experience at medical (specialist) conference

I was fortunate enough to be a part of ten volunteers at a conference this past week. This was a specialist conference in medicine, and most of the attendees were prominent Nepali clinicians. I had a good opportunity to see these faces for the first time, and this post is dedicated to these heroes from Nepali Medicine Fraternity. I write names of few who were really impressive, quote few that were good, and mention some that were plain dumb. The conference was held in Kathmandu, for two days.

the good
As I see it, Dr SL (nickname) had the best presentation (also read the disclaimer below). He talked about emergency medicine and critical care management, and it was the most fruitful 20 minutes of learning experience during that 48 hours. Everyone else was mostly mediocre and some simply dumb. The post presentation / oral session discussions were quite good (all expect one related to Vitamin D). Few good questions and some great answers. Few faces came out again and again, with good talks and reasoning. Great learning experience.

Food was “okay” – nothing out of the world, but rather a standard Nepali set (of good looking rice, vegetables, meat and some cakes). Tea break had good tea/coffee, but very bad cookies selection. Lunch was crowded, but dinner was calm. As usual, dinner was served along with alcohol and 40+ doctors joined us (out of no where) during this feast.

the bad
There were ten of us (volunteers) and we did not get any public appreciation. We were junior doctors, working tireless throughout these two days and there was very little or no acknowledgement for us. There were few (three – to be precise – part of organizing committee) personal note of thanks from good people out of the 250 that attended. This, compared to another conference I attended three years prior, is a nightmare when it came to management (cultural and copycat) aspect.

Every speaker somehow had to be presented with a certificate of appreciation after the sessions, and even those who chaired the session got it. Then there were felicitations to some prominent senior doctors (read more than ten senior doctors). Then there were pharmacy company giving out weird appreciation/gift wrapped up. The so called prominent doctors society had very less ingenuity and patient to sit and listen properly. At one time, there were six audience/participants (three were volunteers), the MC was calling out names, and four doctors lined up to receive their post presentation certificates. The hall was empty.

There was virtually no interaction among the me and these senior doctors. This was mostly my fault (read busy). However, this is also due to our culture of not standing along with the senior faculty members and teachers. Asian education (Indian sub-continent) to be precise, has this great barrier among the teachers and student, which was very evident at this conference. Most of the junior doctors had no urge to question the authority and reason with our senior faculties.

we have this absolute anarchic culture; taught in medical school, not to question our teachers and seniors

The result of which makes most of us a little less bold, and we lack confidence. I know, that among the 45 of us, in my medical school, only handful were bold enough to utter wrong stuffs with absolute confidence. I wasn’t one of them, and a little part of me regrets for not being this. We were not to speak unless we were knew absolute concrete knowledge. If we spoke, were ridiculed and smirked upon.

the ugly
The last two years after my graduation has been very much revealing in aspects related to drug companies. I don’t hate them, but I am not comfortable with some marketing gimmick they put up with. They sure know how to suck it up to the doctors fraternity. There were around 20+ stalls of various pharmacy products just outside the hall where the conference was happening. One stroll through this, and I was filling my complementary bag with free pharmacy gifts, brochures, drug trial literatures/papers, posters/pamphlets and sample medicines.

I am uncomfortable with this. But hey !!! couldn’t resist the free stuffs that they were giving out. All my friends were getting it, some even went the second time, and came back with two sets of everything.

On the medicine side, I god ampules clindamycin (anti-biotics). Oral Tablets of PPI (proton-pump inhibitors) the brand name of which i don’t remember (they were not omeprazole or pantoprazole though). I got a month supply tablets of combination drug – Losartan + Amplodipine. This combination drug has something I will write in my next post. There were paracetamol leafs, and some wet-wipes also. Out of the ordinary, I got a key chain, a pen (good one), numerous cheap pens, coffee mug, a calendar, a beer glass, and lots of chocolates.

I took papers/pamphlets from all the available stores representing some 40 drugs. Read them, and found out that only seven of the medicine had mentioned their side-effects and adverse effect on these advertisement. Another thing I am uncomfortable with. It ought to have been written there. Only three pharmacy provided the drug trials (trials done in USA – sadly Nepal is too poor to conduct RCTs).

There was one strange oral tablet for curing hemorrhoids. It had not pharmacological name, and the brand name suggested it to be an ayurvedic medicine. This oral drug also had a small trial conducted in India among 300 patients with 90% cure rate. I am unaware of Ayurvedic medicines, and my knowledge to this is very limited, so I can’t really comment on it. However, this whole thing looked extremity dubious.

other stuffs…
Both of us went (my wife and I). She was the MC, and I was (as she put it) – “volunteer-by-relation”. We did had our friends circle there, and it was definitely an educational (some) and fun filled event. I had my camera, and at times, I’d go out and take pictures here and there (perks of being a volunteer). Some presentations were plain boring, so we (me and friends) would go out and talk, walk, or eat. With few extra passes, we’d also called our friends for dinner and free alcohol. I must thank Dr PP (nickname) for inviting us to this conference (as volunteers). We did not need pay the usual Nrs.2500 participant fee.

my judgement criteria (my perspective for presentations/oral-sessions)
I looked for the following criteria, in all the presentations for my judgement; and even though I was not present in all of the presentations and discussions, I now have the rough idea of who could present. It would be wise to mention that I very much like reading journal paper, and am keenly interested in public health issues, so my judgement – may be biased.

1. Simple English, Short Presentation.
2. Evidence based Medicine (preferentially local – Nepali evidence)
3. Up dated and latest research findings (with landmark research included)
4. Public or Primary Health related component.

Based on this, there were only three presentations that had all four components, five that had at least three of the component. Remaining were not so appreciable. The international faculty members who presented (read – four – from India) were all good. One of them even questioned the standards of Ethical Review Board (ERB) in Nepal. Rude thing to say, but somehow, he was correct and spot on on pointing out mistakes. So like can’t judge that.

in the end..
The weekend was not that bad, but it could have been a lot better. My past experience attending international conferences, tells me we need to do a lot. But, somehow, I am content, to know that, this is evolving and in times, we will get there. Still, there was no need to gift wrap every presenter with a certificate as soon after he/she spoke. Thats just stupid.

disclaimer – Dr PP and Dr SL was a faculty member to the medical school I graduated from, and I (we) have been in more than few of his lectures to highly appreciate them both.

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