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Caribbean Superheroes – Children and Youth living with Type 1 Diabetes Part 2
In Part 1 the Caribbean Superheroes series you read about the lived experiences of children and young people with type 1 diabetes.
In Part 1 the Caribbean Superheroes series you read about the lived experiences of children and young people with type 1 diabetes.
Jawan, 7 and Tiana, 4, who are aspiring scientists from Trinidad and Tobago shared their dislike for checking their blood sugar levels, taking their insulin, and waiting for their insulin to start working before they can eat. Their mother, Penelope, outlined her daily routine which includes checking in on them during the night and at school.
Kerro, 20, an aspiring graphic artist from Antigua and Barbuda recalled some of her classmates and general public’s curiosity about her condition and the stigma she experienced. Kerro and Xarriah, 22, race car driver fan from Barbados both agreed on the importance of supportive friends on their type 1 diabetes journey.
Given that they have to live with the condition, these superheroes are also experts on how the wider society can better support people living with diabetes. Their recommendations focus on: 1. Diabetes Education, 2. Destigmatization, 3. Prioritizing spaces and environments that support healthy children, 4. Access to Medication and devices.
Aligned with the theme for World Diabetes Day 2022, “access to diabetes education”, all the superheroes agreed that education on one of the most common conditions in the Caribbean is critical. In particular, Xarriah and Kerro think that there should be improved education around all types of diabetes – including type 1. These superheroes have been educators since their diagnosis. However, they need help. Xarriah noted,
As much as we try to educate people, there is still a lot to be learned. And a lot of people still aren’t certain and a lot of people still group together the diabetes, the types, they still group together type 1 and type 2 and I think there needs to be a lot more information about what is type 1 versus what is type 2….not just bulking them all in one place and separating them and giving them their own identities so people understand.
Kerro agreed and she shared that even though diabetes runs in her family, she wasn’t aware of type 1 until she was diagnosed. She said,
Most times I just used to think it was older people. But now I know that people are born with it, you have babies who develop it. So I just think they need to start educating more, because, as I said, a lot of people in my class, at the age of 11 didn’t even know you could get it at such a young age.
Kerro and Xarriah recommend the integration of diabetes education into primary and secondary school subjects including Health and Family Life Education, Physical Education or Science across the Caribbean. Xarriah firmly believes in this approach as she notes that school-based education would have helped her when she got diagnosed as she, like Kerro, wasn’t aware of the realities of living with type 1 diabetes,
And in the event that one person gets type 1 they have an understanding of okay, this is what is happening to my body and this is what I may have to do for the rest of my life. And this is what I might have to endure. Because I feel like I was not very well educated when I was diagnosed. I had a general idea of diabetes because people in my family have type 2 but i didn’t have the knowledge of type 1 until I got diagnosed.
Widespread education on diabetes is critical in addressing the misinformation and resulting stigma that many persons living with diabetes experience.
Kerro recalls numerous cases where she has felt like her condition was misunderstood:
I feel like diabetics are part of that group that people tend to overlook. They just say “If you’re diabetic, it is caused by sugar and if you end up in the hospital it is because you eat too much sugar. “ So essentially you’ve caused it. That is something that I have encountered myself at a hospital.
This is a common misconception with type 1 diabetes. Persons living with type 1 diabetes don’t develop the condition as a result of lifestyle choices. Type 1 diabetes is an autoimmune disease in which your body’s immune system attacks the insulin-producing beta cells in your pancreas which drastically reduces the ability of your body to produce insulin, a hormone that regulates blood sugar.
The lack of understanding of type 1 diabetes has also resulted in people treating those with the condition differently. Kerro, Xarriah and Penelope wished that people would treat children and young people living with diabetes like anyone else.
Kerro shared that, when diagnosed, “It’s not changing personality, it is not changing the person. It is not contagious. It is not going to harm you in any way – you as in the other person.”
For Penelope, she reassures her children that there is “nothing they cannot do” despite the world saying otherwise. She notes that her children are “even more amazing” as they live with diabetes.
In the absence of formal education or mass media awareness campaigns, Kerro encourages people who are curious about the condition to “just ask”.
In addition to improved education across age groups, Penelope, as a parent, highlights the need for schools to better care for children living with diabetes. She said she would value the presence of nurses, even if sporadic, on the school compound and the use of a sanitized private room to assist Jawan and Tiana with administering insulin or anything else they may need.
An effort to better care for children could also be extended to the implementation of healthy school nutrition policies to protect the school food environment. Although Penelope packs lunches for Jawan and Tiana, given their condition, she agreed that a school policy that would restrict the availability of ultra processed foods and improve the availability of fruits would be valuable. Relatedly, Penelope also noted the importance of physical activity at school but also at home. Penelope advises parents to prioritize physical activity and diversify, if possible, the kinds of activities that children do. Jawan, unlike his mom, loves to do burpees (a full body exercise that includes a pushup followed by a leap in the air) and they do them and other physical activities together. Jawan says he can do 20 burpees in 27 seconds and holds his mom accountable.
The final challenge outlined by the superheroes is access to insulin and appropriate glucose monitoring devices. Tiana said insulin gives her “super powers”, like Elsa from the movie Frozen. Children and young people need access to insulin and testing strips daily to be able to carry out their daily superhero duties.
The governments of Antigua and Barbuda, Barbados and Trinidad and Tobago provide a glucose monitoring device (GMD), insulin and testing strips but the quality of the GMD, insulin and the number of test strips provided varies.
Penelope shared her reality with trying to access what Tiana and Jawan need, “We have gotten one device per child and they provide us with the strips for the machines. I have written 2 Letters [to government] to increase the number of containers of strips for both children.” Her request, which had to be written by a doctor, was approved.
The glucose monitoring device that all the superheroes currently have requires them to prick their finger to test the sugar levels in their blood. Their dream is to be able to have access to a GMD that offers continuous glucose monitoring and does not require the user to prick themselves. Kerro painted the reality that unfortunately, “ it isn’t available here and the accessories or counterparts to it are very expensive.” She noted that the Antigua and Barbuda Diabetes Association has been lobbying to make them more widely available locally; currently each sensor costs $200 XCD and lasts 2 weeks (a total of $400 XCD a month).
But for her the Freestyle Libre would be ideal, “It’s much easier to use, and it motivates me to check my blood sugar more. It’s more convenient since I don’t have to continuously prick myself. I just put on the sensor/patch on my arm and put the monitor close to it. It’s almost like using Bluetooth to check my blood sugar”
Penelope shared similar sentiments, “I can’t afford the Libre, it would be so helpful to have access to it. It will definitely benefit my children with their lifestyle and assist me by being able to relax and not have to worry so much.”
In addition to the Freestyle Libre, Penelope said, “ I would love to have access to at least 3 different insulin, needles (suitable for children) and Glucose Gummies to help raise blood sugar when needed.
In Barbados, Xarriah was quite pleased that the insulin pen had recently been added to the drug registry. The insulin pen is an insulin delivery system that generally looks like a large pen; it uses an insulin cartridge rather than a vial, and uses disposable needles. Xarriah says it is particularly convenient because it does not have to be on ice, unlike insulin vials. With the pens being added to the list, this means that “they are available at pharmacies across the island at a significantly reduced cost. This has been a tremendous help for those who prefer the pens and may not have been able to afford them before. The Diabetes and Hypertension Association of Barbados also provides insulin pens and vials to its members for free once they are available”
The superheroes are managing their reality but their quality of life could be improved with changes from all stakeholders – policymakers and you as a reader. The superheroes are calling for Diabetes Education, Destigmatization, Prioritization of spaces and environments that support healthy children and improved access to medication and devices. So, next time you see a child or young person testing their sugar levels or taking insulin, you can be curious but also be kind. If you hear a mother, like Penelope, asking for changes to the school environment to make it healthier and easier to navigate for her children (and yours) – support her.
Diabetes Month is highlighted every November, but let us not wait until November 2023 to share Tiana, Jawan, Penelope, Kerro and Xarriah’s experiences and solutions for change. Diabetes Day is their reality, let us do what we can to cheer on and support our superheroes on their daily journey.
November is World Diabetes Awareness month and November 14th has been deemed World Diabetes Day. The date was chosen in honour of Canadian Sir Frederick Banting, who, together with Charles Best discovered insulin, 100 years ago.
Danielle Walwyn is the Advocacy Officer at the Healthy Caribbean Coalition (HCC) and helps to coordinate its youth arm, Healthy Caribbean Youth. She is also working alongside Xarriah, superhero and member of the HCC People living with NCDS Advisory Committee, to create a space for young people living with NCDS to connect. Send feedback to danielle.walwyn@healthycaribbean.org
The post Caribbean Superheroes – Children and Youth living with Type 1 Diabetes Part 2 appeared first on Healthy Caribbean Coalition.
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DM Paediatric Nephrology: Admissions, Medical Colleges, Fees, Eligibility Criteria details
DM Pediatric Nephrology or Doctorate of
Medicine in Pediatric Nephrology also known as DM in Pediatric
Nephrology is a super
specialty level course for doctors in India that is done by them after completion
of their postgraduate medical degree course. The duration of this super
DM Pediatric Nephrology or Doctorate of
Medicine in Pediatric Nephrology also known as DM in Pediatric
Nephrology is a super
specialty level course for doctors in India that is done by them after completion
of their postgraduate medical degree course. The duration of this super
specialty course is 3 years, and it focuses on the diagnosis, treatment and management of
diseases affecting the kidney and urinary tract in children.
The course is a
full-time course pursued at various recognized medical colleges across the
country. Some of the top medical colleges offering this course include St. Johns Medical College- Bangalore and, All India Institute of Medical
Sciences- Rishikesh.
Admission to this
course is done through the NEET-SS Entrance exam conducted by the National
Board of Examinations, followed by counselling based on the scores of the exam
that is conducted by DGHS/MCC/State
Authorities.
The fee for
pursuing DM (Pediatric Nephrology) varies from college to college and may range
from Rs.5000 to Rs. 20,00,000 per year.
After completion of their respective course,
doctors can either join the job market or can pursue certificate courses and Fellowship programmes recognised by
NMC and NBE. Candidates can take
reputed jobs at positions as Senior residents, Consultants etc. with an
approximate salary range of Rs. 5,00,000 to Rs. 30,00,000 per year.
What is DM in Pediatric Nephrology?
Doctorate of
Medicine in Pediatric Nephrology, also known as DM (Pediatric Nephrology) or DM
in (Pediatric Nephrology) is a three-year super specialty
programme that candidates can pursue after completing postgraduate degree.
Pediatric Nephrology is the branch of medical science dealing with the diagnosis, treatment and management of diseases
affecting the kidney and urinary tract in children.
National Medical Commission (NMC), the apex
medical regulator, has released guidelines for a Competency-Based
Postgraduate Training Programme for DM
in Pediatric Nephrology.
The Competency-Based Postgraduate
Training Programme governs the education and training of DMs in Pediatric Nephrology.
The postgraduate
students must gain ample of knowledge and experience in the diagnosis,
treatment of patients with acute, serious, and life-threatening medical and
surgical diseases.
The PG education
intends to create specialists who can contribute to high-quality health care
and advances in science through research and training.
The required
training done by a postgraduate specialist in the field of Pediatric Nephrology would help the specialist to recognize the
health needs of the community. The student should be competent to handle
medical problems effectively and should be aware of the recent advances in
their speciality.
The candidate is
also expected to know the principles of research methodology and modes of the
consulting library. The candidate should regularly attend conferences,
workshops and CMEs to upgrade her/ his knowledge.
Course Highlights
Here
are some of the course highlights of DM
in Pediatric Nephrology
Name of Course
DM in Pediatric
Nephrology
Level
Doctorate
Duration of Course
Three years
Course Mode
Full Time
Minimum Academic Requirement
Postgraduate medical degree obtained from any
college/university recognized by the MCI (Now NMC)/NBE
Admission Process / Entrance Process / Entrance
Modalities
Entrance Exam (NEET-SS)
INI CET for various AIIMS, PGIMER Chandigarh, JIPMER Puducherry, NIMHANS Bengaluru
Counselling
by DGHS/MCC/State Authorities
Course Fees
Rs.5000 to Rs. 20,00,000 per year
Average Salary
Rs. 5,00,000 to Rs. 30,00,000 per year
Eligibility Criteria
The eligibility criteria for DM in Pediatric Nephrology are defined as the set of rules or
minimum prerequisites that aspirants must meet in order to be eligible for
admission, which include:
- Candidates must
be in possession of a postgraduate medical Degree (MD/MS/DNB) from any
college/university recognized by the MCI (Now NMC)/NBE. - The candidate must have obtained permanent
registration of any State Medical Council to be eligible for admission. - The medical college's recognition cut-off
dates for the Postgraduate Degree courses shall be as prescribed by the Medical
Council of India (now NMC).
