Ardous journey from IACTA education and Research Cell to Indian College of Cardiac Anaesthesia

Superspeciality medical education is an arduous journey, but with two Fellowships courses running successfully, the Indian Association of Cardiac Anaesthesiologists IACTA) patrons could see the light at the end of the tunnel. The goal before the IACTA education and Research Cell was to impart high end knowledge in the subject of cardiac anaesthesia with active recruitment of Fellows in Cardiac Anaesthesia across the length and breadth of the country. Fellowships and degrees in India are one of the most prestigious vocations[1] and the success of the Fellowship in Cardiac Anaesthesia (FIACTA) (started in 2006) and the Perioperative Transesophageal Echocardiography (FTEE) examination (started in 2010) has maintained high standards to anticipate such high goals and complete the vision with the formation of a College, rather than an Education cell to give away the prestigious degrees. But, for most at the helm of authority positions in IACTA such goals were a premature thought!. Most felt it was too early for a college status for IACTA. So, legal advice was sought and an uphill task made easy and after multiple IACTA meetings IACTA Education and Research Cell (IERC) is being converted into the Indian College of Cardiac Anaesthesia (ICCA). The 10 years of struggle has finally borne good fruits.

MEDICAL SUPERSPECIALITY EDUCATION IN INDIA WORKS ON A WELFARE MODEL

In a predominantly capitalistic society, medical superspeciality education is probably the only remaining profession in India which still works on a welfare model, particularly so in the public sector.[2,3] This ensures high profitised academic standards of superspeciality education imparting which are cost-effective, streamlined and much focused on its vision. This was the case with the Education Committee which was started in Chennai in 2006 from the Sri Rama Chandra Medical under the auspices of IACTA. In 2008, the IACTA office shifted to AIIMS, New Delhi and with it the Education Committee - a subcommittee of IACTA.

THE EDUCATION JOURNEY IN CARDIAC ANAESTHESIA HAD BEGUN IN 2006

Fifteen dedicated cardiac anesthesiologists as members of an Education Committee of its parent body IACTA, came together in 2006 and started 2 Fellowship courses: (i) One as a Fellowship in cardiac Anaesthesia and the second as a Fellowship in Perioperative Transesophageal Echocardiography. The aim was one: To support the mission of the parent body IACTA, in academics and research, and to serve as a forum for the exchange of ideas to improve educational opportunities, for Indian Cardiac Anaesthesiogists through the use of innovative technology. Fellowships cannot be without Faculty – so 90 dedicated teachers were recognized across the country and for TEE ten international advisors as well. This aided in supporting professional development among faculty and students all across cardiac anesthesia centers. Accreditation of TEE Workshop and Perioperative TEE Examination was sought from recognized associations like Indian Academy of Echocardiography, University of Minnesota and the University of Leipzig, Germany.

TEAM WORK ALWAYS WINS – THE DUALITY TRAP ALWAYS FAILS

Tremendous team efforts of IERC members to formulate the FIACTA centers; enroll FIACTA students, coordinate with the authorities in the FIACTA centers across the country finally, bore sweet fruits of recruiting 169 FIACTA candidates of which 90 are certified cardiac Anaesthetists in India and are well established nationally and internationally. No other cardiac anaesthesia Postdoctoral course has achieved this big a number in such a short period in India! It is a milestone achievement.

