Medical Council Of India Research Articles

English

India being the second most populous country in the world is among the countries with a large number of graduate medical colleges. To know the extent of regional and population wise distribution of medical colleges, data on the regional population and number of medical colleges in the corresponding regions as on 1st August 2012, was obtained from the official websites of census commissioner of India and the Medical Council of India respectively. So collected information was entered into Excel spreadsheet and analysed using the same software. With 355 institutions imparting graduate medical education in India, the average number of colleges corresponds to 10 per state/ UT. But there is great disparity in the regional distribution of the medical colleges with the difference varying from 43 medical colleges (Karnataka and Maharashtra) to no (zero) medical colleges in 4 states and 4 union territories of the country. In terms of ownership of graduate medical colleges, there is a rising trend in the establishment of non - government graduate medical institutions in India. The states of Madhya Pradesh, Chhattisgarh, Bihar, Jharkhand, Orissa, Rajasthan, Uttar Pradesh and Uttarakhand (Empowered Action Group states) with 45.87 % of the India's population account for 25.69% of the medical colleges. The southern states of Karnataka, Andhra Pradesh, Tamil Nadu and Maharashtra which correspond to 27.29 % of the population have 47.32% of the graduate medical institutions. There is regional inequity and mismatch between the population and the number of graduate medical colleges and seats in India.

Medical Council of India - Regulations on Graduate Medical Education 2012

Medical Council of India - Regulations on Graduate Medical Education 2012

Indian Public Health Leaders Move to Reduce Antimicrobial Resistance

ALTHOUGH THE EMERGENCE OF ANtimicrobial “superbugs” and the paucity of new medicines being developed to combat them is a global problem, circumstances in developing countries raise particular concerns. For those with health care systems that are already overloaded treating or protecting individuals from diseases such as tuberculosis and malaria, confronting the issueofantimicrobialresistanceisalower priority. That lower priority allows such practices as inappropriate use of antibiotics for human and animal health and inadequatemeasurestocontrolthespread of infectionstopromotethedevelopment of resistant strains of microbes. Such a scenario has played out in India. One of the more visible manifestationsof thisproblemwas theemergence in 2010 of a gene that is transmitted on a plasmid and that produces an enzyme called New Delhi metallo-lactamase (NDM-1). This gene has been acquired by a variety of bacterial species, and the NDM-1enzymeitproducesmakesthose bacteria resistant to most antibiotics. However, some public health leaders in India have spearheaded an effort to tackle the issue of antibiotic resistance. These leaders, from medical societies, federal and state governments, and representatives from the World Health Organization, gathered last summer in Chennai, India, to produce the Chennai Declaration, which proposes a plan to create a road map for tackling the challenge of antimicrobial resistance in India. (Ghafur A et al. Indian J Cancer. 2013. http://www .indianjcancer.com/preprintarticle.asp ?id=104065). In India, rates of antimicrobial resistanceareveryhigh.Ahighprevalenceof extended-spectrum -lactamase(ESBL)– producingbacteriaisincreasingtheprevalenceofresistancetocarbapenems,aclass of -lactamantibioticsconsideredthelast resort formanybacterial infections such asEscherichiacoliandKlebsiellapneumoniae. Indeed, experts have estimated in published news stories that more than 100 million of the 1.2 billion individuals living in India could be carrying carbapenem-resistantNDM-1–producing bacteria (Kumarasamy KK et al. Lancet Infect Dis. 2010;10[9]:597-602). A number of circumstances in India foster the development of antimicrobialresistant strains of bacteria. Antibiotics are freely sold without requiring a physician visit or prescription. As a result, individuals often use them improperly, taking the wrong antibiotic for their infection, using a suboptimal dose, or not taking it for the proper amount of time, allowing antibiotic-resistant microorganisms to evolve. Antibiotics have been found in the waters of India, dispersed from manufacturing facilities. Sanitation is also a factor; an estimated 650 million Indians lack access to toilets, which increases the chances of bacterial transmission through the fecal-oral route. But there are barriers, including cultural and political challenges, to changing the health landscape in India. Recognizing this, the authors of the Chennai Declaration said, “India needs ‘an implementable antibiotic policy’ and not ‘a perfect policy.’” Among many recommendations, the declaration calls for regulation of overthe-counter sales of antibiotics, monitoring of in-hospital antibiotic use, and development of a national antimicrobial resistance surveillance system. It also suggests roles for a variety of stakeholders, including the Ministry of Health and Family Welfare, the Medical Council of India (the statutory body regulating medical colleges), and the World Health Organization. Abdul Ghafur, MD, coordinator of the declaration, said that initial efforts to reduce microbial resistance should focus

Indian Medical Council wants doctors to prescribe generics

Indian Medical Council wants doctors to prescribe generics

The rise of super (?sub)-specialties courses in psychiatry: Is India ready for it!