Admission
Process
- The admission process contains a few steps to be followed in
order by the candidates for admission to DM
in Pediatric Nephrology. Candidates can view the complete admission process
for DM in Pediatric Nephrology
mentioned below:
- The NEET-SS or National Eligibility Entrance Test for Super
specialty courses is a national-level master's level examination conducted by
the NBE for admission to DM/MCh/DrNB Courses.
- Qualifying
Criteria-Candidates placed at the 50th percentile or above shall be declared as
qualified in the NEET-SS in their respective specialty.
- The
following Medical institutions are not covered under centralized admissions for
DM/MCh courses through NEET-SS:
- AIIMS, New
Delhi and other AIIMS - 2.PGIMER,
Chandigarh - 3.JIPMER,
Puducherry - 4.NIMHANS, Bengaluru
- Candidates
from all eligible feeder specialty subjects shall be required to appear in the
question paper of respective group, if they are willing to opt for a super specialty course in any of the super specialty courses covered in that
group.
- A
candidate can opt for appearing in the question papers of as many groups for
which his/her Postgraduate specialty qualification is an eligible feeder
qualification.
- By
appearing in the question paper of a group and on qualifying the examination, a
candidate shall be eligible to exercise his/her choices in the counseling only
for those superspecialty subjects covered in said group for which his/ her
broad specialty is an eligible feeder qualification.
Fees Structure
The fee structure for DM in Pediatric
Nephrology varies from college to college. The fee is generally less for
Government Institutes and more for private institutes. The average
fee structure for DM in Pediatric
Nephrology is around Rs.5000 to Rs. 20,00,000 per year.
Colleges offering DM in Pediatric Nephrology
There are
various medical colleges across India that offer courses for pursuing DM in (Pediatric Nephrology).
As per
National Medical Commission (NMC) website, the following medical colleges are
offering DM in (Pediatric
Nephrology)
courses for the academic year 2022-23.
Sl.No.
Course Name
Name and Address of
Medical College / Medical Institution
Annual Intake (Seats)
1
DM - Paediatric Nephrology
St. Johns Medical College, Bangalore
1
2
DM - Paediatric Nephrology
All India Institute of Medical Sciences, Rishikesh
6
Syllabus
A DM in Pediatric Nephrology is a three years specialization
course that provides training in the stream of Pediatric Nephrology.
The course
content for DM in Pediatric Nephrology
is given in the Competency-Based Postgraduate Training Programme
released by National Medical Commission, which can be assessed through the link
mentioned below:
NMC Guidelines For Competency Based Training Programme For DM Pediatric Nephrology
.1 SUBJECT SPECIFIC THEORETICAL COMPETENCIES
3.1.1 Cognitive domain (Knowledge domain)
3.1.2 Affective domain (Attitudes including Communication and Professionalism)
3.2 SUBJECT SPECIFIC PRACTICE-BASED OR PRACTICAL COMPETENCIES
The curriculum outlines competences that trainees must reach by the end of the programme (combining 3.1 and 3.2)
A. Investigation of the kidney
1. Renal Anatomy and Physiology
Knowledge
- To understand the embryology and development of genito-urinary system
- To understand the development of renal function and physiology for the assessment of:
a. GFR from height and plasma creatinine
- Calcium, phosphate & bone mineral metabolism
c. Urinary concentrating and diluting ability
d. Tubular handling of fluid and electrolytes
e. Acid-base balance
- To explain the practicalities, limitations and special precautions of measurement of:
a. Creatinine clearance
b. Protein and calcium excretion
c. Tubular handling
d. Tests for urinary acidification
Skills
To appropriately request and interpret the above investigations
Multidisciplinary
aspects
Laboratory Medicine Department
Resources
Clinical Physiology of Acid-Base and Electrolyte Disorders – Burton David Rose
Principles of Renal Physiology – Chris Lote
Pediatric Renal Investigations – Chapman & Taylor
1. Imaging
Knowledge
- To understand the role, limitations and interpretation of commonly used imaging modalities
- To know the practicalities and safety precautions associated with each test
· To understand the role of arteriography and percutaneous
nephrostomy tube placement
Skills
· To appropriately request the different radiological investigations
· To be able to interpret scan images
Multidisciplinary aspects
- Liaison with radiologists in deciding the most appropriate investigations
Resources
- Nephro-urology radiology meetings/Posting in nuclear medicine unit
· Bank of typical case images
2. Renal Biopsy and nephropathology
Knowledge
· To describe the anatomy of both native and transplant kidneys
· To know the indications for renal biopsy
· To describe the procedure of renal biopsy and its complications
- To know the type of solutions used for light (LM), immunofluorescence (IF), and electron microscopy (EM) specimens immediately post-biopsy
- To have a basic knowledge of handling and processing of renal biopsy tissue and utility of various stains (hematoxylin and eosin, periodic acid Schiff, Trichrome (Masson), silver-stains, and Congo
red /immuno-fluroscence used in the diagnosis of renal disease.
Skills
- To counsel families in preparation for renal biopsy, thus allowing informed consent
· To perform a native (and transplant) biopsy safely
- To recognize the histopathologic characteristics of normal kidney on LM, IF, and EM
- To recognize common histological appearances and consequences for diagnosis, prognosis and treatment
- Able to interpret slides, including all the components: LM, IF and EM.
· Obtain adequate clinical background and information from the
appropriate nephrologist submitting the specimen to allow optimal
interpretation of the biopsy.
Multidisciplinary
aspects
Radiologist and pathologist
Resources
Nephropathology meetings Bank of typical case histology
Training day for processing, staining and interpreting of renal biopsy
samples
(B) Urinary Tract Infection (UTI) and Vesicoureteric Reflux
Knowledge
· To know the epidemiology of UTI
· To understand current theories about renal scarring
· To be aware of issues in diagnosis of UTI
- To describe the role of ultrasound scan, MCU, DMSA and other investigations for UTI
- To know the medical and surgical options in the management of UTI
- To describe the mechanisms of action of antimicrobials and their adverse effects
· To understand the secondary progression of renal damage and its
prevention
Skills
- To appropriately manage urinary tract infection in different age groups
· To show ability to counsel parents about relevant investigations of
UTI, and possible management of siblings of children with reflux
Multidisciplinary aspects
· To know the appropriate follow-up into adult life
· To recognize the role of microbiologists, urologists and radiologists
- To be able to contribute to the development of strategies for management of UTI at local and regional level
Resources
· Microbiology department
· Nephro-pediatric surgery-radiology meeting
- Structural Malformations
Knowledge
· To understand renal embryology and developmental anatomy
- To describe the anatomy of the urinary tract and the sites and causes of urinary obstruction
- To know the presentations of developmental variants and abnormalities, including obstruction
- To describe the fluid and electrolyte disturbances occurring following the relief of obstruction
- To be aware of the different reconstructive procedures performed, and their implications for future management
- To be aware of other urological diagnoses, including genital anomalies
· To know the importance of ambiguous genitalia and intersex in
renal disease: structural as well as neoplastic
Skills
· To be able to provide medical support to urological services,
especially following relief of obstruction
Multidisciplinary aspects
- Liaison with radiologists, obstetricians and surgeons in management decisions and antenatal counseling
· To show ability to communicate and work together with other health
professionals
Resources
· Department of Pediatric Surgery
· Radiology meeting
· Department/Division of Neonatology
(D) Disorders of Micturition
Knowledge
- To know the common renal and non-renal diagnoses associated with enuresis
· To know the appropriate use of urodynamic studies
- To explain the rationale for various management strategies in enuresis using behavioral and pharmacological therapies
Skills
- To be able to interpret urodynamic studies, and instigate appropriate management
· To know the practicalities involved in enuretic alarms
Multidisciplinary aspects
· Liaison with urodynamic staff
· Role of the psychologist
Resources
Pediatric urologists/surgeons
Bank of images
(E) Neurogenic bladder
Knowledge
· To know the pathophysiology of neurogenic bladder
· To know the role of basic urodynamic investigations
- To know the appropriate surgical management of different types of bladder dysfunction
· To understand the treatments available to regularize bowel and
bladder habit
Skills
- To be able to appropriately asses the whole child with neurogenic bladder
· To show ability to investigate and manage the upper and lower
urinary tract
Multidisciplinary
aspects
· To know the importance of shared care with surgeons and urologists
Resources
· Pediatric urology services
(F) Hematuria
Knowledge
- To know the pathophysiology of macroscopic and microscopic hematuria
- To describe the methods of investigation in microscopic hematuria, including the role of renal biopsy
- To understand the various findings of phase contrast microscopy and their meaning
- To know the underlying causes of hematuria
- To know the long term outcome of the underlying causes
Skills
- To be able to perform urinalysis
- To demonstrate appropriate investigation and management of the child with hematuria, including role of imaging,
urological assessment, and genetic and molecular studies
Multidisciplinary aspects
- To explain the mode of inheritance of hereditary nephritis, and implications for other family members
- To appreciate the role of the pediatric surgeon
- To understand the need for long-term follow up
Resources
- Nephropathology meeting
- Pathology laboratory (microscopy of urine)
(G) Proteinuria
Knowledge
- To know the pathophysiology of proteinuria
- To know the physiological and pathological causes of asymptomatic proteinuria
- To describe the methods of investigation of asymptomatic proteinuria
- To list the indications for renal biopsy
- To know the long-term prognosis of the various conditions causing proteinuria
Skills
- To be able to differentiate between pathological and physiological proteinuria
- To show ability to manage the child with proteinuria
Multidisciplinary aspects
- To understand the requirement of long-term follow-up
(H) Glomerular disease
Knowledge
- To describe the etiology, pathophysiology and immunological basis of glomerulonephritis
- To know the different forms of presentation
- To understand the clinical course and prognosis of acute and chronic glomerulonephritis
- To know the indications for immunosuppressive agents,
cytotoxic drugs, plasmapharesis and dialysis
Skills
- To appropriately investigate and manage the acute
nephritic syndrome, and new presentation of chronic
glomerulonephritis
- To demonstrate the appropriate use of general and specific measures to treat glomerulonephritis
Resources
- Pathology laboratory
(I) Nephrotic syndrome
Knowledge
- To know the causes of nephrotic syndrome
- To be aware of the pathophysiology of nephrotic syndrome, including latest research
- To understand the investigation of nephrotic syndrome including indications for renal biopsy
- To understand the complications of the nephrotic state
- To know the pharmacology and side-effects of steroids, other immunosuppressive agents and other treatment modalities
Skills
- To appropriately investigate and manage initial episode of nephrotic syndrome and relapses and the complications
- To appropriately investigate and manage steroid resistant nephrotic syndrome and the complications
- To manage adverse effects of immunosuppressive medications
- To demonstrate the appropriate use of general and specific
measures to treat secondary causes of nephrotic syndrome
Multidisciplinary aspects
Liaison with local pediatricians in long-term management
Resources
Pediatrics, Pathology
(J) Systemic lupus erythematosus (SLE)
Knowledge
- To describe the pathogenesis of SLE and underlying immunological mechanisms
- To list the histological classification of lupus nephritis
- To describe the clinical course of lupus nephritis
- To describe the different treatment options
Skills
- To perform a relevant clinical examination to diagnose and assess a patient with SLE
- To plan and interpret investigations, including renal histology and immunology
- To appropriately manage acute renal failure due to SLE, including use of plasmapharesis
- To show ability to undertake long-term management of the
patient with lupus nephritis
Multidisciplinary aspects
- To appreciate the role of other specialists, especially rheumatologists
- To counsel the patient about long-term implications of SLE, including problems with renal transplantation and
impact on reproductive potential
Resources
Adult nephrology, rheumatology services
(K) Other Vasculitis
Knowledge
- To understand the pathophysiology and immunology of vasculitis
- To know the different causes of vasculitis
- To know the presentation of vasculitis, patterns of multisystem involvement and spectrum of disease
- To describe the investigation and monitoring of the patient with vasculitis
- To list the different therapeutic options available, including
adverse effects
Skills
- To perform a relevant multisystem clinical examination
- To be able to appropriately investigate and treat vasculitis, including use of immunosuppression, in the short and long- term
Multidisciplinary aspects
To work with other specialists including rheumatologists
Resources
Pediatric and adult rheumatology clinics
(L) Hemolytic uremic syndrome (HUS)
Knowledge
- To understand the pathophysiology of microangiopathic hemolytic anemia
- To know the epidemiology of VTEC, S. dysenteriae
- To know the presentation and clinical course of diarrhea- positive and atypical HUS
- To be aware of non-renal manifestations of HUS
- To understand the long-term consequences and prognosis of D+ HUS
- To understand principles of treatment, including conservative, and the role of plasma exchange and dialysis
- To understand the investigation of atypical HUS
- To be aware of the long-term management of atypical HUS including implications for transplantation
Skills
- To be able to investigate, diagnose and manage the initial presentation of HUS
- To appropriately initiate dialysis and plasma exchange
- Interstitial nephritis
Knowledge
To list the causes of interstitial nephritis and tubulo-
interstitial disease, and the relationship to systemic conditions