The TEE and FIACTA Exams and Workshop under IERC

THE NUMBERS KEPT INCREASING - PLACE OF WORK NEVER MATTERED

From two FIACTA centers in 2006, 25 FIACTA centres came up in 2015! In 2008 there were only two FIACTA centers and no TEE examination or workshop. From 2009-15, stupendous growth seen: In FIACTA centers (twenty seven total), Teachers (90) FIACTA students (169 total of which 90 cleared the exams) enrolled with the IERC and 16 examiners enrolled in FIACTA and another twelve for the perioperative TEE examination!! The FIACTA examination started at two centres -Medanta-The Medicity, Gurgaon and Narayana Hrudayalaya, Bangalore with the examination being held at the same time and day, simultaneously. The examination office conducting the 2 Exams was from AIIMS, New Delhi. But, the place of work never mattered – the passion to create something unique, innovative with high end academics to its students was the unifying force amongst the IERC members. In 2012, the Education Committee was renamed as IERC, with a separate headoffice at AIIMS (IACTA office shifted to Cochin) with the aim for separating education from other activities of the association and to help it formulate into a “College” with good accreditation and high standard Fellowship Examinations.

IN THE ERA (2009 – 2015) – THE IERC JOURNEY WAS TOUGH BUT GROWTH WAS HIGH MANY ACHIEVEMENTS FULFILLED IN THIS PERIOD SUCH AS

TEN FIACTA Examinations held in two centers one in North and other in South India.

Eight TEE workshops were held and five examinations in TEE under IACTA/IERC banner conducted annually of which thirty students have a national/international degree in TEE, at Narayana Hrudayalaya, Bangalore

Honorary TEE and FIACTA degrees bestowed to the contributors of Cardiac Anaesthesia and also who worked for IACTA progress, under IERC were awarded this prestigious honor.

Three Refresher courses held in Ahmadabad to teach and train in cardiac anaesthesia with all help from IERC and no monetary remuneration from IACTA.

Travelling Fellowship awarded to six IACTA members.

ACADEMICS ACHIEVED: VIRTUAL EDUCATION BREEDS CONFIDENCE

Virtual online teaching became a reality with “monthly online seminars and tests” for internal assessment and the constraints of “Space” for education for which IERC was under a scanner were thus overcome. The online course in last 2 years was a big hit amongst the students. All jobs are HONORARY in the name of IACTA where education is not a commercial venture.

Eleven dedicated books by IERC faculty to enhance academics in Cardiac Anaesthesia and Critical Care.

WHAT NEEDS TO BE DONE

An association Medical college gives the feeling of a “Home” to every Fellow enrolled in it and also ignites the work passion amongst its organizers. It adds “credibility status” to the Association while giving away of Fellowships and awards and grants it a pedestal position. One FIACTA student had used the word “protection like home, which equips me for a brighter future” when questioned about how he felt in being an FIACTA student enrolled from a IACTA college? It makes the fellowship degree comparable to a DM/DNB in Cardiac Anaesthesia.

Through a series of fixers and arrangements with legal advice and amendment changes, a perilous but passionate journey of unifying cardiac anesthesiologists into a string of education has been achieved. As we make an advanced journey, on to the main road…crossing the borders of hesitancy, inhibition, interpersonal ego differences, which with a lot of tolerance and sacrifices and farsighted leadership of its senior IERC members has, helped open doors to more academic opportunities and exchange of ideas and techniques to gain national and international accreditations, we have arrived to a college status. The arduous journey has borne rich fruits of success and ecstasy. This journey must go on with concrete steps in right direction rather than rhetoric and wishful thinking.

Senior IERC members advised at a recent meeting, that there should be a need to partner the internationally growing trend amongst the other growing medical schools that leverage private – public partnerships for higher educational growth, in Cardiac Anaesthesia a change in thought is what is needed.[4,5]

IMPACT OF AN ASSOCIATION MEDICAL COLLEGE ON MEDICAL PROFESSION

The one value that a doctor cherishes most is freedom: whether it is freedom from oppression or freedom to make choices. To seek true soul liberation in each one of us, we must shatter the false image we have created of ourselves – one for us and another for society. Simply unmasking ourselves with awareness of our inner consciousness will liberate us and make us change the Cardiac Anaesthesia education system. In the words of the Father of nation ……Mohandas Karamchand Gandhi, let us as Cardiac Anesthesiologists “Be the change that you wish to see in the world” as Education is Home to many of us.