Year : 2017 | Volume
: 19 | Issue : 2 | Page : 81--82
Paramedical training in the armed forces: Need for a paradigm shift
Alhad Anant Pawar1, Sheila S Mathai2,
1 Director, General Medical Services (Navy), New Delhi, India
2 Director, Institute of Naval Medicine, Mumbai, India
Dr. Sheila S Mathai
Director, Institute of Naval Medicine, INHS Asvini, Mumbai
|How to cite this article:|
Pawar AA, Mathai SS. Paramedical training in the armed forces: Need for a paradigm shift.J Mar Med Soc 2017;19:81-82
|How to cite this URL:|
Pawar AA, Mathai SS. Paramedical training in the armed forces: Need for a paradigm shift. J Mar Med Soc [serial online] 2017 [cited 2018 Sep 23 ];19:81-82
Available from: http://www.marinemedicalsociety.in/text.asp?2017/19/2/81/225269
The terms “paramedic” and “medical technician” are often used interchangeably when referring to allied health professionals. Etymologically, the former refers to a person who is trained to give prehospital emergency care but who is not a doctor or a nurse, while the latter refers to a trained person who works in a laboratory. However, these formal lines have now blurred and terms such as emergency medical technician and laboratory assistant, to name a few, are well known and accepted.
In recent years, paradigm shifts in concepts and implementation of paramedical training have developed worldwide. Whereas previously a paramedic was essentially meant for emergency care, today he is a highly skilled professional, trained to handle specific medical situations, be it in the field or the hospital. Paramedics are compartmentalized early into specific areas of medical care and become experts in defined skills. These skills are taught by repeated practice on highly sophisticated simulators on which testing and accreditation is done before the individual is actually allowed to practice on patients.
Paramedical Education in India
Paramedical education in our country is in a state of flux. Firstly to date, there is no Central Government body governing this important aspect of health care in our country. This state of affairs will, hopefully, change when the central Allied and Health Care Professional's Central Council Bill 2015 is passed. A Central Council for paramedical education and training, governing the basic and specialty standards and the accreditation of paramedical courses being run by various institutes and universities, is the need of the hour. Maharashtra has recently passed The Paramedical Council Act 2017 mainly directed at laboratory technicians and other states too, have to take responsibility for paramedical education in our country.
Secondly, since paramedics deal with multiple fields of medicine each unique in its requirements, course material changes rapidly, and many formal university courses do not keep pace with this, making them outdated. This reflects in the poor quality of paramedical degrees and diplomas. Each course has to be highly specific and cater to the practical requirements of that specialty. There are a number of such courses run by reputed institutes and organizations which are nationally and internationally accredited and which are more valued on the market than a university degree. For example, in emergency and trauma care, the most widely accepted courses are the Basic Life Support, Advanced Cardiac Life Support, or Advanced Trauma Life Support courses which are copyright of the American Heart Association (AHA). Permissions are needed to run these courses, for a recurring fee. Many organizations have legally modified these courses which have been accepted and accredited by the AHA. This ensures that an international standard is maintained.
Paramedical Training in the Armed Forces
In our Armed Forces Medical Services (AFMS), the paramedic continues to be a multitasker. Besides being a First Responder in most combat and noncombat medical emergencies, he has to be skilled in Trauma Management and Humanitarian and Disaster Management. In addition, he has to be trained to man our increasingly sophisticated hospitals. This is critical in running our specialty outpatient departments, departments, operation theaters and laboratories, both in peace and war. We also need our paramedics to function as nurses and be actively involved in day-to-day care of male patients. We also train them to be ward administrators, receptionists, and attendants. Moreover, with their medical knowledge, we need to ensure that their military knowledge and skills as soldiers, sailors, and air warriors are kept sharp and updated at all times so that they can function effectively in times of conflict.