Skills
To appropriately investigate and manage the child with
interstitial nephritis, including use of corticosteroids
(N) Hypertension
Knowledge
- To define and understand how to diagnose hypertension
- To know the common renal and non-renal diagnoses implicated in hypertension in different age groups
- To describe the possible mechanisms causing primary (essential) and secondary hypertension
- To describe the investigation of hypertension including the use of arteriography and renal vein sampling ; nuclear imaging
- To describe the mechanism of action and side-effects of
anti-hypertensive agents
- To understand vascular interventions in renal artery stenosis
Skills
- To show ability to appropriately investigate the child with hypertension
- To be competent in the management of hypertensive emergencies
- To be competent in the management of chronic hypertension, and in using the different classes of drugs
- To be able perform and interpret ABPM read out and
modify prescription
Multidisciplinary aspects
- Liaison with local pediatricians; interventional radiologist
Resources
- Intensive care unit; Radiology services
(O) Nephrolithiasis
Knowledge
- To know the etiology of renal stone formation, including underlying tubular abnormalities
- To know the biochemical and radiological investigation of renal stones
- To understand the acute and chronic medical (including prevention of the development of renal stones) and surgical
management of renal stones (including lithotripsy)
Skills
- To demonstrate ability to appropriately investigate the child with renal stones
- To show ability to manage the child with renal stones
Multidisciplinary aspects
- To involve pediatric urologists where indicated
- To show understanding of the significance of the family history and genetic implications in some cases
Resources
Departments of Laboratory Medicine, Pediatric Surgery,
Urology and Radiology
(P) Tubular disorders
Knowledge
- To understand the different presentations of primary and secondary tubular disorders
- To know the different causes
- To understand the investigation of tubulopathies
Skills
- To be competent in the investigation and management of
tubular disorders
Multidisciplinary aspects
- To understand the role of other specialists (hepatologists, neurologists, biochemists, geneticists) in the diagnosis, management and treatment of these disorders
- To be able to provide dialysis support to other specialists
Resources
Metabolic clinics, Endocrine clinic
Biochemistry department
- Cystic disease
Knowledge
- To list the different causes of renal cystic disease in different age groups
- To describe the mode of inheritance and methods of screening
- To know the clinical course and associated features of autosomal recessive and autosomal dominant polycystic
kidney disease
Skills
- To appropriately examine and investigate the child with renal cysts in different age groups
- To appropriately manage the child with polycystic kidney
disease
Multidisciplinary aspects
- To appreciate the implications of a diagnosis of autosomal dominant polycystic kidney disease on other family members
- To recognize the importance of genetic counseling
Resources
- Radiology services
(R) Genetic disorders (Inherited diseases of the kidneys)
Knowledge
- To know the presentation and management of commonly encountered inherited renal disease including renal involvement in syndromes, familial nephritis and polycystic kidney disease
- To understand basic genetic principles
Skills
- To be able to advise parents of the risks of recurrences and the need for family screening in commonly inherited
diseases
Multidisciplinary aspects
To understand the role of the geneticist in diagnosis
and counseling, including antenatal diagnosis
Resources
Geneticist
(S) Fluid and electrolyte disturbances
Knowledge
- To understand the physiology underlying fluid and electrolyte imbalance in the child without primary renal disease
- To know the principles of treatment of fluid and electrolyte imbalance
- To know the endocrine diseases associated with electrolyte
imbalance and their management
Skills
To be able to manage fluid and electrolyte imbalances in
non-renal disease including overdose
Resources
- Intensive care unit
- Endocrine clinics
(T) Acute Kidney Injury (AKI)
Knowledge
- To know the differential diagnosis of AKI
- To know the investigation including role of renal biopsy
- To describe the methods to correct fluid and biochemical abnormalities and to know the indications for dialysis
- To describe the principles of dialysis and filtration
- To know the treatment of reversible causes of AKI
Skills
- To perform a reliable and accurate clinical assessment of
the patient's fluid status
- To be able to appropriately manage the complications of AKI – conservative and dialysis
- To be able to select and practically manage the different dialysis modalities including peritoneal dialysis, hemodialysis and hemofiltration
- To be able to commence correct treatment of the underlying cause
- To manage the patient with multiorgan failure or systemic
disease requiring acute renal replacement therapy
Multidisciplinary aspects
- To recognize the role of nurses in the management of AKI
- Liaison and share care with the intensive care unit
Resources
Intensive care and neonatal intensive care units
(U) Chronic Kidney Disease (CKD)
Knowledge
- To know the epidemiology of CKD
- To list the causes of CKD
- To know the investigations required in a child with new presentation of CKD, including assessment of the degree of renal failure and reversibility of the condition
- To understand the natural history and prognosis of common diseases causing CKD, and treatment strategies that may ameliorate the condition
- To understand the factors involved in failure to thrive in CKD
- To describe the pathophysiology, investigation and indications for treatment in the management of renal bone disease
- To describe the pathophysiology of renal anemia, and its investigation and management, including use of
erythropoietin and iron therapy
Skills
- To identify and appropriately manage the underlying cause
- To manage the child with CKD including biochemical disturbance, bone disease and anemia
- To appropriately counsel the family to facilitate the selection of dialysis modality and prior to referral for renal transplantation
- To make an accurate clinical assessment of nutritional status and to use appropriate dietary advice with the assistance of dietitians
- To prescribe and monitor treatment for hyperlipidemia
- To show ability to prevent, diagnose and manage renal bone disease
- To diagnose and appropriately treat renal anemia
Multidisciplinary aspects
- To appreciate the role of the multiprofessional team including dietitian, psychologist, social worker
- To understand the role of the dialysis nurses and transplant coordinator
- To audit biochemical and hematological results against national guidelines
- To appreciate the impact of CKD on cardiovascular disease
in adult life
Resources
- Chronic kidney disease clinics
- Multidisciplinary team meeting
(V) Transplantation
Knowledge
Pre-Transplantation
- To understand the ethical issues surrounding organ donation/ transplant
- To know the principles of recipient selection, indications and contraindications
- To describe the theoretical and practical application of
blood grouping, HLA matching and donor-recipient cross
matching
- To know what is involved in a transplant work-up
- To know the advantages and disadvantages of deceased versus live related donor transplantation
- To know the acceptability criteria for deceased organ donation
- To describe the advantages and disadvantages of preemptive transplantation
Transplantation
- To understand the unique needs of children undergoing organ transplantation
- To know the basic surgical procedures involved
- To know the medications used, including side-effects and recent advances and trials
- To know the approach towards handling deceased organ transplantation
Post-Transplantation
- To know the indications for and knowledge of the procedure of renal transplant biopsy
- To understand the immune mechanisms of rejection
- To know the recurrence rate of the original disease, and other complications pertaining to the original diagnosis and their management
Skills
Pre-transplantation
- To assess the suitability of a patient for renal transplant
- To discuss the issues of transplantation
Transplantation
- To be able to manage the peri-operative transplant period
- To assess renal transplant function
- To plan and modify immunosuppressive therapy
Post-transplantation
- To be competent in the diagnosis and management of acute rejection episodes
- To understand the role of fine needle cytology and histopathology for diagnosing rejection
- To be able to manage the stable transplant patient
- To be able to advise the child, family and school
- To be able to diagnose and manage chronic rejection
- To be aware of the diagnosis and management of the short and long-term complications of transplantation
- To counsel patients with a failing graft and discuss future
management on renal replacement therapy
Multidisciplinary aspects
To understand the role of the transplant coordinator
To appreciate the role of the multidisciplinary team
Resources
- Transplant clinics
- Tissue typing laboratory
- Transplant surgeon
(W) DIALYSIS
1. Hemodialysis
Knowledge
- To describe the principles of hemodialysis and compare and contrast with other methods of dialysis
- To describe the anatomy of the neck veins, and their assessment
- To describe the methods of vascular access and arterio venous fistulas, and their complications
- To understand the principles of water treatment and maintaining water quality
- To define the methods to assess adequacy of hemodialysis
- To list the complications occurring during dialysis
- To list the particular infections which may occur in patients on dialysis, and to define strategies to prevent
blood-borne viral infections in patients on hemodialysis
Skills
- To be able to plan the initiation of hemodialysis
- To manage different forms of vascular access, and their difficulties
- To assess the functional status of AV fistula and cannulate
- To operate hemodialysis machine and respond to alarms; disinfection of machines and circuits
- To be able to handle dialyzers and the dialyzer tubings appropriately
- To adjust the prescription of hemodialysis based on adequacy and monitor change
- To manage the complications of hemodialysis
- To diagnose, investigate and treat infection
Multidisciplinary aspects
- To understand the role of the nurses in preparing the patient physically and psychologically for hemodialysis, and in the long term management
- To counsel patients about blood borne infection
- To work closely with the microbiologist in developing protocols and in audit and management of infection
Resources
Hemodialysis technician and nurses
Departments of Nephrology, Microbiology and Surgery
2. Peritoneal Dialysis
Knowledge
- To describe the principles of acute and peritoneal dialysis, and know the advantages and disadvantages compared to hemodialysis
- To describe methods to assess adequacy of peritoneal dialysis and ultrafiltration
- To describe the anatomy and outline the surgical procedure of insertion of peritoneal dialysis catheters
- To know the complications of peritoneal dialysis, both
infective and mechanical
Skills
- To be able to prescribe peritoneal dialysis and monitor change and measure adequacy
- To perform peritoneal equilibration test (PET)
- To operate and troubleshoot PD cyclers
- To manage the complications of peritoneal dialysis
Multidisciplinary aspects
Pediatric surgeon
(X) Pharmacology
Knowledge
- To define the principles of pharmacokinetics and drug handling in renal impairment
- To list ways in which different classes of drugs act on the nephron
- To describe how drugs may affect renal function
- To list the effects of hemodialysis, hemofiltration and peritoneal dialysis on drug prescribing
- To describe the principles of drug interactions especially
immunosuppressive agents
Skills
- To prescribe safely to patients with renal disease
Multidisciplinary aspects
- To educate patients regarding importance of compliance
and reporting of problems with medication
Resources
Pharmacologists
- Psychosocial and Ethical issues
Knowledge
- To understand the impact of chronic illness on the child, adolescent, parents, siblings and extended family
- To understand the ethics of research in children
- To know the process of informed consent in different ages
- To know the procedures for clinical trials
Skills
- To demonstrate competence in communication skills at initial diagnosis and thereafter
- Liaison with pediatricians and other health professionals
- To show interest in ethical discussions within the department
- To show ability to take informed consent
Multidisciplinary aspects
- To understand the role of the psychologist, psychiatrist,
social worker, teacher and religious leaders
- To understand the care of the dying child
Resources
Multidisciplinary team meeting
(Z) Teaching skills
Knowledge
- To understand the principles of adult learning and different teaching techniques
- To understand the role of clinical audit and research
Skills
- To demonstrate formal and informal teaching skills at undergraduate and postgraduate level, and to other professionals within the multidisciplinary team
- To demonstrate continuing self-education and self- reflection
- To show support or active involvement in research
- To show ability to critically evaluate literature reviews, audit and research papers
- To demonstrate ability in oral presentation skills and
manuscript preparation
(A1) Nutrition
Knowledge
- To develop basic knowledge of nutritional requirements of children with acute kidney injury and chronic kidney
disease including those on dialysis and transplantation
Skills
- To be able to counsel and provide nutritional advice for
children with chronic kidney disease
Multidisciplinary aspects
- Nutritionist
Competency in Procedural /Practical Skills:
The post graduate student should be able to perform independently the following procedures
• Renal biopsy
Satisfactory performance of percutaneous biopsy of native and transplant kidneys entail:
- knowledge of indications for the procedure,
- obtaining informed consent,
- performance of the procedure itself including minimizing patient discomfort, and
- interpretation of results of the biopsy.
• Central venous access insertion for hemodialysis
Satisfactory placement of vascular access entails:
- knowledge of informed consent,
- proper Seldinger technique,
- knowledge of vascular anatomy,
- minimizing patient discomfort, as well as
- functional catheter placement and recognize/manage complications
• Acute peritoneal dialysis catheter insertion
Satisfactory placement of peritoneal catheter placement entails:
- knowledge of informed consent,
- proper technique,
- minimizing patient discomfort, as well as
- functional catheter placement.
