Christian Medical College, Vellore The Home of a Healing God - - PowerPoint PPT Presentation

Christian Medical College, Vellore

Christian Medical College, Vellore The Home of a Healing God (1900-2012)

Christian Medical College, Vellore

CM CMC C is th the e home e of a f a hea ealing ling God.

CMC is many things all in one. For someone who comes for treatment, they will see it as a hospital. For someone who comes for training it is a college. For those in outlying areas, it brings an

• pportunity for change.

It It is is a community community

• f
• f

people people working working tog togeth ether, er, wor worshippi shipping ng toget together, her, and and se serving rving together”.

Christian Medical College, Vellore

Structure of this presentation

• 1. CMC Vellore as an Institution with a Unique Vision
• 2. CMC Vellore as an Institution with a Unique Mission

1. Clinical & Diagnostic Services 2. Training and Mentoring 3. Outreach 4. Research 5. Human Resource Management & Governance

• 3. CMC Vellore as an Institution of Unique Relevance

1. As an alternative model of Healthcare in India today 2. As an alternative model for develping Human Resources in Healthcare for tomorrow

Christian Medical College, Vellore

CMC VELLORE: AN UNIQUE VISION

She chose: “Not to be ministered unto but to minister” Ida Sophia Scudder (1870-1960)

Christian Medical College, Vellore

Aunt Ida and the foundational principles of CMC 1870: Born to Dr. John Scudder (doctor in Tindivanam) Left India for schooling in the US 1890: Returned to India (aged 20 years) to visit ailing mother Three women died in childbirth on one fateful night because she could not respond to their culturally-determined need to have a woman doctor help them Went back to US to train as a doctor

Christian Medical College, Vellore

Responding to a need and taking the road less travelled

1899: Graduated from Cornel University Medical Centre (among its first batch of women doctors) 1900: Returned to India and laid the foundation of what was to become CMC

Christian Medical College, Vellore

1900: One-bed dispensary-Vellore (10 by 12 feet)

Life expectancy at the time: 25 years

Christian Medical College, Vellore

1902: 40-bed Mary-Taber Schell Memorial Centre for women and children

Christian Medical College, Vellore

1924: CMC Hospital in its current location- 267 beds

Christian Medical College, Vellore

1960

Christian Medical College, Vellore

2008

Christian Medical College, Vellore

2012 (~2700 beds)

Christian Medical College, Vellore

Empowering women through training 1903: Training course for compounders 1909: Nursing School: Diploma in nursing

Christian Medical College, Vellore

Medical School for women 1918: LMP course 1932: Medical School moved to College Hill (Bagayam) Campus

Christian Medical College, Vellore

Medical College 1942: MBBS course

Christian Medical College, Vellore

Medical College 1945: Laboratory Technician Training Course 1946: College of Nursing - Degree Course - India's first College of Nursing

Christian Medical College, Vellore

Medical College 1947: First batch of men medical students

Christian Medical College, Vellore

THE VISION OF CMC

Christian Medical College, Vellore

Christian Medical College, Vellore

The Objective “The objective of the Christian Medical College, Vellore is the establishment, maintenance and development of Christian Medical College and Hospitals in India, where men and women shall receive an education of the highest grade in the art and science of medicine, nursing, or one or other of the related professions, to equip them in the spirit of Christ for service in the relief of suffering and in the promotion of health”.

Christian Medical College, Vellore

Sharing the vision

• Dr. TH Somervell
• 1915-1918: World War I
• 1923: Surgical training UCH London
• 1922 & 1924: attempted to climb Mt. Everest –came within 300

meters of summit

• 1926: Gave up lucrative career as a surgeon in London and worked in

Neyoor as Medical Superintendent (now Somervell Memorial CSI Medical College and Hospital)

• Wrote a text book of surgery that was the standard at the time
• 1949: Head of Surgery Unit III- CMC Vellore
• Honoured with the Kaiser-i-Hind in 1938 and the OBE in 1953.
• Somervell Memorial Prize in Surgery

Christian Medical College, Vellore

Sharing the vision

• Paul Brand
• Born 1914 to English Missionary parents; doctors working in the Kolli

Hills (malaria endemic)

• “Mother Brand” carried on her husband’s work
• 1923 went to Englad for a formal education
• Wanted to be carpenter and builder but did a course in tropical

medicine; trained as a surgeon in UCH London

• 1946 joined CMC as general surgeon and later orthopedics- first Head
• Life changing visit to Robert Cochrane’s leprosy sanatorium at

Chingelput

• Decade of meticulous research on leprosy deformities at the Hand

Research Unit at CMC

• Continued work at SLRTC-Karigiri (along with Ernest Fritschi)

Christian Medical College, Vellore

Sharing the vision

• Paul Brand
• Leprosy: A disease of the nerves- lacked the “gift of pain”
• First Reconstructive Surgery for deformities in leprosy

Christian Medical College, Vellore

Sharing the vision

• Paul Brand: Teacher Extraordinaire

Christian Medical College, Vellore

“I asked for feet, and I have been given wings.”

