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Wed May 2 06:33:22 BST 2007

Dear All...

I did happen to register for a NTMC course in Delhi, and found it useful. Dr. Joshipura and Dr Joshi were a really ethusisatic lot.

Got to unlearn a few of the "anaesthesia related stereotypes" as well.

I haven't though attended an ATLS course yet. And would like to know how is it different from it. The attendance was enormous. This shows the yearning and positive energy in the doc's from India, if they are offered an option to further their learning.

My concern though is, whether it is a recognised course in terms of quality. And in what other countries is it recognised..

Regards

Mandeep
Senior Resident, Anaesthesia and Intensive Care
AIIMS, New Delhi

On Wed, 25 Apr 2007 Hardcastle,Tim,Dr<tch at sun.ac.za> wrote :
>Sohail
>
>I disagree on your comment regarding ATLS being the only standardised course. IATSIC's NTMC is standardised and was designed for India in particular. I don't know PTC, but have heard similar comments form others. PTC should apparently not be offered in any country where ATLS is established (by agreement with local bodies). The contact persons for NTMC are the Academy of Traumatology of India. The Chairman is Manjul Joshipura. Visit their site at: http://www.indiatrauma.org/
>
>I am not affiliated to this, but am good friends with many of the SA docs who go there as the external lecturers. Check it out!
>
>Tim
>Dr T C Hardcastle
>M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
>Senior Surgeon / Senior Lecturer: Surgery (Trauma and ICU)
>ATLS  instructor and DSTC Cape Town Course Director
>Intern program Coordinator: Surgery
>M.Med (Emergency Medicine) Executive Committee member
>Clinical Head (Director): Diana Princess of Wales Trauma Unit
>Division of Surgery (General) Room 4064
>Department of Surgical Sciences
>Tygerberg Hospital / University of Stellenbosch
>PO Box 19063
>Tygerberg 7505
>Western Cape
>South Africa
>e-mail: tch at sun.ac.za
>Cell: +27824681615
>Office: +27219389281 or 4911 pager 0302
>
>
>
>-----Original Message-----
> From: trauma-list-bounces at trauma.org
>[mailto:trauma-list-bounces at trauma.org]On Behalf Of Sohail Muzammil
>Sent: Tuesday, April 24, 2007 9:23 PM
>To: Trauma & Critical Care mailing list
>Subject: Re: Trauma training in low income countries
>
>
>While I agree with Sanjay; there is a need for a standardized, reproducible
>approach to trauma care across healthcare facilities in low income
>countries. These standards are only provided by ATLS at this time. PTC and
>other courses lack reproducibility and a central audit. At this time there
>are a myriad different courses being taught in Pakistan and the rest of the
>SAARC countries. Sadly PTC has made major inroads in this region and is not
>in my opinion a robust enough model to deserve this approval.
>
>I shall again go back to the recent first regional meeting of the PTC
>foundation at Lahore. Sri Lanka was training ambulance drivers and a group
> from Karachi was training rickshaw (three wheeled cabs) drivers with the
>PTC! It was all over the place.
>
>Andrew is right about the ACLS but the ATLS is just another matter with
>trauma being the killer it is in these countries.
>
>S Muzammil, FRCS
>----- Original Message -----
> From: "Andrew J Bowman" <andrewj.bowman at gmail.com>
>To: "Trauma &, Critical Care mailing list" <trauma-list at trauma.org>
>Sent: Tuesday, 24 April, 2007 9:52 AM
>Subject: Re: Trauma training in low income countries
>
>
> > Although not exactly trauma, it does remind me of my experience about 9
> > summers ago.
> >
> > I was asked to jojn a group of physicians going to India to teach ACLS.
>The