In addition they should be able to perform independently the following:
To be able to write a prescription, conduct and supervise acute and chronic intermittent hemodialysis
- Entails knowledge of proper indications for hemodialysis,
- knowledge of first dialysis precautions,
- writing of dialysis order which includes choosing dialysis filters,
- estimating dry weight and modification during special circumstances (critically ill child, in-born errors of metabolism),
- choosing dialysate composition,
- understanding and treatment of complications, and
- modifying dialysis prescription for inadequate clearance in chronic hemodialysis patients.
To be able to write a prescription, conduct and supervise acute and chronic peritoneal dialysis:
- Entails knowledge of proper indications of peritoneal dialysis,
- writing orders for peritoneal dialysis which includes dialysis prescription (volume of dialysate, frequency of exchanges, and use of different hypertonic solutions),
- understanding and treatment of complications, and
- modifying dialysis prescription in special situations (lactic acidosis, metabolic disorders) and inadequate clearance in chronic peritoneal dialysis patients
To be able to write a prescription, conduct and supervise continuous renal replacement therapy (CRRT)
- Entails knowledge of proper indications of CRRT,
- writing orders for continuous renal replacement therapy (flow rate of dialysate, choosing ultrafiltration rate,
- choosing dialysate composition including the use of bicarbonate based solutions),
- understanding and treatment of complications, and
- modifying dialysis prescription for inadequate clearance in patients undergoing continuous renal replacement therapy
To be able to write a prescription, conduct and supervise slow low efficiency daily dialysis (SLED)
- Entails knowledge of proper indications of SLED,
- writing orders (flow rate of dialysate,
- choosing ultrafiltration rate,
- choosing dialysate composition,
- understanding and treatment of complications, and
- modifying dialysis prescription for inadequate clearance in patients undergoing SLED
To be able to write a prescription, conduct and supervise plasmapheresis
- Entails knowledge of proper indications of plasmapheresis,
- writing orders (volume of plasma replacement,
- choosing rate of plasmapheresis, monitoring,
- understanding and treatment of complications, and modifying plasmapheresis prescription based on the goal of plasmapheresis.
To be able to perform urine analysis at bedside
- To perform correctly urinalysis and interpret findings and to know the limitations of interpretation as applied to patient care
Procedure
O
A
P
SJ
Renal biopsy
Hemodialysis catheter access
Acute peritoneal catheter insertion
Urine analysis
O- Observed; A- Assisted; P- Performed independently; SJ- Supervised junior colleague
Career Options
After
completing a DM in Pediatric Nephrology,
candidates will get employment opportunities in Government as well as in the
Private sector.
In the Government sector, candidates have various options to
choose from which include Registrar, Senior Resident, Demonstrator, Tutor, etc.
While in the Private sector the
options include Resident Doctor, Consultant, Visiting Consultant (Pediatric Nephrology), Junior Consultant, Senior
Consultant (Pediatric Nephrology), Pediatric Nephrology
Specialist.
Courses After DM
in Pediatric Nephrology Course
DM
in Pediatric Nephrology is a specialisation course which
can be pursued after finishing a Postgraduate medical course. After pursuing
specialisation in DM in Pediatric Nephrology, a candidate could also
pursue certificate courses and Fellowship programmes recognised by NMC and NBE,
where DM in Pediatric Nephrology is a feeder
qualification.
Frequently Asked Question (FAQs) –DM in Pediatric Nephrology Course
Question: What is the
full form of DM?
Answer: The full form of
DM is Doctorate of Medicine.
Question: What is a DM in Pediatric Nephrology?
Answer: DM Pediatric Nephrology or Doctorate of Medicine in Pediatric Nephrology also
known as DM in Pediatric Nephrology is a super specialty level
course for doctors in India that is done by them after completion of their
postgraduate medical degree course.
Question: What is the
duration of a DM in Pediatric
Nephrology?
Answer: DM in Pediatric Nephrology is a super
specialty programme of three years.
Question: What
is the eligibility of a DM in Pediatric
Nephrology?
Answer:
Candidates must be in possession of a postgraduate medical Degree (MD/MS/DNB)
from any college/university recognized by the Medical Council of India (now
NMC)/NBE.
Question: What is the scope of a DM in Pediatric Nephrology?
Answer: DM in Pediatric
Nephrology offers candidates various employment opportunities and career
prospects.
Question: What is the average salary for a DM in Pediatric Nephrology candidate?
Answer: The DM in
Pediatric Nephrology candidate's average salary is between Rs. 5,00,000 to Rs. 30,00,000 per year depending on the experience.
Question: Can you teach after completing
DM Course?
Answer: Yes, candidate can teach in
a medical college/hospital after completing DM course.
2 years 4 months ago
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DM Neonatology: Admissions, Medical Colleges, Fees, Eligibility Criteria details here
DM Neonatology
or Doctorate of Medicine in Neonatology also known as DM in Neonatology is a super
specialty level course for doctors in India that is done by them after completion
of their postgraduate medical degree course. The duration of this super
DM Neonatology
or Doctorate of Medicine in Neonatology also known as DM in Neonatology is a super
specialty level course for doctors in India that is done by them after completion
of their postgraduate medical degree course. The duration of this super
specialty course is 3 years, and it focuses on the diagnosis and treatment of diseases in newborns, particularly premature newborns.
The course is a full-time course pursued at various recognized medical
colleges across the country. Some of the top medical colleges offering this
course include-Rangaraya Medical College- Kakinada, Postgraduate Institute of Medical Education & Research- Chandigarh,
Government Medical College- Chandigarh, and
more
Admission to this course is done through the NEET SS Entrance exam
conducted by the National Board of Examinations, followed by counselling based
on the scores of the exam that is conducted by DGHS/MCC/State Authorities.
The fee for pursuing DM (Neonatology) varies from college to college and
may range from Rs. 30,000 to Rs. 12,00,000 per year.
After completion of their respective course, doctors can either join the
job market or can pursue certificate courses and Fellowship programmes recognized by
NMC and NBE. Candidates can take reputed jobs at positions as Senior residents,
Consultants etc. with an approximate salary range of Rs. 5,00,000 to Rs. 20,00,000 per year.
What is DM in Neonatology?
Doctorate of Medicine in Neonatology, also
known as DM (Neonatology) or DM in (Neonatology) is a three-year super specialty programme that
candidates can pursue after completing a postgraduate degree.
Neonatology is the branch of medical science
dealing with the study of diagnosis, and treatment of diseases in newborns, particularly premature newborns.
National
Medical Commission (NMC), the apex medical regulator, has released guidelines for a Competency-Based Postgraduate Training Programme for DM in Neonatology.
The Competency-Based
Postgraduate Training Programme governs the education and training of DMs in Neonatology.
The postgraduate students must gain ample of knowledge and
experience in the diagnosis, treatment of patients with acute, serious, and
life-threatening medical and surgical diseases.
The PG education intends to create specialists who can
contribute to high-quality health care and advances in science through research
and training.
The required training done by a postgraduate specialist in
the field of Neonatology would help
the specialist to recognize the health needs of the community. The student
should be competent to handle medical problems effectively and should be aware
of the recent advances in their speciality.
The candidate is also expected to know the principles of
research methodology and modes of the consulting library. The candidate should
regularly attend conferences, workshops and CMEs to upgrade her/ his knowledge.
Course
Highlights
Here are some of the course highlights of DM in Neonatology
Name of Course
DM in Neonatology
Level
Doctorate
Duration of Course
Three years
Course Mode
Full Time
Minimum Academic
Requirement
Postgraduate medical degree obtained
from any college/university recognized by the MCI (Now NMC)/NBE
Admission Process /
Entrance Process / Entrance Modalities
Entrance Exam (NEET-SS)
INI CET for various
AIIMS, PGIMER Chandigarh, JIPMER Puducherry, NIMHANS Bengaluru
Counselling by DGHS/MCC/State
Authorities
Course Fees
Rs. 30,000 to Rs. 12,00,000 per year
Average Salary
Rs. 5,00,000 to Rs. 20,00,000 per year
Eligibility Criteria
The eligibility criteria for DM in Neonatology are defined as the
set of rules or minimum prerequisites that aspirants must meet in order to be
eligible for admission, which include:
- Candidates must
be in possession of a postgraduate medical Degree (MD/MS/DNB) from any
college/university recognized by the Medical Council of India (MCI Now NMC)/NBE. - The candidate must have obtained permanent
registration of any State Medical Council to be eligible for admission. - The medical college's recognition cut-off
dates for the Postgraduate Degree courses shall be as prescribed by the Medical
Council of India (now NMC).
Admission Process
- The
admission process contains a few steps to be followed in order by the
candidates for admission to DM in Neonatology.
Candidates can view the complete admission process for DM in Neonatology mentioned below:
- The
NEET-SS or National Eligibility Entrance Test for Super specialty courses is a
national-level master's level examination conducted by the NBE for admission to
DM/MCh/DrNB Courses.
- Qualifying Criteria-Candidates
placed at the 50th percentile or above shall be declared as qualified in the
NEET-SS in their respective specialty.
- The following Medical institutions are
not covered under centralized admissions for DM/MCh courses through
NEET-SS:
- AIIMS, New Delhi and other AIIMS
- 2.PGIMER, Chandigarh
- 3.JIPMER, Puducherry
- 4.NIMHANS, Bengaluru
- Candidates from all eligible
feeder specialty subjects shall be required to appear in the question paper of
respective group, if they are willing to opt for a superspecialty course in any
of the super specialty courses covered in that group.
- A candidate can opt for appearing
in the question papers of as many groups for which his/her Postgraduate
specialty qualification is an eligible feeder qualification.
- By appearing in the question
paper of a group and on qualifying the examination, a candidate shall be
eligible to exercise his/her choices in the counseling only for those
superspecialty subjects covered in said group for which his/ her broad
specialty is an eligible feeder qualification.
Fees Structure
The fee structure for DM in Neonatology varies from college
to college. The fee is generally less for Government Institutes and more for
private institutes. The average fee structure for DM in Neonatology is around Rs. 30,000 to Rs. 12,00,000 per year.
Colleges offering DM in Neonatology
There are various medical colleges across India that
offer courses for pursuing DM in (Neonatology).
As per National Medical Commission (NMC) website, the
following medical colleges are offering DM in (Neonatology)
courses for the academic year 2022-23.
Sl.No.
Course Name
Name and Address of
Medical College / Medical Institution
Annual Intake (Seats)
1
DM - Neonatology
Rangaraya Medical College, Kakinada
1
2
DM - Neonatology
Postgraduate Institute of Medical Education & Research,
Chandigarh
4
3
DM - Neonatology
Government Medical College, Chandigarh
3
4
DM - Neonatology
All India Institute of Medical Sciences, New Delhi
7
5
DM - Neonatology
Lady Hardinge Medical College, New Delhi
4
6
DM - Neonatology
Maulana Azad Medical College, New Delhi
2
7
DM - Neonatology
Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML
Hospital, New Delhi
4
8
DM - Neonatology
Pramukhswami Medical College, Karmsad
3
9
DM - Neonatology
St. Johns Medical College, Bangalore
3
10
DM - Neonatology
Malankara Orthodox Syrian Church Medical College, Kolenchery
2
11
DM - Neonatology
Medical College, Thiruvananthapuram
4
12
DM - Neonatology
Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha
1
13
DM - Neonatology
Government Medical College, Aurangabad
4
14
DM - Neonatology
Bharati Vidyapeeth University Medical College, Pune
5
15
DM - Neonatology
Lokmanya Tilak Municipal Medical College, Sion, Mumbai
3
16
DM - Neonatology
Seth GS Medical College, and KEM Hospital, Mumbai
4
17
DM - Neonatology
All India Institute of Medical Sciences, Bhubaneswar
2
18
DM - Neonatology
Instt. Of Medical Sciences & SUM Hospital, Bhubaneswar
2
19
DM - Neonatology
Jawaharlal Institute of Postgraduate Medical Education &
Research, Puducherry
2
20
DM - Neonatology
All India Institute of Medical Sciences, Jodhpur
4
21
DM - Neonatology
National Institute of Medical Science & Research, Jaipur
3
22
DM - Neonatology
Mahatma Gandhi Medical College and Hospital, Sitapur, Jaipur
2
23
DM - Neonatology
Sri Ramachandra Medical College & Research Institute, Chennai
2
24
DM - Neonatology
Saveetha Medical College and Hospital, Kanchipuram
2
25
DM - Neonatology
Chengalpattu Medical College, Chengalpattu
4
26
DM - Neonatology
Chettinad Hospital & Research Institute, Kanchipuram
2
27
DM - Neonatology
Madurai Medical College, Madurai
1
28
DM - Neonatology
Christian Medical College, Vellore
4
29
DM - Neonatology
Madras Medical College, Chennai
8
30
DM - Neonatology
Osmania Medical College, Hyderabad
3
31
DM - Neonatology
All India Institute of Medical Sciences, Rishikesh
10
32
DM - Neonatology
Sanjay Gandhi Postgraduate Institute of Medical Sciences,
Lucknow
2
33
DM - Neonatology
Institute of Postgraduate Medical Education & Research,
Kolkata
2
Syllabus
A DM in Neonatology is a three
years specialization course that provides training in the stream of Neonatology.
