Chapter 17: Allied Health Sciences

Introduction

Not so long ago most of the medical and health care professionals were doctors, dentists and nurses. Very few other kinds of personnel in this field existed because very few were needed. But now other categories abound. Many new categories came into existence because of technological advances. As biomedical knowledge expanded and skills became sophisticated enough to be applied to practical problems, a division of labour took place. New specialized professions emerged specifically to meet newly created needs. In other words, once a type of equipment or a technique was devised and found to be useful, some one was needed to use them safely and correctly.

This gave rise to two categories of medical and health care professionals to deal with Rehabilitation Medicine and Therapy, and Medical Technology. Training programmes in these areas came to be known as paramedical education and the profession as paramedics. However, the subjects are now labelled as Allied Health Sciences. A small number of medical colleges, in addition MBBS course, were the first to introduce programmes in several areas of allied health sciences, e.g., Christian Medical College, Postgraduate Institute of Medical Sciences, Jawaharlal Institute of Postgraduate Education and Research. It is only during the last two decades or so that a large number of specialized institutions in different areas have been established.

Rehabilitation Medicine and Therapy

The primary goal of rehabilitation is to restore the patients to as near normal a physical condition as possible after disease or injury. It also aims at improving the emotional and psychological state of patients too enable them to make full use of their capabilities and adjust to the limiting effects of disabilities. It further aims at improving their social adjustment capability so that they may resume their place within their families and communities. All over the world, Rehabilitation Medicine and Therapy has been recognised as an integral part of medical and health care system that deals with the management of all types of disabilities.

Different types of disabilities include visual disability, hearing impairment, speech and language disability (communication problem), delayed mental development (mental retardation) loco motor disability, and physical disability (either congenital or caused by illness and accidents). According to the National Sample Survey (1991), the prevalence of disabilities in India was 20 per thousand persons in the rural area and 16 in the urban area. (See also Update) The Ministry of Social Justice and Empowerment of the Government of India is responsible for dealing with the welfare of the disabled.

The Government have set up four National Institutions in each major areas of disabilities, viz., (1) Ali Yavar Jung National Institute for the Hearing Handicapped (KC Marg, Bandra Reclamation, Bandra (West) Mumbai-400050), (2) National Institute for the Visually Handicapped (116 Rajpur Road, Dehra Dun-248001), (3) National Institute for the Orthopaedically Handicapped (BT Road, Bon-Hoogly (Calcutta-700090), and (4) National Institute for the Mentally Handicapped (Manovikas Nagar, Secunderabad—500009). Besides, four other apex level institutions have also been established by the Government of India., viz., the (1) Institute for Physically Handicapped (4) Vishnu Digambar Marg, New Delhi-110002), (2) National Institute of Rehabilitation Training and Research (Olatpur, Bairoi, Cuttack-754010), (3) All India Institute of Physical Medicine and Rehabilitation (Haji Ali Part, K Khadya Marg. Mumbai-400034) and All India Institute of Speech and Hearing (Mysore-570006). These organisations offer a variety of long-term training programmes and rehabilitation services. The Government has also established the Artificial Limbs Manufacturing Corporation of India at Kanpur.

A comprehensive law namely “The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation Act, 1995 for the benefit of the disabled” was enacted and enforced in February 1996.

Rehabilitation Council of India

Considering the importance of this emerging profession, the Government has established a statutory body known as Rehabilitation Council of India (RCI) under the Rehabilitation Council of India Act, 1992 to regulate and maintain standards and norms of education in Rehabilitation Medicine and Therapy. The functions of the Council along with the areas which come under its jurisdiction have been given in the Chapter 7 (Regulatory Authorities). The Council, through advertisements has asked the students seeking admission to courses in these areas to ascertain whether the institutions and courses offered by them are recognised by it.

Those who are already working as teachers (special education for handicapped) and rehabilitation workers prior to 1993 without any formal training have been asked to undergo the National Bridge Course Training Programme of specific disability for one month at the cost of the Rehabilitation Council of India. The Council had brought out Status of Disability in India-2000, the first ever comprehensive document on the issue. It should be an essential reading for all those who are concerned with the problem.