• Mary Verghese
• Inspired by Ida Scudder
• CMC Batch of 1946; Graduated 1952- wished to do Obs & Gyn
• 30th Jan 1954- Car accident while on a picnic- left her paraplegic
• Ardous process of finding purpose to her life
• Dr. Paul Brand suggested she take up Hand Surgery
• India’s famous wheelchair surgeon
• Gwenda Lewis- victim of polio- Rehabilitation in Perth
• Trained in New York under Dr. Howard Rusk-pioneer in PMR
• Started India’s first Deparment of PMR
• 1966-Rehab institute; 80 beds; outreach;-community based rehab
• Mary Verghese Trust: vocational training
• Padma Shree-1972

Christian Medical College, Vellore

Standing on the Shoulders of Giants

• Dr. Edward Gault:
• First Professor of Pathology
• Integrated clinical teaching and pathology
• Worked with Paul Brand
• Building up community life- Men;’s Hostel
• Founding member of the Indian Association of Pathologists
• Dr. P Kuttumbiah- Clinical Medicine
• Dr. Selwyn Baker- Clinical Gastroenterology
• Dr. Kamala I. Vythialingam- Cardiology
• Dr. T Jacob John- Virology
• Dr. Mammen Chandy- Haematology

Christian Medical College, Vellore

Standing on the Shoulders of Giants

• Dr. Jacob Chandy- Neurosurgeon
• Dr. KV Mathai- Neurosurgeon
• Dr. Jacob Abraham- Neurosurgeon
• Dr. Vi Mathan- Gastroenterology
• Dr. MS Seshadri- Endocrinology
• Dr. Stanley John- Cardiothoracic Surgery
• Dr. George Cherian- Cardiology
• Dr. Malathi Jadhav & Dr. Sheila Periera- Paediatrics
• Dr. LBM Joseph- Surgery
• Dr. Prakash Khanduri- Surgery
• Dr. AS Fenn- Surgery
• Dr. CK Job- Pathology

Christian Medical College, Vellore

CMC AS AN INSTITUTION WITH A UNIQUE MISSION

Christian Medical College, Vellore

Christian Medical College, Vellore

How many were served?

Year Beds Inpatients Outpatients Births Outreach 2002-03 2,049 83,239 12,20,745 12,907 1,85,339 2003-04 2,112 85,977 13,57,816 12,809 2,00,329 2004-05 2,142 89,990 14,30,154 12,827 2,08,085 2005-06 2,234 92,248 14,34,057 12,689 2,25,324 2006-07 2,333 1,02,273 15,63,226 14,202 2,24,566 2007-08 2,409 1,05,935 15,86,879 14,225 2,31,861 2008-09 2,512 1,11,770 16,99,022 15,002 1,78,130

Christian Medical College, Vellore

How many were served? 2011

Christian Medical College, Vellore

Clinical

Christian Medical College, Vellore

Meeting unmet needs

Out-patient services

Christian Medical College, Vellore

Staff

Inpatient care

Compassionate care

Christian Medical College, Vellore

Cutting edge Technology

Christian Medical College, Vellore

Still room for a caring touch …

Christian Medical College, Vellore

Christian Medical College, Vellore

2010-2011

Christian Medical College, Vellore

Year Income Expendit ure Deficit % Charity Educatio n subsidy 2002-03 132.2 139.1 5.2 23.6 13.7 2003-04 150.8 157.3 4.3 28.5 16.1 2004-05 174.5 183.2 4.9 32.8 20.2 2005-06 197.7 206.7 4.5 37.5 22.4 2006-07 224.0 233.3 4.1 44.3 23.4 2007-08 286.3 298.2 4.1 49.5 26.4 2008-09 356.6 361.1 1.3 53.9 29.4 CMC – INCOME, EXPENDITURE, CHARITY & SUBSIDY* (Crores of Rupees)