The course content for DM in Neonatology is given in the Competency-Based
Postgraduate Training Programme released by National Medical Commission, which
can be assessed through the link mentioned below:
Also Read:NMC Guidelines For Competency Based Super-Speciality Training Programme For DM Neonatology
Course contents
I. Cognitive
domain
A) Basic
sciences as applied to neonatology
- Basic genetics
- Fetal and neonatal immunology
- Mechanism of diseases
- Applied anatomy and embryology
- Feto-placental physiology
- Neonatal adaptation
- Thermo-regulation
- Development and maturation of lungs, respiratory control,
lung functions, ventilation, gas exchange, ventilation-perfusion. - Physiology and development of the cardiovascular system,
developmental defects, physiology and hemodynamics of congenital heart disease. - Fetal and intrauterine growth.
- Development and maturation of nervous system, cerebral blood
flow, blood-brain barrier, special senses. - Fetal and neonatal endocrine physiology
- Developmental pharmacology
- Developmental hematology,
- Development of liver functions and bilirubin metabolism
- Renal physiology
- Physiology of gastrointestinal tract, sucking, swallowing,
digestion, absorption. - Fluid and Electrolyte balance
- Metabolic pathways including pathways of glucose, calcium,
and magnesium - Biochemical basis of inborn errors of metabolism
B) General
topics
- Research methodology
- Biostatistics
- Ethics in perinatology/neonatology
- Principles of education (objectives, curriculum, assessment,
and use of media) - Computer, information technology, internet, telemedicine,
neonatal networking - Biotechnololgy, and basis of working of common equipment
- Counseling – antenatal, discharge counseling, breaking bad
news, lactation counseling, grieve counseling.
C) Perinatology
- Perinatal and neonatal mortality, morbidity, epidemiology
- Perinatal pathology, autopsy, microbiology
- High-risk pregnancy: detection, monitoring, and management
- Fetal monitoring, clinical, electronic; invasive, and non-invasive
- Intrapartum monitoring and procedures
- Assessment of fetal risk and decision for termination of
pregnancy - Diagnosis and management of fetal diseases
- Medical diseases affecting pregnancy and fetus, psychological
and ethical considerations - Optimal timing of delivery in various medical and obstetric
conditions - Fetal interventions
- Fetal origin of adult disease.
D) Neonatal
resuscitation
Successful completion of the neonatal
resuscitation program (NRP).
E) Essential
newborn care
- Breastfeeding, lactation support
- Kangaroo Mother Care
- Prevention of infections
- Counseling
- Danger signs
- Newborn screening
F) Neonatal
ventilation
- Mechanical ventilation
- Continuous positive airway pressure, high flow nasal canula
- High-frequency ventilation
- Clinical uses of surfactant and administration
- Inhaled nitric oxide therapy
G) Blood gas
and acid-base disorders
H) Neonatal
assessment and follow up
- Assessment of gestation, neonatal behavior, neonatal reflexes
- Assessment of vision & hearing, detection of neuromotor
delay, stimulation techniques - Growth monitoring
- Immunization
- Early intervention and goal directed therapies.
I) Care of low
birth weight babies
J) Specific
body systems
i) Respiratory
system
- Neonatal airways: physiology, pathology, management
- Pulmonary diseases: Hyaline membrane disease, transient
tachypnea, aspiration pneumonia, pulmonary air leak syndromes, pulmonary
hemorrhage, developmental defects - Oxygen therapy and its monitoring
- Pulmonary infections
- Miscellaneous pulmonary disorders.
ii)
Cardiovascular system
- Fetal circulation, the transition from fetal to neonatal
physiology - Examination and interpretation of cardiovascular signs and
symptoms - Special tests and procedures (Echocardiography, angiography)
- Diagnosis and management of congenital heart diseases
- Rhythm disturbances
- Hypertension in neonates
- Shock: pathophysiology, monitoring, management.
iii)
Gastrointestinal system
- Disorders of liver and biliary system.
- Bilirubin metabolism
- Neonatal jaundice: diagnosis, monitoring, management,
phototherapy, exchange transfusion. - Kernicterus
- Prolonged hyperbilirubinemia
- Congenital malformations
- Necrotising enterocolitis
iv) Nutrition
- Fetal nutrition
- Physiology of lactation
- Breastfeeding
- Lactation management, breast milk banking, maternal
medications and nursing - Feeding of Low Birth Weight neonate
- Parenteral nutrition
- Vitamins and micronutrients in newborn health
v) Renal system
- Developmental disorders
- Renal functions
- Fluid and electrolyte management
- Acute renal failure (diagnosis, monitoring, management).
vi) Endocrine
and metabolism
- Glucose metabolism, hypoglycemia, hyperglycemia
- Calcium disorders
- Magnesium disorders
- Thyroid disorders
- Adrenal disorders
- Ambiguous genitalia
- Inborn errors of metabolism
vii)Hematology
- Physiology
- Anemia
- Polycythemia
- Bleeding and coagulation disorders
- Rh hemolytic disease
viii) Neurology
- Clinical neurological assessment
- Neonatal seizures
- Intracranial hemorrhage
- Neurophysiology, EEG, BERA etc.
- Brain imaging
- Neonatal encephalopathy :Hypoxemic ischemic , metabolic etc
- Neuro-muscular disorders
- Degenerative diseases
- CNS malformation
ix) Surgery and
orthopedics
- Diagnosis of neonatal surgical conditions
- Pre and post operative care
- Neonatal anesthesia
- Metabolic changes during anesthesia and surgery
- Orthopedic problems
x) Neonatal
infections
- Intrauterine infections
- Superficial infections
- Diarrhea
- Septicemia
- Meningitis
- Osteomyelitis and arthritis
- Pneumonia
- Perinatal HIV
- Miscellaneous infective disorders including HBV and
Candidemia - Outbreak and its managment
- Establishing an infection control program, audits,
establishing HIC committee
xi) Neonatal
Imaging
- X-rays, ultrasound, MRI, CT Scan etc.
xii)Neonatal
ophthalmology
- Developmental aspects
- Retinopathy of prematurity
- Sequelae of perinatal infections
xiii) Neonatal
ENT disorders
xiv) Neonatal
dermatology
K) Transport of
neonates
Understanding
of safe neonatal support/transport
L) Neonatal
procedures
M) Organization
of neonatal care
N) Follow up
care of the high risk NICU graduate
- Establishing a high risk follow up program
- Identification of early signs of growth and development
disorders (Neuromotor / Neurodevelopmental Assessment techniques)
o Amiel Tison,
Hammersmith, General movements, DDST, TDST, DASII, BSID
- Early intervention therapy
- Counseling
O) Community
neonatology
- Vital statistics, health system;
- Causes of neonatal, perinatal death
- Neonatal care priorities and National programs
- Neonatal care at primary and secondary levels
- Role of low cost interventions
- Role of different health functionaries
- Traditional practices
- IMNCI training,
- Regionalization and neonatal health system organization
P) Other topics
of contemporary importance: Neonatal metabolic screening, neonatal palliative
care, stress in NICU & management, leadership skills and capacity building.
II. Psychomotor
and affective domain
A: The
Postgraduate student should be able to perform the following skills
independently:
1. Core skills
2.
Developmental assessment and follow up
- Should be competent to perform structured neurological
examination of infants and young children in follow-up as well as their
developmental assessment using common standard screening tools used in the
high-risk follow-up clinic. - It is desirable for trainees to learn definitive
developmental assessment tool. Should be able to organize and coordinate
multi-disciplinary care of these infants during follow-up.
3. Infection
control, antimicrobial resistance, and antibiotic stewardship
- Should be familiar with and implement evidence-based
infection control and biomedical waste management measures. - Should have an understanding of mechanisms of development of
antimicrobial resistance. - Should have an understanding, practice and implement various
components of antibiotic stewardship.
4. Organization
of neonatal care and egionalization of neonatal care
5. Adoption
procedures and laws
6. Lactation
management, kangaroo mother care, and enteral feeding support
7. Education /
Training
a. Teaching
skills
b. Learning
skills
c.
Participatory and small group learning skills
d. Preparing
learning resource material
8. Effective
and safe use of teleconsultations/telemedicine
9. Research
methods and activities
Should have
knowledge and understanding of and perform the following:
a. Identifying
researchable issues and framing research questions
b. Choosing
appropriate study design and conducting a study
c. Analyzing
and interpreting data
d. Publication
and writing a paper
e. Review and
presentation of research findings
f. Critically
appraising published literature of various study designs
g. Systematic
reviews, meta-analysis, and GRADING of evidence
10. Research
Activities
The
postgraduate student should be able to perform the following under supervision:
- Thesis: The postgraduate students in superspecialty courses
are not required mandatorily to submit thesis, but, they may be encouraged to
conduct chosen research programs for which research protocol may be submitted
within the first six months of the course. Progress on the conduct of the
research project will give the student valuable training for the future. This
may be reviewed every semester, and feedback given to the student by the guide.
The PG student will make at least 3 formal presentations (i) Protocol, (ii)
mid-course progress and (iii) final report. It is desirable that at least one
research paper based on the above project is published or submitted for
publication during the three-year PG training period. - Quality Improvement Project: A minimum of one quality
improvement project must be carried out by the postgraduate student. - Data analysis: Using the existing database of patient
records, the postgraduate student will be expected to perform one complete data
analysis based on a predefined approved research question. - Follow-up of high-risk infants: A minimum of 15 high risk
infants must be followed up for one year, and a record of all assessments and
their interpretation maintained. - Publications
The following
minimum number of publications will be expected from a DM neonatology
postgraduate student by the end of the course:
- Letters to the editor: 1
- Case reports/series: 1
- Original articles: 1
- Presentations: a minimum of 02 research presentations in
conferences/ workshops.
11. Data
handling skills
The postgraduate
student would be expected to have learned the basics of data entry into Excel,
transferring data to a statistical software program, and performing basic analysis.
12. Bio-medical
equipment
- The postgraduate student should become thoroughly familiar with
parts, accessories, setting-up, maintenance, preventing infection, and basic troubleshooting
of all the equipment used in neonatology. - They should have participated in the entire purchase process
from planning to the installation of at least one equipment costing above Rs.
100,000. - The postgraduate student should know about equipment
inventory and maintenance details of the equipment.
13.
Communication skills
The
postgraduate student should be able to demonstrate interpersonal and communication
skills that result in effective information exchange and teaming with 'infants'
families and professional colleagues. He/she should be able to effectively communicate:
with parents, families, and community, with colleagues and other healthcare
providers and with health authorities.
14. The
postgraduate student should be able to conduct Perinatal Death audits and community-based
death surveillance and response.
15. Quality and
safety in healthcare
a. The
candidate should be well versed with concepts and determinants of quality and safety.
b. Should be
able to work in inter-professional teams to optimize patient safety and quality.
c. Should be
able to communicate effectively for patient safety.
d. Should be
able to anticipate, recognize & manage situations leading to errors & poor
quality.
e. Should be
well versed with the methods and tools of quality improvement.
f. Should be
able to identify medical errors and adverse events, should be able to respond
effectively to mitigate harm, ensure disclosure and should be familiar with the
methods of analysis and preventing recurrences.
16. Medical
Ethics, Laws and Professionalism
The
postgraduate student must demonstrate a commitment to carrying out professional
responsibilities and adherence to ethical principles. They should be familiar
with principles of ethics, evolution of laws over time at national and
international levels and current ethical standards of treatment and research at
national and international level. They should be familiar with various laws
governing medical practice in the country. The postgraduate student will be
expected to inculcate and demonstrate:
- Compassion, integrity, and respect for others
- Responsiveness to patient needs that supersedes self-interest
- Respect for patient privacy and autonomy
- Accountability to patients, society and the profession
- Sensitivity and responsiveness to a diverse patient
population
17. Essential
and desirable workshops during the duration of the course: The student should enrol
in the listed workshop as and when they are organized in the unit or outside
the unit depending on the clinical responsibility and availability of leave of absence.
The idea is to facilitate learning and expand horizon in critical thinking.
