Jagiye Tol Pran

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ISBN : 978-984-94816-7-6
JAGIYE TOLO PRAN

Shastho Bybosthar Pacali
By : DR. MAHMUD HASAN
First Edition : January, 2022
Price : 300$ or 10$
No part of this book may be reprinted, photographed, photocopied, recorded or reproduced in
any from without the written consent of the copyright holder.
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United States and Canada bv‡g GKUv wi‡cvU© cÖKvk K‡ib| wZwb wb‡R
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science (Anatomy, Physiology, Biochemistry BZ¨vw`) Gi fvj Ávb
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cÖwkÿ‡Y nvmcvZv‡j †ivMx †`Lvi eë¯’v _vK‡Z n‡e| †gwWK¨vj ¯‹zj n‡Z
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D¾¡j nq|

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Committee on Medical Education 1834 mv‡j wi‡cvU© cÖKvk K‡i|
G‡Z †gwWK¨vj ¯‹zj¸‡jv‡K wek¦we`¨vj‡qi A½xf‚Z nIqvi mycvwik Kiv nq|
1918 I 1919 mv‡j m¨vi RR© wbDg¨v‡bi wi‡cv‡U©I G mycvwik wQj| d‡j
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Kwgkb mycvwik K‡i, †gwWK¨vj ¯‹zj¸‡jvi wewfbœ wel‡q Aa¨vc‡Ki c` m„wó
Kivi ìKvi| G¸‡jvi †eZb fvZv Ggb nIqv DwPZ hv‡Z Zv‡ì Ab¨ †Kvb
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wnmv‡e Kg©Rxe‡b gvbweK ¸Yvejxi cÖKvk, G¸‡jv wbwðZ nZ bv| d‡j
wewfbœ †`‡k (we‡klZt KvbvWv, nj¨vÛ I Av‡gwiKvq) competency based
education wfwËK wkÿv`vb c×wZi aviYv M‡o I‡V| †ivM wPwKrmvq Ávb
AR©‡bi mv‡_ mv‡_ Ávb cÖ‡qv‡Mi mÿgZv, hš¿cvwZ eënvi I kj¨wPwKrmvi
KzkjZv G¸‡jv AR©b I ev¯Íe cwiw¯’wZ‡Z eënvi wbwðZ Kivi c_ wPwýZ
Kiv nq| GUvI ¯^xK…Z nq †h GKRb fvj wPwKrm‡Ki Ab¨vb¨ ¸Yvejx _vKv
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my‡hvM cv‡”Qb| wPwKrmK‡ì wm×všÍ m¤^‡Ü Zviv cÖkœ K‡ib I Rvb‡Z Pvb|
Revew`wnZvi cÖ‡qvRbI Av‡Mi PvB‡Z evo‡Q| wm×všÍ †bIqv‡Z GLb †ivMx I
Zvi wbKURb‡ì wm×všÍ MÖn‡Y Askx`vi nIqvi cÖ‡qvRbI evo‡Q| mvgvwRK
msMV‡bi cwieZ©‡bi d‡j ¯^v¯’ëë¯’viI cwieZ©b NU‡Q| d‡j ¯^v¯’¨‡mev
c×wZi cwieZ©b NUvb I Zvi m‡½ m½wZ †i‡L Pjv GUvI wPwKrmK‡ì

Rb¨ ìKvwi g‡b Kiv nj| AZx‡Zi Zzjbvq bZzb †ivM wbY©q I wPwKrmv
c×wZi D™¢veb AviI `ªæZZvi mv‡_ n‡”Q| d‡j wPwKrmK‡ì bZzb Ávb,
`ÿZv I Kjv‡KŠk‡ji m‡½ cwiwPZ _vKvi Rb¨ mvivRxebB m‡Pó _vK‡Z
n‡”Q| wkÿv_©x‡ì †kLvbi c×wZ I medical education Gi DbœwZi m‡½
m‡½ cwieZ©b n‡”Q| G¸‡jvi m‡½I Zvj †i‡L Pjvi cÖ‡qvRb n‡q coj|
wkÿvc×wZi cwieZ©‡bi g~j w`K¸‡jv njt (1) GKRb wPwKrmK wK Ki‡Z
cvi‡e, wK wK `ÿZv AR©b Kiv cÖ‡qvRb GUv Av‡M wba©viY Kiv _v‡K, (2)
G¸‡jv KLb, wKfv‡e †kLvb n‡e Zv Av‡M wVK Kiv nq, (3) G jÿ¨¸‡jv
mwVK AwR©Z n‡”Q wK bv Ges AwR©Z bv n‡j Zv wVK Kivi eë¯’v †bIqvi
c×wZI MÖnY Kiv n‡e, (4) ev¯Íe cwiw¯’wZ‡Z cÖ‡qvM I †KŠk‡ji eënvi
hvPvB Kiv nq|
1999 mv‡j Accreditation Council for Graduate Medical
Education (ACGME) I American Board of Medical Specialist
(ABMS) QqUv core competency wkÿv`v‡bi Rb¨ wba©viY K‡i †`b|
G¸‡jv njt
1. Patient care.
2. Medical knowledge.
3. Professionalism.
4. Interpersonal and communication skills.
5. Practice based learning.
6. System based practice.
GB competency ¸‡jv KZUv AwR©Z n‡”Q Zv †`Lvi Rb¨ K‡qKUv level
wVK Kiv nq| ¯œvZK ev †gwWK¨vj ¯‹z‡j `yBwU ¯Íi (bZzb wkÿv_©x I †kl
ch©v‡qi wkÿv_©x) I ¯œvZ‡KvËi ch©v‡q cuvPwU ¯Íi wba©viY Kiv nq| fwel¨‡Z
wewfbœ †ivM I c×wZi †ÿ‡Î competency based education wK wK ¸YMZ
cv_©K¨ Av‡b Ges †m¸‡jvi AR©b wKfv‡e wbwðZ Kiv nq, †m c`‡ÿc †bIqv
n‡e|
Z_¨m~Ît
1. https://journals.lww.com/academicmedicina/Fulltext/2018/03001/
The_History_of_Medical_Education_in_Europe_and_the.10.
aspx.
2. Nara N, Suzuki T, Tohda S. The Current Medical Education

System in the World. J Med Dent Sci, 2011;58:79-83.
3. Rothstein W. American Medical Schools and the Practice of
Medicine: A History. 1987. New York. NY: Oxford University
Press.
4. Ludemerer KM. Learning to Heal. The Development of American
Medical Education. 1985, New York, NY: Basic Books.
5. Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C.
Shifting Paradigms: From Flexner to Competencies. Acad Med.
2002;77:361-367.
6. Fulton JE. History of Medical Education Br Med J. 1953, 2: 457-
461.
7. https://doi.org/10-1136/bmj.2.4834.457.
8. https://knowledgeplus.nejm.org/blog/what-is-competency-based-
medical-education/
9. Bayley TJ. Specialist medical training: implementing Calman:
summing up. Medical Education, 1994;28(Supple 2):46-47

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Z_¨m~Ît
1. Puddley IB and Mercer A. Socio-economic predictors of
performance in the undergraduate medicine and health services
admission test. BMC Med Edu 2013;13:155
2. Puddley IB, Mercer A. Carr SE and Louden W. Potential influence
of selection criteria on the demographic composition of students
in an Australian medical school. BMC Med Edu, 2011;11:97.
3. BMA, Equality and Diversity Committee; Equality and diversity
in UK medical schools. 2009. https://bma.org.uk/developing-
yourcareer/medical-student/equality-and-diversity-in-medical-
schools.
4. O’Neil L, Vonslid MC, Wallstedt B and Dorran T. Admission
criteria and diversity in medical school. Med Edu 2013; 47:557-
561.
5. Reiter HI, Lockyer J, Ziola B, Courneya CA and Eva K. Should
efforts in favour of medical student diversity be focused during
admissions or further upstream? Acad Med; 2012: 87:443-448.
6. James D, Yates J and Nicholson S. Comparison of A Level and
UKCAT performance in students applying to UK medical and
dental schools in 2006; cohort study. Br Med J, 2010;349:c478.
7. Nicholson S. The benefits of aptitude testing for selecting
medical students. Br MedJ.2005:331. https://doi.org/10.1136/
bmj.331.7516.559.
8. McManus IC, Powis DA, Wakeford R, Ferguson E, James D and
Richards P. Intellectual aptitude tests and A Level for selecting UK
school leaver entrants for medical school. Br Med J2005,331:555.
9. Graig SA, Deem LP and Straja SR. Are traditional cognitive tests
useful in predicting clinical success? J Dental Educ, 2005;44:859.
10. Ferguson E, James D, O’Hehir F and Sanders A. A Pilot study
of the roles of personality, references and personal statements in
relation to performance over 5 years of a medical degree. Br Med
J. 2003;326: 42931.
11. Ferguson E, James D and Madeley L. Factors associated with
success in medical school: systematic review of literature. Br Med
J. 2002; 324:952.

12. Deary I. Difference in mental abilities. Br.Med J. 1998; 317:1701.
13. Neisser U, Boodoo G, Bouchard TJ et al. Inteligence: knowns and
unknowns, Am Psychologist 1996:51:77-101.
14. Scotti Jr. MJ. Medical school admission criteria. The needs of
patients matter. J Amer Meds Assoc. 1997; 278:1196-1197.
15. Larkin S, Johnston K, Hogenbirk JC et al. Practice intentions
at entry to and exit from medical schools aspiring to social
accountability: findings from the Training for Health Equity
Network Graduate Outcome Study.
https://www.bmcmededuc.biomedcentral.com/articles/10.1186/
s12909-018-1360-6.
16. https://www.theguardian.com/society/2016/jan/22/medical-
school-students-wealthy-backgrounds.
17. Witzburg RA and Sondheimer HM. Shaping the medical profession
one applicant at a time. N Engl J Med; 2013; 368:1565-1567.
18. Muller D. Reforming premedical education-out with the old, in
with the new. New Engl J Med, 2013; 368: 1567-1569.

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¯’vcb I cwiPvjbvi Rb¨ miKvwi bxwZgvjvq Av‡Q, Zv AwaKvsk †ÿ‡Î miKvwi
†gwWK¨vj K‡jR¸‡jv cvjb K‡i bv| miKvwi †gwWK¨vj K‡jR¸‡jv ¯’vcb
Kivi ci ax‡i ax‡i †fŠZ AeKvVv‡gv M‡o †Zvjv nq, AeKvVv‡gv msµvšÍ
kZ©vejx miKvwi †gwWK¨vj K‡jR¸‡jv †kl ch©šÍ c~iY K‡i| Z‡e BMDC
wb‡`©wkZ wkÿ‡Ki msL¨v †ewkifvM miKvwi I †emiKvwi †gwWK¨vj K‡j‡R
c~iY nqwb| miKvwi †gwWK¨vj K‡jR nvmcvZvj¸‡jv‡Z †ivMxi ¯^íZv _v‡K
bv| miKvwi †gwWK¨vj K‡j‡R wkÿv msµvšÍ cÖZ¨ÿ e¨qI A‡bK Kg|

†emiKvwi †gwWK¨vj K‡jR ¯’vcb I cwiPvjbvi Rb¨ miKv‡ii ¯^v¯’¨ I
cwievi Kj¨vY gš¿Yvj‡qi bxwZgvjv Av‡Q| wbewÜZ Uªv÷, dvD‡Ûkb I
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n‡e (Ab¨vb¨ GjvKvq Pvi GKi Rwg)| GLv‡b `yÕwU Avjv`v GKv‡WwgK I
nvmcvZvj feb _vK‡Z n‡e, cÖwZwU‡Z GKjÿ eM©dzU floor space _vK‡Z
n‡e| Avmb e„w× n‡j AvbycvwZK nv‡i Avek¨KZv evo‡e| cÂvk Avm‡bi
Rb¨ K‡jR ¯’vc‡bi Av‡e`‡bi `yB eQi Av‡M †_‡K 250 kh¨vi nvmcvZvj
Pvjy _vK‡Z n‡e, hvi †ivMx fwZ©i occupancy nvi Kgc‡ÿ 70 kZvsk
_vK‡e| `k kZvsk weQvbv webvg~‡j¨ †ivMx‡ì wPwKrmvi Rb¨ msiwÿZ
_vKv ìKvi I Av‡e`‡bi mgqB †eZb †¯‹j D‡jøLmn wkÿK, wPwKrmK,
Kg©KZ©v, Kg©Pvix‡ì AM©v‡bvMÖvg Rgv w`‡Z n‡e| Aby‡gvw`Z †hvM¨Zvmn
cÖwZ 10 Rb wkÿv_©xi Rb¨ GKRb wkÿK _vK‡Z n‡e| G Qvov †kÖYxKÿ,
j¨ve‡iUwi, jvB‡eªwi BZ¨vw` gvbm¤úbœ n‡Z n‡e| wkÿv_©x Avm‡bi cuvP
kZvsk `wi`ª I †gavex QvÎ‡ì Rb¨ msiwÿZ _vK‡e|
2014 mv‡j evsjv‡`k miKv‡ii ¯^v¯’¨ I cwievi Kj¨vY gš¿Yvjq 2010 mv‡ji
ci ¯’vwcZ miKvwi I †emiKvwi †gwWK¨vj K‡jRmg~‡ni cwiw¯’wZ hvPvB Kivi
Rb¨ cø¨vwbs DBs‡K `vwqZ¡ †`b| 2016 mv‡ji Rvbyqvix gv‡m AbymÜvb KwgwU
wi‡cvU© Rgv †`b| DwjøwLZ mg‡qi g‡a¨ 27wU †gwWK¨vj K‡jR ¯’vwcZ nq|
1972 mv‡j †`‡k 8wU †gwWK¨vj K‡jR wQj| 1990 mv‡j wQj 10wU| 2015
mv‡j G msL¨v nq 105wU (30wU miKvwi I 75wU †emiKvwi)| we‡ePbvaxb
27wU †gwWK¨vj K‡j‡Ri ga¨ †_‡K 13wU †gwWK¨vj K‡jR (QqwU miKvwi I
mvZwU †emiKvwi †gwWK¨vj K‡jR) †e‡Q †bIqv nq| cwiw¯’wZ hvPvB‡qi Rb¨
BMDC, ¯^v¯’¨ wkÿvi cwiPvjK I ¯^v¯’¨ gš¿Yvjq Aby‡gv`b K‡i| †gwWK¨vj
K‡jR ¯’vcb I cwiPvjbvi Rb¨ RvwiK…Z BMDC I ¯^v¯’¨ gš¿Yvj‡qi
bxwZgvjvi Av‡jv‡K ev¯Íe Ae¯’v wjwce× Kiv nq| AbymÜvbKvixiv †gwWK¨vj
K‡jR¸‡jv m‡iRwg‡b cwi`k©b K‡ib, wkÿK, wkÿv_©x I Kg©Pvix‡ì m‡½
Av‡jvPbv K‡ib, †gwWK¨vj wkÿvi m‡½ RwoZ ¸iæZ¡c~Y© e¨w³‡ì gZvgZ
†bIqv nq|
wi‡cv‡U© †`Lv hvq, A‡bK¯’v‡b †gwWK¨vj K‡j‡Ri wbR¯^ feb bvB-
†RvovZvwj w`‡q fvov‡U fe‡b KvR Pj‡Q| A‡bK †gwWK¨vj K‡j‡R
nvmcvZv‡j hZ¸‡jv weQvbv _vKvi K_v, Zvi PvB‡Z A‡bK Kg Av‡Q|

†ewkifvM †gwWK¨vj K‡j‡Ri wb‡`©wkZ cwigvY Rwg wQj bv| cÖvq me
miKvwi I †emiKvwi †gwWK¨vj K‡j‡Ri wba©vwiZ floor space wQj bv|
A‡bK †gwWK¨vj K‡j‡R wW‡mKkb nj, wewfbœ wel‡qi j¨ve‡iUwi, eënvwiK
†kÖYxKÿ nq †gv‡UB bvB A_ev LyeB Abyc‡hvMx †`Lv †M‡Q| †Kvb †Kvb
†gwWK¨vj K‡j‡R dvg©v‡KvjRx, c¨v_jRx, d‡ibwmK †gwWwmb wefvMB bvB|
miKvwi I †emiKvwi me †gwWK¨vj K‡j‡R i‡q‡Q Pig wkÿK ¯^íZv| A‡bK
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Awdmvi Ab †¯úkvj wWDwU‡Z KvR Ki‡Z n‡”Q| †ewkifvM miKvwi
†gwWK¨vj K‡jR nvmcvZvj¸‡jv †Rjv nvmcvZvj †_‡K †gwWK¨vj K‡jR
nvmcvZv‡j DbœxZ n‡Z cv‡i wb| †ewkifvM †emiKvwi †gwWK¨vj K‡jR
nvmcvZv‡j bed occupancy A‡bK Kg cvIqv †M‡Q| wi‡cv‡U© †`Lvb
n‡q‡Q MZ 25 eQ‡i †gwWK¨vj K‡j‡Ri msL¨v `k¸Y †e‡o‡Q| †gwWK¨vj
K‡jR¸‡jv‡Z †fŠZ AeKvVv‡gv I nvmcvZv‡ji AcÖZzjZv, wkÿ‡Ki ¯^íZv,
†ivMxi Afve, wkÿvi DcKi‡Yi Afve BZ¨vw` Kvi‡Y wPwKrmv wkÿv`vb
Zxeªfv‡e e¨vnZ n‡”Q| G‡Z †hme wPwKrmK ˆZwi n‡”Qb Zuv‡ì ¸YMZgvb
ÿzbœ nIqv AeavwiZ| Zuv‡ì mycvwik wQj Avi bZzb †gwWK¨vj K‡jR ¯’vcb
bv K‡i eZ©gvb †gwWK¨vj K‡jR¸‡jv‡K c~Y©v½ iƒc w`‡Z n‡e| Zuviv D‡jøL
K‡ib wek¦ ¯^v¯’¨ ms¯’v 2006 mv‡j AZ¨vek¨Kxq ¯^v¯’¨‡mev †Ìqvi Rb¨
cÖwZ `k nvRvi RbmsL¨vi Rb¨ 2.5 Rb wPwKrmK _vKv cÖ‡qvRb e‡jb|
2015 mv‡j evsjv‡`‡k cÖwZ `k nvRvi gvby‡li wecix‡Z 3.8 Rb wPwKrmK
wQ‡jb| †h me ms¯’v †gwWK¨vj K‡jR cwi`k©b K‡ib Zv‡ì KvQ †_‡K
Rvbv hvq cwiw¯’wZi †Zgb †Kvb DbœwZ nqwb| K‡qKUv wel‡q c‡ì msL¨v
evwo‡q bZzb wb‡qvM w`‡j wkÿK ¯^íZv `~i Kiv hvq| Z‡e A‡bK wel‡q
cÖ‡qvRbxq msL¨K wkÿK †`‡k bvB| 2015 mv‡j GKUv wnmv‡e †`Lv hvq
†`‡k †gwWK¨vj K‡jR I †cv÷MÖvRy‡qU cÖwZôvbmg~‡n †gvU Kg©iZ h_vh_
†hvM¨Zvm¤úbœ GbvUgxi wkÿK wQ‡jb 183 Rb| Gi evB‡i AemicÖvß wkÿK
I GbvUgxi ¯œvZ‡KvËi wkÿv_©x Qvov bvB| BMDC Gi wb‡`©kbv Abyhvqx ïay
†gwWK¨vj K‡jR¸‡jv‡Z Kgc‡ÿ GK nvRvi GbvUgxi wkÿK ìKvi| G
msL¨v †`‡k we`¨gvb †hvM¨Zvm¤úbœ wkÿ‡Ki Zzjbvq K‡qK¸Y †ewk| c„„w_exi
Ab¨vb¨ †`‡k †`Lv †M‡Q we`¨gvb fwZ© eë¯’vq mgv‡Ri D”PweË cwiev‡ii
†Q‡j‡g‡qivB †gwWK¨vj K‡j‡R covi my‡hvM cvq| †gwWK¨vj K‡jR ev
¯‹zj c~e©eZ©x cixÿvi dj I †gwWK¨vj K‡jR ev ¯‹z‡j fwZ© cixÿvi dj