> > coordinator of this project had completed his medical school in Hyderabad
> > before coming to the US to complete his residency and set up shop in
> > Indiana.
> >
> > While I was honored to be included on this trip I came away with a
>lingering
> > question; were we really providing a service to the close to 100
>physicians
> > and few nurses who attended this program? From the seemingly overwhelming
> > numbers of potential patients (11 million+ in Hyderabad) with seemingly
>few
> > hospitals and seemingly difficult access to basic emergency care it did
>not
> > seem to me that ACLS was what the participants needed.
> >
> > I admit, I had just a week to see this country and city but I did not feel
> > that my 3 day ACLS course would have much of an impact.
> >
> > Andrew Bowman
> >
> >
> > On 4/23/07, Sanjay Gupta MD <sanjaygupta99_91 at yahoo.com> wrote:
> > >
> > > I left India about 6 years ago.  I keep a close tab on
> > > medical systems in India and to the best of my
> > > knowledge, there is no community based trauma training
> > > which is appropriate for most doctors.  And that is
> > > exactly my point - getting a course by ACS or any
> > > other organization is not going to help.  The training
> > > program has to be developed in the country and
> > > training imparted to everyone by easily available
> > > resources and by major organization efforts by thought
> > > leaders in India, rather than by paying for the $1400
> > > ATLS course for every doctor in the country.  It is
> > > not the lack of knowledge or training, but rather of
> > > organizing and implementation.
> > >
> > >
> > > Sanjay
> > >
> > >
> > >
> > > --- "Joel U. Macalino, M.D." <jamac at pacific.net.ph>
> > > wrote:
> > >
> > > > In the Philippines, we have adapted a national
> > > > trauma course we now call the
> > > > B.E.S.T. (Basic Emergency Skills in Trauma). The
> > > > course was developed
> > > > through the efforts of the Philippine College of
> > > > Surgeons and is now offered
> > > > almost monthly to accommodate all the trainees in
> > > > surgery. It features
> > > > didactics and skill stations on knowledge we have
> > > > identified to be necessary
> > > > from national injury census and studies. The course
> > > > likewise includes
> > > > disaster management and mass casualty incidents as
> > > > our country is one of the
> > > > most disaster prone area in the planet.
> > > >  Joel U. Macalino, MD
> > > >
> > > > ----- Original Message -----
> > > > From: Miranda Voss <mvossak at yahoo.co.uk>
> > > > To: <trauma-list at trauma.org>
> > > > Sent: Monday, April 23, 2007 8:12 PM
> > > > Subject: Re: Trauma training in low income countries
> > > >
> > > >
> > > > Dear Sanjay and others,
> > > >
> > > > I have only spent 4 months in India but did have the
> > > > impression that you are in the same situation as we
> > > > are in SA: while the urban teaching institutions
> > > > (such
> > > > as AIIMS and Tygerberg) are world class, there are
> > > > many peripheral government hospitals which struggle
> > > > to
> > > > provide a good service and some are frankly awful.
> > > > It
> > > > is in these environments that a systematic approach
> > > > to
> > > > trauma training should be useful.
> > > >
> > > > I am not suggesting that Indian trauma surgeons need
> > > > US style training, but that GPs working in
> > > > peripheral
> > > > hospitals and occasionally (but increasingly) seeing
> > > > severe trauma would find a taught system of managing
> > > > severe trauma useful. I certainly did in my GP days.
> > > >
> > > > Have any of your teaching hospitals developed trauma
> > > > training outreach programmes yet?
> > > >
> > > > Miranda
> > > >
> > > > Dr M Voss FCS(SA)
> > > > Eben Donges Hospital,