Byline: N. Manjunatha, Murali. Thyloth, T. Sathyanarayana Rao The field of psychiatry is still growing; [sup][1] however, the phenomenal growth occurred in many areas in the field of Indian psychiatry in last decade. One of them is the increase in postgraduate seats (Diploma in Psychological Medicine (DPM)/Doctor of Medicine (MD)/Diplomate of National Board (DNB) of psychiatry to address the shortage of psychiatrists in our country. In curious latest development two medical institutes in our country started two super-specialties psychiatry courses (after branching out from department of psychiatry) in the academic year of 2011-2012 such as Doctor of Medicine (DM) (Geriatric Mental Health) at 'King George Medical University', Lucknow (http://www.kgmu.org/dept_geriatric.php) and DM (Child and Adolescent Psychiatry) at 'National Institute of Mental Health and Neurosciences' (NIMHANS), Bangalore (http://www.nimhans.kar.nic.in/cap/default.htm) for candidates of MD/DNB psychiatry. Other awaiting super-specialty psychiatry course is DM (Addiction Medicine) at 'National Drug Dependence Treatment Centre' of 'All India Institute of Medical Sciences', New Delhi and 'Centre for Addiction Medicine', NIMHANS, Bangalore. Debate *In an outlook it is a welcome step, however, authors consider this rise of super-specialties in still growing field of Indian psychiatry is a debatable issue. When our country is already facing 77% average national deficit of psychiatrists, [sup][2] will not this step lead further shortage of general psychiatrists in India? India is currently producing 357 MD (Psychiatry) and 129 Diploma in Psychological Medicine (DPM) per year in various medical college/institutes of our country. [sup][3] Along with these reasons and the migration of qualified psychiatrists to developed countries, will this step be a pragmatic one for MD psychiatry candidates to enter DM in these super-specialties? *Then, what is the need of having super-specialty psychiatric courses? Is there a demand for clinical service, if so, having separate clinic/unit in the psychiatry department (one of the requirement of Medical Council of India (MCI) to start MD psychiatry course) shall be sufficient. Is there a demand in research point of view, if so, developing a separate 3 years course is not justified? If the development for teaching purpose due to lack of expertise, having separate clinic/unit within department of psychiatry would suffice. Considering all above points, Indian academic psychiatry is not ready for premature branching out as 3 years DM course. It may be pragmatic to wait till required number of psychiatrists of India is available for clinical service. *Another important aspect of this development is the employability after their training. Authors tend to believe as not so lucrative for these super-specialties as there are already inadequate practicing general psychiatrists and inadequate teaching psychiatric faculties in medical colleges. *In view of public mental health, when India is struggling to provide primary care psychiatry and facing difficulty in the implementation of 'National Mental Health Program', can we afford to have these super-specialties in psychiatry which further reduces the human resources? Progress in Indian Medical Education with Respect to Super-Specialties Authors feel that the developing new courses with new name are becoming fashionable in the field of Indian education. Medical education of our country is not the exception for this and is already developed new courses in last few decades such as DNB, DM, Magister Chirurgiae (MCh), etc., Irony in this development is having same name (i. …

Emerging alternative model for cardiothoracic surgery training in India

BackgroundIn India, cardiothoracic (CT) surgery training follows a 3+3-year model, where 3 years of general surgery residency with certification (MS/DNB) is required for entering 3 years of thoracic surgery residency (MCh/DNB). There are two certifying boards at the national level. One being the Medical Council of India (MCI), which oversees the major accreditation process involving the undergraduate and postgraduate medical education in India, and the other being the National Board of Examinations (NBE), which was formed for the purpose of establishing a uniform standard of postgraduate medical education. Recently, the latter body has come up with an alternative model for thoracic surgery residency in India. This model includes an integrated 6-year residency, with lesser emphasis on general surgical skills and greater exposure to CT surgery.ConclusionsChanges to the current model of training for CT surgery is the need of the hour and should be initiated very soon by the MCI to meet the future demand for CT surgeons in India. An integrated training program is essential to create a new generation of cardiovascular specialists. Future directions to achieve this goal must include modifications to the undergraduate programs so as to infuse interest for CT surgery in the young minds of medical students.