wkÿv_©xi Av_©-mvgvwRK Ae¯’v‡bi Dci wbf©ikxj| Avgv‡ì †`‡kI D”P
Av_©-mvgvwRK Ae¯’vb, †mme cwiev‡ii †Q‡j‡g‡q‡ì †gwWK¨vj K‡j‡R fwZ©
nIqvi m¤¢vebv A‡bK evovq| GQvov †emiKvwi †gwWK¨vj K‡j‡R `wi`ª ev
wb¤œweË‡ì fwZ©i m¤¢vebv LyeB mxwgZ| wKš‘ †emiKvwi †gwWK¨vj K‡j‡Ri
Avmb msL¨v miKvwi K‡jR¸‡jvi PvB‡Z †ewk| Kv‡RB Avgv‡ì †`‡kI
wPwKrmK‡ì g‡a¨ `wi`ª ev wb¤œweË cwiev‡ii †Q‡j‡g‡q‡ì msL¨v Kg|
Gi GKUv ˆbwZK w`K Av‡Q| †`‡ki RbmsL¨vi 70 kZvs‡ki †ewk gvbyl
wb¤œweË| Kv‡RB †`‡ki AwaKvsk cwiev‡ii †Q‡jg‡qiv (wPwKrmv wkÿv
MÖn‡Yi my‡hvM †_‡K) ewÂZ n‡”Q| D”PweË cwiev‡ii †Q‡j‡g‡qiv `wi`ª
I wb¤œweË gvby‡li Av_©-mvgvwRK mgm¨vi m‡½ cwiwPZ bb| gvby‡li †`n I
g‡bi e¨vwa Ges Zvi wPwKrmvi m‡½ †ivMxi Av_©-mvgvwRK Ae¯’v‡bi Mfxi
m¤úK© Av‡Q| Kv‡RB D”PweË cwiev‡ii wPwKrm‡Ki m‡½ †ewkifvM †ivMxi
Av_©-mvgvwRK Ae¯’vi cv_©K¨ mwVK wPwKrmvi Rb¨ AšÍivq| G m¤^‡Ü c„w_exi
mePvB‡Z eo M‡elYv n‡”Q Training for Health Equity Network, G
M‡elYv 2012 †_‡K 2016 mvj ch©šÍ P‡j Ges 2018 mv‡j dj cÖKvk
Kiv nq| cuvPwU gnv‡`‡ki QqwU †`‡ki AvUwU †gwWK¨vj ¯‹z‡j 3346 Rb
wkÿv_©x‡K wb‡q G M‡elYv nq| G‡Z †`Lv hvq `wi`ª I wb¤œweË cwievi Ges
MÖvg ev †QvU kn‡i emevmKvix cwievi †_‡K Avmv wkÿv_©xivB AwaKvsk
MÖv‡g ev gd¯^‡j KvR Ki‡Z AvMÖn cÖKvk K‡ib Ges cieZ©x‡Z K‡i‡Qb|
M‡elK‡ì wm×všÍ nj ¯^íweË I MÖvgxY Rb‡Mvôx †_‡K wkÿv_©x wbe©vPb Ki‡j
Zv‡ì myweavewÂZ I MÖvgxY GjvKvq KvR Kivi cÖeYZv I m¤¢vebv †ewk|
myweavewÂZ GjvKv I MÖv‡g DbœZ †`k¸‡jvi wPwKrm‡KivI _vK‡Z Pvb bv|
GUv wb‡q GL‡bv M‡elYv I Av‡jvPbv n‡”Q|
Z_¨m~Ît
1. Cooke M, Irby PM, Sullivan W, Ludmerer KM. American
Medical Education 100 years after the Flexner report. New Engl J
Med,2006, 355;1339-1344.
2. Ten Cate O. Competency-based Postgraduate Medical Education.
Past, Present and Future. GMS J Med Edu. 2017; 34(5) Dec.69.
3. Aggarwal R and Darzi A. Technical skills training in the 21st
century. New Engl J Med, 2006; 355:2695-2696.
4. Epstein RM and Hundert EM. Defining and assessing professional
competence. J Amer Med Assoc. 2002; 287:226-235.
5. Epstein RM. Assessment in Medical Education. New Engl J Med,
2007; 356:387-396.

6. Nara N, Suzuki T and Toleda S. The Current Medical Education
System in the World. J Med Dent Sci. 2011; 58:79-83.
7. Abdullah M and Sabur MA. Situation Assessment of New
Medical Colleges in Bangladesh. Sector Wide Management and
Monitoring Operational Plan. Health Population and Nutrition
Sector Development Program. Ministry of Health and Family
Welfare. January 2016.

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1968 mv‡j hy³iv‡R¨ Royal Commission on Medical Education,

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GjvKvq †ivMxi `vwq‡Z¡ _vK‡Z nq| iv‡Î wekÖvg †bIqvi Ni Av‡Q| wKš‘
Uvbv Nyg †Ìqvi m¤¢vebv Kg| †Kvb †ivMxi mgm¨v n‡j †mweKviv Lei †`q,
†Uwj‡dvb, A_ev pager, †gvevB‡j; †`L‡Z †h‡Z nq| †ewkifvM mgm¨vi
mgvavb †Ìqv hvq| KLbI KLbI RwUj mgm¨vi Rb¨ †Uwj‡dv‡b †R¨ô
wPwKrmK‡ì civgk© wb‡Z nq| weij †ÿ‡Î †R¨ô wPwKrmK‡ì G‡m `vwqZ¡
wb‡Z nq| iv‡Î wWDwU _vK‡jI mKv‡j h_vixwZ KvR ïiæ Ki‡Z nq| †mw`b
mÜ¨v ch©šÍ KvR Ki‡Z n‡e| mßv‡n AšÍZt `yB ivwÎ `vwq‡Z¡ _vK‡Z nq|
Gi g‡a¨ †jLvcovI Pvwj‡q †h‡Z n‡e| wPwKrmK nIqvi ci cÖ_g eQ‡iB
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B›Uvb©‡ì wba©vwiZ nvmcvZv‡j †h mgq KvR Ki‡Z nq, Zv cwieZ©b Kiv
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Zzjbvg~jKfv‡e A‡bK Kg| G Qvov †ewkifvM B›Uv‡b©i weivU FY _v‡K|
nvmcvZv‡ji Kv‡Ri GKUv eo Ask Zv‡ì w`‡q Kivb nq| hy³iv‡óª
AwaKvsk nvmcvZvj, †emiKvwi- nvmcvZvj KZ…©cÿI G eë¯’vq AmšÍó bq|
†KD †KD g‡b K‡ib †ewk mgq KvR Ki‡j AviI †ewk †ivMx †`Lvi my‡hvM
nq; GKRb †ivMx nvmcvZv‡j †cŠuQvb †_‡K ïiæ K‡i Zvi wPwKrmv I cieZ©x
NUbvejx †`‡L †kLvi my‡hvM AviI †ewk| A‡b‡Ki aviYv AwaK cwikÖg I
Kg Ny‡gi d‡j ¯^v¯’¨nvwb N‡U, †ivMxi e¨vcv‡i mwVK wm×všÍ †Ìqvi ÿgZvI

ÿzbœ nq| m¤ú~Y© ZË¡veavb Qvov GZ j¤^v mgq Kwbô wPwKrmK‡ì †ivMxi
`vwq‡Z¡ ivLviI mgv‡jvPbv Av‡Q| G e¨vcv‡i M‡elYvq cwi®‹vi djvdj
cvIqv hvq wb|
1984 mv‡ji 4 gvP© iv‡Z Libby Zion bv‡g 18 eQi eq¯‹ GKRb wK‡kvix
K‡jR QvÎx‡K wbDBq‡K©i GK nvmcvZv‡ji Riæwi wefv‡M wb‡q Avmv nq|
Zvi K‡qKw`b †_‡K R¡i wQj| `yÕRb †iwm‡W›U Zv‡K †`‡L-GKRb cÖ_g
e‡l©i B›Uvb© I GKRb wØZxq e‡l©i| Av‡M †_‡KB depression Gi Rb¨ †m
phenelzine bv‡g GKUv Jla Lvw”Qj| fwZ©i mgq Zvi kix‡i GKUv A™¢zZ
ai‡bi K¤úb †`Lv hvw”Qj| `yÕRb †iwm‡W›U wjweÕi cvwievwiK wPwKrm‡Ki
m‡½ Av‡jvPbv K‡i pethidine †Ìqvi wm×všÍ †bq| †iv‡Mi KviY Zviv
eyS‡Z cv‡i wb| Gici wØZxq e‡l©i †iwm‡W›U cv‡ki `vjv‡b wekÖvg K‡ÿ
Nygv‡Z hvq| Ab¨Rb Ab¨vb¨ †ivMx †`L‡Z _v‡K| BwZg‡a¨ Libby AviI
Aw¯’i n‡q I‡V, †dv‡b †hvMv‡hvM Ki‡j cÖ_g e‡l©i †iwm‡W›U Zv‡K medical
restraint (nvZ-cv euvav) Ki‡Z e‡j I haloperidol w`‡Z e‡j| †ivMx
wKQzzUv kvšÍ nq| wKš‘ mKvj 6-30 Uvi w`‡K Avevi Aw¯’i n‡q I‡V, Zvi
R¡i wQj 107 wWwMÖ dv‡ibnvBU| cÖ_g e‡l©i †iwm‡W›U R¡i Kgvbi wKQz eë¯’v
†`q, wKš‘ †m¸‡jv Kvh©Ki Kivi Av‡MB Libby i KvwW©qvK arrest nq, hvi
†_‡K Zv‡K Avi †divb hvq bvB| wjwei evev G wb‡q gvgjv K‡ib Ges
GUv‡K murder e‡j D‡jøL K‡ib| wZwb me©Kwbô wPwKrm‡Ki Øviv wPwKrmv
†Ìqv wb‡q cÖkœ †Zv‡jb| AviI cÖkœ †Zv‡jb me©Kwbô wPwKrm‡Ki 40 Rb
†ivMxi `vwq‡Z¡ 36 N›Uv Kv‡Ri g‡a¨ GB NUbv wb‡q|
g„Zzï Rb¨ phenelzine I pethidine Gi g‡a¨ interaction Gi Kvi‡Y
Serotonin Syndrome bv‡g GKUv Ae¯’vi m„wó‡K `vqx Kiv nq| G m¤ú‡K©
†m mgq ZZUv Rvbv wQj bv| eûw`b ïbvwb‡Z A‡bK weÁ wPwKrmKI Ask
†bb| †kl ch©šÍ `yÕRb wPwKrmK‡K Ae¨vnwZ †Ìqv nq| Z‡e wmwfj †Kv‡U©
Zv‡ì Rwigvbv nq| wbDBqK© iv‡Rï ¯^v¯’¨ Kwgkbvi G m¤^‡Ü Z`šÍ †evW©
MVb K‡ib| Zv‡ì mycvwi‡k 1989 mv‡j cÖwkÿYv_©x wPwKrm‡Ki KvR mßv‡n
†gvU 80 N›Uvq (Riæwi wWDwUmn) mxwgZ Kiv nq| 2003 mv‡j ACGME
(Accreditation Council for Graduate Medical Education) mg¯Í
hy³iv‡óª mßv‡n 80 N›Uv Kv‡Ri mxgv †eu‡a †`b|
evsjv‡`‡k Further Improvement of Medical Colleges Project I
wm‡jU MAG Osmani Medical College GKwU rotatory internship
training programme ˆZwi I piloting K‡i| evsjv‡`k †gwWK¨vj I

†W›Uvj KvDwÝj GB programme †`‡ki me †gwWK¨vj K‡j‡R B›Uvb©kx‡ci
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wkï‡ivM 4 mßvn, KwgDwbwU 2 mßvn (Dc‡Rjv ¯^v¯’¨ Kg‡cø‡·), B‡jw±f
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wPwKrmK‡ì m‡½ †mweKv I Ab¨vb¨ ¯^v¯’¨Kg©x‡ì mn‡hvwMZv I m¤úK©,
nvmcvZv‡j investigation mg~n, †gwWK¨vj Gw_Km, Code of Conduct,
†ivMx wPwKrmK m¤úK© BZ¨vw` m¤ú‡K© Rvb‡Z nq| Gi ci programme
Abyhvqx wefv‡M KvR wkL‡Z nq| Gi GKUv jM-eB Av‡Q| G‡Z †ivMx †`Lv
I Ab¨vb¨ KvR Kivi ci Zv wjwce× K‡i ZË¡veavbKvix †R¨ô wPwKrm‡Ki
mB wb‡Z nq| cÖwZ wefv‡Mi mgq †k‡l g~j¨vq‡bi eë¯’v Av‡Q I †MÖwWs
b¤î †Ìqv nq| `yB mßvn †Kvb GKwU Dc‡Rjv ¯^v¯’¨ Kg‡cø‡· KvR Kiv I
†mLvbKvi ¯^v¯’¨‡mev m¤^‡Ü Rvbvi K_v, GKUv survey K‡i community
diagnosis Kiv wkL‡Z nq| ¯^v¯’¨ Kg‡cø‡·i Ab¨vb¨ ¯^v¯’¨ Kg©x‡ì m‡½I
interaction Ki‡Z nq|
†gwWK¨vj K‡jR nvmcvZv‡j †ivMx †mevi eo AskB B›Uvb©iv cvjb K‡i|
Zv‡ì AskMÖnY Qvov Kvh©µg Pvjvb m¤¢e bq| †ewkifvM miKvwi †gwWK¨vj
K‡jR nvmcvZvj¸‡jv‡Z aviY ÿgZvi PvB‡Z †ò ev `yB¸Y †ewk †ivMx
_v‡K| B›Uvb© Qvov †ivMx †mevi Rb¨ †h K‡qKRb wPwKrmK _v‡Kb Zv‡ì
msL¨v AcÖZzj| XvKvq †Kvb †Kvb miKvwi nvmcvZv‡j †cv÷ MÖvRy‡qU
cÖwkÿYv_©x _vKvi Rb¨ wPwKrm‡Ki msL¨v †ewk| B›Uvb©‡ì fvZv †Ìqv
nq, wKš‘ Zv LyeB mvgvb¨| B›Uvb©iv A‡bK KvR K‡i, †hUv Zv‡ì †Ìqv
nq ev Zviv wb‡RivB †bq| mn‡hvwMZvi gva¨‡g KvR Kiv nq| A‡b‡Ki
g‡Z Kv‡Ri ZË¡veavb Kg| †kLvi Rb¨ ZË¡veavb LyeB ìKvi| wKš‘
ZË¡veavbKvix †R¨ô wPwKrm‡Ki msL¨v Kg| wesk kZvãxi Avwki `k‡Ki
Av‡M wK¬wbK¨vj G¨vwm‡÷›U cieZ©x‡Z (G¨vwm‡÷›U †iwR÷ªvi) I †iwR÷ªviiv
wQ‡jb bb-cÖvKwUwms| Zviv mKvj-mÜ¨v-ivwÎ nvmcvZv‡j †_‡K ZË¡veavb
Ki‡Zb, wkÿv`vbI Ki‡Zb| Avwki `kK †_‡K cÖvKwUm Kivi AbygwZ
†Ìqvq Zviv nvmcvZv‡ji evB‡i e¨¯Í _v‡Kb| B›Uvb©‡ì Drmvn _vK‡jI
Zv‡ì †kLvbi eë¯’v bv _vK‡j Zv‡ì Ávb AR©b Kg n‡e|

Z_¨m~Ît
1. https://www.globalpremeds.com/blog/2012/07/04/medical-
internship-in-the-united-states/
2. https://en.m.wikipedia.org/wiki/internship_(medicine).
3. https://www.medicalboard.gov.au/Registration/Interns.aspx.
4. https://www.bumc.bu.edu/im-residency/why-bmc/internship/