Educational Opportunities: Educational opportunities are available in the following areas: (1) Physiotherapy, (2) Occupational Therapy, (3) Prosthetics and Orthotics, (4) Speech and Language Disorders and Hearing Impairment, (5) Visual Handicap, and (6) Mental Retardation. In addition, there are also a small number of general courses and courses in specific areas, such as, loco motor handicapped, rehabilitation engineering, physically and neurologically handicapped children, multi-rehabilitation work.

In certain areas, courses are available for training teachers involved in teaching the handicapped, e.g., Speech and Language Disorders and Hearing Impairment, Visual Handicap, Mental Retardation. These courses lead to the award of Diploma in special education or B.Ed in special education. There seems to be some ambiguity about the jurisdiction of the Rehabilitation Council of India and the National Council of Teacher Education with regard to such courses. Both the Councils include B.Ed in special education in their lists of approved courses.

For example, the Faculty of Education of Sri Padmavathi Mahila Visavidyalayam (Tirupati) offer B.Ed Special (Hearing Impairment). Bhavnagar University (Faculty of Education) has a course of one-year duration – Bachelor of Hearing Impaired (BHI). Depending upon the nature of the areas, most of the courses in Rehabilitation Medicine and Therapy are available in diploma, first degree and postgraduate degree levels.

Physiotherapy

Physiotherapy (or Physical Therapy) aims towards the restoration of strength and function to sick and injured structure and toward maximizing disabled abilities. Physiotherapists employ exercises, light, heat, electricity, manipulation, water and other mechanical agents in order to restore activity to an injured part of the body. Some physiotherapists treat a wide variety of problems, others specialize in such areas as paediatrics, sports physiotherapy, neurology and cardio respiratory physiotherapy.

Educational Opportunities: In rehabilitation medicine and therapy the largest number of courses are in the field of the physiotherapy. To begin with, this course used to be offered by four apex institutions set up by the Ministry of Social Justice and Empowerment: (1) All India Institute of Physical Medicine and Rehabilitation, (2) National Institute of Rehabilitation Training and Research, (3) National Institute for Orthopaedically Handicapped and (4) the Institute for the Physically Handicapped.

Several medical colleges and deemed medical universities also introduced the programme. During the last five-years or so a large number of institutions have come into existence to offer this course. The total number of institutions at present exceeds 100. Nearly 50% of these institutions are located in Karnataka and Tamil Nadu. While the duration of the first degree course offered by the four apex institutions, is 3 ½ years (including 6 months of internship), the duration of the course offered by all other institutions is 4 ½ years (including 6 months of internship).

All the institutions are affiliated to universities within whose jurisdiction they are located. In States where there are medical universities, the institutions are affiliated to them. Though physiotherapy comes statutorily under the authority of the Rehabilitation Council of India, it is yet to exercise its regulatory control over the institutions offering the course. Qualification requirement for admission to the first degree course (Bachelor of Physiotherapy (BPhT or BPT) or B.Sc (Physiotherapy) is a pass in 10+2 examination with biological science as one of the aggregate. Many institutions specify the minimum percentage marks in the aggregate. Annexure 1 gives an illustrative list of institutions offering physiotherapy courses. Madhya Pradesh Bhoj (Open) University plans to introduce B.Sc (Hons) Physical Therapy course of three-year duration through distance learning mode.

The only institution which offers a specialized first degree course in physiotherapy is the Manipal Academy of Higher Education. It has introduced the Bachelor of Respiratory Therapy and Technology (BRTT) at its College of Allied Health Sciences. Several institutions have introduced Master’s degree courses (M.Sc Physiotherapy), MPhT or MPT) of two-year duration. Students are required to specialize in one of the areas, such as, orghopaedics, neurology, cardio-respiratory physiotherapy, paediatrics, sports physiotherapy, hand conditions. Holders of BPhT degree are admitted to the course. Annexure 1 lists some of the institutions offering the course.

Occupational Therapy

Though its inception was in the psychiatric field, occupational therapy to-day plays an equally important role in other medical fields, including rehabilitation of physically disabled patients. Occupational therapists select and direct educational, vocational and recreational activities designed to restore maximum function to mentally or physically disabled persons. They assist these individuals to achieve the highest level of functioning possible and to reduce or eliminate the need for continued health-care services. The rehabilitation goals include restoring physical, mental or emotional stability, combating boredom during long-term illness, aiding in developing maximum self-sufficiency in activities of living, and helping patients, in the latter stages of treatment, to a acquire a job skill.

