediascene”. He has even made me its advisor. He simple uses this as an excuse now to force me to write, saying that some thing has to come with my signatures. Does he force me to write? Am I reticent? It does seem so. But why? It seems I have become more cynical of being able to make any impact by what I write or say.

And then, what should I write on ? Is it to be on medical education as of today ? – a system which has become a factory to produce plenty of soaps with the hope that they will be able to wash away the illness of those living in extremely poor conditions. Or is it a system which is being today erected on the foundations of a faculty which is either inadequate or anointed by questionable means ? Soon, it is reported, the Medical Council of India will be opening it doors to faculty from countries like Russia, Greece, Spain et al. Yet, whatever faculty we have right now is too busy into projects pushed by NGOs or in training paramedics rather than medical students. Moreover, the infrastructure of the institutions is either woefully insufficient or too extravagant and most graduates are either getting into practicing quackery or going abroad.

Or should I write about our Academy where I am running my second term as EB member. Too many good things have come and are being planned by the concerted efforts of a well meaning and dynamic leadership. But quite often several of the good programmes do not even get the audience that they deserve. The organizers have to go about requesting people to attend. Someone has to work on the cost effectiveness and impact of these programmes. Otherwise, they would seem to be just like programmes organized by the service clubs trying to fulfill certain quota in order to showcase achievements. Moreover, the studies quoted in these meetings are usually from other countries and then extrapolated to our country. I wonder what has happened to the ICMR? Has it become a lame duck or have we restarted turning a Nelson’s eye towards it.

Another, subject that is today being raised in the academy is the question of proprietary especially in matters of our relationship with pharmaceutical companies vis-à-vis funding for programmes or personal use. Money is surely needed to run the wheels of any organization. It came from business houses even for our freedom struggle. It has now become an ever pervasive practice in the political arena today and no comments are needed to make it more explicit. It has filtered to the whole society. We have also examples of the celebrities charging fees for endorsing products over the mass media. This naturally needs to some doubts in the minds of members. In view of this, does the IAP need to evolve its own code of conduct or shall we also remain happy doing what is happening elsewhere ?

Yet another bug afflicting the academy (like the country) today is regionalism. Hope the illness lasts short. And of course, there are some who spend more time in finding faults with those who try to undo the wrongs than with those who do the wrong and also defending what is indefensible.

No matter which subject I write on, it may carry some critical references to some thing. Would this serve any purpose? Perhaps none. Why should I then scorch myself and others if it has not to make any difference ? Perhaps only a hope that small expressions may some times add to similar ones from others to bring about some change in the way of things. The other option remains of not writing at all, doing more of introspection and getting busy elsewhere because there is so much else to do.

(This article was received before the start of the Pediascene debate on sponsorships etc. - Editor)

-- Dr. Ajay Kalra, Professor Pediatrics, S.N. Medical College, Agram