India has fewer than 100 vascular surgeons since the establishment of the first department of vascular surgery in 1978, and the start of the first training course in peripheral vascular surgery in 1985. As a result of this shortage, it is estimated that thousands of avoidable amputations are performed each year.
Though there are no accurate statistics on amputations in India, it is estimated that at least 100,000 people lose a limb every year, and according to the World Diabetes Foundation (WDF), more than 40,000 of those are attributed to diabetes-related complications. Vascular surgeon N. Sekar, MD, of Apollo Hospitals, Chennai, India told the Times of India that at least 80 percent of these people could have [avoided amputations], if specialists like him had attended to them, but because there aren’t adequate specialists like him in the country, that does not happen.
“A large number of people wheeled in for amputations are either trauma victims or long-term diabetics,” Sekar said. “At least 40 percent of people with decade-long diabetes develop vascular problems. In a country where more than [40 million] people are estimated to have diabetes, the number of people estimated to have vascular problems is large…and [now] you know why there is a need to produce a greater number of vascular surgeons.”
At this point in time, educational resources for vascular surgeons in India are slim, while the misconception of the need for the specialty is great. In a country with an estimated population of 1.2 billion, only ten medical colleges have dedicated vascular-surgery departments; there are only eight seats for post-graduate degrees in vascular surgery, up from four a year ago; and the country produces just 16 vascular surgeons annually.
In the article, “Education in Vascular Surgery: Critical Issues in India,” (Journal of Vascular Surgery, December 2008), Sekar wrote, “The widespread misconception that vascular diseases are uncommon and that the result of vascular reconstruction is poor has resulted in vascular surgery not being popular among the medical students.”
The Vascular Society of India (VSI), for which Sekar is the president, has taken a multi-pronged approach to reverse this misconception by promoting an education agenda with medical schools and engaging with the National Board of Examinations for designing curriculum, facilitating conferences, spreading the knowledge of vascular diseases in order to encourage nationwide preventative medical measures and early-treatment options, and advocating for additional educational resources for vascular surgery at a governmental level. Regarding the latter, representatives from VSI want to meet with Union Health Minister Ghulam Nabi Azad and Health Secretary Sujatha Rao to discuss a road map. First, they want the ministry to increase the number of seats for post-graduate degrees in vascular surgery.
“We want them to double the number of seats in a year and increase it by at least three times by 2012,” Sekar concludes.