Demand for the Professional Rights of Prosthetists & Orthotists in India

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Charter of Demands from Prosthetists & Orthotists

Dear Sir

As you must be aware that Rehabilitation Sector going through massive transformation and it is totally different now from what it used to be 20 years ago.

The definition of Health by WHO has been modified to State of complete Physical, Mental, Social and Spiritual wellbeing, includes rehabilitation as a part of healthcare.

Recent guidelines from WHO has clearly mentioned Prosthetics & Orthotics as an Art & Science of treatment by the use of Prosthesis & Orthosis
As per WHO -"Prosthetist & Orthotist are healthcare professionals with overall responsibly of Prosthetics & Orthotics treatment, who can supervise and mentor the practice of other personnel. They are clinicians trained to assess the needs of the user, prescribe treatment, determine the precise technical specifications of prosthesis and Orthosis, take measurements and image of body segments, prepare model of the evaluation, fit devices and evaluate treatment outcome."


Its also mentioned to have a prefix for professionals which remains most suitable as per these definitions.

It has also came to notice that recently many unqualified or under qualified people are indulged in clinical practice as well as Prosthetists & Orthotists are not getting equal pay or respect in comparison to similar rehab or medical professionals.

In the light of recent contexts, we like to raise the following issues to the association which can be passed as resolution and further conveyed to the RCI and other bodies.

The demands are being conveyed in 3 sections – Immediate – to be implemented within 3 months, Short-term – To be implemented in 1 year, Long Term to be implemented in 3-5 years.

Also, the best appropriate justification is given below certain demands.

Immediate Demands:-

1.      Bifurcating the Clinical Part & Non-Clinical part in Prosthetics & Orthotics and not allowing non-clinical professionals to be indulged in any clinical practices without Supervision of any Clinical Practitioner.
Reason:  As guided by WHO only people with Bachelor Degree or above in Prosthetics & Orthotics should be termed as clinicians.
Those below bachelor degree level (Diploma or Certificate holders) should be termed as technicians.
It is necessary so as to set the standards and to get best in class practice methods as well as for better outcome and to stop quackery.
For people who remain concerned about the fact that in their time there was no degree course and so they just did the diploma, there should be provision for them for an upgrade but it must not reduce the criteria of being clinician.

2.      Using the prefix Dr. for all Prosthetist and Orthotist.
As directed by WHO all the Bachelor Degree or above in Prosthetics & Orthotics should get the prefix Dr. (As they are treating the patients through the use of Prosthesis & Orthosis and are clearly designated as Clinicians ) also it can be acknowledged that Prosthetics & Orthotics is a part of Physical Medicine & Rehabilitation which in itself is a part of Modern Medicine . (The reply to RTI (MEDCI/R/2017/80148) which was filled in Ministry and came back through MCI in regard to the question asked about the definition of Doctor and whether Prosthetist & Orthotist can use Dr as prefix or not clearly states that “These queries are in the nature of eliciting opinion and therefore it does not constitute information as defined u s 2(f) of the RTI Act, 2005” It further tells that MCI in its resolution support people practicing modern medicine to be called as Doctor.
Reason: Due to lack of respectable prefix Professionals are feeling demotivated and even are not considered as Healthcare Professionals, offered less salary, and are termed as technicians (In job postings in many Government Hospitals such as AIIMS ) . In contrary Physiotherapists who are using Dr as the prefix (the resolution for which was passed by IAP only and no other agency has yet approved or disapproved it ) are getting more respect and salary in comparison to Prosthetist & Orthotist.

3.      Issuing a Notification to all the concerned organizations (Hospitals/NGOs/Ministry) regarding the essential qualification requirement, similar salary structure as to clinicians in other healthcare expertise and proper nomenclature of the post with mandatory RCI certification requirement.

4.      Updating the website of OPAI and to make available the list of all professionals who are registered with RCI and have RCI certification.
Reason – To check whether the person is actually qualified or not.

5.      Looking into RCI amendment bill and ensuring that there remains separate registration process for clinicians and non-clinicians as well as pushing for the prefix Dr. and to reissue RCI registration certificates properly mentioning the prefix and Clinician or Non-Clinician category.
Reason – this will help to identify the professionals easily based on their RCI certificate
Short-Term Goals

6.      To issue a notification to the universities regarding recent norms and guidelines and to ask them to issue degree certificates with the prefix.

