Cadaver shortage makes simulation best alternative for medical students (Medical Feature)

With India facing a grave shortage of cadavers in medical institutions to train its doctors, surgical simulation - replacing corpses with artificial bodies - is fast becoming the need of the hour, prominent surgeons said.

They said a perfect medical learning atmosphere needs at least one cadaver to teach four medical students, but due to the scarcity of bodies 40 to 50 medical students in medical colleges have to study on only one cadaver.

The shortage has thus forced many medical colleges to turn to simulation (a dummy made of clear gelatin with the key characteristics of the human body), which is

already popular in the Western nations to train medical students.

"Of course, cadavers are the best way to learn about human anatomy. But due to their scarcity, simulation has emerged as an alternative to train medical students in the specialisation and super-specialisation stages," M.C. Misra, director of the All India Institute of Medical Sciences (AIIMS), told IANS.

He said the advantage of using a simulator is that students can get practice better and thus reduce the chances of errors when they qualify as specialists and perform surgeries.

Misra said simulation in India is still very new and only a few medical colleges use it to train their students.

According to the Medical Council of India, there are 398 medical colleges in India.

"AIIMS has been using simulation in its Trauma Center to train students in dealing with cardiac arrest and other cardiac emergencies," said Misra, who is also the head of Jai Prakash Narayan Apex Trauma Center.

"Cardiopulmonary simulation is available at a few medical colleges. This is usually used to train students for emergencies in situations like a heart attack or near drowning, in which an individual's breathing or heartbeat has stopped," Misra said.

AIIMS is the only medical institution in India that has "high-fidelity simulation" that helps in testing new drugs before they are administered to patients.

Misra also emphasised that learning on simulators also helps students perform surgeries faster and in the correct way.

"The first laprascopic surgery that I performed 25 years ago took me four hours. Nowadays, this surgery is performed worldwide in just half an hour. This has only been possible by the quick learning simulators provide," Misra said.

In August, the World Simulation Society, an NGO that encourages simulation among various medical disciplines, was launched in the national capital by Health Minister Harsh Vardhan.

"In the coming years, with the scarcity of unclaimed dead bodies that are used for dissection in medical colleges, every nation will have to use the simulation techniques," World Simulation Society president Yatin Mehta told IANS.

Mehta, who heads the institute of critical care and anaesthesiology at Gurgaon's Medanta Medicity, said the laws and norms to get unclaimed bodies for dissection are getting stringent.

He also said people not coming forward to donate their or their relatives' bodies after death was one reason simulation had picked up in the West.

Harsh Vardhan, who himself is an ENT surgeon, said simulators in every medical college is one of his ministry's priorities.

"Simulation is the perfect modern tool to train the young generation undergoing specialisation in the medical field, especially in view of the scarcity of cadavers," Harsh Vardhan told IANS.

On the cost of simulators, which runs into millions of rupees, Harsh Vardhan, who has already pledged to donate his body after death, said: "Of course the cost of acquiring simulators will be very high but it is very much in the NDA government's agenda for the country's medical advancement."

"Our aim is to make the Indian doctors the best and decrease the number of medical errors during treatment," he added.

According to the WHO, India records a whopping 5.2 mishaps each year due to medical errors by doctors.

Sunil Chandy, director of Vellore's Christian Medical College (CMC), which has been using simulation to teach its students, said the new technology can be really helpful in training doctors.

"The reason simulation came late here was because India is currently 10 years behind the developed Western nations. However, it will take some time for the system to be completely adopted," Chandy told IANS.

"Simulation has also helped bridge the gap between medical students and the teaching fraternity which is happening due to scarcity of cadavers," he added.

(Rupesh Dutta can be contacted on rupesh.d@ians.in)