Putting the humanities back into medicine: some suggestions

The practice of medicine is an art as well as a science. As doctors diagnose illness and treat patients day after day, they constantly interweave the social, psychological, ethical and scientific aspects of clinical practice. However, the humanistic values necessary for this approach are generally perceived to be lacking in today's medical practice. The Medical Council of India (MCI) believes that a course in medical humanities can help students cultivate a humane attitude towards their patients, as well as give them the knowledge and skills to deal with the complex challenges they will face as they practise medicine. The new Graduate Medical Regulations being formulated by the MCI provide time for teaching this aspect of medical practice. This paper contains some suggestions for the implementation of a medical humanities course in medical colleges.

Foundation programme: A student′s perspective

Context:Various colleges and universities worldwide develop and implement students’ orientation programs to acclimatize them to the campus environment, familiarize them with the teaching programs and its importance has been stressed in the document “Vision 2015” planned by the Medical Council of India (MCI).Objectives:To evaluate the feedback questionnaire after conclusion of two day :Foundation Program” for MBBS 2nd Professional students, conducted by the medical education unit at a tertiary care Medical Institute.Material and Methods:After the conclusion of two day “Foundation Program”, a pre-designed, anonymous questionnaire was received from all the students who participated in the program.Results:Of the 100 participants, 67% of the participants labeled the foundation program a very good exercise. Students’ view regarding the factors that facilitated their learning were good topics (covered important aspects pertaining to the clinical phases), good presentations, good and experienced speakers, and interactive faculty.Conclusion:Such orientation programs lay a strong foundation for better understanding and learning of under-graduate courses, and should be a regular feature in the curriculum.

Training in endocrinology: The Indian perspective.

Training in endocrinology: The Indian perspective.

End-of-life care: Indian perspective

According to Hinduism, the main religion of India, the end-of-life (EOL) deals with good and bad death. The WHO definition of palliative care stresses on improving not only the quality of life of patients facing incurable diseases but also their families by providing relief from the pain and suffering that includes the psychosocial and spiritual needs as well. The Indian Society of Palliative Care has been doing a commendable work and appreciable efforts are being done by the Kerala model of delivering the EOL care. The spiritual, ethical issues and ethical challenges raised when the patients are in terminal phase are also reviewed keeping in mind the socio-cultural norms. The Indian Penal Code (IPC) has lacunae, which hamper the physicians from taking proper decision in the EOL care. Some of the sections like IPC 309 are defunct and need to be changed. The Indian Society for Critical Care Medicine has developed a position statement on the patient management of the terminally ill patient in the Intensive Care Unit (ICU) which states that the society should move from the paternalistic model to the share based decision model of the West when deciding the fate of such patients. The literature review on the Indian research on palliative care shows very little emphatic results and the medical under graduates show illiteracy. To strengthen it Medical Council of India has included the palliative care in its curriculum by starting a PG course. Literature review revealed that more research from Indian perspective should be done in this area. This article studies the core issues of developing palliative care in Indian setting keeping in mind the ethical, spiritual and legal issues.

The Chennai declaration: A roadmap to tackle the challenge of antimicrobial resistance

"A Roadmap to Tackle the Challenge of Antimicrobial Resistance - A Joint meeting of Medical Societies in India" was organized as a pre-conference symposium of the 2 nd annual conference of the Clinical Infectious Disease Society (CIDSCON 2012) at Chennai on 24 th August. This was the first ever meeting of medical societies in India on issue of tackling resistance, with a plan to formulate a road map to tackle the global challenge of antimicrobial resistance from the Indian perspective. We had representatives from most medical societies in India, eminent policy makers from both central and state governments, representatives of World Health Organization, National Accreditation Board of Hospitals, Medical Council of India, Drug Controller General of India, and Indian Council of Medical Research along with well-known dignitaries in the Indian medical field. The meeting was attended by a large gathering of health care professionals. The meeting consisted of plenary and interactive discussion sessions designed to seek experience and views from a large range of health care professionals and included six international experts who shared action plans in their respective regions. The intention was to gain a broad consensus and range of opinions to guide formation of the road map. The ethos of the meeting was very much not to look back but rather to look forward and make joint efforts to tackle the menace of antibiotic resistance. The Chennai Declaration will be submitted to all stake holders.