> > > > Worcester
> > > > W. Cape, RSA.
> > > >
> > > > From: "Robert F. Smith" <rfsmithmd at comcast.net>
> > > > Subject: RE: Trauma training in low income
> > > > countries.
> > > > Date: Fri, 20 Apr 2007 18:15:39 -0400
> > > > To: "'Trauma & Critical Care mailing list'"
> > > > <trauma-list at trauma.org>
> > > >
> > > > Plain Text Attachment [ Scan and Save to Computer |
> > > > Save to Yahoo! Briefcase ]
> > > >
> > > > IMHO your thoughts are totally correct.
> > > >
> > > > R. Smith
> > > >
> > > > -----Original Message-----
> > > > From: trauma-list-bounces at trauma.org
> > > > [mailto:trauma-list-bounces at trauma.org]
> > > > On Behalf Of Sanjay Gupta MD
> > > > Sent: Friday, April 20, 2007 5:36 PM
> > > > To: Trauma &, Critical Care mailing list
> > > > Subject: RE: Trauma training in low income
> > > > countries.
> > > >
> > > > Hi Sohail and other members of the trauma list who
> > > > work in India and other "soon to be rich countries"
> > > >
> > > > I have worked in India as a surgeon for 12 years and
> > > > then I trained in US and I am working as a trauma
> > > > surgeon now.  I think that the trauma surgeons in
> > > > other parts of the world (outside the rich
> > > > countries),
> > > > should keep on doing whatever they are doing.  I
> > > > think
> > > > they (until very recently we), do an excellent job
> > > > of
> > > > assessing and managing these patients without
> > > > overinvestigating and over diagnosing non-existent
> > > > conditions.  The money to take the ACS trauma course
> > > > and then to do CT scan for (almost) everyone would
> > > > be
> > > > much better spent in buying some good trauma
> > > > textbooks
> > > > and in organizing teams in hospitals where all
> > > > specialists needed are easily available, blood and
> > > > other resources are defined and made available and a
> > > > good ICU with all resources is available.  My
> > > > professors and other much junior faculty members in
> > > > All India Institute of Medical Sciences (just taking
> > > > an example) are as good surgeons and organizers as
> > > > any
> > > > in the Western world.  Rather than getting an
> > > > outside
> > > > organization get the money to run the course,
> > > > organize
> > > > it with local talent which is abundant and
> > > > excellent.
> > > > Remember also that in many parts of the world, the
> > > > trauma patient is primarily taken care of by ED
> > > > physician who then calls the surgeons of various
> > > > specialities as needed.  Most surgeons in India (at
> > > > least if they train from a standard institute and
> > > > make
> > > > the effort to do a senior residency) are very well
> > > > trained and competent to do all sorts of trauma
> > > > surgery.  Just my opinion and an advice to save some
> > > > money.
> > > >
> > > >
> > > >
> > > >
> > > >
> > > > Sanjay Gupta
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > > --- Thomas Anthony Horan <thoran at sarah.br> wrote:
> > > >
> > > > > Sohail,
> > > > > I can certainly support that sentiment, the people
> > > > > who most need the course are in governemnt
> > > > hospitals
> > > > > that are cash poor for this sort of thing. People
> > > > I
> > > > > talk to here say it , (as well as the vast
> > > > majority
> > > > > of other NA and european CME), is simply priced
> > > > out
> > > > > of their budget range. Tom
> > > > > > ----------
> > > > > > From:
> > > > >
> > > >
> > > trauma-list-bounces at trauma.org[SMTP:trauma-list-bounces at trauma.org]
> > > > > on behalf of Sohail
> > > > > Muzammil[SMTP:sohailmuzammil at hotmail.com]
> > > > > > Reply To: Trauma & Critical Care mailing list
> > > > > > Sent: quinta-feira, 19 de abril de 2007 15:10