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lô Aa¨vq
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e‡j A‡b‡K g‡b K‡ib| Dbwesk kZvãxi ïiæ‡Z BD‡iv‡c mgvR weÁv‡bi
GKUv ch©v‡q RbM‡Yi †kÖYxweb¨vm Gi cwieZ©b NUwQj, mgv‡Ri cÖkvmwbK
KvVv‡gvi I cwieZ©b NUwQj| G¸‡jvi GKUv mw¤§jb d«v‡Ýi c¨vwi‡m cÖ_g
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Dbwesk kZvãxi ïiæ‡Z c¨vwim wQj BD‡iv‡ci wØZxq e„nËg kni|
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wQj| ivóªxq c„ô‡cvlKZvq mgwš^Z I msMwVZ wPwKrmv †mev I wkÿv
cÖwZôvb M‡o I‡V| 1820 mv‡j ¯’vwcZ c¨vwi‡mi GKv‡Wgx Ad †gwWwmb
wQj †m mgq BD‡iv‡c me©e„nr wPwKrmv wkÿv cÖwZôvb| we‡klvwqZ wPwKrmv
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we‡kl welqwfwËK| GLvbKvi 26 Rb Aa¨vc‡Ki c‡ì A‡bK¸‡jvB wQj
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DrmvwnZ n‡jb| mvaviY wPwKrmK hviv A‡bK †ivMx †`L‡Zb-wK¯‘ me
ai‡bi †ivMx †`Lvi Rb¨ †Kvb GKUv we‡kl †iv‡Mi †ivMxi msL¨v †ewk nZ
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cÖK…wZ AviI Mfxifv‡e ch©‡eÿY Kivi my‡hvM †cZ| bZzb wPwKrmv c×wZ
cixÿv Kivi my‡hvMI †ewk wQj| mviv c¨vwi‡mi nvmcvZvj¸‡jv mshy³ wkÿv
I M‡elYv cÖwZôvb wnmv‡e KvR KiZ| we‡klvwqZ welq¸‡jvi g‡a¨ wQj
Pÿz wPwKrmv, Pg©‡ivM, g‡bv‡ivM, avÎxwe`¨v BZ¨vw`| 1845 mv‡j cÖKvwkZ
GK ZvwjKvq c¨vwi‡mi cÖvq 1500 wPwKrm‡Ki g‡a¨ 12 kZvskB we‡klÁ
wnmv‡e wjwce× nb|
Dbwesk kZvãx‡Z jÛb wQj BD‡iv‡ci e„nËg kni| wPwKrmv eë¯’vi
AvKvi I Rbej c¨vwi‡mi PvB‡Z Kg wQj bv| wKš‘ K‡qKwU Kvi‡Y we‡klÁ
wPwKrmv GLv‡b †`wi‡Z M‡o I‡V| cÖkvmwbK w`K w`‡q wPwKrmv I wkÿv
cÖwZôvb¸‡jv wfbœ wQj| c¨vwi‡mi gZ msMwVZ I mgwš^Z eë¯’v wQj bv|
eo nvmcvZvj¸‡jvi wek¦we`¨vj‡qi m‡½ ms‡hvM Kg wQj| AjvfRbK I
`vZe¨ nvmcvZvj¸‡jvi wbqš¿Y wQj A‡bKvs‡k AwPwKrmK‡ì nv‡Z| wewfbœ
c‡` wb‡qvM w`‡Zb ZvivB| d‡j †gav, Ávb PP©v BZ¨vwì PvB‡Z wb‡qv‡Mi
†ÿ‡Î Ab¨vb¨ Dcv`vb KvR KiZ| GQvov Ávb PP©v I M‡elYvi Rb¨ †h
miKvwi c„ô‡cvlKZv c¨vwi‡m wQj GLv‡b Zv wQj bv| wkÿv`v‡bi A_© I
wRwbmcÎ wb‡R‡ì †RvMvo Ki‡Z nZ, wkÿK‡ì m¤§vbx AvmZ wkÿv_©x‡ì
cÖ‡`q A_© †_‡K| ¯^fveZB bZzb wel‡qi AbycÖ‡ek wkÿ‡Kiv PvB‡Zb bv|
GQvov wPwKrmv †ckvq wb‡qvwRZ e¨w³‡ì g‡a¨ Ø›Ø wQj| †m mgq Zuviv
wZbwU †kÖYx‡Z wef³ wQ‡jb| kj¨wPwKrmK, wdwRwkqvb I apothecary
(apothecary †kÖYx Jla ˆZwi I weµq Ki‡Zb, wPwKrmvI w`‡Zb)| Gici

Av‡iKUv Ø›Ø †`Lv †`q-†Rbv‡ij cÖvKwUkbvi I nvmcvZv‡ji we‡klÁ‡ì
g‡a¨| jvB‡mÝ †Ìqvi AwaKviI wQj GKvwaK ms¯’vi|
Aóv`k kZvãx †_‡K BD‡iv‡ci Ab¨vb¨ †`‡ki gZ Bsj¨v‡ÛI `šÍ wPwKrmK,
Pÿz wPwKrmK, nvo fv½vi wPwKrmK BZ¨vw` KvR Ki‡Zb| wKš‘ g~j avivi
wPwKrm‡Kiv G‡ì quack e‡j Zvw”Qj¨ Ki‡Zb| ax‡i ax‡i Ae¯’vi cwieZ©b
nq| GB kZ‡KB we‡klvwqZ nvmcvZvj M‡o I‡V| †ewkifvM †ÿ‡Î G¸‡jv
wQj †emiKvwi I `vZe¨ Ges `wi`ª gvbyl‡ì Rb¨| G nvmcvZvj¸‡jv abx
gvbyl‡ì Aby`vb AvKl©Y Kivi †Póv KiZ| GLv‡b we‡klvwqZ wPwKrmv
†Ìqv nZ|
Dbwesk kZvãxi wØZxqfv‡M we‡klvwqZ nvmcvZv‡ji msL¨vI evo‡Z _v‡K|
d‡j Ab¨vb¨ wPwKrm‡Kiv Gi cÖwZ‡iva Ki‡Z _v‡Kb| Zuv‡ì Awf‡hvM
wQj G nvmcvZvj¸‡jv A‡_©i Aby`vb I †ivMx `Õy‡UvB wb‡q hv‡”Q, d‡j
mvaviY nvmcvZvj¸‡jvi Kv‡Ri Amyweav n‡”Q| we‡klÁ wPwKrmK‡ì
cÖvwZôvwbKfv‡eI evav †Ìqv nZ| †m mgq Royal College of Surgeons
Gi wbqg wQj we‡klÁ kj¨ wPwKrmK Royal College m`m¨ wbe©vwPZ n‡j
Av‡M Zv‡K we‡klvwqZ nvmcvZvj †_‡K c`Z¨vM Ki‡Z n‡e| Royal
College of Physicians we‡klÁ‡ì cÖwZ êix wQj| G m‡Ë¡I we‡klÁ
eë¯’v we¯Ívi jvf K‡i| Z‡e G¸‡jv eo nvmcvZvj I cÖvwZôvwbK wkÿvi
evB‡i weKvk jvf K‡i, M‡elYvI Gi evB‡i †QvU †QvU we‡klvwqZ nvmcvZv‡j
n‡Z _v‡K| A‡bK e„wUk wPwKrmK BD‡iv‡ci g~j f‚L‡Û d«vÝ, Rvg©vbx I
nj¨v‡Û we‡klÁ nIqvi cÖwkÿY †bb| AvšÍR©vwZK êÁvwbK ej‡qi Pv‡c
e„wUk wPwKrmv †ckvi †bZ…e„‡›ì evav K‡g Av‡m| wKš‘ GiciI we‡klÁ
wPwKrm‡Kiv wPwKrmv wkÿv cÖwZôvb I jvB‡mÝ †Ìqvi cixÿvq Ask wb‡Z
cvi‡Zb bv|
cÖwkÿ‡Yi KvVv‡gv cwieZ©bt

e„‡U‡b wesk kZvãx‡Z wewfbœ mg‡q GK GKUv Kwgk‡bi mycvwi‡ki
wfwË‡Z we‡klÁ cÖwkÿ‡Yi KvVv‡gv‡Z cwieZ©b G‡m‡Q| GB Kwgkb¸‡jv
weÁvb I cÖhyw³i ¸iæZ¡c~Y© AMÖMwZ, mgv‡Ri cwiewZ©Z Pvwn`v, ¯^v¯’¨‡mev
eë¯’vi weeZ©b BZ¨vwì d‡j ¯œvZ‡KvËi ch©v‡q wPwKrmK‡ì cÖwkÿ‡Y
cwieZ©b Avbvi mycvwik K‡i‡Qb| wKš‘ GB cwieZ©b¸‡jv wQj AwbqwgZ I
mgš^qwenxb|

1921 mv‡j Athelone Committee mycvwik K‡ib jÛ‡b ïaygvÎ ¯œvZ‡KvËi
cÖwkÿ‡Yi Rb¨ GKwU Post Graduate Medical School _vKv ìKvi|
Gi m‡½ we‡klvwqZ nvmcvZvj¸‡jv mshy³ _vK‡e Ges GUv wek¦we`¨vj‡qi
Ask n‡e| n¨vgviw¯§‡_ Gici Post Graduate Medical School ¯’vcb
Kiv nq| GUv ¯œvZ‡KvËi cÖwkÿY I M‡elYvq ¸iæZ¡c~Y© f‚wgKv iv‡L|
1944 mv‡j cÖKvwkZ nq Goodenough Report, G‡Z ¯œvZK ch©v‡qi
wkÿv m¤^‡ÜI mycvwik wQj| ¯œvZK ch©v‡q †ivM cÖwZ‡iva m¤^‡Ü wkÿv,
wkï‡ì †ivM I g‡bv‡ivM m¤^‡Ü wkÿv`vb AšÍf©y³ Kiv I wPwKrmK nIqvi
ci I ¯^vaxbfv‡e KvR ïiæ Kivi Av‡M eva¨Zvg~jK cÖwkÿY; we‡klvwqZ
¯œvZ‡KvËi cÖwkÿY †`q Ggb me nvmcvZv‡ji mgš^‡q Post Graduate
Medical Federation MVb| GB mycvwi‡ki wfwË‡Z 12wU we‡klvwqZ
nvmcvZvj‡K wb‡q Post Graduate Medical Federation MVb Kiv
nq| 1948 mv‡j National Health Service (NHS) Pvjy Kiv nq| Gi
AvIZvq me©Rbxb ¯^v¯’¨‡mev ïiæ nq Ges me wPwKrmK I nvmcvZvj Gi
Aax‡b Av‡m| District nvmcvZvj¸‡jv‡Z NHS Pvjy Kivi d‡j ¯^v¯’¨‡mevi
DbœwZ nq I cÖwkÿ‡Yi cwi‡ek ˆZwi nq| 1961 mv‡j Nuffield Hospital
Trust Gi D‡`¨v‡M Christchurch Kbdv‡iÝ nq| G‡Z cÖwZ District
G GKRb Post Graduate Dean wb‡qvM †Ìqv nq| Zvi `vwqZ¡ nq
Zvi GjvKvq ¯œvZ‡KvËi cÖwkÿ‡Yi Dbœqb| cÖwZ District G GKwU K‡i
Postgraduate Medical Centre ˆZwi Kivi K_v ejv nq| 1978 mvj
bvMv` Bsj¨vÛ I I‡qjm G cÖvq 300 GiKg †m›Uvi ˆZwi Kiv nq| G
†m›Uv‡i cÖwkÿYiZ wPwKrmK, wPwKrmv wkÿK I General practitioner
(GP) wbqwgZ êÁvwbK Av‡jvPbv, e³…Zv BZ¨vw`‡Z wgwjZ nIqv ïiæ
Ki‡jb| wPwKrmv I cÖwkÿ‡Yi gvb G‡Z A‡bK ev‡o| 1968 mv‡ji Royal
Commission ev Todd wi‡cvU© cÖwkÿ‡Y cwieZ©b Av‡b| ¯œvZK cvm K‡i
c~Y© †iwR‡÷ªkb cvIqvi ci wZb eQi †iwR÷ªvi wnmv‡e cÖwkÿY †bIqvi
weavb Kiv nq| Gi ci GK GKwU specialty †Z cÖwkÿY (†gqv` specialty
Abyhvqx) †bIqvi ci consultant c‡ì †hvM¨ n‡e| Royal College mg~n
cÖwkÿY c‡ì Aby‡gv`‡bi `vwqZ¡ †cj| Z‡e cÖwkÿ‡Yi wbqš¿‡Y miKvwi
cÖwZwbwa, General Medical Council GivI RwoZ _vKj| GP †ì
RbÏ eva¨Zvg~jK `yB eQ‡ii cÖwkÿY Pvjy Kiv nj| General Medical
Council †K me ch©v‡qi cÖwkÿ‡Yi gvb wbqš¿‡Yi `vwqZ¡ †Ìqv nq| 1987
mv‡j General Medical Council Gi Education Committee mycvwi‡k

¯œvZ‡KvËi cÖwkÿ‡Y cÖwZ wel‡q core curriculum wVK K‡i structured
training Pvjy Kiv nq| Royal College ¸‡jv‡K specialty †Z cÖwkÿ‡Yi
AšÍf©~³ nIqvi †hvM¨Zv cÖgvY Kivi Rb¨ cixÿv †bIqv Ges cÖwkÿ‡Yi c`
Aby‡gv`b †Ìqvi `vwqZ¡ †Ìqv nq| 1990 mv‡ji ms¯‹v‡i ¯œvZ‡KvËi
cÖwkÿ‡Yi Znwej Post Graduate Dean Gi nv‡Z b¨¯Í Kiv nq| d‡j
Dean cÖwkÿYiZ wPwKrmK‡ì †eZ‡bi GKUv Ask wbqš¿Y K‡ib| †h
c‡` cÖwkÿ‡Yi gvb h‡_ó bq wZwb †m c‡ì A_© eivÏ eÜ Ki‡Z cv‡ib|
1993 mv‡j Calman wi‡cvU© G cÖwZwU wel‡qi KvwiKzjvg ˆZwi Kiv I
†mB KvwiKzjv‡gi wfwË‡Z structured training †Ìqvi mycvwik Kiv nq|
cÖwZ wPwKrm‡Ki cÖwkÿ‡Yi djvdj cÖwZ eQi hvPvB Kivi weavb _v‡K|
†iwR÷ªvi I wmwbqi †iwR÷ªv‡ii c` GK Kivi civgk© †Ìqv nq| cÖwkÿY
†k‡l Certificate of completion of Training †Ìqvi weavb _v‡K-GUvB
wkÿv_©xi consultant nIqvi Avewk¨K kZ©|
Av‡gwiKvq 1910 mv‡j †d¬·bvi wi‡cvU© cÖKvk nIqvi cieZ©x eQi¸‡jv‡Z
†gwWK¨vj ¯‹zj¸‡jv‡Z cwieZ©b NU‡Z _v‡K- GUv we‡klÁ nIqvi cÖwkÿ‡Yi
†ÿ‡ÎI N‡UwQj| wesk kZvãxi cÖ_g K‡qK `k‡K kj¨wPwKrmv, avÎxwe`¨v
I ¯¿x‡ivM, Pÿz‡ivM Gme wel‡q mb` †Ìqvi Rb¨ Avjv`v Avjv`v †evW© ˆZwi
nq| AviI specialist I subspecialist welq wÎk I Pwjø‡ki `k‡K M‡o
I‡V| 1942 mv‡j 15wU wel‡q we‡klÁ mb` †Ìqvi †evW© wQj-Gi g‡a¨
12wU Kgc‡ÿ wZb eQi cÖwkÿ‡Yi c~e©kZ© wba©viY K‡iwQj| 1920 mv‡ji
g‡a¨B Kgc‡ÿ GK eQi B›Uvb©kxc Kiv wbq‡g cwiYZ n‡qwQj| 1942
mv‡ji g‡a¨B GK eQi B›Uvb©kxc I wZb eQi residency cÖvq me †gwWK¨vj
¯‹z‡jB AbymiY Kiv nw”Qj|
1960 I 1970 Gi `k‡Ki g‡a¨ Av‡gwiKvq AvaywbK we‡klÁ cÖwkÿY
eë¯’vi †gŠwjK Dcv`vb¸‡jv ˆZwi n‡q †MwQj| Pvi eQi †gwWK¨vj ¯‹z‡j
covi ci B›Uvb©kxc Ki‡Z nZ| Gici cÖwkÿY wQj we‡klÁ nIqvi-hv‡K
residency ejv nq| Gi g‡a¨ Zv‡ì wewfbœ cixÿv w`‡Z nZ| cÖwkÿ‡Yi
mgq we‡klÁ nIqvi wkÿv_©x‡ì nvmcvZv‡j GKRb attending physician
I Zvi team Gi m‡½ KvR Ki‡Z nq| G‡Z cÖwkÿYv_©xiv nvmcvZv‡j
fwZ© ¸iæZi Amy¯’ †ivMxi wPwKrmv wkL‡Z cvi‡Zb wKš‘ †h mg¯Í ˆ`bw›`b
†iv‡Mi mgm¨v wb‡q †ewkifvM gvbyl Av‡mb, †m¸‡jvi AwfÁZv Kg nZ|
AZ¨šÍ ax‡i cÖwkÿ‡Yi wKQz Ask †R¨ô wPwKrmK‡ì ewnwe©fv‡M †ivMx †`Lvi

mgq cÖwkÿ‡Yi eë¯’v nq| wKš‘ GiciI cÖkœ †Zvjv nq †R¨ô wPwKrmK‡ì
cÖwkÿYv_©x‡ì mgm¨vi we‡kølY †Ìqvi mgq _v‡K wKbv Ges `xN©¯’vqx RwUj
†iv‡Mi Av‡jvPbv ewnwe©fvM ev GP †P¤^v‡i m¤¢e wKbv| G msµvšÍ ms¯‹v‡ii
Av‡jvPbv GLbI Pj‡Q|
wPwKrmK‡ì g‡a¨ we‡klÁ nIqvi AvKl©Y µ‡gB †e‡o‡Q Ges Kg msL¨vq
wPwKrmK General practitioner (GP) n‡”Q| GUvi KviY Avq I m¤§vb-
`yÕ‡UvB we‡kl‡Ái †ewk|
Z_¨m~Ît
1. Lister J. The history of postgraduate medical education. Postgrad
Med J. 1994;70:728-731.
2. https://www.theclassroom.com/history-american-medical-
education-6292307.html.
3. Carraccio C et al. Shifting paradigms: From Flexner to
competencies.Acad Med, 2002;77:361-367.
4. Ten Cate O. Competency Based Medical Education, Past, Present
and Future. GMS J Med Edu.2017 34(5), doc; 69.
5. https://en.wikipedia.org/wiki/Medical-education.
6. https://www.hopkinsmedicine.org/about/history3.html.