Educational Opportunities: Compared to the large number of institutions offering physiotherapy courses, occupational therapy courses are available in about 25 institutions. Like physiotherapy, the four apex institutions established by the Ministry of Social Justice and Empowerment mentioned earlier were the first to introduce the course. While the duration of the first degree course (B.Sc (OT) or BPT) offered by these four institutions is 3 ½ years (including 6 months of internship), it is 4 ½ years (including 6 months of internship) in other institutions. The entry requirement is similar to that of physiotherapy course.

The Master’s degree course (M.Sc (OT) or MOT) is offered by four institutions only. Annexure 2 gives a list of institutions offering Bachelor’s and Master’s degree programmes. Although occupational therapy comes under the jurisdiction of the Rehabilitation Council of India, like the physiotherapy course, it is yet to extend its jurisdiction over the subject. Madhya Pradesh Bhoj (Open) University has a plan to introduce a B.Sc (Hons) Occupational Therapy course of three-year duration through distance learning mode.

Prosthetics and Orthotics

Prosthesis is an artificial replacement for a missing part of the human body. Examples of prostheses (or prosthetic devices) used to restore normal function include artificial legs or arms fitted after amputation or artificial heart valves to replace damaged ones. Prostheses are also used for cosmetic reasons, e.g., breast prosthesis fitted after removal of a breast (mastectomy). Prosthetists are professionals who are involved in designing the devices and choose the material for their construction and fit the patients with the devices, teach the patients the use and care of them. Orthoses, on the other hand, are devices which support weakened body parts or help to correct physical defects such as spinal deformities. Like prosthetists, orthotists are responsible for designing the orthotic devices (also known as orthopaedic appliances), selecting proper material for making them, fit the patients with the devices and advise patients about their use and care. Continued growth in the fields of both prosthetics and orthotics has been spurred by two world wars, the Korean and the Vietnam wars, and by injuries resulting from sports activities and automobile accidents. New developments in both the fields allow more ailments to be successfully treated with orthotics and prosthetics. This has also led to increasing specialisation in both the fields.

Educational Opportunities: Despite the importance of the subject, the number of institutions offering the courses are very small. The Ministry of Social Justice and Empowerment took the first step to introduce educational programme in prosthetics and orthotics by establishing three institutions; viz., All India Institute of Physical Medicine and Rehabilitation, the National Institute of Rehabilitation Training and Research. Diploma courses in the subject were first introduced in these three institutions which have since been upgraded to the degree level (B.Sc-Prosthetics and Orthotics).

The only other institution offering the degree courses is the (1) Indian Institute of Health Education, Health Institute Road, Near Central Jail, Patna). The degree course is of 3 ½ years duration including 6 months of internship. Eligibility requirements is a pass (50% marks in the aggregate) with Physics, Chemistry and Biology (or Mathematics). Four institutions offer the Diploma in Prosthetic and Orthotic Engineering of 2 ½ years duration: (1) Safdarjung Hospital, Department of Rehabilitation (Ansari Nagar, New Delhi-110016); (2) Schieffeline Leprosy Research Centre, Karigiri, SLR Sanatorium, North Arcot 632106, TN); (3) Government Institute of Rehabilitation Medicine (KK Nagar, Chennai-600083), and (4) Christian Medical College (Thorapudi, Vellore-632002).

Speech and Language Disorders and Hearing Impairment

Speech disorders can arise in various parts of the nervous system and muscles and other apparatus involved in speech. These may lead to inability to communicate effectively. Some of these disorders however are disturbances of language rather than of speech since they result from an impaired ability to understand or to form words in the language centres of the brain rather than from any defect in the apparatus of speech production. People with speech and language disorders can be helped by speech therapy. Hearing impairment (deafness) may be complete or partial inability to hear.

Total deafness is usually congenital. Mutism – refusal or inability to speak – is a symptom off profound congenital deafness. Rehabilitation professionals in this field help people with three inter-related problems of speaking, language, and hearing. There are three types of professionals – speech and language therapists, audiologists, and teachers for the hearing impaired. Speech therapists diagnose and evaluate the individuals, speech and language abilities and plan treatment programmes to restore or develop patient’s communication skill. Audiologists are concerned with the prevention of hearing impairment.