> > > > > > To: Trauma & Critical Care mailing list
> > > > > > Subject: Re: Trauma training in low income
> > > > > countries.
> > > > > >
> > > > > >
> > > > > > The ACS has enough money so why can they not
> > > > earn
> > > > > some goodwill and waive
> > > > > > the franchise and other fees for third world
> > > > > countries? Beats me.
> > > > > >
> > > > > > S Muzammil, FRCS
> > > > > >
> > > > > > ----- Original Message -----
> > > > > > From: "Matt Oliver" <moliver1 at iinet.net.au>
> > > > > > To: "'Trauma & Critical Care mailing list'"
> > > > > <trauma-list at trauma.org>
> > > > > > Sent: Thursday, 19 April, 2007 2:15 AM
> > > > > > Subject: RE: Trauma training in low income
> > > > > countries.
> > > > > >
> > > > > >
> > > > > > WHO was promoting PTC (Primary Trauma Care)some
> > > > > years ago, this may also be
> > > > > > worth looking into as India is on the list of
> > > > > countries participating. See
> > > > > > http://www.primarytraumacare.org/
> > > > > >
> > > > > > Matt Oliver
> > > > > > Bendigo
> > > > > > Australia
> > > > > >
> > > > > > -----Original Message-----
> > > > > > From: trauma-list-bounces at trauma.org
> > > > > [mailto:trauma-list-bounces at trauma.org]
> > > > > > On Behalf Of Miranda Voss
> > > > > > Sent: 18 April 2007 22:07
> > > > > > To: trauma-list at trauma.org
> > > > > > Subject: Trauma training in low income
> > > > countries.
> > > > > >
> > > > > > The International Comittee of the Red Cross also
> > > > > > offers the Emergency Room Trauma Course (ERTC)
> > > > as
> > > > > a
> > > > > > cost effective alternative to ATLS in lower
> > > > income
> > > > > > countries.
> > > > > >
> > > > > > Miranda.
> > > > > >
> > > > > > Dr M Voss
> > > > > > Eben Donges Hosital
> > > > > > Worcester
> > > > > > W Cape, RSA.
> > > > > >
> > > > > >
> > > > > > From: "Hardcastle, Tim, Dr <tch at sun.ac.za>"
> > > > > > <tch at sun.ac.za>
> > > > > > Subject: RE: world road safety.org (was -
> > > > Disaster
> > > > > in
> > > > > > Roanoke - Proximity oftrauma centers)
> > > > > > Date: Tue, 17 Apr 2007 10:49:18 +0200
> > > > > > To: "Trauma & Critical Care mailing list"
> > > > > > <trauma-list at trauma.org>
> > > > > > Plain Text Attachment [ Scan and Save to
> > > > Computer
> > > > > |
> > > > > > Save to Yahoo! Briefcase ]
> > > > > > Rajesh
> > > > > >
> > > > > > You do, however have NTMC - the IATSIC lower
> > > > > income
> > > > > > country trauma
> > > > > > course. If yuor passion is strong get involved.
> > > > > > Contact through Indian
> > > > > > Trauma Society.
> > > > > >
> > > > > > Tim
> > > > > > Dr T C Hardcastle
> > > > > > M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
> > > > > > Senior Surgeon / Senior Lecturer: Surgery
> > > > (Trauma
> > > > > and
> > > > > > ICU)
> > > > > > ATLS  instructor and DSTC Cape Town Course
> > > > > Director
> > > > > > Intern program Coordinator: Surgery
> > > > > > M.Med (Emergency Medicine) Executive Committee
> > > > > member
> > > > > > Clinical Head (Director): Diana Princess of
> > > > Wales
> > > > > > Trauma Unit
> > > > > > Division of Surgery (General) Room 4064
> > > > > > Department of Surgical Sciences
> > > > > > Tygerberg Hospital / University of Stellenbosch
> > > > > > PO Box 19063
> > > > > > Tygerberg 7505
> > > > > > Western Cape
> > > > > > South Africa
> > > > > > e-mail: tch at sun.ac.za
> > > > > > Cell: +27824681615
> > > > > > Office: +27219389281 or 4911 pager 0302
> > > > > >
> > > > > >
> > > > > >
> > > >
> > > >
> > > >
> > > >
> > > >
> > > >
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> > >
> > >
> > > Sanjay Gupta MD
> > > Tel: 412 335 6304
> > >
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Trauma training in low income countries