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LETTER TO THE EDITOR  
Year : 2015  |  Volume : 25  |  Issue : 2  |  Page : 207-208
Do most radiologists in India really have a choice?


Department of Radiology, NM Medical, Kalyani Nagar, Pune, Maharashtra, India

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Date of Web Publication27-Apr-2015
 

How to cite this article:
Sohoni CA. Do most radiologists in India really have a choice?. Indian J Radiol Imaging 2015;25:207-8

How to cite this URL:
Sohoni CA. Do most radiologists in India really have a choice?. Indian J Radiol Imaging [serial online] 2015 [cited 2020 May 25];25:207-8. Available from: http://www.ijri.org/text.asp?2015/25/2/207/155884
Sir,

I read with great interest the editorial "Pursuing a radiology career: Private practice or academic?" published in the previous issue. [1] A doctor is also a scientist, and the majority of resident radiologists wish to be involved in academic radiology even beyond their post-graduation. However, most radiologists who manage to earn a post-graduate seat purely on the basis of merit come from a middle-class background. Having already invested close to a decade in educating themselves, such merit-based radiologists are very likely to look for a decently paying job in private sector and keep their research interests for another day. For most, the day never arrives, thanks to the relentless socio-economic pressures.

A doctor is also a part of the society that is continuously adapting to socio-economic and socio-political changes. When the value system of the society as a whole undergoes a change, it is impractical to expect one of its components to remain static. When money becomes the prime driving force of a society, it becomes an unavoidable force to deal with for everyone, doctors included. Today, the social standing of a person is primarily, if not completely, influenced by his or her economic status. [2] Most radiologists primarily seek to practice medicine honestly and earn a standard of living at par with their peers from other walks of life. As some studies suggest, the purchasing power, consumption, and savings of an individual are dictated by that of others than by abstract standard of living. [3] The actual value of income of an individual depends upon his percentile position within the income distribution. [3] Thus, appropriateness of income is relative and not absolute. It is natural for radiologists to see their incomes in relation to others within and outside the medical fraternity. If statistics are any indication, some recent Indian studies assessing the preference pattern for post-graduate streams among medical students reveal that higher income, job opportunities, and job reputation are the prime selection criteria. [4],[5] The 2014 Medscape Physician Compensation Survey report for the United States brought out some important figures - only 58% doctors said that they would choose medicine again as a career, only 47% would choose the same speciality, and just 26% would choose the same practice setting. Interestingly, among those least likely to choose medicine again were radiologists! The reasons for such discontent among physicians were declining income, excessive paperwork, and the changes dictated by the Affordable Care Act. Medicine is a noble profession and doctors are bound by an ethics code; however, the society offers neither exceptions nor discounts for the practitioners of this noble profession.

There are also misconceptions about private practice. Radiology is considered as one of the most sought-after specialities by Indian graduates, primarily based on the belief that it is a high-income, white-collared job. As another editorial in one of the past issues of this journal had pointed out, this belief is often misplaced. [6] In the United States, radiologists are among the highest earning medical specialists and, therefore, glamorous. It is too naive to believe that the same is true for India. [6] All too often, people confuse the income from radiology business for the income of a self-employed or employee radiologist.

Barring the remuneration part, a radiologist could actually benefit by working in an academic institution, since an institutional environment would negate to a certain extent some of the radiology-specific adverse factors. But even if a radiologist decides to work for a medical college, it is a daunting task to find such employment. Despite the high standards of exams set by the National Board of Examinations and the fact that the central government has granted Diplomate of National Board (DNB) a status at par with masters degree recognized by the Medical Council of India, DNB doctors continue to face bias when it comes to recruitment for teaching posts in medical colleges. [7] For diploma holders, that option is almost non-existent. Thus, a substantial number of radiologists are forced to forgo academic interests due to insurmountable technicalities. In some states of India, a doctor working in a government institution is not allowed private practice, and vice versa. While this move is supposedly aimed at improving the efficiency of government institutions, it also unfortunately deprives radiology residents of valuable insights into the minds of some very fine radiologists in private practice. It robs medical research of some precious contribution that could be made by some research-oriented radiologists in private practice. Private practitioners of repute should be involved in training students in medical colleges. It will give students a perspective on the soft skills that are essential in private practice, in addition to the knowledge of the subject. The editorial has correctly pointed out the need for the development of research-oriented clinical practice. [1] It is extremely unfortunate that despite the tremendous clinical experience that our country offers and a legacy of great physicians, we still look up to western qualifications as being more worthy. The world will respect and recognize Indian medical qualifications if we back ourselves with exemplary academics and path-breaking research. However, the conflict between business and science is eternal. Unless scientific research translates into financial gains, it is often not valued in the private sector. Compensation issues, bureaucracy, and internal politics mar the government sector.

We live in a society today that worships movie stars and roughs up medical doctors. Young minds are shaped by the prevalent conditions. It is difficult to convince young Indian radiologists to pursue academic career during such turbulent times. Those who do make the choice to pursue genuine research often seek additional security in the form of higher pay scales and better standard of living offered by the western world. Few are lucky to strike a balance between academics and economics while in India. Most others hardly have a choice.

 
   References Top

1.
Jain SN. Pursuing a radiology career: Private practice or academic? Indian J Radiol Imaging 2014;24:207-8.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Rowlingson K. Does Income Inequality Cause Health and Social Problems? York: The Joseph Rowntree Foundation; 2011. Available from: http://www.jrf.org.uk/sites/files/jrf/inequality-income-social-problems-full.pdf. [Last accessed on 2014 Oct 22].  Back to cited text no. 2
    
3.
Ball R, Chernova K. Absolute income, relative income, and happiness. Soc Indic Res 2008;88:497-529.  Back to cited text no. 3
    
4.
Gour N, Shrivastava D, Adhikari P, Shahi A, Sharma MK, Mahajan PC. Speciality preference among medical students and factors affecting it. Online J Health Allied Scsi 2011;10:12.  Back to cited text no. 4
    
5.
Arun Babu T, Joseph NM, Sharmila V, Balachandran S. Speciality preferences of Indian medical graduates and factors influencing them. Res J Pharm Biol Chem Sci 2003;2:263-70.  Back to cited text no. 5
    
6.
Jankharia B. The business of radiology. Indian J Radiol Imaging 2010;20:239.  Back to cited text no. 6
[PUBMED]  Medknow Journal  
7.
Nagarajan R. Government Deals MCI Fresh Blow in Teacher′s Eligibility. Times of India; 2014. Available from: http://timesofindia.indiatimes.com/india/Govt-deals-MCI- fresh-blow-on-teachers-eligibility/articleshow/41237657.cms. [Last accessed on 2014 Oct 22].  Back to cited text no. 7
    

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Correspondence Address:
Chandrashekhar A Sohoni
Department of Radiology, NM Medical, Kalyani Nagar, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.155884

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