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Kivi ciB G ¯^xK…wZ cvIqv hvq| kZ©¸‡jvi g‡a¨ _v‡K KZ †ivMxi wPwKrmv
Kiv nq, wK wK ai‡bi †ivMxi wPwKrmv nq, wPwKrmvi h_vh_ eë¯’v Av‡Q
wKbv, wkÿK‡ì gvb wK, cÖwkÿ‡Yi wK wK myweav Av‡Q BZ¨vw`| cÖwkÿY
cwiPvjbvi Aby‡gv`b †Ìqvi Rb¨ Gme †`‡k `vwqZ¡cÖvß cÖwZôvb _v‡K|
wesk kZvãx‡Z we‡klZt wØZxq gnvhy‡×i ci †_‡K we‡klÁ wPwKrmv eë¯’vi
cÖmvi N‡U‡Q| Gi GKUv KviY nj Ávb I cÖhyw³i `ªæZ DbœwZ nq GB mg‡q|
GKUv we‡kl kvLvi †ivMmg~n m¤^‡Ü Áv‡bi AMÖMwZ I †mB †ivMmg~‡ni wbY©q
I wPwKrmvi Rb¨ bZzb cÖhyw³ D™¢veb I Zvi eënvi GZUvB evoj †h, GKUv
mvaviY kvLvq †gvUvgywU `ÿZv AR©b Ki‡Z K‡qK eQi mgq cÖ‡qvRb nj|
D`vniY nj KvwW©IjRx‡Z we‡klÁ nIqvi Rb¨ hy³ivR¨ I hy³ivóª Dfq
†`‡kB GgweweGm ev mggv‡bi cixÿvq DËxY© nIqvi ci Kgc‡ÿ AvU eQi
cÖwkÿY wb‡Z nq| d‡j GKvwaK kvLvq we‡klÁ ch©v‡q Ávb I `ÿZv AR©b
Am¤¢e n‡q coj| GgbwK weÁv‡bi AMÖMwZ GZ †e‡o‡Q †h GK kvLvi
we‡kl‡Ái c‡ÿI Zvi wb‡Ri kvLvi mvgwMÖK AMÖMwZ I `ÿZv AR©b KwVb
n‡q c‡o‡Q| d‡j kvLv¸‡jv †_‡K cÖkvLvi (super speciality) m„wó n‡”Q|
†hgb, hy³iv‡óª wbD‡ivjRxi 10wU cÖkvLv Av‡Q (Vascular Neurology,
Clinical Neurology, Child Neurology BZ¨vw`)| G cÖkvLv¸‡jv‡Z
cÖwkÿY †bIqvi Rb¨ cÖ_‡g g~j kvLvq †hvM¨Zv AR©b Kivi ciB cÖkvLvq
cÖwkÿY †bIqv hvq| cÖwkÿYKvjxb mg‡q Kv‡Ri `vwqZ¡ †ewk, †eZb Kg,
my‡hvM myweavI Kg| GZ `xN© mgq cÖwkÿY †bIqv e¨w³MZ, cvwievwiK,
mvgvwRK Gme Kvi‡Y KwVb n‡q D‡V‡Q| K‡qK `kK Av‡MI hviv kj¨
wPwKrmK bb Zv‡ì cÖavb hš¿ wQj †÷‡_v‡¯‹vc| cÖhyw³i DbœwZi d‡j †hme
wPwKrmv kj¨ wPwKrm‡Kiv Ki‡Zb, Zv GLb Ab¨vb¨ we‡klÁiv kj¨ wPwKrmv
Qvov Ki‡Z cvi‡Qb| †hgb, ürwc‡Ûi agbxi †Kvb ¯’vb msKzwPZ n‡q
ü`‡iv‡Mi m„wó Ki‡j Acv‡ikb Qvov A¨vwÄIcøvw÷ K‡i stent ¯’vcb K‡i
wPwKrmv Kiv hv‡”Q| wcËbvjxi cv_i Acv‡ikb QvovB G‡Ûv‡¯‹v‡ci mvnv‡h¨

†ei K‡i †djv hvq| GiKg AviI D`vniY Av‡Q| wKš‘ GB c×wZ¸‡jv RwUj
Ges cvi`wk©Zv AR©b Ki‡Z h‡_ó cÖwkÿY jv‡M| G‡ZI mgq evo‡Q|
weMZ kZ‡Ki mË‡ii `kK †_‡K we‡klÁ‡ì Kv‡Ri cÖK…wZ cwieZ©b
Kivi cÖ‡qvRbxqZv Abyfe Kiv †M‡Q| AZx‡Z we‡klÁiv Zvi wb‡Ri
kvLvq wPwKrmvq cvi`k©x n‡j ZvB h‡_ó g‡b Kiv nZ| wKš‘ DbœZ
†`k¸‡jv‡Z K‡qKUv Kvi‡Y we‡klÁ‡ì Kv‡Ri cÖK…wZi cwieZ©b n‡q‡Q|
Gi GKUv KviY nj A_©‰bwZK I cÖkvmwbK Kvi‡Y me †`‡kB ¯^v¯’¨‡mev
eë¯’vi cwieZ©b N‡U‡Q| cwieZ©bkxj ¯^v¯’¨‡mev eë¯’vi m‡½ Lvc LvB‡q
†bIqv wkL‡Z n‡”Q| wPwKrmv c×wZi DbœwZ I cwieZ©‡bi d‡j †Kvb
GKRb gvby‡li wPwKrmvi Rb¨ wdwRwkqvb, mvR©b, G‡ÛvµvBb we‡klÁ,
Wv‡q‡Uwkqvb, mgvRKg©x GiKg K‡qKRb we‡kl‡Ái mw¤§wjZfv‡e †mev
w`‡Z n‡”Q| d‡j G ai‡bi team G KvR Kiv ev †bZ…Z¡ †Ìqvi `ÿZvI
AR©b Ki‡Z n‡”Q| Z_¨ cÖhyw³i cÖmvi NUvi Rb¨ mvaviY gvbyl GLb †ivM
I Zvi wPwKrmv m¤^‡Ü A‡bK wKQzB Rvb‡Z cv‡ib| d‡j †h wPwKrmv †Ìqv
n‡”Q Zvi Zzjbvg~jK we‡kølYI Zviv K‡ib| A‡bK †ivM wbY©q I wPwKrmvi
GKvwaK c×wZ i‡q‡Q| G cwiw¯’wZ‡Z †Kvb c×wZ Aej¤^b Kiv DwPr
n‡e Zv wba©vi‡Yi Rb¨ †ivMx I Zvi ¯^Rb‡ì m‡½ Av‡jvPbvi cÖ‡qvRb
nq| GRb¨ GKRb wPwKrm‡Ki fvj communicator nIqvi ìKvi|
µgcÖmvigvb Ávb I `ÿZv AvZ¥¯’ K‡i †ivMx †mev bv w`‡j †ivMx AvaywbK
wPwKrmv cv‡e bv| Kg©Rxe‡b AMÖMwZmg~n wKfv‡e AvqË¡ Kiv hvq †mUvI
wkL‡Z nq| DbœZ we‡k^ GLb GKRb we‡klÁ wK Rv‡b ev wK wk‡L‡Q †mUv
†hgb ¸iæZ¡c~Y©, ZZUvB ¸iæZ¡c~Y© n‡”Q wZwb wK wK Ki‡Z cv‡ib| GRb¨
competency based wkÿv I cÖwkÿY eë¯’v Pvjy Kiv n‡q‡Q|
G c×wZ‡Z wPwKrmK wkÿv m¤ú~Y© n‡j wK wK `ÿZv AR©b Ki‡eb Zv Av‡M
†_‡K wba©vwiZ _v‡K| cÖwkÿYKvjxb mgq wkÿv_©x wba©vwiZ KvR¸‡jv Ki‡Z
cvi‡Qb wK bv, Zv wbiƒc‡Yi eë¯’v _v‡K| gvb`Û Abyhvqx AMÖMwZ bv n‡j
Zv wVK Kivi eë¯’vI _v‡K| cÖvq me Dbœqbkxj †`kI G c×wZ MÖnY
K‡i‡Q| hy³iv‡Rï Accreditation Council for Graduate Medical
Education (ACGME) I American Board of Medical Specialities
1999 mv‡j competency QqwU domain wba©viY K‡i| G¸‡jv njt
1. †ivMx †mev I eënvwiK `ÿZv (Patient care and
procedural skills).

2. wPwKrmv kv‡¯¿ Ávb (Medical knowledge).
3. Ab¨ gvby‡li m‡½ gZvgZ wewbg‡qi I †hvMv‡hv‡Mi `ÿZv
(Interpersonal and communication skill).
4. Kg©iZ Ae¯’vq Ávb Avni‡Yi `ÿZv (Practice based
learning).
5. we`¨gvb ¯^v¯’¨‡mev eë¯’vq KvR Kivi mÿgZv (System
based practice).
6. †ckvMZ AvPiY †hgb ˆbwZKZv,mZZv,mngwg©Zv BZ¨vw`
(Professionalism).
†cv÷ MÖvRy‡qU †gwWK¨vj wkÿvi KvVv‡gv I cÖmvi me‡`‡k GKiKg bq|
cÖwkÿ‡Y cÖ‡e‡ki wbqgvejx, wkÿv`v‡bi c×wZ, gvb hvPvB‡qi aib,
mgqKvj G¸‡jv †`k‡f‡` c„_K| GgbwK GKB †`‡k wewfbœ ai‡bi wkÿvi
MVb _vK‡Z cv‡i| †hgb, e„wUk ai‡bi †cv÷ MÖvRy‡qU †gwWK¨vj wkÿvi aib
I Av‡gwiKvi aib Avjv`v| Avevi Rvg©vbxi †cv÷ MÖvRy‡qU †gwWK¨vj wkÿv
e„‡Ub I Av‡gwiKvi PvB‡Z Avjv`v| BD‡ivcxq BDwbq‡bi AšÍM©Z †`k¸‡jvi
GK †`‡ki †cv÷ MÖvRy‡qU wWwMÖi †hvM¨Zv Ab¨ †`‡k ¯^xK…wZ cvq| Gi evB‡i
cÖvq DbœZ †`kB Ab¨ †`‡ki †cv÷ MÖvRy‡qU †hvM¨Zv ¯^xK…wZ †`q bv| †hgb
e„wUk †cv÷ MÖvRy‡qkb hy³iv‡óª ¯^xK…Z bq|
wek^vq‡bi d‡j GK †`‡ki wPwKrmK Ab¨ †`‡k wM‡q Gme evav AwZµg
K‡i hvIqvi cÖeYZv evo‡Q| Av‡gwiKv, e„‡Ub I BD‡iv‡ci †Kvb †Kvb †`‡k
Kg©iZ wPwKrmK‡ì cÖvq GK-PZz_©vsk we‡`‡ki †gwWK¨vj ¯‹z‡j wkwÿZ| Z‡e
†cv÷ MÖvRy‡qk‡bi Rb¨ †h †`‡k hvIqv nq †m †`‡ki wbqg Abyhvqx cÖwkÿY
MÖnY Ki‡Z nq| bZzb †`‡ki ¯^v¯’ëë¯’v, †ivMx †mevi aib, ¯^v¯’ëë¯’vi MVb
BZ¨vw`‡Z gvwb‡q †bIqv KóKi| G‡Z gv‡bi wewfbœZvI †`Lv hvq| Am½wZ
`~i Kiv I me †`‡ki †gwWK¨vj wkÿv‡K GKUv mvaviY KvVv‡gvq wb‡q Avmvi
cÖ‡Póvq World Federation of Medical Education ¯œvZK I ¯œvZ‡KvËi
Dfq ch©v‡qB wkÿvi wKQz bxwZgvjv cÖYqb K‡i‡Q| GB bxwZgvjv GKB gv‡bi
GKUv KvVv‡gv hvi wfwË‡Z wewfbœ †`k Zvi wb‡Ri cÖ‡qvR‡bi m‡½ wgwj‡q
wkÿv I cÖwkÿY eë¯’v M‡o Zzj‡Z cv‡i|
hy³ivóªt mvaviY welq¸‡jv‡Z (†hgb †Rbv‡ij mvR©vix, †Rbv‡ij †gwWwmb
BZ¨vw`) we‡klÁ cÖwkÿ‡Yi cÖ_g avc nj residency training| †gwWK¨vj
¯‹zj, jvB‡mÝ cixÿv, B›Uvb©kxc G¸‡jv mdjfv‡e †kl Kivi ci cÖwZ‡hvwMZvi

wfwË‡Z cQ‡›ì wel‡q Av‡e`b Kiv hvq| Avmb msL¨v _v‡K mxwgZ|
1952 mvj †_‡K cÖwkÿ‡Yi ¯’vb weZiY Kiv nq National Residency
Matching Programe (NRMP) Gi gva¨‡g| GUv GKUv AjvfRbK
†emiKvwi cÖwZôvb| Z_¨vw`mn welq D‡jøL K‡i †m‡Þ¤î gv‡m Av‡e`b
Ki‡Z nq| Av‡e`bKvixiv M‡o 25 †_‡K 30wU cÖwZôv‡b AšÍf©yw³i Rb¨
Av‡e`b Rvbvq| mvaviYZt GKRb Av‡e`bKvix 12-13wU ¯’v‡b B›UviwfD
†`q Ges Zv‡ì cQ›` Abyhvqx ¯’vb¸‡jv‡Z µgvbymv‡i mvwR‡q †`q| cÖwZwU
cÖwZôvb ev nvmcvZvjI Zv‡ì Kv‡Q hviv Av‡e`b K‡i‡Q Zv‡ì ga¨ †_‡K
†e‡Q wb‡q B›UviwfD †bq I µgvbymv‡i Zv‡ì cQ›` Rvbvq| NRMP
Kw¤úDUvi †cÖvMÖv‡gi gva¨‡g Ab¨vb¨ cÖv_©x‡ì m‡½ cÖwZ‡hvwMZvi wfwË‡Z
I cQ‡›ì µgvbymv‡i cÖwZôvb wba©viY K‡i †`q| gvP© gv‡mi †kl w`‡K GB
djvdj Rvbv hvq| hv‡K †hLv‡b †Ìqv nq †mLv‡bB cÖwkÿY wb‡Z nq| hviv
¯’vb †c‡jb bv Zviv supplemental offer and acceptance Gi gva¨‡g †h
me c` GLbI Lvwj _v‡K †mLv‡b my‡hvM †c‡Z cv‡ib|
we‡klÁ wkÿv I cÖwkÿ‡Yi (†Rbv‡ij †gwWwm‡bi Rb¨ cÖwkÿY wZb eQi
†Rbv‡ij mvR©vix cuvP eQi) bvg residency| cÖ_‡g mvaviY wel‡q (†hgb
†Rbv‡ij mvR©vix, †Rbv‡ij †gwWwmb BZ¨vw`) †iwm‡WÝx Ki‡Z nq| wbw`©ó
KvwiKzjvg AbymiY K‡i competency wkÿv †Ìqv nq| cÖwZwU assignment
Gi g~j¨vq‡bi eë¯’v _v‡K hv †gwWK¨vj wkÿvi M‡elYvwfwËK ¯^xK…Z c×wZ‡Z
Kiv nq| cÖwZ Qq gvm ci Clinical Competency Committee me
cÖwkÿYv_©xi g~j¨vqb K‡i| †Kvb NvUwZ _vK‡j Zv c~i‡Yi eë¯’v Kiv nq|
mdj cÖwkÿY †k‡l GKwU cixÿvq DËxY© n‡j cÖwkÿYv_©x †mB wel‡q Board
Certificate AR©b K‡ib| GB ¯^xK…wZi c‡i wZwb †mB wel‡q we‡klÁ nIqvi
†hvM¨Zv AR©b K‡ib| A‡b‡K mvaviY wel‡q we‡klÁ wnmv‡eB KvR Ki‡Z
_v‡Kb| Z‡e hviv mvaviY wel‡qi kvLvmg~‡n we‡klÁ n‡Z Pvb Zv‡ì AwZwi³
wkÿv wb‡Z nq| †hgb, †Rbv‡ij †gwWwmb †_‡K †KD †KD KvwW©IjRx,
†bd«jRx, M¨v‡÷ªvG›Uv‡ivjRx BZ¨vw` wel‡q we‡klÁ n‡Z PvB‡Z cv‡ib|
cÖwZ‡hvwMZvi gva¨‡g wba©vwiZ msL¨K c‡` Av‡e`bKvix‡ì wbe©vPb Kiv nq|
cieZ©x cÖwkÿ‡Yi bvg Fellowship hv wel‡qi Dci wbf©i K‡i GK †_‡K
wZb eQ‡ii n‡Z cv‡i| †hgb, KvwW©IjRx I M¨v‡÷ªvG›Uv‡ivjRx‡Z wZb eQi,
†bd«jRx I wbD‡ivjRx‡Z `yB eQi| †ewkifvM †d‡jvkxc †cÖvMÖv‡g M‡elYvi
GKUv Ask _v‡K| †d‡jvkxc cÖwkÿ‡YiI competency KvwiKzjvg _v‡K|
g~j¨vq‡bi eë¯’vI GKB ai‡bi| cÖwZ Qq gv‡m g~j¨vq‡bi wi‡cvU© cvVv‡Z nq|