Christian Medical College, Vellore

Christian Medical College, Vellore

1906

Commitment to help the poorest of the poor : reaching the unreached

Christian Medical College, Vellore

Commitment to help the poorest of the poor : reaching the unreached

Christian Medical College, Vellore

Community outreach still core to

• ur mission

Christian Medical College, Vellore

PTCHW – Part Time Community Health Worker  grass root volunteer

Community Health & Development Programme (CHAD)

Christian Medical College, Vellore

Community base providing primary care to >250,000 rural and urban residents

Christian Medical College, Vellore

RUHSA DEPARTMENT C.M.C. VELLORE

(RUHSA)

Rural Unit for Health and Social Affairs

Christian Medical College, Vellore

Low Cost Effective Care & Urban Health Centre

Affordable high quality care for urban poor Consultant’s visit Army of volunteers

Christian Medical College, Vellore

Outreach integral to every department

• Community based psychiatry
• Homeless mentally ill
• School-mental health; learning disabilities
• Diabetes education and detection
• Stroke service
• Surgical outreach
• Community based rehabilitation
• Eye camps
• CONCH (nursing led)
• It focuses on a population of 63,199 persons living in 22

villages and 23,000 persons living on the urban periphery

• f Vellore city

Christian Medical College, Vellore

Training

Christian Medical College, Vellore

Christian Medical College, Vellore

Christian Medical College, Vellore

Christian Medical College, Vellore

Christian Medical College, Vellore

Christian Medical College, Vellore

Fellowship Course

Christian Medical College, Vellore

Christian Medical College, Vellore

Innovative curriculum

• Foundation and bridge courses
• Integrated with community care
• Integrated teaching units
• Inte-disciplinary care
• Family Medicine
• Secondary hospital programme
• Distance education
• Clerkship
• E-learning
• Compulsory rural service
• Learning by example and by doing
• Ethical practice

Christian Medical College, Vellore

Research Mission statement

Christian Medical College, Vellore

• The inculcation of an attitude
• f inquiry
• knowledge of basic methods
• f research
• Conduct of research at

various levels of health care are a part of the culture of the institution.

Christian Medical College, Vellore

Some earlier major contributions

• Tendon transfer techniques for leprosy
• Mechanisms of intestinal injury in tropical enteropathy and

trpical sprue

• Arylsulphatase A deficiency responsible for metachromatic

leucodystrophy

• Establishment of the basis of the pulse-polio immunization

program

• Description of mutations associated with hereditary hematologic

and metabolic disorders

Christian Medical College, Vellore

Current major foci of research

• Infectious diseases
• HIV, tuberculosis, diarrhoeal diseases, arboviral infections,

rickettsial infections, antimicrobial resistance

• Non-communicable diseases
• Metabolic syndromes, diabetes mellitus, mental disorders and

insight, rehabilitation, epilepsy, cancer clinical trials

Christian Medical College, Vellore

Investing in research

• Office of research
• 20010-2011

Christian Medical College, Vellore

Major research initiatives

• Stem Cell Research Center
• Prof BV Moses & ICMR Advanced Centre for Evidence

Based Medicine (South Asian Cochrane Centre)

• Reference laboratories for HIV, streptococci,

pneumococci, rotavirus

• WHO Data Management Centre
• Bioengineering Department
• Infectious Diseases Training & Research Centre
• Centre for vaccine preventable diseases

Christian Medical College, Vellore

Commitment to Research Training

• Epidemiology Resource Center and Clinical Epidemiology Unit
• Department of Biostatistics
• Only medical school in India with Master’s and PhD programs in

biostatistics and epidemiology

• Research Methodology Course for all post-graduate trainees

(resident equivalent)

• Undergraduate; postgraduate and faculty research awards
• Research ethics & Research integrity

Christian Medical College, Vellore

HUMAN RESOURCES

Christian Medical College, Vellore

Human Resources

• Selection of students: Foundational values
• Fostering students
• Spiritual life
• Research fellowships
• Student exchange
• Sponsoring for faculty
• Senior and Junior training fellowships
• Deputation leaves; study leave; sabbatical leave
• Housing
• Medical care
• Pension

Christian Medical College, Vellore

Core values

• Integrity
• Compassion
• Empathy
• Walking the Extra Mile
• Not to get into a Comfort Zone
• Break schedules to care for a patient in need
• Take considered Risks
• Collaboration not Competition