Essential and
desirable courses and workshops
Essential:
1. Online
certification in Research Methodology
Course on SWYAM
platform*
2.Neonatal
Resuscitation Program (NRP)
3.Lactation
Management
4.Neurodevelopmental
supportive care
5.Neonatal
Ventilation (Basic)
6.POCQI
7.Kangaroo
mother care
8.Death
certificate ICD 10 **
9.Neonatal
Ventilation (Advanced)
10.Functional
Echocardiography
11.Cranial
ultrasonography
Desirable
1. Neonatal EEG
2. Therapeutic
Hypothermia
3.
Developmental assessment
(DASII/BSID/Griffiths
etc)
*Must undertake
online certification in Research Methodology Course on SWYAM platform
**Must
undertake online certificate course on death certificate filling by ICMR DHR
Career Options
After completing a DM in Neonatology, candidates will get employment opportunities
in Government as well as in the Private sector.
In the Government
sector, candidates have various options to choose from which include Registrar,
Senior Resident, Demonstrator, Tutor etc.
While
in the Private sector the options include Resident Doctor, Consultant, Visiting
Consultant (Neonatology), Junior Consultant,
Senior Consultant (Neonatology), Neonatology Specialist.
Courses After DM in Neonatology Course
DM in Neonatology is a specialisation course which
can be pursued after finishing a Postgraduate medical course. After pursuing
specialisation in DM in Neonatology, a candidate could also pursue certificate
courses and Fellowship programmes recognised by NMC and NBE, where DM in Neonatology is a feeder
qualification.
Frequently Asked Question (FAQs) –DM in Neonatology Course
Question: What is the full form of DM?
Answer: The full form of DM is Doctorate of Medicine
Question: What is a DM in Neonatology?
Answer: DM Neonatology or Doctorate of Medicine
in Neonatology also known as DM in Neonatology is a super specialty level course for doctors in India that is done by
them after completion of their postgraduate medical degree course.
Question: What is the duration of a DM in Neonatology?
Answer: DM in Neonatology is a
super specialty programme of three years.
Question: What is the eligibility of a DM in Neonatology?
Answer: Candidates must be in possession of a postgraduate
medical Degree (MD/MS/DNB) from any college/university recognized by the
Medical Council of India (now NMC)/NBE.
Question: What
is the scope of a DM in Neonatology?
Answer: DM in Neonatology offers candidates
various employment opportunities and career prospects.
Question: What
is the average salary for a DM in Neonatology
candidate?
Answer: The DM in
Neonatology candidate's average salary is
between Rs. 5,00,000 to Rs. 20,00,000 per year depending on
the experience.
Question: Can you teach after completing DM Course?
Answer: Yes, candidate can teach in a medical
college/hospital after completing DM course.
Question: Can a paediatrician be a neonatologist?
Answer: A neonatologist is a medical doctor (MD or DO)
who has received special training to care for premature and sick newborns. All neonatologists are also paediatricians and attend medical
school and a full paediatric residency. They then complete an additional 3-year
neonatal training program, known as fellowship.
2 years 4 months ago
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Fill up vacancies at AIIMS, other state-run hospitals: Parliamentary panel tells Health Ministry
New Delhi: In a bid to ensure an adequate healthcare workforce for delivering healthcare facilities, a parliamentary panel has raised concerns over the filling up of vacant posts at various hospitals under the Health Ministry.
The Parliamentary Standing Committee on Health in its 140th report tabled in Rajya Sabha asked Health Ministry to submit the response of the cadres controlling authorities towards filling up vacant posts.
The panel has expressed concern saying it must have bearing on the administrative efficiency and overall functioning of these facilities.
It is incumbent on the ministry to take up the matter of filling up the vacant posts with respective cadre controlling authorities — Department of Personnel and Training, Department of Economic Affairs and the Ministry of Statistics and Programme Implementation.
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The panel also recommended that the ministry must give green signal to the Master Plan of AIIMS, New Delhi, so that the cherished goal of developing the institute into a world-class medical university by March, 2024, can be achieved without failure. The panel noted that vacancies in various AIIMS across the country is a matter of concern.
Even though the recruitment exercise is planned by respective management of the institutes, the ministry cannot shrug off its responsibility from monitoring the progress of recruitment process, the panel said in its report.
The committee does not approve the ministry's plea that posts are filled up to the range of service already operational in the institute.
Rather the reverse proposition is correct/true — many departments in various AIIMS remain in-operational due to vacant faculty and non-faculty staff, the panel noted. It urged the ministry to ensure an adequate healthcare workforce not only for delivering the assured health services but for imparting education and undertaking research projects to understand the biology of various diseases.
The committee also pointed out that the ministry, in its action taken note, has not informed about the steps taken to fill up 283 vacant posts of the total 4,126 sanctioned posts at Atal Bihari Vajpayee Institute of Medical Sciences and the RML Hospital, and furnished old status of vacancy as on February 1, 2022, that was already in its possession.
The committee urged Union Health Ministry to monitor the recruitment process in ABVIMS and Dr. RML Hospital.
It also recommended that the renovation work of labour room at the Lady Hardinge Medical College (LHMC) and Smt SK hospital must be completed within 2022-23. The committee takes into account the status of the recruitment process for filling up of various posts at the Safdarjung Hospital and Vardhman Mahavir Medical College that in fact retard the functioning of the various departments of Institute. In order to express the access of healthcare facilities, it is pertinent to fill up the vacant posts at the earliest. The panel recommends that the ministry chalk out specific time frame to complete the recruitment process so that vacant posts are filled up without delay, it added.
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Dr. Richard Amenyah Public policies, programmes and laws are meant to protect everyone equally. However, this does not hold true when there is disconnect between human rights norms and public health interventions. Thus, making vulnerable and marginalized people more at risk of contracting HIV. More than four decades into the HIV pandemic, the world is […]
Dr. Richard Amenyah Public policies, programmes and laws are meant to protect everyone equally. However, this does not hold true when there is disconnect between human rights norms and public health interventions. Thus, making vulnerable and marginalized people more at risk of contracting HIV. More than four decades into the HIV pandemic, the world is […]
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DM Endocrinology: Admissions, Medical Colleges, Fees, Eligibility Criteria Details
DM Endocrinology
or Doctorate of Medicine in Endocrinology also known as DM in Endocrinology is a super
specialty level course for doctors in India that is done by them after completion
of their postgraduate medical degree course. The duration of this super
DM Endocrinology
or Doctorate of Medicine in Endocrinology also known as DM in Endocrinology is a super
specialty level course for doctors in India that is done by them after completion
of their postgraduate medical degree course. The duration of this super
specialty course is 3 years, and it focuses on the diagnosis, treatment and management of the diseases that affect the endocrine system.
The course
is a full-time course pursued at various recognized medical colleges across the
country. Some of the top medical colleges offering this course include- Andhra Medical College- Visakhapatnam, Sri Venkateswara Institute of
Medical Sciences (SVIMS)-Tirupati, Narayana Medical College-Nellore, and more.
Admission to this course is done through the NEET-SS Entrance exam
conducted by the National Board of Examinations, followed by counselling based
on the scores of the exam that is conducted by DGHS/MCC/State Authorities.
The fee for pursuing DM (Endocrinology) varies from college to college
and may range from Rs. 50,000 to Rs. 25,00,000 per year.
After completion of their respective course, doctors can either join the
job market or can pursue certificate courses and Fellowship programmes recognised by
NMC and NBE. Candidates can take reputed jobs at positions as Senior residents,
Consultants etc. with an approximate salary range of Rs. 6,00,000
- Rs. 30,00,000 per year.
What is DM in Endocrinology?
Doctorate of Medicine in Endocrinology,
also known as DM (Endocrinology) or DM in (Endocrinology) is a three-year super specialty
programme that candidates can pursue after completing postgraduate degree.
Endocrinology is the branch of medical science
dealing with the diagnosis, treatment and management of diseases that affect the endocrine system.
National
Medical Commission (NMC), the apex medical regulator, has released guidelines for a Competency-Based Postgraduate Training Programme for DM in Endocrinology.
The Competency-Based
Postgraduate Training Programme governs the education and training of DMs in Endocrinology.
The postgraduate students must gain ample of knowledge and
experience in the diagnosis, treatment of patients with acute, serious, and
life-threatening medical and surgical diseases.
The PG education intends to create specialists who can contribute
to high-quality health care and advances in science through research and
training.
The required training done by a postgraduate specialist in
the field of Endocrinology would
help the specialist to recognize the health needs of the community. The student
should be competent to handle medical problems effectively and should be aware
of the recent advances in their speciality.
The candidate is also expected to know the principles of
research methodology and modes of the consulting library. The candidate should
regularly attend conferences, workshops and CMEs to upgrade her/ his knowledge.
Course
Highlights
Here are some of the course highlights of DM in Endocrinology
Name of Course
DM in Endocrinology
Level
Doctorate
Duration of Course
Three years
Course Mode
Full Time
Minimum Academic
Requirement
Postgraduate medical degree obtained
from any college/university recognized by the MCI (Now NMC)/NBE
Admission Process /
Entrance Process / Entrance Modalities
Entrance Exam (NEET-SS)
INI CET for various
AIIMS, PGIMER Chandigarh, JIPMER Puducherry, NIMHANS Bengaluru
Counselling by DGHS/MCC/State
Authorities
Course Fees
Rs. 50,000 to Rs. 25,00,000 per year
Average Salary
Rs. 6,00,000 - Rs. 30,00,000 per year
Eligibility Criteria
The eligibility criteria for DM in Endocrinology are defined as the
set of rules or minimum prerequisites that aspirants must meet in order to be
eligible for admission, which include:
- Candidates must
be in possession of a postgraduate medical Degree (MD/MS/DNB) from any
college/university recognized by the Medical Council of India (MCI). - The candidate must have obtained permanent
registration of any State Medical Council to be eligible for admission. - The medical college's recognition cut-off
dates for the Postgraduate Degree courses shall be as prescribed by the Medical
Council of India (now NMC).
Admission Process
- The
admission process contains a few steps to be followed in order by the
candidates for admission to DM in Endocrinology. Candidates can view the complete admission process for DM in Endocrinology mentioned
below:
- The
NEET-SS or National Eligibility Entrance Test for Super specialty courses is a
national-level master's level examination conducted by the NBE for admission to
DM/MCh/DrNB Courses.
- Qualifying Criteria-Candidates
placed at the 50th percentile or above shall be declared as qualified in the
NEET-SS in their respective specialty.
- The following Medical institutions are
not covered under centralized admissions for DM/MCh courses through
NEET-SS:
- AIIMS, New Delhi and other AIIMS
- 2.PGIMER, Chandigarh
- 3.JIPMER, Puducherry
- 4.NIMHANS, Bengaluru
- Candidates from all eligible
feeder specialty subjects shall be required to appear in the question paper of
respective group, if they are willing to opt for a superspecialty course in any
of the super specialty courses covered in that group.
- A candidate can opt for appearing
in the question papers of as many groups for which his/her Postgraduate
specialty qualification is an eligible feeder qualification.
- By appearing in the question
paper of a group and on qualifying the examination, a candidate shall be
eligible to exercise his/her choices in the counseling only for those
superspecialty subjects covered in said group for which his/ her broad
specialty is an eligible feeder qualification.
Fees Structure
The fee structure for DM in Endocrinology varies from college
to college. The fee is generally less for Government Institutes and more for
private institutes. The average fee structure for DM in Endocrinology is around Rs. 50,000 to Rs. 25,00,000 per year.
Colleges offering DM in Endocrinology
There are various medical colleges across India that
offer courses for pursuing DM in (Endocrinology).
As per National Medical Commission (NMC) website, the
following medical colleges are offering DM in (Endocrinology)
courses for the academic year 2022-23.
S.No.