Laws Applicable to Medical Practice and Hospitals in India

ABSTRACT Healthcare in India features a universal healthcare care system run by the constituent states and territories. Law is an obligation on the part of society imposed by the competent authority, and noncompliance may lead to punishment in the form of monetary fine or imprisonment or both. The earliest known code of laws called the code of Hammurabi governed the various aspects of health practices including the fees payable to physician for satisfactory services. The first ever code of medical ethics called the Hippocratic oath was laid down 2500 years ago, in the 5th century BC, by Hippocrates'the Greek physician. The modern version of Hippocratic Oath (called the declaration of Geneva), devised by the WHO after the second world war and is accepted by international medical fraternity. The process of establishment of healthcare system during the colonial rule also necessitated creation of legislative framework for practitioners of medicine. As the number of doctors qualified in Indian medical colleges increased, creation of laws for them became necessary. The medical council of India, a national level statutory body for the doctors of modern medicine, was constituted after the enactment of Indian Medical Council Act 1933. The first legal recognition and registration for the Indian systems of medicine came when the Bombay Medical Practitioner’ Act was passed in 1938. Laws governing the commissioning of hospital are the laws to ensure that the hospital facilities are created after due process of registration, the facilities created are safe for the public using them, have at least the minimum essential infrastructure for the type and volume of workload anticipated and are subject to periodic inspections to ensure compliance. There are other laws pertaining to governing to the qualification/practice and conduct of professionals, sale, storage of drugs and safe medication, management of patients, environmental safety, employment and management of manpower, medicolegal aspects and laws pertaining to safety of patients, public and staff within the hospital premises. There are laws governing professional training and research, business aspects, licences/certifications required for hospitals, etc. A hospital administrator should be aware about all these laws, regulations, policies, procedures, reports and returns and keep abreast with the latest amendments to be on the safe side of law and provide quality care to the patients. How to cite this article Singh MM, Garg US, Arora P. Laws Applicable to Medical Practice and Hospitals in India. Int J Res Foundation Hosp Healthc Adm 2013;1(1):19-24.

Correlation of students performance in theory and practical of final summative pharmacology examination in MBBS curriculum: A critical insight

Background: Assessment of learning has always been difficult, yet an important part of our education system. Curricular guidelines of Medical Council of India lay emphasis on methods of assessment of knowledge and skills in Pharmacology. Advances in scientific knowledge and innovations in educational field that necessitates constant change in medical curriculum. Aims & Objective: To correlate student\'s performance in theory and practical of final summative pharmacology examination in M.B.B.S curriculum in order to have a critical insight. Materials and Methods: Present study is a record-based observational study done at PDU Govt. Medical College, Rajkot, Gujarat. We have taken data for six consecutive years from 2007 to 2012. Based on their performance in terms of percentage of marks, all students in a batch were classified into five categories: \'failed\' (F) = 55 to

After supersession of The Medical Council of India

After supersession of The Medical Council of India

Emergency Medical Service System: World and the Changing Indian Scenario

Emergency Medical Service System(EMSS) is a specialty in which time is critical. Broadly, EMSS consists of pre-hospital care (synonyms, out of hospital care), emergency medical services and in-hospital care (popularly called emergency medicine). Dynamic as it is, EMSS is fast changing throughout the world. It may be in its infancy in India but change is imminent and can be perceived in many states and union territories where the pre-hospital care is becoming organized; life-support ambulances can be visualized on the roads. Medical Council of India's recent stand by permitting universities to start the MD course in Emergency Medicine and documenting the minimum standard requirements regarding infrastructure & manpower for recognition are steps in the right direction. JMS 2012;15(2):101-105