hy³ivR¨t GgweweGm ev mggv‡bi cixÿv cvm Kivi ci `yB eQi Foundation
Training mevi Rb¨ eva¨Zvg~jK| G mgq wPwKrmvkv‡¯¿i wewfbœ kvLvq
Riæwi †ivMxi I mvaviY †ivMxi wPwKrmv †kLvb nq| cÖ_g eQi †kl n‡j
c~Y© †iwR‡óªkb †Ìqv nq| Foundation Training `yB eQi c~Y© n‡jI
¯^vaxbfv‡e KvR Kivi my‡hvM bvB| wØZxq eQ‡i cÖv_©x‡ì wm×všÍ wb‡Z nq
Zviv †Kvb welq wkL‡e| GP n‡Z n‡jI Av‡e`b K‡i cÖwZ‡hvwMZvi wfwË‡Z
cÖwkÿ‡Yi my‡hvM †c‡Z nq| Avmb msL¨v wbw`©ó _v‡K| cÖ_g †ò eQi
nvmcvZv‡j K‡qKwU wefv‡M KvR Ki‡Z nq| Gi g‡a¨ wkï‡ivM, avÎx we`¨v
I ¯¿x†ivM, g‡bv‡ivM I eq¯‹ gvby‡li †ivM G¸‡jv _vK‡Z n‡e| Gi cieZ©x
†ò eQi GKRb AwfÁ †Rbv‡ij cÖvKwUkbv‡ii ZË¡veav‡b KvR wkL‡Z nq|
Gici GKUv cixÿv nq| DËxY© n‡j GP wnmv‡e KvR Kivi †hvM¨ e‡j MY¨
Kiv nq|
hviv wPwKrmv weÁv‡bi Ab¨vb¨ kvLvq we‡klÁ n‡Z Pvb Zv‡ì mswkøó wel‡q
cÖwkÿY †bIqvi Rb¨ Av‡e`b Ki‡Z nq| hy³iv‡R¨ wPwKrmv weÁv‡bi 60wU
we‡klvwqZ kvLv Av‡Q| cÖwZwU kvLvq cÖwkÿYv_©xi msL¨v wbw`©ó| wba©viY nq
cÖwZ‡hvwMZvi wfwË‡Z| wKQzUv mijxK…Zfv‡e †gwWwmb I Zvi kvLvmg~‡ni
cÖwkÿ‡Yi eY©bv †Ìqv n‡”Q| cÖ_g wZb eQi stage-1 training (2019 mvj
†_‡K)| GLv‡bI †gwWwm‡bi cÖvq me kvLvq KvR wkL‡Z nq| Foundation
Training Gi PvB‡Z †ewk `vwqZ¡ wb‡q G ch©v‡q KvR Ki‡Z nq| G wZb eQ‡ii
g‡a¨B MRCP (Member of the Royal College of Physicians) Gi me
ce© cvm Ki‡Z nq| GUv nj cÖwkÿ‡Yi cieZ©x ch©v‡q ¯’vb cvIqvi c~e©kZ©|
wZb eQi stage-1 training mdjfv‡e m¤ú~Y© Ki‡j Gici †h specialized
kvLvq (†hgb KvwW©IjRx, †bd«jRx, wbD‡ivjRx BZ¨vw`) cÖv_©x we‡klÁ n‡Z
Pvb †m kvLvq ¯’v‡bi Rb¨ Av‡e`b Ki‡Z n‡e| cÖwZ‡hvwMZvg~jKfv‡e wbw`©ó
msL¨K Avm‡b wbe©vPb Kiv nq| Gici we‡klvwqZ kvLvq AviI wZb eQi
KvR Ki‡Z nq, hvi bvg stage-2 training| Dfq stage G cÖwkÿYKvjxb
mgq KvR †kLvi AMÖMwZ g~j¨vqb Kiv nq| cÖZ¨ÿ wkÿK QvovI cÖwZôv‡bi
Ab¨vb¨ wkÿK Ges Ab¨vb¨ ch©v‡qi ¯^v¯’¨Kg©xivI g~j¨vq‡b mswkøó _v‡K|
Pjgvb g~j¨vq‡bi m‡½ m‡½ cÖwZ eQi cÖwkÿ‡Yi AMÖMwZi wi‡cvU© ˆZwi Kiv
nq Ges Zv ch©v‡jvPbv Kiv nq AvÂwjK Deanery A_ev Local Education
and Training Board G| GUv nj Annual Review of Competency
Progression (ARCP)| †Kvb wkÿv_©xi NvUwZ _vK‡j Zv c~iY Kivi
eë¯’v †bIqv nq| wØZxq ch©v‡qi training mdjfv‡e †kl n‡j Certificate

of Completion of Training (CCT) †Ìqv nq| Gi m‡½ Specialty
Certificate Examination (SCE) bv‡g mswkøó wel‡qi GKUv cixÿv w`‡Z
nq| SCE I CCT AR©b Kivi ci wkÿv_©x General Medical Council
(GMC) G we‡klÁ wnmv‡e †iwR‡óªk‡bi Rb¨ Av‡e`b Ki‡Z cv‡ib|
†gwWwm‡b MÖæc 2 G Avjv`v wKQz kvLv i‡q‡Q †hgb Clinical Genetics,
Haematology, Sports and Exercise Medicine, Aviation Medicine
and Space Medicine BZ¨vw`| G¸‡jv‡Z stage-1 training-2 eQ‡ii;
stage-2 training wZb eQi|
cÖwkÿ‡Yi `vwq‡Z¡ †h me msMVb I KZ…©cÿ _v‡Kb Zviv njt 1) Bsj¨vÛ,
¯‹Uj¨vÛ ev I‡qjm Gi ¯^v¯’¨ wefvM, 2) Post Graduate Dean ev Local
Education and Training Board, 3) mswkøó wel‡qi i‡qj K‡jR,
Ges 4) General Medical Council| ¯^v¯’¨ wefvM nvmcvZvj cwiPvjbv
K‡i, wkÿv_©x‡ì Kg©wewa ˆZwi K‡i; Post graduate Dean ev Local
Education and Training Board wkÿv_©x‡ì wb‡qvM K‡i, miKv‡ii
cÿ †_‡K Zv‡ì †eZb †`q I Zv‡ì cÖwkÿY g~j¨vqb K‡i; Royal
College mg~n KvwiKzjvg ˆZwi K‡i; General Medical Council †Uªwbs
c‡ì Aby‡gv`b †`q, KvwiKzjvg Aby‡gv`b †`q I cÖwkÿ‡Yi gvb hvPvB
K‡i I we‡klÁ wnmv‡e mdj wkÿv_©x‡K ¯^xK…wZ †`q|
hy³iv‡R¨ we‡klÁ cÖwkÿY eë¯’v cwieZ©bkxj| ¯^v¯’¨‡mevi cÖ‡qvR‡bi
m‡½ gvwb‡q †bIqvi gZ bgbxqZv bvB Ges ¯^”QZv bvB Zv wKQz wbi‡cÿ
ch©‡eÿK e‡jb| wewfbœ cÖwZôv‡bi cÖwkÿ‡Y we‡klÁ gv‡bi AmgZv
`~i Kivi Rb¨ 2005 mv‡j KvR ïiæ K‡i Post Graduate Medical
Education Training Board (PMETB)| 2010 mv‡j GMC G `vwqZ¡
wb‡q †bq| ¯^v¯’¨‡mevq cÖ‡qvRbxq ms¯‹v‡ii mycvwik †Ìqvi Rb¨ 2010 mv‡j
Time for Training Report (Temple Report bv‡g cwiwPZ) I 2013
mv‡j The Future Hospital Commission Report wKQz mycvwik K‡i|
wkÿK‡ì h_vh_ gvb wbwðZ Kivi Rb¨ 2012 mv‡j GMC wKQz bxwZgvjv
ˆZwi K‡i| G‡Z wkÿK‡ì wbqwgZ g~j¨vq‡bi eë¯’v ivLv nq| Zuv‡ì
wkÿv`v‡bi mÿgZv g~j¨vqb Kiv nq| Zuv‡ì cÖwkÿ‡Yi RbÏ Avjv`v eë¯’v
Kiv n‡q‡Q| wkÿK‡ì K‡qKwU w`K †kLvbi Dci †Rvi †Ìqv nq| 1)
†ivMxi Rb¨ Kvh©Ki I wbivc` †mevi eë¯’v Kiv| 2) wkÿvi Dchy³ cwi‡ek
wbwðZ Kiv| 3) wkÿv`vb Kiv| 4) h_vh_ g~j¨vq‡bi gva¨‡g wkÿv_©x‡ì

cÖwkÿY mnRZi Kiv| 5) wkÿK wnmv‡e wb‡Ri mÿgZv eRvq ivLvi Rb¨
cÖwZwbqZ wb‡R‡K mg„× ivLvi eë¯’v Kiv|
cÖ‡Z¨K we‡klÁ‡K cÖgvY Ki‡Z nq Zv‡ì †ivMx †`Lvi gvb mwVK I Zviv
bZzb Ávb I cÖhyw³‡Z ey¨rcwË AR©b K‡i‡Qb I Zvi mwVK eënvi Ki‡Qb|
GRb¨ we‡klÁ wnmv‡e KvR Kiv Kvjxbmg‡q Zv‡ì Ávb I `ÿZvi wbqwgZ
g~j¨vqb Kiv nq I †ivMx †meviI g~j¨vqb Kiv nq| GUvi Rb¨ cÖwkÿYcÖvß
appraiser _v‡Kb| cÖwZ cuvP eQi ci ci †iwR‡óªkb bevqb Kivi mgq Gme
welq we‡ePbvq †bIqv nq| G cÖwµqvi bvg Revalidation|
fviZt ga¨hy‡M fviZ Dcgnv‡`‡k Avqy‡e©`x I BDbvbx c×wZi wPwKrmv Pvjy
wQj| cZ©yMxRiv cÖ_g lô`k kZvãx‡Z cwðgv (A¨v‡jvc¨vw_K) wPwKrmv
c×wZ G‡`‡k wb‡q Av‡m| Z‡e Zv g~jZt G‡`‡k Zv‡ì wb‡R‡ì †jvK‡ì
wPwKrmvi Rb¨B eënvi KiZ| 1600 wLª÷v‡ã †MÖU e„‡U‡bi ivbx GwjRv‡e_
B÷ BwÛqv †Kv¤úvwb‡K fviZe‡l© evwYR¨ Kivi mb` †`b| B÷ BwÛqv
†Kv¤úvwb †bŠeni wb‡q fvi‡Z Av‡m| †bŠen‡ii m‡½ Avmv wPwKrm‡Kiv
BD‡ivcxq wPwKrmv c×wZ G‡`‡k wb‡q Av‡m| 1715 mv‡j †mbvevwnbxi
wPwKrmK‡ì wb‡q e„wUk GjvKv¸‡jv‡Z nvmcvZvj †evW© ¯’vcb Kiv nq|
1785 mv‡j mvgwiK I †emvgwiK Dfq ai‡bi e„wUk bvMwiK‡ì ¯^v¯’¨‡mevi
Rb¨ KjKvZv, †ev¤^vB I gv`ªvR †cÖwm‡WÝx‡Z †gwWK¨vj wefvM ¯’vcb Kiv
nq| 1857 mv‡j wmcvnx we‡`ªv‡ni ci B÷ BwÛqv †Kv¤úvwbi KvQ †_‡K e„wUk
miKvi fvi‡Zi kvmbfvi wb‡q †bq| Gici BwÛqvb †gwWK¨vj mvwf©m MwVZ
nq Ges cÖ‡`k¸‡jvi Rb¨ Avjv`v kvLv MwVZ nq| G¸‡jv Pvjv‡Zb e„wUk
wPwKrmK I Ab¨vb¨ ¯^v¯’¨Kg©x| ¯^v¯’¨‡mevq K¤úvDÛvi, †Wªmvi, dvg©vwm÷
BZ¨vw` mnKvwi Qvov wPwKrmvKvh© Pvjvb †hZ bv| wKš‘ Gm‡ei Rb¨ e„wUk
bvMwiK wb‡qvM e¨qeûj weavq 1822 mv‡j KjKvZvq Native Medical
Institution cÖwZôv Kiv nj| GLv‡b BD‡ivcxq wPwKrmv eë¯’vi mnKvwi
ˆZwi Kivi Rb¨ fviZxq‡ì cÖwkÿY †Ìqv ïiæ nj| cÖwkÿY †Ìqv nj
¯’vbxq fvlvq Ges wkÿvi welqe¯‘i g‡a¨ BD‡ivcxq wPwKrmvi m‡½ m‡½
Avqy‡e©`x I BDbvbx wPwKrmv c×wZI AšÍf©y³ nj| 1833 mv‡j Mfb©i jW©
DBwjqvg †ew›U¼ wPwKrmv eë¯’v ch©v‡jvPbv Kivi Rb¨ KwgwU K‡i w`‡jb|
Wvt Rb MÖv›U Gi †bZ…‡Z¡ GB KwgwU 1834 mv‡j mycvwik Kij BD‡iv‡c
†hfv‡e wPwKrmv we`¨v †kLvb nq; †mfv‡eB GLv‡b †kLvb ìKvi, GRb¨
†gwWK¨vj K‡jR ¯’vcb Kiv cÖ‡qvRb| 1835 mv‡j KjKvZvq †gwWK¨vj
K‡jR ¯’vcb Kiv nj 49 Rb QvÎ wb‡q| Pvi eQi †jLvcov K‡i cvm Kivi

ci G‡ì cwiPq nj ÔNative Doctor’ Ges BwÛqvb †gwWK¨vj mvwf©‡m
gvwmK 30 UvKv †eZ‡b PvKzwi Kivi Rb¨ †hvM¨ we‡ewPZ nj| gv`ªv‡R 1835
mv‡j †gwWK¨vj K‡jR ¯’vcb Kiv nq| †ev¤^vB‡Z MfY©i m¨vi ievU© MÖv›U
fviZxq‡ì wPwKrmvi D‡`¨vM wb‡jb| m¨vi Rvg‡k`Rx wRwRf‡qÕi Aby`v‡b
1843 mv‡j †gwWK¨vj K‡jR ¯’vwcZ nq| GLv‡b wPwKrmK ˆZwii D‡Ïk¨
wQj †`kxq mvaviY gvby‡li wPwKrmv Kiv| GQvov G cÖwZôv‡b subordinate
medical service Gi K¤úvDÛvi, †Wªmvi BZ¨vw` cÖwkÿY †Ìqvi D‡Ï‡k¨
†Kvm© †Lvjv nj| cZ©yMxRiv †Mvqv‡Z 1843 mv‡j †gwWK¨vj K‡jR ¯’vcb
K‡i| gv`ªvR †gwWK¨vj K‡jR cÖ_g 1875 mv‡j gwnjv‡ì Rb¨ Øvi D¤§y³
K‡i| 1857 mv‡j KjKvZv, †ev‡¤^ I gv`ªv‡R wek^we`¨vjq ¯’vwcZ nIqvi
ci GLvbKvi †gwWK¨vj K‡jR¸‡jv Zv‡ì wbR GjvKvi wek^we`¨vj‡qi
m‡½ hy³ nq| 1877 mv‡j mviv fviZe‡l© A¨v‡jvc¨vw_K wPwKrmvq cvm Kiv
wPwKrmK wQj 450 Rb| 1947 mv‡j †`k fvM nIqvi mgq mviv fviZ
Dcgnv‡`‡k 23wU †gwWK¨vj K‡jR wQj| fviZ ¯^vaxb nIqvi ci †gwWK¨vj
K‡j‡Ri msL¨v ev‡o| 1990 mv‡ji ci †_‡K †gwWK¨vj K‡j‡Ri msL¨v
†ewk ev‡o, we‡kl K‡i †emiKvwi †gwWK¨vj K‡j‡Ri msL¨v ev‡o| 1965
mv‡j †gwWK¨vj K‡jR wQj 86wU, 1990 mv‡j wQj 143wU, 2020 mv‡j
Av‡Q 535wU|
†`kfv‡Mi Av‡M fvi‡Z we‡klÁ wPwKrmK nIqvi Rb¨ †Kvb eë¯’v wQj
bv| we‡klÁ cÖwkÿY I wkÿv we‡`‡k wb‡Z nZ| 1956 mv‡j w`jøx‡Z
¯’vwcZ nq All Indian Institute of Medical Sciences (AIIMS)
Ges GUv‡K Institute of National Importance (INI) Gi D”P gh©v`v
†Ìqv nq| fvi‡Zi ZrKvjxb cÖavbgš¿x RIqvnvijvj †bniæÕi D‡`¨v‡M GwU
GKwU ¯^vqZ¡kvwmZ I wWwMÖ `vb Kivi ÿgZvm¤úbœ Bbw÷wUDU wnmv‡e ¯’vwcZ
nq| fvi‡Zi cÖ_g ¯^v¯’¨gš¿x Ag„Z KvDi G Bbw÷wUDU M‡o †Zvjvi Rb¨
wbDwRj¨vÛ miKv‡ii GKUv eo mvnvh¨ Znwej msMÖn K‡ib| cieZ©xKv‡j
wZwb †dvW© dvD‡Ûkb, iK‡djvi dvD‡Ûkb, A‡÷ªwjqv I cwðg Rvg©vbxi
miKv‡ii KvQ †_‡KI mvnvh¨ †RvMvo K‡i †`b| 2003 mv‡j cÖavbgš¿xi
¯^v¯’¨ myiÿv †hvRbv bv‡g cÖKí †bIqv nq| Gi `yÕ‡Uv jÿ¨ wQj| GKUv nj
AIIMS gZ cÖwZôvb †`‡ki Ab¨vb¨ ¯’v‡b M‡o †Zvjv I we`¨gvb †gwWK¨vj
K‡jR¸‡jvi DbœwZ Kiv| 2012 mv‡j All India Institute of Medical
Sciences (Amendment) wej cvm Kiv nq| Gi d‡j QqwU bZzb AIIMS

