Not a case for social triage
I request the author of the letter “Institutions should take responsibility for student suicides” (1) to refrain from passing unwarranted judgement on a matter that is still before the courts. It is premature to implicate the medical education system and its institutions for a possible role in the untimely death of Dr Payal Tadvi. Medical ethics and human rights are among the core ideas of the medical education system. We do observe situations that could be regarded as somewhat encroaching into violation of human rights; but that is of an unpremeditated nature and mostly due to infrastructural or manpower limitations. Like any other social institution, violence is not considered normal in healthcare. “Normalised violence” is bit of an overstatement. Personal feelings derived from hearsay evidence should not be the basis to jeopardise a time-tested system.
The Indian medical education system is high on reliability as we do see millions of people getting treated every day in every corner of the country. Discrimination is a cultural phenomenon and is a reflection of society as a whole. A better approach would be to formally identify and deal with ‘root causes” rather than casually shifting blame upon a highly esteemed system of education for events that are beyond its reaches.
There is a fundamental difference between medical postgraduates and medical undergraduates. Medical postgraduates are registered medical practitioners—doctors and employees with a salary structure. Every senior doctor has a responsibility to get patient-related work done by juniors because that is the central idea running the healthcare machinery. Although citing pressure of work is a terrible excuse for making discriminatory slurs, there is no denying that such things do happen. The important thing to note here is that holding the medical “education” system, which is just one component of healthcare, responsible for discriminatory attitudes of employees is a bit impulsive. I did not get “time to bathe, eat and sleep” during my residency because we understood and were taught that a patient’s right to healthcare cannot be denied under any circumstances. It was a lot of physical hardship but we generally tend of think of that as a professional hazard due to a huge patient inflow, rather than a flaw in medical education/ training.
The demise of Dr Tadvi is a sad incident but we must have faith in our judiciary and refrain from prematurely passing judgement against individuals and systems. The three detained individuals in Dr Tadvi’s case did not have “unaccountable power”. It was unfortunate that Dr Tadvi did not report to authorities that she was facing discrimination or else the college administration would have taken a strict stance as discrimination is neither tolerated nor propagated in any educational institution. I request the author to avoid making highly opinionated statements that might inflame sentiments and patiently wait till the trial is over.
I declare no competing interests and no funding.
Mrinal Prakash Barua (mrinalbarua@gmail.com), Associate Professor, Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, INDIA