Ethics: the physician–pharma dyad in India

The study examines the attitudes among physicians regarding acceptance of gifts, sponsorships, and drug samples in response to marketing efforts of pharmaceutical companies in India. The research also attempts to study physicians’ perceptions of the Medical Council of India (MCI) guidelines on the code of conduct for pharmaceutical marketing practices and the influence of these guidelines on physicians’ actions. A structured questionnaire was developed for collecting primary data regarding exposure of physicians to promotional tools and physicians’ attitudes and practices with regard to various professional ethical issues. One thousand physicians from private and government hospitals located in a metropolitan area were approached personally or through email for getting the questionnaire filled. A total of 189 completed and usable questionnaires could be obtained which is a response rate of approximately 20 %. Respondents in the study indicate being offered samples, sponsorship, and gifts by pharmaceutical companies with a frequency of at least once a month. Thus, many pharmaceutical firms are not following the code of conduct issued by the Department of Pharmaceuticals, Govt. of India. Further, though almost all physicians report being aware of the guidelines issued by the MCI, yet as many as 69 % of the sample admitted to be accepting gifts and sponsorships offered by the pharmaceutical firms. Educational programs were found to be influencing physician prescription behavior to a greater extent when compared with gifts. Frequency of offers made for gifts and sponsorships were found to be dependent upon physicians’ practice (number of prescriptions written) and the type of hospital they are associated with (private or government). The study focuses on sensitive yet critical ethical issues related to the promotional practices of pharmaceutical firms in India and physicians’ responses with regard to these promotional practices in the context of the guidelines of the Medical Council of India and the Department of Pharmaceuticals.

A comparison of data sources and models to project HRH needs in India: lessons from the universal health coverage planning process

Description of the problem The path to universal health care in India requires concurrently addressing several human resource issues and is thus an opportunity to bring about much needed reforms in the health workforce. A key component of these reforms is systemic knowledge generation around what Human Resources for Health (HRH) capacity currently exists in the country and what future needs may be projected to achieve universal health coverage. A lack of uniform sources of data has resulted in the use of diverse sources, which presents its own challenges in the planning process. Methods Based on a qualitative comparative framework, we examine the implications of multiple data sources and models to estimate HR needs for India over the next 30 years. One set of comparisons projects estimates from Census and other sample survey data to adjusted figures from professional health councils to actually determine what the population coverage of various HRH cadres is (doctors, nurses and ANMS). Here we compare the data sources, assumptions and methodologies of HRH estimation approaches. Another set of comparisons is of models that propose to achieve international norms of doctor-population coverage and nurse/midwife to doctor ratios, as compared to models that operate on more general health worker densities incorporating the role and contribution of community health workers and mid-level health practitioners. Here we compare theoretical bases, historical contexts and international evidence supporting that justify various model and assess their relevance to the Indian case. Main findings The use of different data sources results in estimation exercises with varying baselines and ultimately projects widely divergent HR numbers and requirements. Major reliability and validity concerns may be raised with regard to typical sources of HRH data in India (the Census, the Medical Council of India, Indian Nursing Council, Sample Registration System). This is also related to a lack of inter-operability across these sources in terms of definitions and frequency in generation of health information. Profound epistemological questions regarding India’s vision for health emerge in comparing doctor-driven models to community health worker-driven models or models that seek a middle path of mid-level practitioners. India’s successes with producing doctors has to be reconciled with the lack of a supportive eco-system for practice, its world renowned record of community health worker programmes has to be reconciled with the scale of coverage and resultant quality and training implications; finally, operationalizing mid-level practitioners across the country will require overcoming legal and normative barriers that privilege medical dominance and circumscribe what a legitimacy of HRH cadres. Discussion including recommendations HR Projection exercises and sensitivity analyses raise key questions around the level of clinical competency across cadres, the functional implications of proposed new cadres, the paucity of “live” data, and epistemic considerations related to India’s vision for how to (human) resource universal health coverage. Recommendations include the use of human resources information management systems as part of management reform.There is an urgent need for systematic data generation related to HRH at appropriate levels in the country, supplemented by routinized cadre review. The country also needs to evolve uniform standards for regulation and accreditation, with appropriate (legal) attention to the scope and integration of practice across cadres at various levels of care. These structural changes require a careful balance between central guidance and strategic planning at the state level – in striking that balance, knowledge generation and management around HRH could improve in the country and by extension, enhance HRH planning. Conflict of Interest Statement The author was a member of the technical secretariat of the High Level Expert Group on Universal Health Coverage.

Where are all the bioethicists when you need them?