Course Name
State
Name and Address of
Medical College / Medical Institution
Annual Intake (Seats)
1
DM -
Endocrinology
Andhra
Pradesh
Andhra Medical College,
Visakhapatnam
3
2
DM -
Endocrinology
Andhra
Pradesh
Sri Venkateswara Institute of
Medical Sciences (SVIMS) , Tirupati
2
3
DM -
Endocrinology
Andhra
Pradesh
Narayana Medical College,
Nellore
2
4
DM -
Endocrinology
Assam
Gauhati Medical College,
Guwahati
4
5
DM -
Endocrinology
Chandigarh
Postgraduate Institute of
Medical Education & Research, Chandigarh
8
6
DM -
Endocrinology
Delhi
All India Institute of
Medical Sciences, New Delhi
11
7
DM -
Endocrinology
Delhi
University College of Medical
Sciences & GTB Hospital, New Delhi
2
8
DM -
Endocrinology
Goa
Goa Medical College, Panaji
2
9
DM -
Endocrinology
Jammu &
Kashmir
Sher-I-Kashmir Instt. Of
Medical Sciences, Srinagar
4
10
DM -
Endocrinology
Karnataka
Jawaharlal Nehru Medical
College, Belgaum
2
11
DM -
Endocrinology
Karnataka
A J Institute of Medical
Sciences & Research Centre, Mangalore
2
12
DM -
Endocrinology
Karnataka
Belagavi Institute of Medical
Sciences, Belagavi
2
13
DM -
Endocrinology
Karnataka
Sapthagiri Institute of
Medical Sciences & Research Centre, Bangalore
2
14
DM -
Endocrinology
Karnataka
Vydehi Institute Of Medical
Sciences & Research Centre, Bangalore
2
15
DM -
Endocrinology
Karnataka
St. Johns Medical College,
Bangalore
2
16
DM -
Endocrinology
Karnataka
M S Ramaiah Medical College,
Bangalore
5
17
DM -
Endocrinology
Kerala
Medical College,
Thiruvananthapuram
2
18
DM -
Endocrinology
Kerala
Amrita School of Medicine,
Elamkara, Kochi
3
19
DM -
Endocrinology
Madhya
Pradesh
Sri Aurobindo Medical College
and Post Graduate Institute , Indore
2
20
DM -
Endocrinology
Madhya
Pradesh
Index Medical College
Hospital & Research Centre,Indore
2
21
DM -
Endocrinology
Maharashtra
Topiwala National Medical
College, Mumbai
2
22
DM -
Endocrinology
Maharashtra
Seth GS Medical College, and
KEM Hospital, Mumbai
3
23
DM -
Endocrinology
Orissa
Kalinga Institute of Medical
Sciences, Bhubaneswar
3
24
DM -
Endocrinology
Orissa
Instt. Of Medical Sciences
& SUM Hospital, Bhubaneswar
2
25
DM -
Endocrinology
Orissa
MKCG Medical College,
Berhampur
2
26
DM -
Endocrinology
Orissa
SCB Medical College, Cuttack
2
27
DM -
Endocrinology
Pondicherry
Jawaharlal Institute of
Postgraduate Medical Education & Research, Puducherry
2
28
DM -
Endocrinology
Rajasthan
Mahatma Gandhi Medical
College and Hospital, Sitapur, Jaipur
2
29
DM -
Endocrinology
Rajasthan
National Institute of Medical
Science & Research, Jaipur
2
30
DM -
Endocrinology
Rajasthan
SMS Medical College, Jaipur
2
31
DM -
Endocrinology
Tamil Nadu
Madras Medical College,
Chennai
1
32
DM -
Endocrinology
Tamil Nadu
Madurai Medical College,
Madurai
2
33
DM -
Endocrinology
Tamil Nadu
Sri Ramachandra Medical
College & Research Institute, Chennai
2
34
DM -
Endocrinology
Tamil Nadu
Christian Medical College,
Vellore
5
35
DM -
Endocrinology
Telangana
Osmania Medical College,
Hyderabad
4
36
DM -
Endocrinology
Telangana
Gandhi Medical College,
Secunderabad
2
37
DM -
Endocrinology
Uttarakhand
All India Institute of
Medical Sciences, Rishikesh
4
38
DM -
Endocrinology
Uttar
Pradesh
Institute of Medical
Sciences, BHU, Varansi
3
39
DM -
Endocrinology
Uttar
Pradesh
Sanjay Gandhi Postgraduate
Institute of Medical Sciences, Lucknow
4
40
DM -
Endocrinology
Uttar
Pradesh
LLRM Medical College, Meerut
1
41
DM -
Endocrinology
West Bengal
Institute of Postgraduate
Medical Education & Research, Kolkata
6
42
DM -
Endocrinology
West Bengal
Nilratan Sircar Medical
College, Kolkata
3
43
DM -
Endocrinology
West Bengal
Govt. Medical College,
Kolkata
2
Syllabus
A DM in Endocrinology is a three
years specialization course that provides training in the stream of Endocrinology.
The course content for DM in Endocrinology is given in the Competency-Based
Postgraduate Training Programme released by National Medical Commission, which
can be assessed through the link mentioned below:
NMC Guidelines For Competency-Based Training Programme For DM Endocrinology
I. Cognitive
domain
A. Basic
Sciences as applied to Endocrinology and Metabolism
1. History of
Endocrinology
2. General
principles of hormone synthesis, action, degradation, receptors,
analogues and
antagonists
3. Receptors,
biorhythms
4. Endocrine
Anatomy, Biochemistry and Physiology
5. Endocrine
Pharmacology and Pharmacokinetics
6. Metabolism
of fat, protein, carbohydrates and other nutrients
7. Endocrine
Pathology and Cytology
8. Endocrine
functions from foetal to adult life
9. Genetics
including cytogenetics and applied genetics including principles of
Sanger
sequencing and the importance of next generation sequencing and
applied
inherited basis of disease
10. Principles
and performance of biostatistics
11. Basic
applied immunology
B. Clinical
Endocrinology, Diabetes and Metabolism
1. Diabetes:
Genetics and
pathophysiology, classification, epidemiology and pathogenesis and management
of type 1 diabetes, type 2 diabetes, gestational diabetes/diabetes
in pregnancy, monogenic diabetes, secondary diabetes; specific
aspects of diabetes in the sub-continent. Should include principles of life style
management and details of various oral & injectable agents as well devices used in
the treatment of diabetes mellitus, , screening and management of all acute
and chronic complications of diabetes and management of diabetes special
situations.
2.
Epidemiology, pathogenesis, clinical features, diagnosis and management of endocrine
disorders in pediatric (including neonatal) and adult age groups in the
following diseases:
i. Hypothalamus
and pituitary:
a) genetic and
acquired (including infective, neoplastic, vascular and inflammatory)
pituitary dysfunction,
b) functional
pituitary tumors (including prolactinomas, GH, ACTH and TSH secreting
tumors),
c)
nonfunctional pituitary adenomas and other sellar/ suprasellar/ parasellar masses,
d) posterior
pituitary dysfunction (including diabetes insipidus, syndrome of inappropriate
ADH secretion).
ii. Thyroid:
a)
thyrotoxicosis (including Graves disease, Toxic multinodular goiter, Toxic
adenoma,
transient thyrotoxicosis due to various forms of thyroiditis, drug
induced
thyrotoxicosis, thyrotoxicosis due to thyrotropin secretion,
thyrotoxicosis
due to extra-thyroidal tissue and thyrotoxicosis facticia,
b)
hypothyroidism and thyroiditis,
c) Thyroid
nodules and thyroid malignancies including medullary thyroid
carcinoma.
iii. Adrenal
cortex and medulla:
a) Cushing
syndrome,
b) Adrenal
insufficiency,
c) Congenital adrenal
hyperplasia,
d) Adrenal
adenomas, carcinomas and incidentalomas,
e)
Pheochromocytoma and Paraganglioma
f) Primary
hyperaldosteronism and other adrenal causes of endocrine
hypertension.
iv. Pancreas:
a) Pancreatic
endocrine disorders including diabetes, insulinomas,
glucagonomas,
VIPomas,
b) Pancreatic
exocrine insufficiency including fibrocalcific pancreatic disease
and chronic
pancreatitis,
c) Pancreatic
neoplasms and malignancies, particularly neuroendocrine
tumours.
v. Gonads:
a) Delayed or
early puberty,
b) Chronic
anovulatory disorders including polycystic ovary disease,
c) Hirsutism,
d) Premature
ovarian failure and menopause,
e) Male
hypogonadism -primary and secondary,
f) Disorders of
sex development.
vi.
Parathyroid:
a)
Hyperparathyroidism,
b)
Hypoparathyroidism.
3. Reproductive
Biomedicine
4. Endocrine
Dysfunction in other systemic disorders
5.
Endocrinology of aging, transition care (from adolescent to young adult)
6. Oncologic
Endocrinology
7. Drug hormone
interaction
8. Radiology
and Radiation Therapy in Endocrinology
9. Clinical
Metabolic disorders
10.
Endocrinology of pregnancy and foetus
11. Adolescent
and development endocrinology including growth and development,
sexual
differentiation, and pubertal maturation
12. Clinical
epidemiology
13. Ethics,
economics and psychosocial aspects of management of endocrine
diseases
14. Obesity and
lipid disorders including bariatric surgery
15. Endocrine
Hypertension
16. Endocrine
aspects of cardiovascular disease
17. Any other
related areas:- Multiple endocrine neoplasia, polyglandular
autoimmunity
18. Surgical
aspects of Endocrinology.
C. Laboratory
and Experimental Endocrinology
1. Principles
of Nuclear medicine as applied to Endocrinology
2. Hormone
Measurements, in vitro and in vivo
3. Principles
and practice of immunoassay of hormones
4. Principles
of quality control and quality assurance in laboratory estimations
5. Principles
of Radioisotope safe handling and disposal
6. Endocrine
Biochemistry investigations including semen analysis
7. Animal
models in Endocrinology
8. Laboratory
evaluation of Endocrine and Metabolic disorders
9. Any other
related areas.
D. Recent
Advances
1. Molecular
Endocrinology
2. Recent
advances in Clinical, Comparative, Experimental and Investigative
Endocrinology
and Metabolism
3. Review of
recent literature in the field of Endocrinology, Metabolism and
Reproductive
Biomedicine
4. Any other
related areas.
Career Options
After completing a DM in Endocrinology, candidates will get employment opportunities
in Government as well as in the Private sector.
In the Government
sector, candidates have various options to choose from which include Registrar,
Senior Resident, Demonstrator, Tutor etc.
While
in the Private sector the options include Resident Doctor, Consultant, Visiting
Consultant (Endocrinology), Junior Consultant,
Senior Consultant (Endocrinology), Endocrinology Specialist.
Courses After DM in Endocrinology Course
DM in Endocrinology is a specialisation course which
can be pursued after finishing a Postgraduate medical course. After pursuing
specialisation in DM in Endocrinology, a candidate could also pursue certificate
courses and Fellowship programmes recognised by NMC and NBE, where DM in Endocrinology is a feeder
qualification.
Frequently Asked Questions (FAQs) –DM in Endocrinology Course
Question: What is the
full form of DM?
Answer: The full form of DM is Doctorate of Medicine
Question: What is a DM in Endocrinology?
Answer: DM Endocrinology or Doctorate of Medicine
in Endocrinology also known as DM in Endocrinology is a super specialty level course for doctors in India that is done by
them after completion of their postgraduate medical degree course.
Question: What is the
duration of a DM in Endocrinology?
Answer: DM in Endocrinology is a
super specialty programme of three years.
Question: What
is the eligibility of a DM in Endocrinology?
Answer: Candidates must be in possession of a postgraduate
medical Degree (MD/MS/DNB) from any college/university recognized by the
Medical Council of India (now NMC)/NBE.
Question: What
is the scope of a DM in Endocrinology?
Answer: DM in Endocrinology offers candidates
various employment opportunities and career prospects.
Question: What
is the average salary for a DM in Endocrinology
candidate?
Answer: The DM in
Endocrinology candidate's average salary is
between Rs. 6,00,000 - Rs. 30,00,000 per year depending on
the experience.
Question: Can you teach after completing DM Course?
Answer: Yes, candidate can teach in a medical
college/hospital after completing the DM course.
2 years 4 months ago
News,Health news,NMC News,Medical Education,Medical Colleges News,Medical Courses News,Medical Universities News,Medical Admission News,Latest Medical Education News,Medical Courses
Belize experiencing new wave of COVID-19 cases
BELMOPAN, Belize (CMC) — Belize is experiencing a new wave of COVID-19 infections with the Ministry of Health and Wellness releasing a report indicating that 69 new cases were recorded during the period November 29 to December 5.
While there are no new hospitalisation cases or deaths, the health authorities said the positivity rate is at 11 cumulatively, while the daily rate is at 3.71.
Health Minister Kevin Bernard told reporters "we have to remember that COVID is here, and while 69 may be a significant jump indeed, there is surveillance being done.
"We continuously want to encourage people that if you feel ill come and get tested because that is the only way we will really get to know where we stand. The numbers had dropped all the way down to, I think, 16 at one point and now we have that increase last night, yes," he said Wednesday.
"As you know there are a lot of activities now and there's a lot of people moving close together, having major functions and that could be why there has been an increase. I have not gotten any indication from the surveillance team that they suspect a major wave or a huge spike, but we must understand that we live in a system where COVID is around us and it exists."
The health minister said while the effects are still minimal, it serves as "one reason why we believe that people are still not going to get tested.
"So those that are being tested are the ones that really reach to the facilities. But we want to encourage people if you feel ill and you feel like you have symptoms, go and get tested just for those assurances.
