Dr. T.V. Rao discusses the emerging crisis in medical microbiology education and practice in India. He argues that the current system produces graduates with theoretical knowledge but little practical skills. As a result, infectious diseases are often misdiagnosed or inappropriately treated with antibiotics. Several commenters agree with Dr. Rao's assessment and suggest reforms such as competency-based training, reducing non-medical influence over education, and integrating microbiology teaching with clinical case studies. There is a need to improve faculty training and make microbiology education more relevant to patient care.

1. EMERGING CRISIS IN MEDICAL MICROBIOLOGY
IN INDIA
Dr.T.V.Rao MD
Medical Microbiology is a part of the whole system of Medical education which is in crisis mode
today and we are paying a very heavy price for inadequately investigating the patients to even
diagnose and rule out basic infectious diseases of more than 100 years old, with scientific
evaluations, I think I am in a mood to get out of active work in Microbiology, with many limitations
to work with integrity, certainly lack of commitment to develop the Medical microbiology leads to
crisis with the misuse of Antibiotics and today patient spends more on Antibiotics than on the basic
disease process, Many clinicians think that Laboratory Medicine is COW they can get maximum MILK
out of ignorance of the laboratory system. Ultimately the Laboratory Medicine is turning out to be
a profit making industry at the cost human life and survival. Our education system is wonderful and
MD in Microbiology course teaches many great matters in syllabus and curriculum our educational
system is wonderful, competitive and producing many graduates and postgraduates, however, if you
analyse our Microbiology our students talk many things beyond what we can do in our country. It
means we are loading them with imaginary things drifting from realities, the skills and performance.
Today our Microbiology students learn complex things beyond their need; our syllabus is excellent;
everything is told as theory and I see even the postgraduates in medical microbiology practice with
least interest in laboratory procedures, they think laboratory is a Technicians Job and they are expert
to guide system and supervise with little knowledge in basics and many may not be talented to do
few basic things even after post-graduation. It is unfortunate that very Senior Professors and many
HOD’s think they are born angels of Microbiology and few can read a Gram stain a basic procedure
in Microbiology it ex expected to read well by BSc student in Microbiology, It is not fault of any one
they think they are the administrators of Departments and living in illusion they know all the matters
well start kidding the students with ignorance I feel majority of the seniors never take any clue from
many events. Even after spending more than nine years to be a medical microbiologist with MD, and
another period of more than nine years in waiting to become a professor, most of us go into
unproductive work without contributing much to patient care which makes the clinicians reluctant
to accept us as a part of the system. This all happens with cumulative effect; in microbiology the
teachers, once they become associate professors, they read very little and leave the laboratory work
to assistants spending time with the so-called administrative work, finding faults with many around
as idle ness causes perverted minds and some chasing examiner-ships. As we know they are fulltime
examiners and part time teachers.
IS MD Microbiology COURSE HEADING TO COLLAPSE? Today no body joins MD
Microbiology may be because the chances of employment are low, and to be trained by most
ignorant people heading the departments. With least interest and it is just a Time pass to juniors
like our senior professors in Medical colleges who come to enjoy the hospitality of Medical council of
India as they need a person to lead the department. I can definitely say our Medical microbiology is
most contaminated course as anybody can interfere and report without having basic knowledge on
pathophysiology of Infectious diseases, The ignorance of Senior MD is compensated by MSc
graduates, and private managements cannot find people with little commitments and clashes
between Medical and Non-Medical people killing the profession in Many private Medical Collages, as
everybody acts smarter than what they know the Microbes, In this process the Microbes are
competing with Microbiologists to be smarter than we think and winning the dynamics of crisis in

