Yesterday ,research work carried out by our team was quoted by Hindustan times highlighting the substance use pattern among the students in the city
Vishav Bharti, Hindustan Times
Chandigarh, October 08, 2013
First Published: 21:06 IST(8/10/2013)
Last Updated: 21:41 IST(8/10/2013)
More than 50% of the male college students in Chandigarh are into substance abuse, including alcohol,
smoking and tobacco chewing. The fact has come to the fore in a study conducted by department of internal
medicine of Government Medical College and Hospital, Sector 32 (GMCH-32).
The study titled ‘prevalence, pattern and familial effects of substance use among the male college students -a
north Indian study’ was published in the Journal of Clinical and Diagnostic Research.
For the study, a total of 256 male college going students were interviewed from different colleges. The study
found that 57% students were into substance abuse.
As far as the nature of the substance is concerned, the study found that alcohol tops the chart with 54% use.
It was followed by smoking with 27%, tobacco chewing 8%, cannabis 7%, opiate use 3% and solvent use
In this study, none of the students reported use of cocaine, amphetamine, sedatives or heroin. No student
reported injections as a source of drug abuse.
Highlighting the frequency of the use, the study found 49% of the users were using the substance on daily
basis, while 23% used it on weekly basis.
While highlighting the reason of use, the study observed that 66% were using for relief from psychological
stress and easy availability was another common reason of substance abuse.
The study also suggested some lifestyle-related interventions in order to reduce the problem of substance
abuse. “There is an utmost need to educate and counsel young students regarding harmful effects of substance
abuse. Health education may be imparted in the school curriculum. Parents should also be educated on what
was the best way to discourage their wards against drugs,” it observed.
Tobacco chewing 8%
About 94% substance abusers spend their pocket money on buying substance of their choice. 9% reported
that they had started using substances before attaining the age of 10. 97% were aware about the ill-effects of
substance abuse. 48% said they had tried to stop using substances at some time or the other. 4% said they
had undergone counselling to get rid of substance.
Substance abuse by streams
What’s substance abuse
Substance abuse can simply be defined as a pattern of harmful use of any substance for mood-altering
purposes. Medline’s medical encyclopedia defines drug abuse as “the use of illicit drugs or the abuse of
prescription or over-the-counter drugs for purposes other than those for which they are indicated or in a
manner or in quantities other than directed.”
The complete article is available from
Ashish Khanna, 1998 batch
Connections-May 2013 (Volume 10, Issue 2)
The Oxford dictionary definition of Anaesthesia is “insensitivity to pain, especially as artificially induced by the administration of gases or the injection of drugs before surgical operations”. The Merriam-Webster dictionary defines Anesthesia as “loss of sensation and usually of consciousness without loss of vital functions artificially produced by the administration of one or more agents that block the passage of pain impulses along nerve pathways to the brain” Synonymous: yes?
Anyone would agree that the difference between Anaesthesia (British English) versus Anesthesia (American English) is above and beyond the addition of a single alphabet of the English language. I started my journey as an anesthesia resident in a country where Anaesthesia was the correctly spelt version of the branch of medicine that dealt with this specialty. Today, three years after re-training the art and re-learning Anaesthesia to be spelt as Anesthesia in the United States, it is time to look back and ponder on the finer points.
The decision to leave your own country after finishing a residency always comes with a pinch of salt. As you look to expand your clinical and academic training beyond the horizon, you are faced with the uncertainty of the unexpected. The challenge is a system of medicine distinctly different from your home country and a culture to healthcare that demands considerable understanding. A question that I am very often faced with when I make my frequent trips back home is “What is different about Anesthesia practice in the United States?” It might come as a surprise to a lot of people if I say “nothing at all” in reply. Well, what is different is not Anesthesia or Anaesthesia, only the fine print!! The other very frequent question that is thrown at me is the almost rhetorical “Is it better there?” Let me step back today and say let’s keep all this better – worse talk aside. It never was and it will never be fair to compare two vastly different systems of medicine. As I direct this piece of writing to those friends of mine who are faced with doubts and internal struggles before they leave the comfort of their own homes I would like to emphasize one singular fact: forget about quality of medicine or quality of life and remember the biggest challenge is the ability to train to re-train or put
in more simple words another residency program after a prior residency in your home country. Starting a residency program in Anesthesia under the Accreditation Council for Graduate Medical Education (ACGME) at the Cleveland Clinic Foundation, I realized early on that the essence of getting the most out of this education is to wipe my slate clean and restart again. Tell the world that you are trained in your specialty in your own country and you are capable of doing your thing does provide you with the much-needed independence of clinical work at times, but can be your worst
enemy if you want to acquire new knowledge. It is important to understand that there will be days where the attending will hold your hand when you are doing a procedure that you have done so many times before or might tell you that “this is the way it is done here”. Days, when you need to keep you’re your ego at home. Days when you will feel your neurons are struggling to cope with erasing old skills and acquiring new skills for the same procedures again. But, hey did you want to do things the way you were doing them in your own country? That said, what is the reason you
made this trip across 4000+ miles half way across the planet? The answer to these questions will help you understand that unless you let your guard down in a foreign land and show that you are an open book you will never learn anything new and in essence never grow as a clinician. Medicine is repetitive science; it is very easy to be lulled into a false sense of satisfaction practicing the same
things over and over again, the same very way every day. The only way to appropriately imbibe your area of expertise and to mature as a clinician is to step out and see what else can be done differently and is being done differently. My message here is not to train in the United States after training in India, but to train at different places and in that process acquire a new set of skills all the time.