7.      To make a social media and electronic media wing so as to keep tracking the news of camps etc which are organized without any Prosthetist or Orthotist as well as to timely respond to the emails and queries of the professionals.

8.      To make a 24 X 7 helpline number for PWDs and professionals

9.      To collaborate with all the private players in the field and to make minimum salary structure norms and work hour norms so as to prevent exploitation of professionals.



Long-Term Goals:-

10.  Restructuring both Bachelor and Master degree for the Course so as to give better theoretical and practical knowledge along with management of training of rehabilitation so as to properly align with other medical courses such as BDS etc.
Reason –This will help in further strengthening the claim of Doctor as prefix and will help the professionals to have a standalone entity in Medical and Healthcare field
Suggested Changes for BPO course

BPO course current structure:-
FIRST YEAR

1. Anatomy

2. Physiology

3. Workshop Technology & Material Science

4. Applied Mechanics & Strength of Materials

5. Biomechanics I

6. Basic Electronics

7. Prosthetic Science–I

8. Orthotic Science -I

 

SECOND YEAR

1. Pathology

2. Orthopaedics, Amputation Surgery & Imaging Science

3. Community Rehabilitation & Disability Prevention

4. Biomechanics II

5. Psychology & Sociology *
6. Prosthetic Science-II

7. Orthotic Science-II

8. Pharmacology


THIRD YEAR

1. Computer Science & graphical communication

2. Bio-Mechanics- III

3. Assistive Technology

4. Research Methodology & Bio-Statistics

5 Prosthetic Science-III

6. Orthotic Science-III

 

FOURTH YEAR

1. Prosthetics Science-IV

2. Orthotic Science-IV

3. Management & Administration

4. Prosthetics Clinical Practice

5. Orthotics Clinical Practice


6 Months rotatory internship

Suggested Changes for BPO course:-

Extending the course from 4 years to 4.5 years (making the 1st year of 1.5 years  and extending the internship from 6 months to 1 year
Mandatorily adding following subjects in brief for better understanding of medical terms and conditions along with other basic requirements which are needed in this field   :-
General Medicine  (2nd year)
General Surgery (2nd year)
Radiology (replacing imaging science with radiology )
Community Medicine (3rd year)
Neurology (3rd year)
Physical Medicine & Rehabilitation Management (3rd year )

Ethics, Law and Healthcare Regulations

-Shifting pathology and pharmacology in 1st year
-Adding practical skills of general basic medication and diagnosis (using stethoscope, CPR, giving IV fluid, giving injection etc for basic Emergency conditions )
- Reducing Biomechanics from 3 to 2
- Compulsory internship in general Surgery ward
-Compulsory Internship in field like CBR project


MPO course current structure:-
MPO-1st Year
1.Advance Lower Extremity Orthotics & Clinical Gait Analysis
2.Advanced Lower Extremity Prosthetics & Clinical Gait Analysis
3.Research Methodology & Biostatistics
4.Mechatronics
5.Applied Biomechanics & Kinesiology

MPO-2nd year
1.Advanced Upper Extremity Prosthetics
2.Advanced Upper Extremity Orthotics
3.Advance Spinal Orthotics
4.Pedagogy in P&O Education & Administration, Management & Ethical Issues
5 .Dissertation
Making Advance Spinal Orthotics as Advance Spinal and Cranial Orthotics

Suggested Changes:-
Adding 8 courses as Choice based credit courses as per latest UGC guideline  4 of them should be taken in 2 years  -
Adding mandatory subjects:-
Neurosurgery
Advance Orthopaedics & Radiology
The subjects can be :-
Sports Medicine
Advance Rehabilitation Management
Advance Assistive technology
Robotics
Lean Six Sigma
Medical Laws
Public Health & Social medicine
Advance Biostats

6 Months compulsory Field Training

Hope that all the demands are looked at and a resolution is passed as soon as possible for this.

With Best Regards
Prosthetists & Orthotists of India along with Students enrolled for the courses.

 



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