Educational Opportunities: There are two types of courses: (i) courses for speech and language therapists and audiologists, (ii) courses for preparing teachers for the hearing handicapped. Courses for speech and language therapists and audiologists are offered at three levels- diploma, graduate and postgraduate. Entry requirement for the diploma course of one-year duration is a pass in 10+2 examination in Science subjects. The qualification requirement for the first degree programme of three-year duration is also a pass in 10+2 examination with biology is open to degree holders preferably in speech, hearing and audio logy. Two premier institutions in this field are (1) Ali Yavar Jung National Institute for the Hearing Handicapped (AYJNIHH) (KC Marg, Bandra Reclamation, Bandra (West), Mumbai-400050), an autonomous institution under the Ministry of Social Justice and Empowerment; and (2) All India Institute of Speech and Hearing (Manasagangotri, Mysore-570006) established by the Ministry of Health and Family Welfare.

AYJNIHH offers the largest number of courses for speech language therapist and audiologist and teachers for the hearing handicapped both at its main campus in Mumbai and other centres in several cities. Annexuure 3 gives a list of the courses. The All India Institute of Speech and Hearing is the only institution to offer a PhD programme in speech & hearing. Sri Ramachandra Medical College & Research Institute (Porur, Chennai-600116), a deemed university has introduced a course of four-year duration (including one-year of internship) leading to the award of B.Sc (Speech Language and Hearing Sciences). Although the number of institutions offering these courses are small the nomenclatures of the award vary, e.g., B.Sc (Audiology and Speech), B.Sc (Hearing Language and Speech), B.Sc (Audiology and Speech Rehabilitation), B.Sc (Speech Language & Hearing Sciences), BASLP (Bachelor in Speech Language Pathology).

A total number of 13 institutions (see Annexure 4) offer the B.Sc course. Of these, only four, viz., AYTNIHH, Postgraduate Institute of Medical Education and Research, Institute of Health Science, and All India Institute of Speech and Hearing, have introduced M.Sc course. Diploma course is offered by four institutions, vi., AYJNIHH, J M Institute of Speech and Hearing, (Inder Puri, Shastri Nagar, Patna-800023), Medical Trust Hospital (MG Road, Cochin-582016) and the Gujarat University (entry requirement is a B.Sc degree).

There are two types of courses (called special education) for preparing teachers for the hearing impaired: (1) Degree course (B.Ed-Hearing Impaired) (also M.Ed – Hearing Impaired), and Diploma in Special Education – Hearing Impaired (DSE-Hearing Impaired). The degree course of one-year duration is open to graduates while the entry requirement for diploma course, also of one-year duration, is a pass in 10+2 examination.

B.Ed (H1) is offered by three institutions – AYJNIHH (at Mumbai, Hyderabad and Calcutta), AWH College of Education (Rehmani School for Handicapped, P.O. Medical College, Calicut-673048), and Shrud B.Ed (H1) College (805 Smruti Bhandarkar Road, Pune-411004). Diploma Courses are offered by more than 25 institutions. An illustrative list is given in Annexure 5.

Visual Handicap

Visual handicap may range from partial loss of vision to complete blindness. Despite a large number of visually handicapped people in the country, the number of institutions for preparing rehabilitation professionals in the field and educational facilities for the visually handicapped are very small.

Educational Opportunities: The National Institute for the Visually Handicapped (116 Rajpur Road, Dehra Dun-248001), an autonomous body under the Ministry of Social Justice and Empowerment, is the apex body for preparing rehabilitation professionals particularly for teaching the blind. There are four types of courses:

(1) Diploma in Special Education (Visually Handicapped) (DSEVH) for secondary level teachers; (2) Diploma in Special Education (Visually Handicapped) (DSE-VH) for primary level teachers; (3) B.Ed (Visually Handicapped); and (4) M.Ed (Visually Handicapped).

Only four institutions offer DSE-VH course for secondary level teachers, viz., (1) National Institute for the Visually Handicapped; (2) Blind Relief Association, (Lal Bahadur Shastri Marg, New Delhi-110003), and (3) Blind Men’s Association, (Dr Vikram Sarabhai Road, Vastrapur, Ahmedabad-364002), and (4) Ramakrishna Mission Blind Boys Academy, (Narendrapur-743508 West Bengal). The only institution which offers both B.Ed and M.Ed (Visually Handicapped) courses is the Shri Ramakrishna Mission Vidyalaya College of Education, (Coimbatore-641020). The entry requirement for all the courses of one-year duration is a Bachelor’s degree in arts or science.