†`‡ki wewfbœ ¯’v‡b (cvUbv, †fvcvj, ivqcyi, †hvacyi, f‚e‡bkî I üwl‡Kk)
¯’vcb Kiv nq I INI Gi gh©v`v †Ìqv nq| Gi c‡ii eQi¸‡jv‡Z AviI
AIIMS ¯’vwcZ nq| 2020 mvj bvMv` 19wU AIIMS KvR ïiæ K‡i‡Q I
PviwU wbg©vYvaxb Av‡Q|
1962 mv‡j cvÄve iv‡Rï PÛxM‡o †cv÷ MÖvRy‡qU Bbw÷wUDU Ad
†gwWK¨vj GWz‡Kkb GÛ wimvP© ¯’vwcZ nq| 1967 mv‡j AvBb cvm K‡i
INI Gi gh©v`v †Ìqv nq| 1964 mv‡j cÛx‡Pix‡Z ¯’vwcZ nq RIqvnvijvj
Bbw÷wUDU Ad †cv÷ MÖvRy‡qU †gwWK¨vj GWz‡Kkb GÛ wimvP©| DËi cÖ‡`k
ivR¨ miKv‡ii D‡`¨v‡M 1983 mv‡j j‡ÿèŠ kn‡ii A`~‡i ¯’vwcZ nq mÄq
MvÜx †cv÷ MÖvRy‡qU Bbw÷wUDU Ad †gwWK¨vj mv‡qÝm| PÛxMo I mÄq
MvÜx Bbw÷wUD‡U †Kvb GgweweGm †Kvm© bvB, ïay ¯œvZ‡KvËi †Kvm© Av‡Q|
1906 mv‡j DËi cÖ‡`k miKvi j‡ÿèŠ‡Z wKs RR© †gwWK¨vj K‡jR ¯’vcb
K‡i| 2002 mv‡j ivR¨ miKvi GUv wek^we`¨vj‡q DbœxZ K‡i| Av‡Mi GKUv
†gwWK¨vj K‡jR iƒcvšÍwiZ K‡i 2015 mv‡j DËi cÖ‡`k BDwbfvwm©wU Ad
†gwWK¨vj mv‡q‡Ým ¯’vwcZ nq|
GgweweGm cvm I B›Uvb©kxc †kl nIqvi ci GKRb wPwKrmK ¯œvZ‡KvËi
wkÿvq †h‡Z cv‡ib| ¯œvZ‡KvËi wkÿvq cÖ‡e‡ki Rb¨ me©fviZxq cixÿv
w`‡Z nq hvi bvg National Eligibility cum Entrance Test (NEET),
GUv National Board of Examination Øviv cwiPvwjZ| †cv÷ MÖvRy‡qU
wkÿvq cÖ‡ek AZ¨šÍ cÖwZ‡hvwMZvg~jK| cÖwkÿ‡Yi cÖvq 6200 R‡bi Avm‡bi
Rb¨ 2016 mv‡j 79000 wPwKrmK cixÿv †`b| †cv÷ MÖvRy‡qU wkÿvi
`yB avc-cwðgv †`k¸‡jvi gZB| cÖ_g av‡ci bvg MD (Doctor of
Medicine) †gwWwm‡bi †ÿ‡Î I MS (Master of Surgery) mvR©vixi
†ÿ‡Î| wZb eQi †Rbv‡ij †gwWwmb I †Rbv‡ij mvR©vix‡Z cÖwkÿY wb‡Z
nq| DËxY© n‡j †Rbv‡ij mvR©vix ev †Rbv‡ij †gwWwmb Gi we‡klÁ wnmv‡e
¯^xK…Z nq| Gici hw` †KD AviI we‡klvwqZ wel‡q †hvM¨Zv AR©b Ki‡Z
Pvb Zv nÕ‡j Zv‡K Avevi cÖwZ‡hvwMZvg~jK cixÿv w`‡q cÖ‡ek Ki‡Z n‡e|
cieZ©x avcI wZb eQ‡ii| G av‡c subspecialty †Z wkÿv †Ìqv nq
(†hgb: †gwWwm‡b-KvwW©IjRx, M¨v‡÷ªG›Uv‡ivjRx BZ¨vw`), mvR©vix‡Z
(wbD‡ivmvR©vix, KvwW©qvK mvR©vix BZ¨vw`)| mdjfv‡e †kl n‡j †gwWwm‡bi
subspecialty †Z DM (Doctor of Medicine) I mvR©vix‡Z MCh
(Master of Chirugiae) wWwMÖ †Ìqv nq| GQvov cÖ_g ev †Rbv‡ij Ges

wØZxq ev subspecialty ch©v‡q National Board of Examination Gi
Aax‡b wkÿv I cÖwkÿY †k‡l cixÿv w`‡q DNB (Diplomate National
Board) wWwMÖ †Ìqv nq| wKš‘ MD, MS A_ev DNB †KvbUv‡ZB cÖ_g avc
General cvm bv K‡i wØZxq avc subspecialty †Z hvIqv hvq bv| A‡bK
wel‡q 2-3 eQi †gqv‡ì wW‡cøvgv †Kvm© Av‡Q|
Dfq ¯Í‡iB competency wfwËK cÖwkÿY †Ìqv nq| †ivMx †mevi mve©ÿwYK
c~Y© `vwqZ¡ wb‡q KvR Ki‡Z nq| †ivM m¤^‡Ü me©vaywbK Ávb, †ivM wPwKrmvq
`ÿZv, mnKg©x, †ivMx I Zvi ¯^Rb‡ì m‡½ communication Gi mÿgZv,
professionalism, empathy, mZZv I wbôvi m‡½ KvR Kiv, Ávb I
cÖhyw³i Dbœqb AvZ¥¯’ Kivi mÿgZv, ¯^v¯’ëë¯’vi m‡e©v”P eënvi K‡i †mev
Kvh© cvjb-G¸‡jv AvqË¡ Kiv †kLvb nq| Gi m‡½ M‡elYvi g~jm~Î Rvbv I
eënvi K‡i Áv‡bi cÖmvi NUvb I wb‡Ri Kv‡Ri g~j¨vqb Gi mÿgZvI AR©b
Ki‡Z nq| †ivMx †mevi `vwq‡Z¡ †_‡K KvR Kivi m‡½ m‡½ wkÿv`vb P‡j|
m¤ú~Y© cÖwkÿYKv‡j wkÿvi g~j¨vqb Kiv nq (formative assessment)|
wkÿv`v‡bi me¸‡jv †ÿÎ (cognitive domain, psychomotor domain,
affective domain) wkÿ‡Kiv g~j¨vqb K‡ib| wZb gvm ci ci G¸‡jv
hvPvB Kiv nq| cÖwkÿYKvjxb mg‡q M‡elYvwfwËK w_wmm wjL‡Z nq| †Kvm©
ïiæ nIqvi AvovB eQi ci GUv Rgv w`‡Z nq Ges w_wm‡mi Dci cixÿv nq|
ivR¨ A_ev RvZxq ch©v‡qi êÁvwbK m‡¤§j‡b GKUv poster presentation,
GKUv oral presentation I GKUv M‡elYvcÎ cÖKvk Ki‡Z nq|
fvi‡Zi †cv÷ MÖvRy‡qU wkÿv m¤^‡Ü †m †`‡ki wKQz wkÿ‡Ki gZ n‡”Q
wkÿv_©xiv cÖwkÿYKvjxb mg‡q h‡_ó cwikÖg K‡i| Z‡e KvwiKzjvg I
wkÿv`vb c×wZ AvaywbK bq| GRb¨ ¯^v¯’¨ gš¿Yvjq 1975 mv‡j kÖxev¯Íe
KwgwU I 1986 mv‡j evRvR KwgwU MVb K‡i cwiw¯’wZ ch©v‡jvPbv K‡i
mycvwik Kivi Rb¨| Zuviv wKQz ms¯‹v‡ii mycvwi‡ki m‡½ wek` ch©v‡jvPbvi
Rb¨ Kwgkb MVb Kivi K_v e‡jb| KvwiKzjvg I wkÿv`vb GLbI
Kvw•LZiƒc cvqwb| A‡b‡Ki gZ nj Psychomotor domain (clinical
skill AR©b) I affective domain (mngwg©Zv, ˆbwZKZv, civ_©ciZv
BZ¨vw`) Gi Dci ch©vß ¸iæZ¡ †Ìqv nq bv|
evsjv‡`kt e„wUk Avg‡j 1946 mv‡j G †fŠMwjK AÂ‡j cÖ_g †gwWK¨vj
K‡jR ¯’vwcZ nq XvKvq| Gici PÆMÖvg (1957) I ivRkvnx†Z (1958)
†gwWK¨vj K‡jR ¯’vcb Kiv nq| gqgbwmsn I wm‡jU †gwWK¨vj K‡jR

¯’vwcZ nq 1962 mv‡j| G mgq bvMv` ZrKvjxb c~e© cvwK¯Ív‡b 5wU †gwWK¨vj
K‡jR wQj| we‡klÁ nIqvi Rb¨ †cv÷ MÖvRy‡qU wkÿv eë¯’v ev cÖwZôvb
ZLb cvwK¯Ív‡bi †Kvb AÂ‡jB wQj bv| 1962 mv‡j ZrKvjxb c~e© cvwK¯Ív‡b
me welq wgwj‡q we‡kl‡Ái msL¨v wQj †ò kÕ‡ZiI Kg| D‡jøL Kiv hvq
GLb †`‡k we‡kl‡Ái msL¨v cÖvq c‡bi nvRvi| cvwK¯Ív‡bi Ab¨ As‡kI
NvUwZ wQj| we‡klÁ nIqvi c_ wQj we‡`‡k, cÖavbZt hy³iv‡R¨ D”Pwkÿv
†bIqv| fviZ Dcgnv‡`k cÖvq `yBkÕ eQi e„‡U‡bi Aax‡b _vKvq e„wUk D”P
wkÿvB cwiwPZ wQj I miKvi ¯^xK…Z wQj| wKQz wPwKrmK‡K miKvi e„wË
w`‡q we‡`‡k cvVvZ, wKš‘ c~e© cvwK¯Ívb †_‡K wPwKrmK‡ì KgB †bIqv nZ|
wKQz wPwKrmK e¨w³MZ D‡`¨v‡M e„‡U‡b D”P wkÿvi Rb¨ †h‡Zb I PvKzwi
Ki‡Zb| G msL¨vI c~e© cvwK¯Ív‡b Kg wQj| †emiKvwi ch©v‡q we‡`‡k †M‡jI
miKv‡ii AbvcwË No Objection Certificate (NOC) jvMZ| GUv c~e©
cvwK¯Ív‡b cvIqv mnR wQj bv|
1962 mv‡j ZrKvjxb mvgwiK miKv‡ii ¯^v¯’¨gš¿x †Rbv‡ij IqvwR` Avjx
Lvb evK©x cvwK¯Ív‡bi e‡qv‡R¨ô we‡klÁ wPwKrmK‡ì I wkÿK‡ì civgk©
wb‡jb †`‡k †cv÷ MÖvRy‡qU wPwKrmv wkÿvi eë¯’v Kiv hvq wKbv| Zv‡ì
civg‡k© KivPx‡Z 1962 mv‡j ¯’vwcZ nj K‡jR Ad wdwRwkqvÝ GÛ mvR©Ý
Ad cvwK¯Ívb-GKUv AwW©b¨v‡Ýi gva¨‡g| Gi MVb wQj A‡bKUv e„‡U‡bi
i‡qj K‡jR¸‡jvi gZ| Zvi wbR¯^ †Kvb nvmcvZvj _vK‡e bv| †`‡ki me
eo nvmcvZv‡j `yB eQi cÖwkÿY wb‡Z n‡e| Z‡e cÖwkÿ‡Yi gvb mgš^q Kiv
I DbœxZ ivLvi Rb¨ cÖwkÿ‡Yi †kl `yB eQi GKUv DbœZ gv‡bi nvmcvZv‡j
†Kvm© Ki‡Z n‡e| GUv e„‡U‡b wQj bv| †mLv‡b cy‡iv cÖwkÿYB ¯^xK…wZcÖvß
nvmcvZvj¸‡jv‡Z nq, †Kvb †Kvm© Ki‡Z nq bv| i‡qj K‡jR¸‡jv ïay
cixÿv †bq| †Kvm© cwiPvjbvi Rb¨ 1965 mv‡j 148 GKi Rwgi Dci ¯’vcb
Kiv nj wRbœvn& †cv÷ MÖvRy‡qU †gwWK¨vj †m›Uvi| GLv‡b wK¬wbK¨vj welq
QvovI Basic welq¸‡jv‡Z (‡hgb GbvUgx, wdwRIjRx BZ¨vw`) MPhil
†Kv‡m©i gva¨‡g D”P wkÿvi eë¯’v Kiv nj-wWwMÖ w`Z KivPx wek^we`¨vjq|
GLv‡b c~e© cvwK¯Ívb †_‡K wbe©vwPZ wPwKrmK‡ì D”Pwkÿvi eë¯’v wQj, wKš‘
Lye Kg msL¨K my‡hvM †cZ|
c~e© cvwK¯Ív‡b we‡klÁ wPwKrm‡Ki m¼U †gUvbi Rb¨ c~e© cvwK¯Ív‡bi
cÖv‡`wkK miKvi cÖvq 40 Rb wPwKrmK‡K D”Pwkÿvi Rb¨ we‡`‡k e„wË
w`‡q cvwV‡qwQj, †K›`ªxq miKv‡ii AvcwË m‡Z¡I cÖv‡`wkK miKv‡ii
¯^v¯’¨ mwPe (cieZ©x‡Z g~L¨ mwPe) kwdEj AvRg G D‡`¨vM wb‡qwQ‡jb|

cÖv‡`wkK miKvi 1964 mv‡ji 22†k RyjvB XvKv †gwWK¨vj K‡j‡Ri GK
As‡k Bbw÷wUDU Ad †cv÷ MÖvRy‡qU †gwWwmb GÛ wimvP© ¯’vcb K‡i| XvKv
†gwWK¨vj K‡j‡Ri wZbRb †R¨ô cÖ‡dmiÕ‡K GUv M‡o †Zvjvi `vwqZ¡ †Ìqv
n‡qwQj| Zuviv n‡jb cÖ‡dmi Ave`yi ingvb (wdwRIjRx), Aa¨vcK G,†K,
kvgmywÏb Avn‡g` (†gwWwmb), I cÖ‡dmi Avwmi DwÏb †PŠayix (mvR©vix)|
e„wUk KvDwÝ‡ji gva¨‡g hy³iv‡Rï GwWbeiv i‡qj K‡jR Ad wdwRwkqvÝ
Gi mv‡eK mfvcwZ m¨vi †Rgm †WwfWmb ÷zqvU© K¨v‡gib‡K cwiPvjK
wnmv‡e wb‡qvM †Ìqv nq| cÖ‡dmi byiæj Bmjvg, whwb ZLb PÆMÖvg †gwWK¨vj
K‡j‡Ri cÖ_g †gwWwm‡bi cÖ‡dmi wnmv‡e Kg©iZ wQ‡jb, Zuv‡K hyM¥ cwiPvjK
wnmv‡e wb‡qvM †Ìqv nq| cÖ‡dmi byiæj Bmjvg ZLbI RvZxq Aa¨vcK nb
wb, Zuv‡K RvZxq Aa¨vcK Kiv nq 1987 mv‡j| wZwb G c‡` KvR Ki‡Z
ivwR wQ‡jb bv, KviY G Bbw÷wUD‡Ui ZLb ej‡Z †M‡j †Zgb wKQyB wQj
bv| miKv‡ii Pv‡c wZwb †hvM`vb K‡ib I m¨vi K¨v‡gibI †hvM`vb K‡ib
1965 mv‡ji wW‡m¤î gv‡m| 1966 mv‡j 33 Rb †cv÷ MÖvRy‡qU wkÿv_©x
wb‡q KvR ïiæ nq XvKv †gwWK¨vj K‡j‡Ri GK †KvYvq| Av‡M GUv wQj
XvKv wek^we`¨vj‡qi AvU©m I Kgvm© wewìsG| GUv ms¯‹vi K‡i 100 kh¨vi
nvmcvZvj Pvjy Kiv nq| wKš‘ evav Av‡m †K›`ªxq miKv‡ii KvQ †_‡K| †K›`ªxq
miKvi wjwLZfv‡e Rvbvq †h‡nZz KivPx‡Z GKUv †cv÷ MÖvRy‡qU Bbw÷wUDU
Av‡Q, AZGe XvKvq Avi GKUv †cv÷ MÖvRy‡qU †gwWK¨vj Bbw÷wUDU Kivi
ìKvi bvB| cÖv‡`wkK miKvi DËi w`j Gi Av‡M K‡qKevi XvKvq †cv÷
MÖvRy‡qU Bbw÷wUDU Kivi Rb¨ †K›`ªxq miKv‡ii Kv‡Q Av‡e`b K‡i †Kvb
mvov bv †c‡q cÖv‡`wkK miKvi GUv ¯’vcb K‡i‡Q| nvRvi gvB‡ji †ewk `~i‡Z¡
c~e© cvwK¯Ívb †_‡K A‡bK wPwKrm‡Ki c‡ÿ KivPx‡Z D”Pwkÿvi Rb¨ hvIqv
m¤¢e n‡e bv| GQvov GKUv we‡klvwqZ D”P gv‡bi nvmcvZvj _vK‡j c~e©
cvwK¯Ív‡bi gvbyl GLv‡b RwUj †iv‡Mi ¯^v¯’¨‡mev wb‡Z cvi‡e, KivPx‡Z wM‡q
Zv †bIqv m¤¢e bq| †K›`ªxq miKvi DËi w`j Zviv †Kvb mvnvh¨ Ki‡e bv|
1968 mv‡j m¨vi K¨v‡gib Pzw³ †k‡l wbR †`‡k wd‡i †M‡jb, cÖ‡dmi byiæj
Bmjvg cwiPvjK wb‡qvM †c‡jb|
lv‡Ui `k‡K kvnevM †nv‡Uj wQj XvKvi GKgvÎ AwfRvZ †nv‡Uj| XvKvq
†nv‡Uj B›UviKw›U‡›Uvj Pvjy nIqvi ci kvnevM †nv‡U‡ji eëmv K‡g hvq
Ges GUv †jvKmvbx cÖwZôv‡b cwiYZ nq| miKvi GUv eÜ K‡i †`q| 1971
mv‡ji Ryb gv‡m cÖv‡`wkK miKvi kvnevM †nv‡U‡j AvBwcwRGgAvi‡K
¯’vbvšÍ‡ii wb‡`©k †`q| ZLb †h `vjvbUv wQj Zv nj eZ©gv‡bi Ôwe eøKÕ I Zvi

