PATNA, May 5 -- The first batch of five medicos who complete their superspecialisation (MCh degree) in trauma surgery and critical care in July from Patna's All-India Institute of Medical Sciences (AIIMS) will not have an option to work as a teaching faculty in the field of their specialisation in the public sector, as barring AIIMS, none of Bihar's 21 medical colleges, including 13 under the government sector, have either a postgraduation (PG) or superspecialty course in trauma surgery, said doctors familiar with the matter. The near-total absence of specialists in state having postgraduation or superspecialisation degrees in trauma surgery and critical care looks scary, especially given that Bihar ranks seventh in terms of road accidents deaths in India. It reported a 16% rise in the number of accident deaths from 7,600 reported in 2021 to 8,898 in 2022, with nearly 82% reported accidents turning into deaths, as per government data of the Ministry of Road Transport and Highways (MoRTH), said experts. The state ranks 16th in terms of number of accidents reported in a year, with the number rising from 7,016 in 2020 to 7,946 in 2021 and then declining to 7,068 in 2022. Shocking against this backdrop is the fact that barring AIIMS and Medanta hospital, both in Patna, none of the other medical college hospitals in the state have a dedicated trauma and emergency unit, having doctors with postgraduate or superspecialty degree in trauma surgery, for management of accident or trauma cases. On paper, however, Bihar has 47 functional trauma centres out of the designated 57 along national and state highways, said officials. Bihar does not have level I (highest ranked) trauma centre. It has, however, 47 level II and 10 level III trauma centres. All community health centres (CHCs) or primary health centres (PHCs), near highways, are set to be notified as level IV trauma centre, which is the first level designated facility for management of trauma cases. The Ministry of Health and Family Welfare (MoH&FW) designates trauma care facilities based on levels or their preparedness in terms of availability of trained doctors, paramedics and infrastructure. Interestingly, none of the health facilities, including medical colleges, under the Bihar government have trauma surgeons with requisite superspecialisation degree. Though the MoH&FW guideline does not make it necessary to have trauma surgeons at designated trauma centres along highways, they are desirable, said officials. "There may be just around 50 trauma surgeons with postgraduation or superspecialisation degrees in traumatology or trauma surgery and critical care in India. Such trained doctors are the need of the hour given the number of road accidents and deaths being reported in them, as also the trauma centres along highways that the government is focusing on," said Dr Anil Kumar, professor and head of the department at Patna's AIIMS. "A trained trauma surgeon, like those at AIIMS, can handle polytrauma (multiple injury), involving the head, abdomen, chest, bone, maxillofacial injury or any critical care, as a victim of road accident may have multiple injury. A trauma department, in the true sense, works on the concept of one patient, one doctor under one umbrella," said Dr Kumar. "However, in other health facilities in the state, barring the AIIMS and Medanta, it would require a general surgeon to deal with surgery involving the abdomen, a neurosurgeon to tackle head or spine injury, a maxillofacial surgeon (dental specialist) to deal with injury involving the mouth, face and jaw, and an orthopaedician to deal with injury involving bones, say for instance the upper and lower limbs, spine, etc." he added. Patna's AIIMS has 22 students presently doing specialisation in trauma surgery and critical care in the two courses it offers - a six-year post-MBBS integrated superspecialisation (MCh) course in trauma surgery and critical care, the only such course in India, and a three-year M.Ch programme in trauma surgery and critical care. Both courses have 11 students each. The first batch of five doctors in the three-year M.Ch course, all having joined in 2022 after completing their postgraduation in surgery, will complete their superspecialisation course in July. Dr Harendra Kumar and Dr Deepak Kumar, both having done their masters' in surgery (MS) postgraduation degree from the Patna Medical College Hospital, are from Bihar. The other three are Dr Vakil Ahmad Khan, Dr Abdul Hakeem and Dr Rachit Sreedhar are from Maharashtra, Cheenai and Karnataka. "All the five students are spoilt for choice, with each having an offer letter from private hospitals even before they complete their course in July," said Dr Kumar. "The post-MBBS six-year integrated superspecialisation (M.Ch) course in trauma surgery and critical care, which we introduced in 2023, is unique only to our institute in India. Parallel to this, we also have the three-year M.Ch programme in trauma surgery and critical care, having begun the first batch in 2022 for students with postgraduation (MS degree) in surgery or orthopaedics. Both the courses have 11 students each," he said. "Resident doctors are the backbone to run any trauma and emergency department 24x7. Given the fact we have 22 medicos four surgeons and two anaesthesiologists, our institute is doing well in trauma surgery," added Dr Kumar. Among the 20 operational AIIMS in India, there are only four, including Delhi, Rishikesh, Jodhpur and Patna, which offer superspecialisation (M.Ch) programme in trauma surgery. While AIIMS-Delhi introduced the course in 2015-16, AIIMS Rishikesh, Jodhpur and Patna did it in 2019. However, AIIMS Patna got its first batch of students for M.Ch programme in trauma surgery and critical care in 2022, after the Covid-19 pandemic. Barring AIIMS-Patna, no other medical college in the state offers the MCh programme in trauma surgery....