The DSE-VH course for primary level teachers of one-year duration is available in 13 institutions (See Annexure 6). The entry requirement is a pass in Class 10+2 examination. Ramakrishna Mission Blind boy’s Academy, (Narendrapur-743508) also offers a DSE-VH course for in-service primary level teachers.

The National Institute for the Visually Handicapped has an Orientation and Mobility Training Course of six-month duration open to Class 10 passed candidates. The Institute is also well-known for its vocational training programmes for the visually handicapped.

Mental Retardation

Mental retardation should not be confused with mental illness. Mental illness is a general term that describes any form of psychiatric disorder. Mental retardation, on the other hand, signifies impaired intellectual function that results in an inability to cope with the normal tasks of life. “Mental Handicap” is sometimes the preferred term. There are various degrees of severity of mental retardation resulting in different levels of disability. While psychiatric disorders are handled by qualified medical professionals, the rehabilitation professionals assist mentally handicapped persons to cope with their disability and also act as their teachers.

Educational Opportunities: The National Institute for the Mentally Handicapped (Manovikasnagar, Secunderabad-500009), an autonomous organisation under the Ministry of Social Justice and Empowerment, is the apex institute for preparing qualified manpower to deal with the mentally handicapped persons. The Institute offers four courses:

(1)  Bachelor in Rehabilitation Services (Mental Retardation) (BRSMR): The course is of 4 years duration including 6 months of internship). Eligibility: A pass in class 10+2 examination with 50% marks in the aggregate (40% in case of SC/ST candidates. Admission is on the basis of an entrance test held at about ten centres in the country. The degree is awarded by the Osmania University, Hyderabad.

(2)  B.Ed (Special Education – Mental Retardation): The course affiliated to the Osmania University, Hyderabad is of one year duration (plus three months of internship). Eligibility: Graduate in any discipline (B.A, B.Sc, B.Com) or BRS – MR. Admission is on the basis of an entrance test.

(3)  Diploma in Vocational Training & Employment (Mental Retardation) (DVTE-MR): The course is of one-year duration (plus three months of internship). Eligibility: A pass in Class 10+2 examination. The course is offered in the National Institute for the Mentally Handicapped, Secunderabad and Novjyothi Trust Institute of Mentally Retarded (40 Meenambedu Road, Sidco Industrial Estate, Kanchanakuppam, Chennai-500098).

(4)  Diploma in Special Education – (Mental Retardation) (DSEMR): The duration of the course is one year (plus three months of internship). Eligibility: A pass in Class 10+2 examination. The course is offered by 36 institutions including the National Institute for the Mentally Handicapped. The National Institute coordinates the programme. Annexure 7 gives an illustrative list off institutions throughout the country.

Miscellaneous Courses

Multiple Disabilities (Physical and Neurological): One important programme, training of teachers for children afflicted by multiple disabilities (Physical and Neurological), is offered only by four institutions. The Postgraduate Diploma in Special Education in the subject of one-year duration is available in (1) Spastic Society of Northern India, (Balbir Saxena Marg, Hauz Khas, New Delhi-110016); (2) Open Learning System (275/A Sahid Nagar, Bhubaneshwar-751700); (3) Spastic Society of Tamil Nadu (Opposite TTTI, Taramani Road, Chennai-600113); and (4) Indian Institute of Cerebral Palsy Spastic Society of Eastern India P-3 5/1 Taratolla Road, Calcutta-700099). The Spastic Society of Northern India has now introduced a PG Diploma in Development Therapy (Cerebral Palsy and other Neurological Disabilities). The courses are generally open to B.Sc degree holders in Home Science, Biological Science or Medical Sciences.

There are also a small number of general programmes for rehabilitation workers:

B.Ed/M.Ed Special Education: SNDT Women’s University – B.Ed/M.Ed; Hashu Advani College of Special Education (64-65 Collector’s Colony, Chembur, Mumbai-400764); Avinashilingam Institute for Home Science and Higher Education for Women (Coimbatore-641043) – B.Ed/M.Ed/B.Sc (Special Education and Rehabilitation); Institute of Advanced Studies in Education MJP Rohilkhand University, Bareilly-243006); Rehabilitation Sciences (BRSc/MRSc): Holy Cross College Department of Rehabilitation Sciences (Tiruchirappally-620002) – BRSc/MRSc. Madhya Pradesh Bhoj (Open) University proposes to introduce a distance learning programme B.Sc (Hons) in Rehabilitation Therapy of three-year duration; Postgraduate Diploma in Developmental Rehabilitation: Thakur Hari Prasad Institute of Research and Rehabilitation, Hyderabad-500660; and P G Diploma in Rehabilitation Psychology: Aligarh Muslim University.