A¨v‡b·| †nv‡U‡ji wewfbœ ¯’v‡b nvmcvZvj, j¨ve‡iUwi, K¬vkiæg, G·-†i
wefvM, Kwbô wPwKrmK‡ì I †mweKv‡ì _vKvi RvqMv G¸‡jvi eë¯’v K‡ib
K‡qKRb cÖ‡dmi, G‡ì g‡a¨ wQ‡jb cÖ‡dmi Gg,Avi, Lvb (ZLbI RvZxq
Aa¨vcK nb wb), cÖ‡dmi †kL Ave`ym †mvenvb, cÖ‡dmi Ave`yj gvbœvb,
cÖ‡dmi †kL Avjx Avkivd, cÖ‡dmi Kvgvj DwÏb Avng`, cÖ‡dmi dwi`
DwÏb, cÖ‡dmi Ave`yj gwZb| ¯^vaxbZvi ci ciB 1972 mv‡ji Rvbyqvwi
gv‡m cÖ_g ¯^v¯’¨gš¿x Rûi Avng` †PŠayix kvnevM †nv‡U‡ji Amgvß `vjvb
(eZ©gvb eøK-G) AvBwcwRGgAvi‡K n¯ÍvšÍi K‡ib| G mgq kvnevM †nv‡U‡ji
wKQz cÖv³b Kg©Pvix wek„•Ljv m„wói †Póv K‡i| ¯^v¯’¨gš¿x Rbve Rûi Avng`
†PŠayix I ¯^v¯’¨ mwPe Wvt wU, †nv‡mb mv‡n‡ei n¯Í‡ÿ‡c cwiw¯’wZ mvgwqKfv‡e
kvšÍ nq| wKš‘ Kg©Pvixiv DËi A¨v‡b· `vjvb `Lj K‡i iv‡L| K‡qK w`b
c‡i RvwZi Rb‡Ki wb‡`©‡k cwiw¯’wZ wbqš¿‡Y Av‡m| RvwZi RbK e½eÜz
†kL gywReyi ingvb 1972 mv‡ji Ryb gv‡m AwW©©b¨v‡Ýi e‡j evsjv‡`k K‡jR
Ad wdwRwkqvÝ I mvR©Ý cÖwZôv K‡ib| cÖ_‡g GKUv mxwgZ mg‡qi g‡a¨
we‡`k †_‡K wWwMÖ I wW‡cøvgv cÖvß we‡klÁ wPwKrmK‡ì, hviv ZLb wPwKrmv
kv‡¯¿ wkÿK wnmv‡e Kg©iZ wQ‡jb, Zuv‡ì GKUv wbw`©ó wd Gi wewbg‡q
†d‡jvkxc †Ìqv nq| 1972 mv‡ji RyjvB gv‡m cÖ_g cixÿv AbywôZ nq|
cvwK¯Ív‡bi †K›`ªxq miKv‡ii Aax‡b ¯‹zj Ad UªwcK¨vj †gwWwmb bv‡g GKUv
cÖwZôvb wQj| G‡Z †ek wKQz wkÿK, cÖhyw³we` I Ab¨vb¨ Kg©x _vK‡jI Zvi
wbR¯^ †Kvb ¯’vcbv wQj bv| wKQz Ask gnvLvjx‡Z msµvgK e¨vwa nvmcvZv‡j
Aew¯’Z wQj, wKQz wQj Rb¯^v¯’¨ Bbw÷wUD‡U| Avjv`v fe‡bi cÖ¯Íve _vK‡jI
Zv ev¯Íevqb nqwb| cÖ‡dmi G,‡K, gbmyi (c¨v_jRx) Dcjwä K‡iwQ‡jb †h,
†K›`ªxq miKvi c~e© cvwK¯Ív‡b †cv÷ MÖvRy‡qU Bbw÷wUDU ¯’vcb Ki‡Z ivwR
n‡e bv| wZwb UªwcK¨vj †gwWwmb Gi bv‡g †K›`ªxq miKvi‡K w`‡q GKUv †cv÷
MÖvRy‡qU Bbw÷wUDU ùvo Kivbi †Póv K‡iwQ‡jb| wZwb wQ‡jb G cÖwZôv‡bi
LÛKvjxb cwiPvjK| Zuvi AbvcwË‡Z ¯^v¯’¨gš¿x Rbve Rûi Avng` †PŠayix G
cÖwZôvb‡K AvBwcwRGgAviGi m‡½ GKÎxKiY K‡ib| G‡Z wkÿK, Rbej,
hš¿cvwZ‡Z AvBwcwRGgAvi mg„× nq|
1972 mv‡ji 8B A‡±vei RvwZi RbK AvBwcwRGgAviG †K›`ªxq eøvW e¨v¼
I bZzb gwnjv IqvW© Gi D‡Øvab K‡ib| wZwb Zuvi fvl‡Y gyw³hy‡× weaŸ¯Í
evsjv‡`k c~bM©V‡b Zuvi me©vZ¥K †Póvi K_v D‡jøL K‡i e‡jb, 30 jÿ
knx‡ì AvZ¥`v‡bi wewbg‡q cvIqv G †`k c~bM©V‡b mevi AvZ¥wb‡qvM Ki‡Z
n‡e| wPwKrmK‡ì cÖwZ wZwb mvaviY gvby‡li cÖwZ m¤§vb mnvbyf‚wZi m‡½

wPwKrmv †mev †Ìqvi AvnŸvb Rvbvb| RbM‡Yi ¯^v¯’¨‡mevi Rb¨ wZwb cÖwZwU
_vbvq GKwU K‡i nvmcvZvj ¯’vcb Kivi m¼í †NvlYv K‡ib| RbM‡Yi †Ìqv
K‡ii UvKvq wkÿv`vb †_‡K ïiæ K‡i me miKvwi Kg©KvÛ P‡j| ZvB wZwb
mvaviY gvbyl‡K †mev †Ìqvi †ÿ‡Î mevB‡K Zrci nIqvi AvnŸvb Rvbvb|
1973 mv‡j XvKv wek^we`¨vj‡qi GKUv bZzb d¨vKvwë wnmv‡e d¨vKvwë
Ad †cv÷ MÖvRy‡qU †gwWK¨vj mv‡q‡Ým GÛ wimvP© ¯’vwcZ nq| †m mgq
GgwW ev GgGm †Kvm© wQj bv| wKš‘ wewfbœ wel‡q wW‡cøvgv †Kvm© wQj I
Basic welqmg~‡n Ggwdj †Kvm© wQj| G¸‡jv Under graduate †gwWK¨vj
d¨vKvwë‡Z GgweweGm †Kv‡m©i m‡½ _vKvq cÖkvmwbK RwUjZv nw”Qj|
cixÿvi ZvwiL †Ìqv, cixÿv †bIqv, djvdj †NvlYv G¸‡jv e¨vnZ nw”Qj|
XvKv wek^w`¨vj‡qi ZrKvjxb DcvPvh© cÖ‡dmi W. Ave`yj gwZb †PŠayix G
e¨vcv‡i D‡`¨vM †bb I ivóªcwZ Rvwóm Avey mvC` †PŠayix 1973 mv‡ji RyjvB
gv‡m Av‡`k Rvwi K‡ib| cÖ_g Wxb wbhy³ nb cÖ‡dmi byiæj Bmjvg| 12 †g
1974 ZrKvjxb ¯^v¯’¨gš¿x Rbve Ave`yj gvbœvb †NvlYv K‡ib, miKvi gxR©vcy‡i
Aew¯’Z Kzgyw`bx nvmcvZvj AwaMÖnY K‡i †mLv‡b AvBwcwRGgAvi ¯’vbvšÍwiZ
Kiv n‡e| G nvmcvZvjwU wQj `vbexi iY`v cÖmv` mvnv KZ…©K cÖwZwôZ
Kzgyw`bx I‡qj‡dqvi Uªv‡÷i cwiPvjbvaxb| iY`v cÖmv` mvnv‡K gyw³hy×Kv‡j
cvK evwnbx nZ¨v K‡i| G nvmcvZvj AwaMÖn‡Yi wm×v‡šÍ Kzgyw`bx nvmcvZv‡ji
wPwKrmK, Kg©Pvixe„›` cÖwZev` Rvbvb, Kzgyw`bx I‡qj‡dqvi Uªv÷I cÖwZev`
K‡ib| cÖ‡dmi byiæj Bmjvg ¯^v¯’¨gš¿xi m‡½ †`Lv K‡i Zuv‡K eySvbi †Póv
K‡ib I wjwLZ cÖwZev` Rgv †`b| Zuvi hyw³ wQj A‡bK wkÿK Ges
wkÿv_©x gxR©vcy‡i †h‡Z PvB‡eb bv| †mLv‡b GZ msL¨K wkÿK, wPwKrmK,
Kg©Pvix‡ì Rb¨ h‡_ó evm¯’vbI wQj bv| hvZvqvZ eë¯’vI ZLb fvj wQj
bv| Kv‡RB XvKv †_‡K †hgb wPwKrmK‡ì hvIqv mgm¨v †Zgwb †ivMx‡ì
RbÏ| AvBwcwRGgAvi GKwU we‡klvwqZ nvmcvZvj I XvKvq bv _vK‡j
†`‡ki me AÂ‡ji gvby‡li Rb¨ †mev †Ìqv m¤¢e n‡e bv| cÖ‡dmi byiæj
Bmjvg e½eÜzi m‡½ †`Lv K‡i Zuvi Kv‡Q hyw³ Zz‡j a‡ib| RvZxq wkÿv
Kwgk‡bi †Pqvig¨vb W. LyìZ G Ly`vÕI cÖwZev` Rvbvb|
1975 mv‡j miKvi kvnev‡Mi eZ©gvb ¯’v‡b _vKvi Aby‡gv`b †`q| 1976 mv‡j
AvBwcwRGgAvi Gi msjMœ cuvP GKi miKvwi Rwg Bbw÷wUDU‡K †Ìqv nq|
1978 mv‡j AviI Pvi GKi Rwg †Ìqv nq| 1976 mv‡j ZrKvjxb ¯^v¯’¨ Dc‡`óv
†gwWK¨vj wek^we`¨vjq ¯’vc‡bi †NvlYv †`b| wKš‘ †gwWK¨vj wek^we`¨vj‡qi †Kvb
cÖKí wQj bv| †gwWK¨vj wek^we`¨vjq ¯’vc‡bi bv‡g AvBwcwRGgAvi eÜ K‡i

†Ìqvi Rb¨B G cÖ‡Póv Zv Rvbv †Mj| cÖ‡dmi byiæj Bmjvg Gi cÖwZev` Rvbvb
I G m¤^‡Ü mwVK Z_¨ w`‡q G lohš¿ cÖwZnZ K‡ib|
¯^vaxbZvi c‡ii `k‡K AvBwcwRGgAvi †_‡K wkÿvcÖvß I wewmwcGm Gi wWwMÖ
cÖvß we‡klÁiv mviv †`‡ki †gwWK¨vj K‡jR¸‡jv‡Z KvR Ki‡Z _v‡Kb|
A‡b‡K KbmvjU¨v›U wn‡m‡e †Rjv nvmcvZvj¸‡jv‡Z we‡klÁ †mev †Ìqv
ïiæ K‡ib, hv Av‡M †Rjv nvmcvZvj¸‡jv‡Z wQj bv| G AR©‡bi GKUv eo
K…wZZ¡B RvZxq Aa¨vcK Wvt byiæj Bmjv‡gi, whwb evisevi AvNv‡Zi ga¨
w`‡q ¯œvZ‡KvËi wPwKrmv wkÿv eë¯’v‡K wUwK‡q †i‡L‡Qb|
BwZg‡a¨ †`‡ki RbmsL¨v †e‡o‡Q, †hvMv‡hvM eë¯’vi DbœwZ n‡q‡Q, †gwWK¨vj
K‡j‡Ri msL¨vI †e‡o‡Q| mvaviY gvbyl cÖ_gw`‡K cÖwkÿYcÖvß we‡klÁ‡ì
m¤^‡Ü AwbðqZvq wQj| we‡klÁ gv‡bB we‡`kx wWwMÖ _vK‡Z n‡e, Rbg‡b G
aviYvB e×g~j wQj| cÖwZ‡hvwMZv mnR wQj bv| Z‡e cÖ_gw`‡Ki we‡klÁiv
Kv‡Ri GKwbôZv †`wL‡q‡Qb| †`‡ki wewfbœ AÂ‡ji gvbyl Zv‡ì KvR
†`L‡Z _vKj| †gwWK¨vj K‡jR¸‡jv‡Z wkÿv_©xiv wkÿK wnmv‡e Zuv‡ì
g~j¨vqb Kij| Zuv‡ì mZZv I †ckvMZ AvPiYI wQj †ewkifvM †ÿ‡ÎB
mgv‡jvPbvi D‡aŸ© wQj| ax‡i ax‡i gvby‡li Kv‡Q we‡klÁ wnmv‡e Zv‡ì
MÖnY‡hvM¨Zv evoj|
1961 mv‡ji XvKv wek^we`¨vjq AwW©b¨v‡Ý wPwKrmv kv‡¯¿ ¯œvZ‡KvËi wWwMÖi
eë¯’v wQj| Basic welqmg~‡n I wW‡cøvgvi †ÿ‡Î GUv eënvi Kiv nZ|
¯^vaxbZvi ci hy×vnZ gyw³‡hv×v I gyw³hy‡× ÿwZMÖ¯Í Ab¨vb¨ gvbyl hviv AvnZ
n‡q kvixwiK cÖwZeÜx n‡qwQj Zv‡ì wPwKrmv I cybe©vm‡bi Rb¨ miKv‡ii
Avgš¿‡Y Wvt †ivbvì †Rv‡md Mv÷© ZrKvjxb †mvnivIqvw`© nvmcvZv‡j
A‡_©v‡cwWK nvmcvZvj ¯’vcb K‡ib| wZwb wQ‡jb hy³iv‡óªi we‡klÁ
wPwKrmK| BDbvB‡UW †g_wWó Pv‡P©i c„ô‡cvlKZvq wZwb fvi‡Zi jywaqvbvq
wµwðqvb †gwWK¨vj K‡jR nvmcvZv‡j †hvM w`‡q cÖvq 15 eQi KvR K‡ib|
evsjv‡`‡ki †hme gyw³‡hv×vi A½nvwb n‡qwQj Zv‡ì mvnvh¨ Kivi Rb¨ wZwb
evsjv‡`k miKv‡ii Kv‡Q mw`”Qv cÖKvk K‡ib| cieZ©x‡Z wZwb gyw³‡hv×v
QvovI mvaviY gvby‡li wPwKrmv Kivi Rb¨ †mev cÖmvwiZ Ki‡Z evsjv‡`k
miKv‡ii m‡½ GKgZ nb| wZwb Dcjwä Ki‡jb, ZiæY wPwKrmK‡ì AvMÖnx
Ki‡Z cvi‡j †`‡k A‡_©v‡cwWK· mvR©vixi DbœwZ n‡e| ¯^vaxbZvi ci nv‡Z
†MvYv K‡qKRb A‡_©v‡cwWK· mvR©b wQ‡jb †`‡k| Wvt Mv÷© Abyfe Ki‡jb
A‡_©v‡cwWK mvR©vix‡Z we‡klÁ nIqvi my‡hvM m„wó Kivi Rb¨ †cv÷ MÖvRy‡qU

†Kvm© †Lvjv cÖ‡qvRb| Zuvi D‡`¨v‡M 1973 mv‡j XvKv wek^we`¨vj‡qi d¨vKvwë
Ad †cv÷ MÖvRy‡qU †gwWK¨vj mv‡q‡Ým GÛ wimv‡P©i Aax‡b A‡_©v‡cwWK
mvR©vixi GgGm †Kv‡m© wkÿv_©x fwZ© ïiæ nq| RvZxq ü`‡ivM Bbw÷wUDU
¯’vwcZ nq 1978 mv‡j RvZxq Aa¨vcK weª‡MwWqvi Wvt Ave`yj gvwjK mv‡n‡ei
cÖ‡Póvq| 1982 mv‡j G Bbw÷wUD‡U ü`‡iv‡Mi GgwW I GgGm †Kvm©
†Lvjv nq| Gi cieZ©x eQi¸‡jv‡Z wPwKrmv weÁv‡bi Ab¨vb¨ kvLvq XvKv
wek^we`¨vj‡qi Aax‡b wewfbœ we‡klÁ †Kvm© †Lvjv nq|
1998 mv‡ji GwcÖj gv‡m ZrKvjxb AvBwcwRGgAvi‡K iƒcvšÍwiZ K‡i e½eÜz
†kL gywRe †gwWK¨vj wek^we`¨vjq Kivi wm×všÍ †bq miKvi I G msµvšÍ wej
msm‡` cvm Kiv nq| G cÖ¯Íve miKv‡ii D”P ch©v‡q RvZxq Aa¨vcK Wvt
byiæj Bmjvg DÌvcb K‡iwQ‡jb| †NvlYv †Ìqvi ci Z…Zxq I PZz_© †kÖYxi
Kg©Pvix‡ì GK Ask Gi we‡ivaxZv K‡i Av‡›`vjb ïiæ K‡i| Zv‡ì e³e¨
wQj Zviv miKvwi PvKzwi nviv‡Z Pvq bv| A_P ¯^v¯’¨gš¿Yvjq †_‡K cÖÁvcb Rvwi
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cÖ_g DcvPvh© wbhy³ nb cÖ‡dmi Gg, G, Kv‡ìx| wZwb wek^we`¨vj‡qi Rb¨
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wZwb cÖkvmwbK wefvM M‡o †Zv‡jb I †iwRóªvi wb‡qvM †`b| wZwb cixÿv
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gvm e¨v¼ †_‡K avi K‡i †eZb I Ab¨vb¨ LiP Pvjv‡Z n‡q‡Q| †Kvb LvZ
†_‡K A_© †Ìqv n‡e GUv wb‡q A_© mwPe I gš¿x cwil` mwPe mgm¨v m„wó
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wkÿK‡ì ZË¡veav‡b nv‡Z-Kj‡g cÖZ¨ÿ KvR Kivi gva¨‡g cÖwkÿY †Ìqvi
weavb wQj| eënvwiK wkÿvi m‡½ m‡½ theoretical I affective domain
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assessment) Gi eë¯’vI Kiv n‡qwQj| GK eQi wkÿv_©xI fwZ© Kiv nq|
GB e¨vP Ab¨vb¨ e¨v‡Pi PvB‡Z fvj wkLwQj Gi ev¯Íe cÖgvYI Av‡Q| 2001
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mycvwik K‡ib| GgweweGm cvm Kivi ci GK eQi B›Uvb©kxc m¤ú~Y© K‡i c~Y©
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n‡”Q| G m¤^‡Ü Zv‡ì AewnZ Kivi Rb¨ DbœZ †`kmg~‡n wkÿK‡ì wbqwgZ
cÖwkÿY †Ìqv nq| wPwKrmv c×wZ‡Z bZzb cÖhyw³ I `ÿZv (skill) AR©b
Kivi cÖvwZôvwbK eë¯’v bvB| we‡klÁiv wbR D‡`¨v‡M GUv K‡ib| Gi d‡j
h‡_ó msL¨K we‡kl‡Ái cÖ‡qvRbxq gv‡b bZzb cÖhyw³i cÖ‡qvM †`‡k nq bv|
miKvwi eë¯’vcbvq wkÿK‡ì wbw`©ó bZzb cÖhyw³ I `ÿZv AR©‡bi wbqwgZ
eë¯’v †`‡k I we‡`‡k _vKv ìKvi|
Z_¨m~Ît
1. Cooke M, Irby DM, Sullivan W, Ludmerer KM. American
Medical Educaton 100 years after Flexner Report- N Eng J
Med,2006;355:1339-1344.
2. Epstein RM. Assessment in Medical Education. N Eng J.Med.
2007;356:387-396
3. Leung W. Competency based medical training.Review. Brit Med
J, 2002;235: 693-696.
4. Epstein RM, Hundert EM. Defining and assessing professional
competence. J Amer Med Assoc. 2002; 77:361-367.
5. Aggarwal R, Darzi A. Technical Skills Training in the 21st
Century. N Eng J Med, 2006; 355:2695-2696
6. Bayley TJ. Specialist medical training: implementing Calman:
Summing up. Med Education, 1994; 28 (suppl 2); 46-47.
7. https://thesavoyimg.co.uk/specialty-training-residency-in-the-uk/
8. https://en.wikipedia.org/wiki/Medical_education_in_the_United_
Kingdom.
9. https://en.m.wikipedia.org/wiki/Medical_education_in_the-