Is biomedical ethics just casual talk? Is it merely medical etiquette, philosophical window dressing, full of empty rituals and little substance? Do doctors take ethics seriously? What should we expect from bioethicists when the ethical practice of medicine is at stake? One cannot ignore these questions in the aftermath of a shameful saga – ‘upon which it is difficult to speak, and impossible to be silent’ – that unfolded over the election of a president-elect of the World Medical Association (WMA).1 The WMA is an international association of doctors established in the aftermath of Nazi medicine to ‘work for the highest possible standards of ethical behaviour and care by physicians at all times.’2 In keeping with its goal to provide ‘ethical guidance to physicians,’ the WMA ‘has adopted global policy statements on a range of ethical issues’ including the International code of medical ethics, and the Declarations of Geneva and Helsinki.3 The annual assembly of the WMA, hosted by the Indian Medical Association in New Delhi on October, 2009, featured ‘the unopposed election in his own country’ of Ketan Desai, [then] president of the Medical Council of India (MCI) as president-elect of the WMA.4 Six months later, in April 2010, Desai was arrested on charges of seeking a bribe of 20 million rupees (£296,000; €350,000; $450 000).5,6 No stranger to accusations of unethical behaviour, Desai was ousted from his position as president of the MCI in 2001 by order of the Delhi High Court,7–9 which observed that Desai and his family had ‘received unexplained payments totalling 6.5 million rupees (£92,000; €105,000; $150,000).’1 The Supreme Court of India dismissed this case against Desai as no evidence was found that he had ‘extended official favours to those from whom he had received payments.’ Eventually Desai was reinstated as head of the MCI in 2009.5 Reports of corruption and new bribery charges against Desai in 2010 led the government of India to disband MCI and re-establish it with a new board of governors. Undeterred by being removed as president of the MCI for a second time, WMA president-elect Desai, who had been jailed on the bribery charges, obtained bail and was about to assume his position as the new president of the WMA at its annual assembly in Canada. The MCI's new board of governors revoked Desai's license to practice medicine and informed the WMA that ‘It would be a travesty of justice if Desai, who has brought disgrace to the medical profession, is allowed to take charge as the president of the World Medical Association.’1 When the annual assembly of the WMA met in Vancouver, Canada, in October 2010, the president-elect of the WMA was found ‘unable to carry out his duties’ and his ‘inauguration’ as president was ‘suspended indefinitely.’10 In an extraordinary election, Wonchat Subhachaturas from Thailand was elected as president of the WMA. This incident – ignored or unnoticed by doctors, professional medical associations, and other stakeholders – deserves careful reflection by all who are concerned about the cause of ethics in medicine. That an ethically compromised doctor became president of a medical council or professional association is shameful but not impossible in a country like India, where corruption is endemic.9 It is difficult to believe, however, that no one in the WMA knew about Desai's past record given the fact that his removal from the MCI was reported in both national and international medical journals.7–9 The case of Desai, and the anemic reaction to his election and suspension, raise several questions about the place of bioethics in medicine: How could an ethically challenged doctor become the president-elect of the WMA? Is ethics simply a look-good decorative badge on the white coat? What will prevent this kind of ethical lapse from being repeated? This case is not about a single person or a professional association, but rather about the integrity of the medical profession and the place of ethics in medicine. Regrettably, there is no indication – at least publicly – that Desai's case generated any introspection on the part of the WMA. Corruption was noticeably absent from the agenda when the WMA adopted a number of resolutions on several health-related issues in their assembly. Is it not an ethical imperative for a professional association of the stature of the WMA to come clean and explain their position?

Self-financing students in private medical schools

Self-financing students in private medical schools

A survey of psychiatric services for people who attempt suicide in south India

Background and Aims:Self-harm is a major public health problem in the southern parts of India. This survey was undertaken to assess the nature of psychiatric services available in hospitals attached to medical colleges for those who have attempted suicide.Materials and Methods:After reviewing the relevant literature, a questionnaire was prepared. We sent this questionnaire to 94 medical colleges in South India.Results:The response rate of the survey was 50%. Psychiatric assessment of suicide attempters in the casualty department are done by mental health professionals in 23 (66%) hospitals. Psychotropic medications are prescribed for appropriate patients in 33 (94%) hospitals, while talking therapies are available in 31 (89%) hospitals. Six (17%) centers have training sessions for casualty staff in mental health assessment of patients who have attempted suicide. A majority of hospitals have medical students posted in the psychiatry department.Conclusions:The services available for people who have attempted suicide appear to be patchy in south Indian teaching hospitals. Training of frontline staff in the assessment and management of people who have attempted suicide is extremely important.