AIIMS will have a 460 Bed most modern Digestive Diseases Center

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 Interview: Prof. Peush Sahni from AIIMS, New Delhi

AIIMS will have a 460 Bed most modern
Digestive Diseases Center

India has thirty centers which are doing liver transplants
but 
most foreign nationals come to New Delhi centers

It is a great privilege to be a faculty member at AIIMS which
brings with it great respect in the profession and the society

By Shaukat Ali Jawaid

LAHORE: Prof. Peush Sahni, a distinguished academician and an extremely humble personality who is Prof. & Head of the Dept. of Gastrointestinal Surgery  at All India Institute of Medical Sciences (AIIMS) New Delhi India, who is President of Indian Association of Medical Journal Editors, also former President of World Association of Medical Editors (WAME) and Editor of National Medical Journal of India published by AIIMS visited Pakistan along with his wife Dr. Ameet Sahni consultant anaesthetist recently. Their visit was in connection with the Pakistan Association of Medical Editors (PAME) Third National Conference 2016 held at University of Health Sciences Lahore from April 1-2, 2016 where he was one of the invited Guest Speakers. Despite the fact that he got the visa on April 1, 2016, they managed to travel to Pakistan via Oman and enriched the conference proceedings with their contributions on second day of the conference. During his stay he managed to spare some time to talk to Pulse International Chief Editor. During this exclusive interview a number of topics were discussed which included postgraduate teaching and training programme in India, functioning of the Indian Association of Medical Journal Editors, World Association of Medical Editors (WAME) G.I. Surgery and liver transplant prgramme besides collaboration between India and Pakistan to promote the art of medical writing and scientific publishing. Given below are the excerpts from the conversation:

When did you qualify and how you got interested in G.I. Surgery?

I joined All India Institute of Medical Sciences in 1976 as an undergraduate and graduated in 1981. Then I got admitted in MS programme in 1982 and qualified in 1985 after completing the three years training curse.  It was MS in General Surgery.  I started working as Senior Resident. At the same time GI Surgery unit was started. I opted to go to GI Surgery. To begin it was a unit but in 1989 it became a full-fledged Department. I did my Ph.D. in 1988.  While working as senior resident I also got enrolled as Ph.D. student as it was allowed.  I earned my PhD in 1993. Topic of my thesis was   Non Cirrhotic Portal Hypertension.


Dr. Fatema Jawad outgoing President PAME presenting certificate
of participation to Prof. Peush Sahni from AIIMS, New Delhi, India.

While doing my PhD, in 1991 I joined AIIMs as Assistant Professor in G. I. Surgery.  I was the second faculty member apart from my head of the dept.  In 1993 the third faculty member joined. He was also working with us since 1986. Since my undergraduate in 1976, I am at the AIIMS for the last forty years.   We had four surgical units in the dept.  I had also done Internship through general surgery for six weeks.   Surgical unit four in which I was working was closely working with medical gastroenterology.  Hence those needing surgery were referred to this unit. So I got posted to that unit.  It was a unit in 1985 but it became a Dept. in 1989.  Now we have five faculty members. We started with an eight bed but now we have 32 beds. It is named as Dept. of GI Sugary and Liver Transplant. We chose those areas in which other people were not interested or did not had expertise or were under developed, underworked. Hence we had a smooth sailing without any hindrances. We now run MCH programme. We induct five trainees every year.  These postgraduates join in January and in July every year. We have induction twice a year. First we had an occasional operation theatre but now we have six tables a weeks. We are now poised for a major expansion. It will have 460 Bed Digestive Diseases Center within the campus.  It will have medical surgical anesthesia and all other allied specialties. It has been planned. Land has been located. Funds are allocated. It is in planning stage and it should be ready in next three to four years’ time by 1920-1922.

Retirement age for teachers in India is 65 years but in non-teaching public sector hospitals, it is 62 years. But we can work as medical teachers up to seventy years of age as it is allowed by Medical Council of India.


Would you like to give some details of the Liver Transplant programme in your department?

We started doing deceased donor liver transplant in 1995. We did one or two. But for next three years, we did not do any. We did not have donors. During the last three four years, it has picked up again. Now we do four to five liver transplants a year. We do wish to do more but because of non-availability of donors it is not possible.  Deceased donor programme is not good in Northern India. In South India it is good. Live donor programme has picked up n Northern India. New Delhi has two major centers. They are doing about three hundred liver transplants a year. There are two other centers and they do 50-100 liver transplant a year. In all there are thirty or more liver transplant centers in India. There are eight in and around New Delhi capital territory. There are many centers in West and South. Tamil Nadu has ten enters. Kerala has eight centers.  More foreign nationals come to New Delhi for liver transplant. Dr. Rela is doing lot of work. He is working at Kings College Hospital UK but he is also affiliated with a center known as Global Hospital where he works in Chennai.