The current method of training our military paramedics varies among the three services in our country. In the Navy, induction of Medical Assistants (MAs) into the medical branch is done (after the initial service orientation) at the School of Medical Assistants (SOMA), Mumbai. Specialization opportunity is given at around five years of service in the form of two-year university-recognized diploma courses at SOMA. In the Air Force, the Integrated Pattern of Training has been implemented since 2014 at the Medical Training Centre (MTC), Bangalore MTC, Command Hospital Air Force Bangalore, and other Air Force hospitals. At six years of service, they can go back to MTC for two or three Specialist Diploma courses. In the Army, after recruitment they are sent to Army Medical Corps Centre, Lucknow, with some being selected to undergo the three years University Bachelor in Paramedical Training course and a pharmacology course at Armed Forces Medical College, Pune.
Future Challenges in Paramedical Training for the Armed Forces Medical Services
Firstly, we need to have a uniform structure of paramedical training across the three services with modern schools, incorporating state-of-the-art simulation centers, and manned by highly trained instructors.
Secondly, capsules on Emergency Medical and Trauma Care, Combat Medical Care and Medical Aid in Humanitarian Assistance and Disaster Relief (HADR) activities have to be structured for our needs and these have to be accredited with National and International bodies. These have to be made compulsory for all our military paramedics, irrespective of their subspecialties as this is a military requirement. These psychomotor skills need reinforcement with regular re-assessments and re-accreditation. This will empower our paramedics to function independently, particularly in “field” or “afloat” situations.
Thirdly, specialization has to start early and keep abreast of the latest advances in the field. Pharmacists and Physiothrapists should preferably complete the 4-year professional degree BSc courses as is required by law. Capsule specialty training rather than a general diplomas or degrees in paramedical training is the need of the hour. We also need to re-look the utility of some of the university courses for which we are registering our paramedics and see if they have a national and international standing, as many of these courses are poorly designed and do not fulfill the needs of the specialty. This affects later job prospects of our paramedics when they leave service and makes them unwilling to join the medical branch. Running accredited modules and courses which are recognized nationally and internationally by the specialty governing bodies is more important than just registering our paramedics for a general diploma or degree from a university. Having our own in-house training modules without official certification may also not be enough. Training our paramedics with proper certification and accreditation from authorized, nationally recognized agencies is the way forward in our paramedical schools. This comes for a price but is worth it. Not only will our paramedics be empowered to render the best possible service to our clientele, but young recruits would also be incentivized to join the medical branch knowing that there are job opportunities for them even after they leave service.
Fourthly, we should aim at making ourselves an accredited body, for various aspects of paramedical training, with the best agencies/bodies in the future. This would entail an adequate number of instructors and other requirements and the need to renew affiliation and recognition periodically and would make us true leaders in paramedical training. Till this happens, we may have to have to rely on external agencies for training of specific, accredited courses.
Paramedical training in our country is undergoing changes at a very rapid rate. We in the AFMS need to be alert and sensitive to these changes and act in our own best interests. We need to align the training in the three services with these changes and ensure a standard of paramedical training which is of the highest order and commensurate with the best in the world. Only then can we do justice in providing quality medical care to our clientele.
|1||Potokar T, Ali S, Bouali R, Walusimbi M, Chamania S. Training of medical and paramedical personnel in burn care and prevention. Indian J Plast Surg 2010;43:S121-5.|
|2||Available from: https://www.timesofindia.indiatimes.com/city/nagpur/paramedical-council-formed-act-enforced/articleshow/59584683.cms. [Last accessed on 2017 Nov 30].|
|3||Cooper S. Contemporary UK paramedical training and education. How do we train? How should we educate? Emerg Med J 2005;22:375-9.|
|4||Roshana S, Kh B, Rm P, Mw S. Basic life support: Knowledge and attitude of medical/paramedical professionals. World J Emerg Med 2012;3:141-5.|
|5||Chopra BK. Paramedical personnel of the Armed Forces Medical Services: The unsung heroes. Med J Armed Forces India 2016;72:5-7.|