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I heard about this issue from some of my friends from Mumbai. This seems like an exceptional issue but unfortunately it is the escalation of the terrible situation of medical residencies in government hospitals in India. Mumbai government hospitals have been one of the prime culprits but they are not alone.Before I go on to what is at the crux of this present situation I would like to add that this miserable situation is not present in all residency programs (including mine) but the problems of residents in medical colleges have been unaddressed for quite a long time.I would like to start with a little background.The general work culture in government hospitalsThe brilliant medical students who have cleared a very tough residency entrance exam to secure a government medical residency seat are often treated shabbily by the system. They are often put up in slum like living condition in hostels with bug infested rooms, mosquitoes and the works by government colleges.Hostel rooms for residents of Sion Hospital, MumbaiMost of the student & resident hostels in government medical college hospitals in India resemble the above photograph.The residents are often made to work 80-100hrs a week resulting poor nutrition and low morale. A lot of them end up sick and in extreme cases even dead. Every year several residents of very busy hospitals in Mumbai (KEM, Sion, JJ) and many other cities die of communicable diseases like dengue, malaria,tuberculosis, etc These diseases are exacerbated by the malnutrition, depression and lack of sleep for these doctors (Who takes care of doctors in BMC-run hospitals?). There are several incidents of residents' suicides due to excessive stress and harassment by their professors every year.[1]There is also an added danger of flash mobs assaulting the emergency doctors on call. The general feeling is the residents are often disgusted with the system and with their seniors for perpetuating this unfair system. This is how the brightest in the field are treated by the system (Why Indian doctors fear for their lives).The Grant Medical College crisisThis harassment has been an open secret for quite a long time now. The man at the center of it all is Dr. T. P. Lahane is a man who presently holds the world record for the highest number of cataract surgeries. He is presently the dean of Grant Medical College, Mumbai and formerly head of the department of the Ophthalmology there. He still runs the show in the department. He has been highly decorated with many awards including a civilian award- Padma Shri for his services. But what hides behind these accolades is a culture of bullying, harassment and political power which supersedes everything else. The ground realities are nearly all eye surgeries done in the hospital are attributed to him (and hence the record). The residents don't get education nor training in ophthalmic surgery. The following video is the account right from the aggrieved junior residents themselves.I admire this bunch of 12 brave residents who had the courage to come out and report this harassment. They are made to work for long hours everyday and not allowed to eat or drink. Insulted and abused regularly for no fault of theirs and blamed for the complications of the professors. I'm worried for them as they face a huge political lobby which thrives in this cesspool. Dr. Lahane is no stranger to controversy (JJ Hospital's dean Dr TP Lahane's anticipatory bail challenged in Bombay high court) and has emerged out of every kind of trouble without any trouble. He and his associates (Dr. Ragini Parekh who is co-accused) have immense political clout and I would be pleasantly surprised if any action is taken at all on them, much less a suspension or transfer as demanded by the the Maharashtra Association of Resident Doctors (MARD) in their petition to the chief minister and director of medical education (DME). I just hope these 12 residents don't suffer for their brave step.What is also striking is the near silence on this issue by most media outlets. If this had occurred in a multinational company or even a major Indian company, there wouldn't be any other "breaking news" playing nationally. But this issue is relegated to the corners of newspapers never to be followed up again. Few junior doctors asking for dignity is not going to shake the nation nor win elections for politicians.There is an online petition to the government which was started 7 months back to take back the Padma Shri on account of various illegal activities. I hope some good can come off this situation.Government of Maharashtra: Truth behind the facts of a Padmashri awardeeFootnotes[1] �Resident doctors being mentally harassed' | The Asian Age

My opinion might be a little controversial among the medical fraternity and I do understand their concerns. Having such a 2/3 year course in India is possibly one step too near towards possible quackery. This would enable any person working in a medical facility for a few years to do this course and then call him/herself a doctor in rural and urban communities- sanctioned legally by the government.Such programs are common place in many developed countries.Physician assistants in the United StatesNew medicine course in West Cumbria is ‘first of its kind’ in the UKSo we need to see the ground realities in India before we totally throw this idea out of the window. India does need to recognize the need for integration of a large volume of practitioners of alternative medical streams into mainstream medical sector. A 2015 report by Reuters, has some worrying statistics regarding the quality of existing medical professionals and the sorry state of healthcare in India."About 45 percent of the people in India, who practice medicine have no formal training, according to the Indian Medical Association. These 700,000 unqualified doctors have been found practicing at some of India’s biggest hospitals, giving diagnoses, prescribing medicines and even conducting surgery," it says.So 45% of people treating our countrymen are practicing illegally anyway despite all the laws that was supposed to ensure good quality healthcare access. So ignoring this fact will not help us in anyway. So how do you get many of these unqualified medical workers into the fold of mainstream healthcare?We need