"But, as I said, we have not gotten an indication that they are suspecting any spike. We believe that over the Christmas period we must expect that people are going to have individual parties, family get-togethers and all we encourage [is responsible behaviour] as the Ministry of Health continues to try prevent spreading of the virus. We have to do our part," Bernard added.
Belize has recorded 688 COVID-19 deaths and 69,117 infections since the first case was recorded in 2020.
2 years 4 months ago
Tufton lauds Code Care nurses as health heroes
ROSE HALL, St James — Health and Wellness Minister Dr Christopher Tufton has lauded the first batch of six nurses from the United States of America who recently participated in the ministry's Code Care programme.
Noting that the COVID-19 pandemic has highlighted the importance of working together, Tufton told the nurses at a dinner reception held in their honour Tuesday evening that with such exemplary work, they should consider themselves heroes.
COVID-19, he said, had shown the importance of collaboration.
"It was the greatest equaliser. So, if we use that principle to go forward, you will appreciate the importance of working together. And, this silo approach to health has to be abundant and so, what you are doing here is setting an example. So, consider yourself a national hero," Tufton told the appreciative group.
Under the programme, the team of six nurses — two of whom are non-Jamaicans — performed some 18 surgeries alongside local doctors at the Noel Holmes Hospital, a type C facility in Hanover.
The minister later pointed out the importance of the initiative during his address to the function.
"We tell people every day that health care has to be a partnership, and we mustn't be afraid of it. Indeed, when this programme started, there were many who doubted it and complained about different aspects of the concerns without focusing on the bigger picture of pain relief to those who are suffering. We pressed ahead and we are where we are today. And 164 Jamaicans are better off for it," said Tufton.
Clinical coordinator for the Western Regional Health Authority Dr Delroy Fray, in his overview, said the Code Care initiative works and goes to show that with adequate staff, Jamaican medical staff can accomplish a lot.
"There were two nurses in the operating theatre, two in the recovery area, and let me tell you, it was like clockwork. As soon as one case was finished, the operating theatre was prepared for the next case and the nurses in the recovery area had the patients ready to move. We must have adequate staff in order to do this. I know our nurses can do this as well but we just don't have enough. What we have seen here, we have seen where Code Care has moved to another level. The next level is where we invite professional nurses to assist us in giving us adequate hands to work with. And, I can tell you, the difference was great," stated Dr Fray.
"Minister, I want to thank you, sir, for this initiative, and at the second stage I believe that if we can expand for a year or two, I don't think that we will have a waiting time in this country and I look forward to seeing that for our people," he added.
In response, the health minister said an assessment would be made to determine if there is a need to continue the programme.
"If there is a need to continue it beyond March, then we will give that some serious consideration because the objective is to get the work done and if we are doing it efficiently, then it is worth it and indeed, the pain and suffering that we can't put a price tag on that," stated Tufton.
Noting that it could cost up to $400,000 in the private sector for the various types of surgeries done under the Code Care programme, the minister argued that the country has saved up to 60 per cent in expenses.
Tufton said the cost of bringing the team from the states of Philadelphia, New York, Washington, and California to Jamaica and ensuring their comfort cost the country $169,400 each.
He said another set of nurses is expected on the island by mid-January.
Nurse Claudette Coleman, who spoke on behalf of the participants, said the group did not anticipate the reception and hospitality received from the ministry, the Western Regional Health Authority, and the Noel Holmes Hospital.
The hospital has two operating theatres, but the main one currently has been earmarked for rehabilitation for some time now. Coleman said the group was able to accomplish much with the resources at hand.
"We were amazed by what we had accomplished these past six days. With one operating theatre, minimal instruments and supplies, the patient safety and quality of care at the forefront, this is teamwork at its best," she said.
"The theatre staff was very receptive to the exchange of knowledge and techniques which went both ways. We learned from them and they learned from us and it was awesome. The patients' gratitude for getting that surgery they were waiting so long for was heartwarming," added Coleman.
The Code Care initiative is aimed at clearing a backlog of elective surgeries by performing 2,000 over 12 months and reducing the wait time for these surgeries to less than 180 days.
This is being achieved through public-private partnerships; procurement of surgical equipment; nursing missions; project management and rehabilitation of operating theatres at some public hospitals.
Since the start of the programme in September, 164 surgeries that had to be pushed back due to the COVID-19 pandemic have been performed.
Among the other participating hospitals are Bustamante Hospital for Children, Hospiten, Montego Bay Medical, GWest, and Noel Holmes.
2 years 4 months ago
Health – Demerara Waves Online News- Guyana
Rural TeleMedicine Clinic launched in Rupununi
Health Minister Dr Frank Anthony on Wednesday officially launched the Rural TeleMedicine Clinic in Masakenari (Gunns Village), South Rupununi, Region Nine, government’s Department of Public Information said. Through this initiative, community health workers will gain access to expertise from doctors and specialists in Georgetown via tablets and other electronic devices.
331 residents will benefit from ...
2 years 4 months ago
Health, News
The risk of cholera on the island of Hispaniola is “very high,” according to PAHO
The Pan American Health Organization (PAHO) reported at the end of November that the risk of cholera on the island of Hispaniola, which is home to the Dominican Republic and Haiti, is “very high.” The international organization used the magnitude and widespread of the disease in Haiti and the country’s complex humanitarian crisis as parameters.
Add to that the limited cholera control resources and the constant migratory flow to the Dominican Republic, which reported two new cases of the disease yesterday. PAHO defines cholera as an acute diarrheal infection caused by the ingestion of contaminated food or water containing the Vibrio cholera bacterium.
Although it is a treatable disease, the World Health Organization warned that if treatment is not administered promptly, it can quickly lead to severe dehydration and death.
2 years 4 months ago
Health
'Heartbeat' of Chapelton back in full operation
MORE than 100,000 people from Clarendon will benefit from the recently renovated Chapelton Community Hospital after experiencing inconvenience while seeking medical attention at other facilities in the parish for the last four years.
The renovation project, which was funded by Culture, Health, Arts, Sports and Education (CHASE) Fund, Push Start Foundation and the National Health Fund at approximately $309 million, included the replacement of heavily infested termite floor and roof, building of doctor's offices, asthma bay, triage and waiting areas and a 20-bed ward.
Additionally, the hospital, which has been in service for the last two weeks, will begin 24-hour operation come January.
Speaking at the reopening ceremony of the hospital and launch of the Compassionate Care Programme on Tuesday, Member of Parliament for Clarendon North Central Robert Nesta Morgan said the facility will strengthen economic development in the parish.
"The people of North Central Clarendon are thankful as the Chapelton Community Hospital is the heartbeat of our town. Our heart is beating again. In a health emergency, one minute can save a life. No longer will we all have to take the long journey to May Pen to get emergency medical health," he said.
"Over the last several years we have had a new hardware store, new supermarket, we've renovated the police station and we are doing work in the constituency but what was missing was the heartbeat. This hospital has brought people from all walks of life. While the health aspect of the hospital is important, the hospital is a centripetal force in drawing people to the community who can improve our economic prospects," he added.
He noted that residents from more than 100 communities will benefit, including Summerfield, Thompson Town, Mocho, Frankfield, Kellits, Croft's Hill, Nine Turns, Blackwoods, and Smithville.
Meanwhile, some residents from Chapelton, who spoke with the Jamaica Observer, said they are relieved as they now have easier access to health care.
One woman, who gave her name as Marlene, said it was very challenging traversing from Chapelton to May Pen Hospital to get medical care for her 85-year-old father.
"It did hard, hard, hard, because we haffi go May Pen, especially if there was an emergency. A nuff time we even have sickness especially mi father and when they couldn't provide a certain service they send you to another facility in Kingston. I am elated that it's open because I live very close to it," said the woman who has been a resident in the community for 40 years.
Eighty-one-year-old Hazel Brown who has been living there for 50 years was also pleased.
"This is the go-to facility for me. I am very happy because I can see people here are willing to help. If I need my medication or a doctor's help, I have no problem," she said.
Derrick Baker, 75, added, "It is a good thing, it has been closed for a long time. We had to fight to go to May Pen if there was any health issue and even at health centre at Summerfield, it was very frustrating especially when raining, so it's nice we have it back."
In the meantime, Prime Minister Andrew Holness urged the residents to take better care of their health so as to avoid seeking care at the hospital.
"It is important that the next generation of Jamaicans who are coming and the current generation of Jamaicans who are with us now understand that the solution is not just the hospital, the solution is how to avoid the hospital by being healthy," he said.
"We are and we were the pioneers of primary health care putting people into the communities to get the better health-care practices actually in practice in daily life. We have not enhanced the model as much as we should and we have not built hospitals as much as we should, but this Administration is changing. We are making massive investments in the health infrastructure. Our health is in our own hands not in the hands of the doctors or the nurses," he added.
2 years 4 months ago
Managing stress in the season
There are several reasons your days may not be ‘merry and bright’ around the holiday season. These may include having a jam-packed social calendar, deadlines at work, the loss of a loved one, or all of the above. There are, however, ways in which...
There are several reasons your days may not be ‘merry and bright’ around the holiday season. These may include having a jam-packed social calendar, deadlines at work, the loss of a loved one, or all of the above. There are, however, ways in which...
2 years 4 months ago
Keep your cholesterol in check this holiday
This year’s holiday season may not involve the large gatherings of past years, but you may still want to enjoy traditional foods with close family members. Managing your cholesterol while maintaining holiday traditions is possible. Although holiday...
This year’s holiday season may not involve the large gatherings of past years, but you may still want to enjoy traditional foods with close family members. Managing your cholesterol while maintaining holiday traditions is possible. Although holiday...
2 years 4 months ago
STAT+: Pharmalittle: FDA fast tracks OTC version of Narcan; Express Scripts to keep Humira on its formulary but add biosimilars
Hello, everyone, and how are you today? A steely gray sky is hovering this morning over the Pharmalot campus, where the official mascot is romping about in search of creatures and commuter traffic is humming by. As for us, we are foraging for interesting stories and quaffing cups of stimulation, as you might have guessed.
Our choice today is the ever-flavorful pumpkin spice. And you? Is your schedule filled with meetings and deadlines and what-not? To help you along, here are some tidbits. Hope you conquer the world, and do keep us in mind when you see something fascinating. …
Emergent BioSolutions, which makes Narcan, a nasal-spray form of naloxone, said the U.S. Food and Drug Administration fast-tracked an application it submitted for an over-the-counter version of its widely used opioid-reversal nasal spray, The Wall Street Journal writes. The company said the priority review gives the drug an expected approval date of March 29, 2023, putting it first in line for approval ahead of rivals that announced a planned foray into the market. The FDA has encouraged companies to apply for approval for over-the-counter versions of overdose-reversal medications to help confront a swelling overdose crisis from bootleg versions of the powerful opioid fentanyl.
2 years 4 months ago
Pharma, Pharmalot, pharmalittle, STAT+
Virologist advises resuming mass screening
The Covid-19 virus’s adaptability is demonstrated by the fact that it will change and persist over time, so outbreaks or spikes every hundred years should not be unexpected, and their frequency will be determined by human behavior.
This is stated by virology specialist and Dominican researcher Robert Paulino, who stated that it has been demonstrated that the zero Covid or closure policy is not the solution because it maintains a very strong social pressure on the countries and advises that the country resume mass case tracking at this time.
To reduce the impact, the specialist understands that measures must focus on capturing and isolating cases, cutting off the transmission, wearing a mask in closed spaces and health centers, and practicing good hygiene. According to Paulino, countries should consider maintaining the availability of tests and treatment, which is a challenge with the new variants because those previously used do not work, so they must continue to invest in research.
Paulino stated that, at this time, when the virus is becoming more prevalent, it is critical to resume massive tests to track cases, which would allow the health system to guarantee access to the population and have more complete surveillance statistics. He emphasized that tracking cases allow them to identify hot spots for virus spread and take appropriate action. “The use of a mask must begin to be reinforced, particularly in medical care spaces, because there is no better place to become infected than health centers, where the first line of response is exposed and also serves as a transmission vehicle,” Dr. Paulino said.
2 years 4 months ago
Health
Covid-19 Vaccine Hesitancy Report for Eastern Caribbean
“Recommendations from the study included the need for increased efforts to persuade parents to see the value of the Covid-19 vaccination for children and harnessing the power of social media”
View the full post Covid-19 Vaccine Hesitancy Report for Eastern Caribbean on NOW Grenada.
2 years 4 months ago
Health, PRESS RELEASE, carlene radix, coronavirus, COVID-19, oecs, organisation of eastern caribbean states, tanya radosavljevic, unicef, united states agency for international development, us embassy barbados, usaid, vaccine hesitancy