Medical Technology

Medical technology is a very broad term denoting the application of medical and allied sciences for the prevention and treatment of diseases. There are two kinds of medical technology – the diagnostic and the therapeutic. As the name suggests, diagnostic technology is used for diagnosing diseases by means of instruments, appliances and equipment and also for making laboratory analysis of samples of urine, stool, blood, etc., of the patients. Therapeutic technology, on the other hand is applied for curing diseases. For example, in radiotherapy, ionizing electromagnetic radiation such as x-ray and gamma-rays has therapeutic use in the treatment of disease, particularly cancer. Radiology, involving the application of radiation, has both diagnostic and therapeutic uses.

While in the 19^th Century the doctors used to solely depend on their own senses, aided occasionally by such simple instruments as stethoscopes, laryngoscopes, clinical thermometers, their successors at the beginning of the 20^th Century started using additional information from medical laboratories and x-ray departments to confirm their preliminary diagnosis. Since 1950, there have been many new developments in medical technology with the invention of diagnostic equipment, and medical technology with the invention of diagnostic equipment, and medical laboratory techniques supported by new analytical instruments. Among the wide range of equipment and techniques now in use are: ultrasound imaging, computerised axial tomography (CAT) scanners, magnetic resonance imaging (MRI), electrocardiographs (ECG), Lasers, Ortho’s and prostheses, heart-lung machines, perfusion technology, dialysis machines, perfusion technology, dialysis machines, radioactive isotopes scanner, radiotherapy, radiology, bacteriology, hematology, medical biochemistry, medical microbiology.

The introduction of these new tools and techniques created a new world in which doctors have started increasingly depending on them. This in turn, led to the birth and growth of a new breed of professionals called medical technologists to provide support to doctors. Medical technologists are professionals who are skilled in the use of a wide range of instruments and equipment and analytical techniques to perform various tasks in medical laboratories, hospitals and diagnostic centres. Their jobs often may require the exercise of independent judgement and responsibility in the diagnosis and treatment of diseases. They should also be able to relate the results of the tests performed to the normal healthy stage of a person, to the presence of diseases or other conditions which may alter test results.

Educational Opportunities

To begin with, education in medical technology was provided for laboratory work (medical laboratory technology) involving the analysis of blood, urine, etc. Most of the training programmes were of short duration offered primarily by private agencies, which, however, served the purpose of the day. The introduction of new analytical instruments and techniques require comparatively higher level of manpower with proper education and training. As a result, medical colleges and other institutions introduced diploma (DMLT) and degree level courses in medical laboratory technology (B.Sc-DMLT).

The diploma courses of two-year duration are open to candidates who have passed Class X examination. Eligibility for the degree course is a pass in the 10+2 examination with biological science as one of the subjects. In other areas of medical technology technician-level training was introduced mostly on-the-job type, in hospitals possessing diagnostic equipment. Introduction of more sophisticated and complex equipment, hospitals and diagnostic centres also require highly trained manpower. Many medical colleges, therefore, started introducing courses in this area and new institutions were also established for this purpose. Compared to the number of courses in medical laboratory technology, the number of institutions and the intake capacity in courses, in other areas of medical technology are still very small.

There is a great demand for qualified medical technologists in specialty hospitals (both government and corporate) and large number of diagnostic centres in big and small cities. The types of courses in this area include the following: Anaesthesia Technology, Blood Bank Management, Cardiovascular Technology/Cardiac Technology, Clinical Neurophysiology Technology, Dialysis (Renal) Technology, ECG Technology, Medical Microbiology, Nuclear Medicine Technology, Neuroscience Technology/Neuro-technology, Operation Theatre Technology, Optometry, Perfusion Technology, Radiography and Imaging Technology/Radio Diagnosis and Imaging Technology, Radiotherapy/Radiography, Respiratory Care Technology, X-ray.