How you fell in love with Medical Journalism.

Stephen Lock Editor of BMJ came to India in 1987 and conducted a workshop on Better Medical Writing. It was a two day workshop. We published its proceedings in a Book form. During the panel discussion somebody asked a question to Stephen Lock that “you are very bias you do not publish articles from India”. At this he responded that they will publish papers from India if they are of good quality but they do not get good quality papers. We accept papers which are of interest to our international readers. During the discussion he also pointed out that he has done four workshops in India and he feels that there is a need for a good quality General Medical Journal from India but he does not see it in India. Our Director at that time, a Radiologist lady she was member of the panel. She was also sitting among the audience. She asked my Head of the department to start a journal and it should be owned by AIIMS. That is how the National Medical Journal of India was born and that is how I got involved.  I was still a resident.  I was involved in proof reading and other related work of the journal. We thought let us find somebody who can start how to write proposals for getting funds. I was part of it and institution had allocated funds for that. Since we were working in the same unit, we were asked to do it. So I have seen this journal i.e. National Medical Journal of India from the first issue. Now it is in its 29 years of publication.

Prior to that I had some interest in journalism. My boss and Gastroenterology Dept. were publishing a journal Tropical Gastroenterology Journal. It is still being published.  I was included in the working committee of the Journals. I became associate editor.  For the last six years I am the Editor of National Medical Journal of India.

Becoming President of a prestigious body of medical editors like World Association of Medical Editors (WAME) is a great honour and achievement. How it became possible?

It was in 1995 that I was asked to attend the first meeting of WAME held in Italy. Prof. Nundy from National Medical Journal of India was invited. We together became members of WAME.  In the year 2000 there was a strategy meeting how to promote and strengthen WAME. I was also invited. Fiona Golde Editor of BMJ invited me. She was the President of WAME at that moment. She sent me an e mail if I will be willing to be nominated as a Vice President. I said I do not have funding and cannot come to the meeting. She said they have some funds for travel grant for people from developing countries. Your travel, boarding and lodging will be looked after. I said ok I will come. It was WAME strategy meeting in 2000. A few months later I again got an n e mail if I will accept the nomination as Vice President of WAME.  I asked what I will have to do. She said, do not worry we are all there to support you. So I agreed.

 

On left Prof. M. AkbarChaudhry presenting mementoe to Prof. Peush Sahni on behalf of UHS and
on right
Mr. Shaukat Ali Jawaid presenting him mementoe on behalf of PAME. Also seen in
the center is 
Prof. Mohammad Aslam VC UHS.

WAME has a nomination committee. It is chaired by past president. One WAME Director and one ordinary member are its members. It nominates a slate of candidates. Then it is proposed to the general membership. Vice President is elected. If anyone else is also interested he is also allowed to contest. Vice President then becomes the President when the next elections are organized. That is how I became President of WAME.

What about the Indian Association Medical Journal Editors and how it functions?

Indian Association of Medical Journal Editors was formed in 1993-94. We had very irregular meetings. Sometime an emergency meeting was organized which was attended by twenty to thirty people.  If someone was visiting, we held the meeting. It used to be a one Day meeting, two day meeting or one and a half day meeting. But there meetings were very Irregular. There is always a small group which is loitering and looks at what are options.  Then they remain away from it. They are not interested. People are not coming to the meetings People had no funding. If they have funds they will prefer to attend their own specialty meeting rather than journalism meetings.  Some people remain interested for four to five years.  Hence we had a floating membership. Eventually the association got established on sound footing in 2002-2003.  We had a meeting in 2008 in collaboration with India US technology Forum and we were able to invite five facilitators from oversees. Seventy Editors attended it. We continued our efforts to get on.  In 2011 we had a small meeting. In 2013 we had a well attended meeting which was attended by 110 editors. We arranged funding for five facilitators. We had WAME meeting in 2015. Now we have been on track. I was elected President of IAMJE in 2013 for three years term up to 2016.