Going further, another area of distress for the physician from India as he or she steps onto alien soil is the cultural aspect of medicine. The interaction between peer groups as resident doctors and patient physicians as healthcare providers is different to say the least. As you move away from the “yes sir/ma’am” policy to “yes Dr. XYZ” even when that Dr. XYZ might be your department chair, you will quickly realize that you have to prove your worth as a resident by the sheer quality of your work and not the weight of your courtesy and multiple salutations directed to your staff. Decision making for the betterment of your patient is another area where the young resident here is thrown into the deep end every single day. An ICU attending will ask you for your plan, and so will your anesthesia attending in the operating room. And yes, your plan will be plan that will be executed as long as you can justify it. And that holds true for every provider from the lowest level of an intern to upwards.
Protecting patient privacy and respecting that the patient is the true owner of his or her healthcare information is another moot point here. Not to discuss patients with names or anything that could identify them, not to talk about them in the hospital corridors or the escalators is a habit that is difficult to get rid of. The tendency to try to force your decision as a clinician on the patient or the patient’s family is also something that we live by all the time in India. The patient is the master of his/her own destiny here and whether it be morbid obesity, chronic smoking in a vasculopath or narcotic abuse in a chronic pain patient, your job will be to ask them whether they feel they can change theirlifestyleand not to enforce that change on them. Difficult times will also revolve around “End-of-Life” decisions in the ICU and DNR (Do Not Resuscitate) statuses. The ability of families here to think very practically for their dying loved ones and to let go of them when there is point of futility, is commonplace. Another challenge that is
beyond the understanding of anesthesia and different from back home, and is something that you
have to deal with on a regular basis.
How can I forget to include in my set of challenges also, the change from using pharmaceuticals as brand names versus names of salts back home. Or the different abbreviations that come inherent with another healthcare system. Yes, I gave my senior resident a quizzical look when he said “Did you tube your patient” ( a.k.a intubation) or “Can you do the A-line first?” ( a.k.a arterial line) or “ Is he off the vent ?” (weaning from the ventilator) or “When is your ICU patient going to the sniff?” (a.k.a skilled nursing facility). There are numerous more such which define the distinct cultural differences in healthcare here in the United States.
As I look back today, I know that things have evolved for me as a clinician but also more importantly as a human being. I look at medicine differently; I look and understand a patient’s emotions differently. That to me is the pivotal change. For all those fellow friends who are getting ready to step out on this often-treaded path of training in another country after training as a specialist in India, I hope this writing will give a better idea of what to expect. All said and done, the
difference is not in quality of healthcare or the quality of life that you can expect to live, but in what you can assimilate from the new system of medicine.
In the end, it is not Anesthesia versus Anaesthesia, and it really does not matter!
Divyanshoo Kohli, 2003 batch
Connections:September 2012 (Eds: Divyanshoo’s essay was originally published in the 2012 issue of the GMCH magazine Glimpse)
As the Independence Day of India rolled by, I read an interesting series of article on the state of the country that looked back at the past 65 years of the country. It was an instructive reading, at times critical, at times sentimental and occasionally comical. It is in a similar vein that I pen down these thought regarding the state of GMCH over the past 22 years.We began way back in September 1991 in a rented building that was still under construction. Much like the students who reach the class 10 minutes too late and asks around softly for ‘an extra pen’ and prays for the good humor of the attending, we too were on a borrowed existence teetering on the precipice of failing. The stools that the students sat on were marked for Government College for Men-11, the building was for mentally challenged children (poetic!), the specimens were from PGIMER! The hostel of GMCH students was in the engineering college in sector 12. Even the director was on a loan from PGI and the patients were seen at the poly clinic in sector 22! The faculty had been hurriedly assembled from any place feasible. Like a newly born, we were dependent for everything on everyone.
Like the famed Indian approach to things we began with nothing, survived with sheer luck and blossomed through sheer perseveration despite the powers that were. Getting a letter of recognition for the medical college had all the ingredients of steep uphill battle that remind me of the ‘83 victory of Kapil Dev or VVS Laxman’s terrific score against Australia. Some of the old timers recall going on hunger strikes and shuttling between Chandigarh and New Delhi in a desperate attempt fighting an obdurate and insensitive bureaucracy that was beholden to the letter but blind to the spirit of the law. We owe it to the members of the initial batch who fought for their own and our good.