2. Medical Microbiology with mismanagement of Infectious diseases I find that microbiology
departments are least funded and in future to continue in the departments will be disappointing. I
feel in future many least interested people would join the MD (Microbiology) just for a job for MCI
regulations and the departments will be loaded with mediocre teachers and future of the
departments would be at stake.
When I published a Article on the above matters in widely read India Medical Times as Falling
standards in medical microbiology Monday, August 11, 2014 Some of the learned people experts
commented with following ideas
Comment by Dr Jacob John 2014-09-18 06:00:02 Professor of Eminence from
CMC Vellore
Dear Dr Rao,
The scenario is exactly the same not only for medical microbiology but for other subjects too clinical
subjects included. Quite often we get microbiology reports at a technician’s level but signed by an
MD Microbiology (without any interpretation or recommendation).The training for UG/PG has to be
reoriented as competency based. Admission should be merit based -no capitation fee/management
quota/NRI quota.
Only those with stuff should enter the portals of higher education.
Comment by Rajwardhan Yadav
2014-10-11 02:16:11
Dear Dr. Rao,
I appreciate you taking the time to write your opinion. Your honesty is humbling. We are facing with
a scare of Ebola in the US and the media is going bonkers with the coverage. One death to date in
Dallas and the entire town is on the edge. The big wigs at the CDC and Department of Public Health
are having sleepless nights. Microbiologists and infectious disease specialist are providing their
opinions through most of the media outlets. You have brought up two main issues, first being the
age old, stereotyped and non-pragmatic education (microbiology) system that exists in most of the
medical schools in India and the second being the if an individual infected with Ebola were to come
to one of the metropolitan cities of in India and transmit the virus to various individuals he comes in
contact with and the chain reaction that it would set in, is unimaginable. I wonder what can be done
about these issues. The regulatory body overlooking medical education in India is in the news only
when the Courts give directives and when disproportionate assets are recovered from the official
(s)/aficionados. It just appears that there is no accountability. Dr. Rao, people like you with a
conscience need to advice how to make subjects like microbiology attractive and lure the bright
medical graduates towards the field. Microbes are evolving, novel mutations are resulting in
antigenic shifts and drifts. Genomic exchanges are taking place within and across species and
serotypes. When evolution is occurring even among viruses and bacteria why is so difficult for our
MCI to evolve. Intelligence and brightness is inherent within the students who join our medical
schools. We have to provide the optimal learning environment for them to flourish. A start that
comes to my mind is to provide good training to the faculty who teach our students. In today’s world
of molecular and personalized medicine we need to expose our students to the tools of modern
medicine and how they can utilize them to provide better health care to the Indian people. Just to
end, I hope the Indian government has a plan in place to screen individuals coming out of West

3. Africa otherwise we are going to have a public health crisis on our hands in the subcontinent. After
reading your opinion I just had to applaud you for the candidness in which you expressed your
thoughts and also write a few of my thoughts. Good luck.
Raj Yadav MD, PhD
Division of Rheumatology
Yale School of Medicine New Haven CT
Comment by CHUGH, TD
2014-08-23 21:25:21
Teach microbiology as case studies in collaboration with clinicians. The present format is dull and not
worth it.look at the way antibiotics are taught to 3rd year students in micro and pharma without the
teachers even knowing their proper use on patients. Times have changed, we need integrated
teaching programs. All the wet practical’s for undergrads are useless. Make micro training
interesting and life -like. Give it the colour of infectious diseases. Teachers must change before u can
improve microbiology standards.
Comment by Kavita Raja Head Division of Microbiology Sree Chitratirunal
Institute of Medical Sciences
2014-10-10 13:40:54
In 1997, we started an association called Academy of Clinical Microbiologists in Trivandrum. Those
interested in taking Microbiology to the patient’s bedside can join us. The Association is open to only
Medical doctors who have specialised in Microbiology (MD), but is not restricted to India.
With more active members we can do many things like curriculum development, antibiotic policy
development, training of faculty in clinical application of microbiology results with treatment
suggestions/antibiotic stewardship. For our activities, please go to http://www.clinicalmicrobio.org .
We have a journal- Journal of academy of Clinical Microbiologists (JACM) that promotes clinically
oriented articles
Ref OPINIONS Falling standards in medical microbiology Monday, August 11, 2014 India Medical
Times by Dr.T.V.Rao MD
I WISH MANY FRIENDS MEDICAL MICROBIOLOGISTS PHYSICIANS AND HOSPTIAL ADMINISTRATORS
READ JUST NOT ARTICLE AND SHARED OPIBION OF Dr Jacob John a luminary in Medical
Microbiology from Christian medical college Vellore and other great luminaries who fought for
improving standards in Medical Microbiology
I WISH MANY TO JOIN MY LITTLE SPACE ON FACEBOOK AND CONTRIBUTE YOUR IDEAS ON RAO’S
MICROBIOLOGY AND RAO’S INFECTION CARE WITH HUNDEREDS OF CONTRIBUTIONS ON
www.slideshare.com www.medmicrobes.com
NEVER FORGET EVERYONES LIFE IS IN CRISIS OUR ICU’S MIC’S WILL BE KILLER FIELDS IF THE
MICROBIOLOGY DEPARTMENT ARE NOT KEPT IN ORDER

4. The article carries no conflict of interest an opinion for betterment of Medical Microbiology as we
are heading to a state BUGS AND SUPERBUGS FREE FOR ALL
Dr.T.V.Rao MD Professor of Microbiology Freelance writer