Christian Medical College, Vellore

Renaissance Man

Primary Care Secondary Care

T ertiary Care Quaternary Care

Christian Medical College, Vellore

The Health of a Tertiary-care, Teaching Hospital in South India

Job Stress, Job Satisfaction, Coping and Burnout in Medical Faculty at CMC Vellore: A Cross-sectional Survey of Prevalence, Determinants, Modifiers and Correlates

Amos Lal, Batch of 2005 Prathap Tharyan; Professor of Psychiatry Anna Tharyan; Professor of Psychiatry Christian Medical College, Vellore

Christian Medical College, Vellore

JOB STRESS

• 80/343

(23%) reported moderate to extremely high overall work stress levels

• No difference across specialties, gender, age

groups (<45 vs >45 years; decades of age)

• Overall stress levels are similar to those

reported among consultants in the UK (27%)

Christian Medical College, Vellore

Job Satisfaction

• 338 (98%) of faculty reported high levels
• f job satisfaction
• No difference across specialties, gender,

age groups (<45 vs >45 years; decades of age)

Christian Medical College, Vellore

Most Important Sources of Satisfaction

• Deriving intellectual stimulation from

teaching Increased odds by 50 fold

• Having a high level of responsibility

Increased odds by 5O fold

Christian Medical College, Vellore

Sources of Satisfaction: <45 vs. >45 yrs

 What faculty > 45 yrs found more satisfying than those <45 yrs

• A high level of job security
• Deriving intellectual stimulation from teaching
• Having a high level of autonomy
• Having good relationships with other staff

members

• Being involved in activities, which contribute to

the development of their profession

• Having a high level of responsibility

Christian Medical College, Vellore

Empathy /Burnout/ religious beliefs

• Over 75% of faculty endorsed statements

indicative of high empathy

• Those scoring high on Emotional Exhaustion

reported higher scores on empathy than those with low EE.

• Those who had strong religious influences

(60%) reported significantly higher levels of personal accomplishment than those who did not (22%)

Christian Medical College, Vellore

CMC AS AN INSTITUTE OF NATIONAL RELEVANCE

Christian Medical College, Vellore

Alternative model

• Subsidized education
• Free patient care
• Professional care
• Compassionate care
• Serving those in need the most
• Linked with founding values
• Innovative teaching and learning
• Integrated with primary, secondary care
• Striving for relevance

Christian Medical College, Vellore

What does our vision imply today?

It implies that we must be committed to: Excellence Relevance and be Challenging Suranjan Bhattacharji

Christian Medical College, Vellore

• Dr. Ida Scudder was confronted with the reality of

the avoidable death of young women ….. We are confronted with

Christian Medical College, Vellore

India’s current health status

• 56 infants die per 1000 births
• Americas:

20

• Africa:

99

• Incidence of TB: 168 per 100,000 people
• Americas:

39

• Africa:

343

• 51% of <5 year old children are short for their age:
• Americas:

14

• Africa:

43

Christian Medical College, Vellore

India’s population

• 2nd largest in the world

( i.e. equal to the next 6 countries combined - USA, Indonesia, Brazil, Russia, Pakistan & Bangladesh)

• Each state is as large as a country
• Uttar Pradesh ~ Brazil
• Tamil Nadu ~ Iran
• 29% live in Urban areas

Christian Medical College, Vellore

Christian Medical College, Vellore

• At present we are able to set aside about 15

million $ per year (about 15%-20% of the total budget) for our charity work

• Most of this (98%) comes from the fees for high

quality, advanced medical care that our paying patients provide

Christian Medical College, Vellore

• Our challenge, like hers, is to ensure

that access to health is an inalienable human right, not a commodity that can be bought only by the rich

Christian Medical College, Vellore

• Dr. Ida Scudder was confronted with the belief that the women
• f India cannot be trained as doctors …..

We are confronted by the commercialization of education

Christian Medical College, Vellore

• Our challenge, like hers, is to ensure that those

who have had the privilege of education will continue the struggle against poverty, ignorance and ill health

Christian Medical College, Vellore

How can we achieve this?

Not by ourselves – but with God’s help and by all of us working together in partnership towards a shared vision

Christian Medical College, Vellore

Our current vision

We believe there should be an alternative to current pardigms We seek partnerships so that our work can be more fulfilling and

• ur lives can have more meaning

Christian Medical College, Vellore