title: Musculoskeletal training for orthopaedists and nonorthopaedists: experiences in India.
abstract: In India, health policies, services, health indices, and medical education are improving despite the country's enormous population and limited resources. Orthopaedic training in India should be geared to serve the predominantly rural population (72% of total population) living in some 550,000 villages, but unless the basic amenities improve in villages and towns, orthopaedists will remain averse to serving in these areas. Traditional practitioners play an important role in musculoskeletal trauma care in villages and even some town and city areas, and hence cannot be ignored. We suggest a stratified system of orthopaedic training for medical graduates, postgraduates, and paramedics with a well-defined need-based curriculum, and a clear cut division of labor, terms, and conditions to suit the stratified social and demographic structure of India. This stratified system is intended to provide appropriate musculoskeletal trauma care services to the rural population, reduce neglected and mismanaged trauma, consequently avoiding subsequent orthopaedic disability, and reduce the financial burden of managing these cases. This system also intends to prevent overloading of teaching hospitals and apex institutes and ensure availability of subspecialized orthopaedic services in the country at designated centers. Traditional practitioners shall be periodically educated regarding safe orthopaedic practices, which are anticipated to yield improved trauma care services.
authors.affiliation: University College of Medical Sciences, University of Delhi, Delhi, India. anilarora@delhiorthojournal.com
authors.forename: Anil
authors.initials: A
authors.lastname: Arora
authors.forename: Anil
authors.initials: A
authors.lastname: Agarwal
authors.forename: Panos
authors.initials: P
authors.lastname: Gikas
authors.forename: Apurv
authors.initials: A
authors.lastname: Mehra
mesh_terms: D001291:Attitude of Health Personnel; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D003906:Developing Countries / Q000191:economics / Q000706:statistics & numerical data; D004501:Education, Medical / Q000191:economics; D004632:Emergency Medical Services / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D017048:Health Care Costs; D015276:Health Care Rationing; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006302:Health Services Research; D054625:Healthcare Disparities; D006801:Humans; D007194:India; D008519:Medicine, Traditional; D009141:Musculoskeletal System / Q000293:injuries*; D009313:National Health Programs; D019637:Orthopedic Procedures / Q000191:economics / Q000193:education* / Q000706:statistics & numerical data; D016730:Program Development; D019035:Rural Health Services; D014947:Wounds and Injuries / Q000191:economics / Q000401:mortality / Q000628:therapy*