As the decade rolled by, things began to gather pace (or thereabouts!). After a series of false starts, the building of the hospital was inaugurated. The Prayaas building, our rented home in sector 38, got completed. The current students would not be able to appreciate the open hallways and the dreadful anatomy halls complete with a feeling of freedom that characterized that place. We ended up moving from sector 38 to sector 32 a few years back. Earlier, the first and second year students often commuted from 38 to 32 for college functions. Some of those innocuous trips have actually ended up in wedlock! The hostels for boys and girls were constructed; the emergency started functioning as did the ICUs. I was still around when the C-block was inaugurated and we would often lose our way in that labyrinth. Soon, the D-block came into being as well.
Through these years the college, the hospital, its faculty and students grew in numbers, strength and stature. We held convocations, organized national and international conferences one of which was graced by the former president Dr. APJ Abdul Kalam.
The strength of our college and hospital has been to a huge extent the faculty that has guided us from strength to strength as we scaled from peak to peak. A lot of the original faculty members stayed with GMCH – Drs. Atul Sachdev, Jagdish Chander, Ram Singh, SMS Lehl, AK Attri, Harsh Mohan, Kanchan Kapoor, Rajeev Sharma, Suman Kochhar among others. However, some incredibly talented people left early as well: Drs. Krishan Vij, KK Gombar, AS Bawa, Robby George among others. While the reasons they left were myriad, their loss was monumental and absence felt acutely. Any hospital is the sum of the talent of its physicians and talent retention is incumbent on the administration.
The brand ambassadors of the college are always going to be its students. In this context, the college is well-endowed. Consistently, the students entering the MBBS course have been the top-rankers and
crème-da-le-crème of the tri-state area. We have also consistently shone brightly in the national PG entrance exams of PGIMER, CBSE and AIIMS. I vividly remember the time 2 years ago when my mother had to undergo a hysterectomy at PGI. To my intense surprise and undisguised relief, every single resident in that particular Gynecology unit was from GMCH (including 2 from my batch itself)! If demographics are anything to go by, the residency class of OBGYN there is dominated by the girls of GMCH. Interestingly, some of the students have gone in a full circle and have joined the hospital as faculty – a truly joyous feeling of accomplishment!
The success story of the students in the US is self-perpetuating. We have excelled in the USMLEs and are starting to create a name. As an example, during my interviews in the USA that were spread all along the east and Midwest, I had to pay for accommodation only once! Everywhere else, there was someone from GMCH who opened the doors for me and let me stay overnight. I have no relatives in the US but still feel that help is only a phone call away. For a lot of my friends, the experience has been the same.
A matter of pride for all of us has been the newspaper stories of our students excelling in the civil services exams. Our students have gone into services as diverse as the Indian army medical corps, the IAS and even the corporate world. There have been some blemishes on this count as well. The recent spate of suicides among the younger lot has been a matter of intense shame and introspection. All our glory and accomplishments fade away when one of our own goes down so tragically.
All in all the students and faculty have worked hard to reach where we are. It is easy to bask in the glory of the bygone days and let the nostalgia sweep us under its dizzying influence. It would however be futile to pat ourselves on the back and enter into a state of inertia. Much like our nation, we have worked a lot to awaken, break the shackles and cobwebs, and gather pace as we race ahead. The time though, is to fly.
It has been a decade since I have seen brainstorm evolve.
From 2002 where i spent sleepless nights with many of my batch mates checking those mcq exams with Gubakshish Singh (98 batch)to a phase where we started involving the private education institutes for conducting exams 2001 batch to a phase where brainstorm evolved into a multi city event .The success and growth of Brainstorm has been tremendous and reflects the commitment of GMCH students to Euphoria .
Looking at the history of brainstorm which is now into 15th year; mock test,exhibition and counselling are a part of the event nowadays The term used for the composite event which is spread over 5 days is “Integrated Health Education”.The event now has about 4000 participants and this year covered over 20 cities .
This year I again got an opportunity to be a part of the brainstorm and held an interactive session with over 400 students on “Adolescence-A big challenge,A big change”.
The organizers had done a great job and kudos to the Euporic spirit that drives this event on…………..
It was a real fun to be part of this campaign ,and there was so much to learn from this endeavor.
A lot of school children participated in this drive and as a part of campaign a poster competition,essay writing competition,Rally and tree plantation drive was carried out in the sector 56 Chandigarh.
I got to have an interactive session with school kids and it was real fun interacting with them and hearing them talk.And lot of practical ideas for saving paper were generated by them during talk which included subscribing for E bill for phones,and avoiding printing ATM statements and so on..
The posters made were really good and few of them are pictured below………
When nothing makes sense, start talking non-sense.
Beautiful photos of hiking and other outdoor adventures.
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