In these areas both diploma and degree level courses are offered. Eligibility requirement for the three-year degree courses is a pass in 10+2 examination with biological science as one of the subjects. The diploma courses are mostly open to graduates in science. The nomenclature of degrees varies, e.g., B.Sc (Medical Technology)- Radiography; B.Sc (Medical Radiological Technology), B.Sc (Medical Technology) – Radio diagnosis; B.Sc (Medical Technology) –Radiotherapy

A brief account of the training courses offered by some well-known institutions in medical technology (including Medical Laboratory Technology) is given in Annexure 8 Optometry and Opthalmic Techniques

Optometry is the professional practice of primary eye and vision care, including diagnosis, treatment and prevention of disorders and the prescription of corrective lenses. Optometrists may provide all of these services or they may specialize in a particular area of optometric care. For example, due to the ever increasing use of contact lenses, some optometrists prefer to devote their entire attention to prescribing and fitting contact lenses. Along with ophthalmologists, opticians and ophthalmic assistants (or technicians), optometrists provide eye-care services. Ophthalmologists are medical doctors (holders of postgraduate diplomas and degrees), while opticians are trained to fit supply and adjust glasses and lenses prescribed by ophthalmologists or optometrists. Ophthalmic technicians assist ophthalmologists.

Educational Opportunities

Although there is a great demand for second tier manpower for eye and vision care, the training programme for optometry is inadequate. Only two universities offer degree course in the subject; Bharati Vidyapeeth (Pune) and Birla Institute of Technology and Science (BITS). Vidyapeeth’s course is of four-year duration (including one year of internship). The degree awarded is B Optometry. BITS offer BS (Optometry), also of four-year duration in collaboration with Sankara Nethralaya. Admission requirement for both is a pass in 10+2 with biology as one of the subjects. BITS also offers, in collaboration with Sankara Nethralaya M.Phil (Optometry) of two year duration. Eligibility requirement is BS (Optometry) or its equivalent qualification.

L V Prasad Eye Institute (Bausch & Lomb School of Optometry Hyderabad-500034) offers Bachelor of Optometry of four-year duration open 10+2 pass students in science stream with biology. Jadavpur University offers a Diploma in Optometry course of three-year duration in association with the Optometric Association of India. Entry requirement is a pass in 10+2 examination with biological sciences. The course is likely to be upgraded to the degree level. All India Institute of Medical Sciences and Mahatma Gandhi University (Kottayam) offer B.Sc (Ophthalmic Technique) course of three-year duration. Admission requirement is a pass in 10+2 examination with biological sciences. Besides, several institutions have introduced two-year diploma programmes in ophthalmic technique. They are, SNDT Women’s University. Aligarh MuslimUniversity and Aravind Eye Hospital and Postgraduate Institute of Ophthalmology (Madurai).

Career Opportunities

During the past one decade or so there h as been considerable expansion of medical and health care services in the private sector. Corporate hospitals (including specialty hospitals and health clinics, nursing homes and diagnostic laboratories have sprouted not only in metropolitan areas but in almost all the major cities. Employment prospects of physiotherapists and occupational therapists are now bright. Many health clubs and sports organisations have started using the services of physiotherapists. This explains the rapid increase in the number of institutions offering physiotherapy courses during the last two or three years. Physiotherapists, occupational therapists, and speech therapists can also undertake private practice.

There is now a great demand for physiotherapists in the USA. The demand for teachers specialising in teaching of the physically and mentally handicapped children has no increased. Many non-governmental organisations engaged in the welfare activities of the disabled also need teachers qualified in special education. Increasing use of most sophisticated medical technology and equipment in hospitals, nursing homes and diagnostic laboratories has resulted in the growth of the demand for trained medical technologists. With the introduction of the accreditation system for the diagnostic centres to ensure high standard of diagnostic services, appointment of properly trained staff is likely to become obligatory.

Financial rewards for professionals in allied health sciences may not be as lucrative as those in medicine and dentistry. Then, underemployment and unemployment is not uncommon among the medical profession, Rehabilitation medicine and therapy may not necessarily be the second option for those who fail to get into the coveted medical and dentistry courses. And for those who are looking for something more than just money or status and want to do something meaningful in life, may like to work as a teacher for the physically and mentally disabled. It is a job that needs great patience and empathy with those unfortunate persons. It may be a very rewarding experience.

Update

Data on Disabled Persons: On page 165, the 1991 NSS figures of disabled persons have been quoted. The Government of India has decided that data on disabled population would be collected in the 2001 population census. It was in the 1941 census that such data were last collected.