to create a separate class of medical workers below the primary health care physician level but above the untrained people (posing as doctors) to help in primary care. This class of medical workers can be called Medical Assistants( MA). A separate course of two-three years (and not a bridge course) is the need of the hour. Mind you, we SHOULD NOT call these workers doctors or physicians. The dispensing of over the counter (OTC) drugs, giving vaccines including injections, prescribing glasses, dispensing drugs and dietary supplements supplied by government schemes, providing appropriate dietary advice can be in the realm of their duties.Nurses, practitioners of alternative medicine, midwives, medical technologists and optometrists can apply for this course to become medical assistants in specific areas of medicine. Few examples:A midwife working in labour ward can become an Obstetrics assistant after this course. They can conduct deliveries in rural areas as well prescribe & administer few obstetrics related and birth control drugs (Oxytocin, Misoprostol, etc). They should also be empowered to perform an episiotomy and suturing of the vaginal opening after delivery legally. MTP, C- section, complicated labour should be left to OBGGYN specialists.An optometrist working in an eye hospital can become an Ophthalmic assistant. They can help screen patients in rural areas those that need to be referred for secondary and tertiary care, dispensing glasses, prescribe OTC/common eye drops (not steroid or other dangerous eye drops). Every such Ophthalmic assistant should have an easy referral channel to an eye hospital where complicated cases can be referred.Once a patient is diagnosed with tuberculosis and prescribed a DOTS regimen (a government-sponsored scheme), the patient's further treatment can be supervised by medical assistant (who has undergone MA course in primary care) and referred to higher centers in case of complications of the disease or drugs.A nurse can qualify to be a Anesthetic assistant. They can be empowered to provide short general and regional anesthesia, so that a primary healthcare physician may be able to perform simple procedures like removing small masses, drain abscess or perform a medical examination (like in a child)This medical assistant course needs to be designed for specific function that they will serve and their range of work shouldn’t exceed that brief. You don’t want an optometrist doing cataract surgeries after this medical assistant course. They should 'not' be able to practice modern medicine on par with an MBBS practitioner or specialist. They can be under government employment mainly (most likely) or in private they can charge their own fee (which may not be a sustainable model so not likely)Just starting this course and creating qualified personnel will not be of much benefit unless it is supported on ground with appropriate infrastructure. Unless the Obstetric assistant has a supply of drugs and access to labour related instruments in a primary health center they may not be of any benefit whatsoever for rural women. Unless good quality drugs are supplied to rural areas by the government, having a medical assistant in a village is useless.There also needs to be checks and balances factored into the system. Those MAs found to be prescribing medicines they are not authorized to or performing surgeries should be permanently banned from the field , fined and even jailed depending on the level of the offence. They should also be liable to be sued by aggrieved parties in case of negligence because that makes them accountable to the treatment they give and also makes them refer to higher center when they realize that it’s beyond their capability.Our healthcare policy needs to make healthcare in India more inclusive to all, empowering people providing healthcare with more resources and also make them accountable for the service they provide. This will take a lot of planning and responsibility on the part of the government. The governments should not be using “bridge course” policy to take short cuts and help achieve their political goals. They should have a vision to improve healthcare delivery to the most remotest parts of the country and should have strong systems in place for that.

After studying Optometry, you can make your career as optometrists, ophthalmologists & Optician.An ophthalmologist is a physician (medical doctor) who specializes in the surgical and medical care of the eye & vision system. Ophthalmologists offer complete eye care services. These include: Vision services, Medical eye care, Surgical eye care, Diagnosis and treatment of eye, Plastic surgery.Optician is also a very important part of the eye care team, but it is not an eye doctor. An optician uses a prescription that is written by an optometrist or an ophthalmologist. Optician is a technician who is trained to design, verify fit eyeglass lenses and frames, contact lenses, and other devices to correct eyesight.The career opportunities in all these fields are wide & huge in demand both in India and abroad.Optometrists can work as post-secondary teachers, occupational/industrial safety programs, consultants in the eye care industry or do research in optometry colleges. Optometrists can also set up their own private clinics & work independently. They can also choose a career in sports vision, public health and government service or community health centers.Ophthalmologist may choose to set himself up in private practice, as a solo practitioner or as part of a medical group. As an Ophthalmologist, you can work as a public health employee, professor in the medical universities, military doctor, & as an employee of a clinic, hospital & government agencies.Top Job ProfilesSome most famous job profiles of Optometrists are given below.Customer Care Associate.Private Practitioner.Professor.Trainee Optometrist.Vision Consultant.Optometry Researcher.Salary & Pay ScaleThe initial monthly salary of an optometristranges between Rs.20, 000 to Rs.40, 000. Optometrist can earn Rs. 4 to 5 lacs per year as a fresher. An ophthalmologist makes different salaries depending upon their employment place, applicable skills and geographical area. In India, they can earn at least Rs. 9 to 10 lacsin a year. The median salary for an ophthalmologist in the US is $202,133 annually.