We do not have regular workshops under the banner of IAMJE. But we do hold in house workshops in our department three to four meetings every year addressed at junior faculty members and residents. Two workshops are held in Lucknow. It is funded by NIH grant for capacity building. Prof. Rakesh Agrawal has managed this grant and we cover Medial Writing, Statistics and Medical Editing. Now it is mandatory for PGs to attend five days’ workshop on Research Methodology. Last day is for presentation and publication papers.

AIIMS has full time faculty. What motivates the faculty to keep working without any private practice and has there been any move to get permission for at least institutional practice at AIIMS?

 Sometime ago it was attempted and the idea was to start private clinics in the evening after 5.00 PM allowing the faculty members to see private patients.  Some of us protested as we felt that it will destroy the culture of this institution. Health Minister at that time was an industrialist. He said he wants to see those who had written a letter and who do not want more money. We had a meeting. He listened to us and said he agrees with our viewpoint and will not push this proposal. People, who do want to make money, resign and go to private sector.   Being a faculty member of AIIM brings with it privilege and respect not only in the medical profession but also in the society. Some people do leave. There are two groups one is those who are close to retirement and they resign two three years ago. Other group is young people who join AIIMS and soon realized that they had some idea but it was not feasible so they quit. We now have over fifty departments and seven centers. These centers are Cardiac, Neurosciences, Cancer Hospital run in collaboration with Rotary, Trauma Center and National Drug Dependence Center. The proposed Digestive Disease Center will be yet another addition to these centers.

Please give some details about the MS MD programme.

After MBB and internship you join three years MS MD programme. It is a structured training programme. It consists of teaching and training in the Out Patients Departments, in the ward.  There is rotation in specialty and sub specialty centers. One has to go through Two to three months rotation in different departments in related allied subjects.

We have now introduced internal assessment as well and it is included in the evaluation for the final exit exam. At the end of the training, they have to write a Thesis.  Pass percentage is 90%  but it is difficult to get in. For example in AIIMS it is a big problem to get into sub specialties training. For two seats in Gastroenterology there will be two hundred applicants.  So those who are selected are really good and those who fail are those who have some problems, they were sick or could not concentrate.


 We in India also have a second postgraduate training programme which is known as DNB i.e. Diplomat of National Board in different specialties. It is mostly run in private medical colleges and corporate hospitals. Getting in is easy but Pass percentage is poor, at present it is about 65% but previously it used to be just 30%. At some centers the pass percentage is still very low. The department who are training for MD MS won’t be training for DNB. But there are a few exceptions where both programmes are running.

Do you think we can have some exchange program of faculty members between India and Pakistan?

It may be difficult for both governments to listen to it at present but with advances in information technology we can listen and watch and organize some academic programmes through video conferencing. We can also have programme on SKIPE.  For Hands on training, someone has to do it. It can be introduced and may be this is the beginning of our collaboration in the field of academics.

What is the number of medical colleges in India and what is the government policy?

At present there are about 400 medical colleges in India of which 50% are in private. In the last few years there has been a huge increase in their number in private sector. I believe the situation is similar in Pakistan and Bangladesh. Now Government policy is to encourage it. They feel we need more doctors. For the last five to seven years government has also started opening new medical colleges as it feels this is the answer.

There was lot of news about corruption in Medical Council of India?

Ministry of Health has now constituted a committee to revamp Medical Council of India.  This committee consists of some very senior people and one hopes they will be able to suggest some measures to make it more effective and transparent in its functioning.

Did you enjoy attending the PAME National Conference?

It was an excellent meeting. Five to seven days ago it looked it won’t be possible for us to attend  but then when we had the NOC from Government of Pakistan issued on March 31st 2016. I got the Visa on April 1st at 2.30 PM and we got night flight and reached in ten hours flight through Oman rather than one hour flight from New Delhi.


Our problems of running small journals are the same.  Publishing a journal is not economically viable except for few twenty thirty journals with deep pockets, huge advertising revenue.  We should discuss and try to resolve our problems instead of reinventing the wheel.  To every meeting I have gone, I learnt a lot listening to other Editor colleagues. And it helped solve some of my problems.

My son came to attend South Asian Youth Conference in Islamabad through Bus to Lahore and then by bus to Islamabad and spent three days plus two days of travelling.  He was very much excited. We were also keen to visit Pakistan as my forefathers had lived in Lahore. My wife is anesthetist at Delhi University. She graduated from Maulana Azad Medical College which is an undergraduate medical college. She did MD in anesthesia from the same university where she is currently working? We would like to thank everyone for the excellent reception and hospitality we got while in Pakistan.

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