United_States.
10. https://www.nmc.org/information-desk/for colleges/pg-curriculum-2.
11. https://www.indiatoday.m/education-today/featurephilia/story/
medical-education-problems-327613-2016-07-06.
12. Kulkarni P, Pushpalatha K and Bhat O. Medical Education in
India; past, present and future. J Int Med, 2019; 7:69-78.
13. Mushtaq MU. Public Health in British India: A brief account of
the history of medical services and disease Prevalence in colonial
India. Ind J Comm Med, 2009; 34:6-14.
14. Sood R. Medical Education in India. Med Teach 2008, 30:585-
591.
15. Anshu AS. Evolution of medical education in India. Impact of
colonialism. J Postgrad Med; 2016:62:255-259.
16. https://www.org/publications/wfme-global-standards-for-quality-
improvement-pgme-2015 /wpd.
17. Islam N. History IPGMR 1969-1978. Dhaka,1980.
18. Patel M. Changes to Postgraduate Medical Education in the 21st
Century. Clinical Medicine,2016;16:311-314
19. Braun J and Gresser U. Comparison of the specialist Medical
Training in Internal Medicine in between Germany, Austria and
Switzerland; An Overview.2017;8:1729-1741.
20. RaO S. Doctors by Merit, not previlege. The Hindu, June 26,2013

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wZwb K‡qK `dvq mvB‡Kv‡_ivwc K‡i‡Qb| †KvbUv‡ZB †Zgb cwieZ©b nq
wb| ¯^vgx cÖ_gw`‡K wKQzUv nZvk n‡jI GLb †g‡b wb‡q‡Qb| ev”Pv‡ì ¯‹z‡j
Avbv-‡bIqv Kiv, evwo †`Lv‡kvbv Zuv‡K Ki‡Z nq| cÖvqB K¬vwšÍ Abyfe
K‡ib| wKQz wKQz KvR evwoi Kv‡Ri †jvK K‡i|
Zuvi †èi XvKvq GKRb we‡klÁ Wv³vi †`Lvbi eë¯’v K‡i‡Qb| GZRb
Wv³vi †`wL‡q‡Qb wZwb, Avi †`Lvbi Drmvn cvw”Q‡jb bv| wZwb nq‡Zv

Avevi A‡bK †U÷ Kiv‡Z PvB‡eb| ZvQvov XvKvq †`Lvb †ek mgm¨v| hwÌ
eo †evb XvKvq _v‡Kb, Kv‡RB _vKvi mgm¨v bvB| wKš‘ PÆMÖvg †_‡K XvKvq
Avmv hvIqv gv‡bB cwiev‡ii mevi Amyweav| ¯^vgx QzwU cvb wb| ZeyI Avm‡Z
nj, †èi ej‡Q Wv³v‡ii A¨vc‡q›U‡g›U cvIqv KwVb| wKš‘ nvmcvZv‡j
†`‡L †`‡eb, AwfÁ cwicvKZš¿ we‡klÁ Wv³vi, myivnv n‡ZI cv‡i| ¯^vgx
wKQzUv BZ¯ÍZt K‡i ivwR n‡q‡Qb|
eo †ev‡bi †Q‡j we‡klÁ Wv³v‡ii Kv‡Q eo GKUv miKvwi nvmcvZv‡j wb‡q
†Mj| hvevi wKQzÿY ci †`Lv nj| kvgmyb bvnvi GK e¨vM fwZ© †cÖmwµckb,
wi‡cvU© I G·-‡i wb‡q N‡i XzK‡jb| Wv³vi eq¯‹, †Pv‡L-gy‡L weiw³i fve
bvB, e‡jøb, emyb| †Uwe‡ji GKcv‡k e‡m e¨vM †_‡K me KvMRcÎ, G·-‡i
†ei K‡i †Uwe‡j ivL‡jb| `yÕGK K_vq Kzkj wRÁvmvi ci Wv³vi KvMRcÎ
GKcv‡k mwi‡q ivL‡jb, Gici wRÁvmv Ki‡jb, wK mgm¨v ejyb| kvgmyb
bvnvi e‡jøb, Avgvi †Zv cixÿv wbixÿv Kiv Av‡Q| Avgvi Functional
Bowel Disorder, Anaemia I Osteoporosis| Wv³vi e‡jøb, Avcbvi
me KvMRcÎ †`Le, wKš‘ Av‡M K‡ói K_v ejyb| K‡e †_‡K, wK, wK? kvgmyb
bvnvi Av‡¯Í Av‡¯Í K_v ejv ïiæ Ki‡jb cÖ_g †_‡K| Wv³vi g‡bv‡hvM w`‡q
ïb‡Qb, †Kvb Zvov Av‡Q g‡b nj bv| gv‡S gv‡S `yÕGKUv cÖkœI Ki‡Qb|
wPwKrmv †Ìqv exact weÁv‡bi gZ bq, †hgb c`v_©we`¨v ev imvqb| A‡bK
†ÿ‡ÎB GKRb †ivMxi †ivM wK Zv wbY©q Kiv mnR Ges wPwKrmvi c_I LyeB
¯úó| wKš‘ †Kvb †Kvb †ÿ‡Î †ivM wbY©q nIqvi ci wPwKrmvi c_ †`Lv hvq
GKvwaK| GKB Jl‡a me †ivMxi GKB dj nq bv| Avevi GKB †iv‡M GK
GKRb †ivMx Avjv`v Avjv`v Jl‡a dj cvq| A‡bK †ÿ‡Î M‡elYvi Av‡jv‡K
G e¨vcv‡i wb‡`©kbv _v‡K| A‡bK †ÿ‡Î M‡elYvi dj _v‡K AwbwðZ| wKš‘
cÖ_g cÖ‡qvRb n‡”Q †ivM wbY©q|
†ivM wbY©q Kivi c×wZ wK? wK c‡_ mwVK †ivM wbY©q Kiv hvq? Wv³v‡iiv
wKfv‡e †ivM wbY©‡qi Rb¨ wPšÍv K‡ib? wPšÍvi †Kvb DËg c×wZ Av‡Q wK? †ivM
wbY©‡qi Rb¨ wPšÍvavivi wK GKvwaK c×wZ Av‡Q? me Wv³vi wK GKBfv‡e wPšÍv
K‡ib? wewfbœ wel‡qi we‡klÁ (†hgb, mvR©b, wdwRwkqvb, †cwWqvwUªwkqvb
BZ¨vw`) wK wfbœ wfbœ c×wZ‡Z wPšÍv K‡ib? hLb `ªæZ wm×všÍ wb‡Z nq (†hgb
Riæwi Ae¯’vq) ZLb †hfv‡e wPšÍv Kiv nq Zv wK wbqwgZ †ivMx †`Lvi mgq
wPšÍv Kivi †_‡K Avjv`v? G¸‡jvi DËi mn‡R cvIqv hv‡e bv| cvV¨ eB‡q
GUv Av‡jvPbv nq bv| wKš‘ GUv Rvbv ìKvi| Wv³vi‡ì Rvbv ìKvi GB

Kvi‡Y †h, †ivM wbY©q I wPwKrmv †Ìqvi Rb¨ wPšÍvi avc ev gvbwmK c×wZ
†KvbUv †ewk Kvh©Ki Zv Rvb‡j †mUv AbymiY Kiv hvq| mvaviY gvby‡li Rvbv
cÖ‡qvRb G Kvi‡Y †h, G cÖwµqvq †ivMxi wK KiYxq hv‡Z Wv³vi‡K mvnvh¨
Kiv hvq|
†gwWK¨vj wkÿvi Dci A‡bK M‡elYv n‡q‡Q| RwUj MvwYwZK MYbvi mvnv‡h¨
g‡Wj ùvo Kivb n‡q‡Q-wKš‘ †ewkifvM wPwKrmKB ¯^xKvi K‡ib ev¯Í‡e ev
†ivMxi kh¨vi cv‡k †hfv‡e †ivM wbY©q Kiv nq, Zvi m‡½ G¸‡jvi wgj bvB|
†gwWK¨vj wkÿv_©x‡ì †kLvb nq, †ivM wbY©q KZK¸‡jv QK euvav, wew”Qbœ
c`‡ÿ‡ci gva¨‡g mij †iLvq Pj‡e| cÖ_‡g BwZnvm wb‡Z n‡e, ZviI wbw`©ó
Kjv‡KŠkj Av‡Q; Zvici physical examination, ZviI euvavaiv c×wZ
Av‡Q| †Kvb test hw` Kiv _v‡K Zvi djvdj Rvb‡Z n‡e| Gici †h me Z_¨
cvIqv †Mj, Zvi g‡a¨ †KvbUv †KvbUv we‡ePbvq Avbv ìKvi †m¸‡jv †e‡Q
wb‡Z n‡e| GB Dcv`vbMy‡jvi mgš^‡q we`¨gvb data base Gi m‡½ hvPvB
K‡i m¤¢ve¨ †ivMmg~‡ni GKUv ZvwjKv differential diagnosis Ki‡Z n‡e|
GB ZvwjKvi AMÖvwaKv‡ii µg wba©vwiZ nq Z_¨ fvÛv‡ii Av‡jv‡K m¤¢ve¨Zv
we‡ePbv K‡i| GUv n‡”Q Bayesian Analysis Gi wbqg| GUv cwimsL¨vb
kv‡¯¿i GKUv c×wZ †hLv‡b GKUv ARvbv Dcv`v‡bi m¤¢vebv wnmve Kiv nq|
†ewmqvb c×wZ mwVKfv‡e AbymiY Ki‡Z n‡j GKUv Z_¨ fvÛvi _vK‡Z
n‡e, hvi wfwË‡Z we‡ePbvaxb Dcv`v‡bi m¤¢vebv wnmve Kiv hvq| wKš‘
c×wZUv GB bxwZ Abyhvqx n‡jI wkÿv_©xiv GUv Rv‡b bv| Gfv‡e AbymiY
KivI nq bv| Z_¨ fvÛv‡ii e`‡j wkÿ‡Kiv Zv‡ì Ávb, AwfÁZv Kv‡R
jvMv‡Z e‡jb| wKš‘ wkÿv_©x‡ì AwfÁZv †ewk nIqvi K_v bq| Zv‡ì
wbf©i Ki‡Z nq cvV¨ eB jä †ivM m¤^‡Ü Áv‡bi Dci| Kv‡RB symptoms,
sign, test Gi dj G¸‡jv †_‡K †e‡Q wb‡q ïay Áv‡bi Dci wfwË K‡i mwVK
m¤¢vebv hvPvB Kiv KwVb| ¯œvZK ch©v‡q ZvB Z_¨ msMÖ‡ni Dci A_©vr mwVK
c×wZ‡Z BwZnvm †bIqv physical examination Gi gva¨‡g sign wbY©q
Kivi Dci †Rvi †Ìqv nq|
¯œvZ‡KvËi ch©v‡q A_©vr we‡klÁ ˆZwii cÖwkÿ‡Y †ivMx †`Lvi mgq †ivM
wbY©‡qi DcmM© I jÿY msMÖ‡ni mv‡_ Dcv`vb¸‡jvi mwVK we‡kølY K‡i †ivM
wbY©‡qi Dci †ewk ¸iæË¡ †Ìqv nq| GRb¨ wewfbœ c_ AbymiY Kiv nq|
GKUv nj Socratic discussion c×wZ| wMÖK `vk©wbK m‡µwUm (wLª÷c~e©
470 †_‡K 399) G c×wZ‡Z wkÿv`vb Ki‡Zb| G c×wZ‡Z †Kvb GKUv
wel‡qi Av‡jvPbvq cÖ‡Z¨K wkÿv_©x‡K Avjv`vfv‡e cÖ‡kœi ci cÖkœ Kiv nZ|

Gi ga¨ w`‡q m‡µwUm wkÿv_©xi wPšÍvq duvK A_ev êcixZ¨ cÖKvk K‡i Zv‡K
mwVK wm×v‡šÍ †cuŠQv‡Z mvnvh¨ Ki‡Zb| KL‡bv KL‡bv wZwb `yÕGKUv Dcv`vb
cwieZ©b K‡i Av‡jvPbvi my‡hvM w`‡Zb, Zv‡Z †`Lv †hZ wm×všÍ wKfv‡e
e`‡j hvq| Ask bv wb‡q ïay DËi ïb‡jI †h †Kvb wkÿv_©x DcK…Z n‡Zb|
wKš‘ cÖ‡Z¨‡KiB cÖ‡kœi m¤§yLxb nIqvi m¤¢vebv _v‡K, Kv‡RB mevi g‡bv‡hvM
†K›`ªxf‚Z _v‡K| A‡bKUv GB c×wZ AbymiY Ki‡Zb RvZxq Aa¨vcK byiæj
Bmjvg| †Kvb †ivMx wkÿv_©xiv †`Lvi ci wZwb mevB‡K wb‡q Av‡jvPbv
Ki‡Zb| cÖ‡Z¨K‡K G‡Ki ci GK cÖkœ wRÁvmv Kiv nZ, Av‡jvPbv †k‡l
cÖvq mevB eyS‡Z cviZ wKfv‡e wPšÍv K‡i wm×v‡šÍ Avmv †Mj| Zuvi AbymvixivI
A‡b‡K †Kvb bv †Kvbfv‡e GB c×wZ AbymiY K‡ib|
K_v †kvbv I K_v ejv Qvov non-verbal communication I ¸iæZ¡c~Y©|
†ivMxi gy‡Li fve, †Pv‡Li MwZ, emvi fw½, bovPov me wg‡j wKQz evZ©v
enb K‡i| A‡b‡K G wel‡q M‡elYv K‡i‡Qb| Gi g‡a¨ D‡jøL‡hvM¨ nj
hy³iv‡óªi Rbm ncwKÝ wek¦we`¨vj‡qi RywW_ nj I †W‡eviv iUvi| Zuviv
wewfbœ wel‡qi (†hgb mvR©vix, †gwWwmb, †cwWqvwUª· BZ¨vw`) we‡klÁ I
†ivMxi g‡a¨ K‡_vcK_‡bi K‡qK nvRvi wfwWI †iKW© ch©v‡jvPbv K‡i‡Qb|
Zuviv Ab¨vb¨ M‡elK‡ì Z_Ï we‡kølY K‡i‡Qb| Zuviv †`wL‡q‡Qb Wv³vi
wKfv‡e cÖkœ K‡ib Ges Zv‡Z †ivMxi Abyf‚wZi †Kgb cÖwZwµqv nq, Zvi Dci
wbf©i K‡i †ivMx KZUv †LvjvLywjfv‡e cÖ‡qvRbxq BwZnvm w`‡eb| Wv³vi
AvšÍwiK bv n‡j, †ivMx‡K Nb Nb _vwg‡q w`‡j, †ivMx cÖwZeÜKZv Abyfe
K‡i| Zv‡Z †ivMx me Z_¨ w`‡Z cvi‡e bv- nq‡Zv cÖ‡qvRbxq Dcv`vb ev`
co‡Z cv‡i| we‡køl‡Y †`Lv hvq ïiæ nIqvi ci M‡o 18 †m‡K‡Ûi g‡a¨
Wv³vi †ivMx‡K _vwg‡q †`b|
†ewkifvM †ivMxB Wv³v‡ii m‡½ †`Lv Kivi mgq ¯œvqyweK Pv‡c _v‡K| Zvi
_v‡K †iv‡Mi fq I Zvi m‡½ D‡ØM| Wv³vi wK wRÁvmv Ki‡e, wK wK †U÷
Kiv‡e, Avwg wVKgZ ej‡Z cvie wKbv, Wv³vi ïb‡e wK bv, Gme wPšÍv †Zv
_v‡KB, m‡e©vcwi _v‡K fq, Avgvi wK eo ev Lvivc †ivM n‡q‡Q? A‡bK mgqB
†ivMx wVKgZ DËi w`‡Z cv‡i bv, Avevi KL‡bv wKQz Z_¨ w`‡Z fz‡j hvq|
†ivMxi gvbwmK Pvc I D‡ØM Kgvbi e¨vcv‡i Wv³vi mvnvh¨ Ki‡Z cv‡ib|
mv¤úªwZK eQi¸‡jv‡Z QK †eu‡a †Ìqvi †Póv Kiv n‡q‡Q algorithm Gi
gva¨‡g| G¸‡jv we`¨gvb Z_¨ fvÛvi †_‡K m¤¢vebvi wfwË‡Z ˆZwi Kiv nq|
GLv‡b GKUv Dcv`vb (hv n‡Z cv‡i GKUv DcmM©) †_‡K GKUv c_‡iLv a‡i

GwM‡q †h‡Z n‡e, Zv n‡j †ivM wbY©q n‡e I wPwKrmvi w`K wb‡`©kbv cvIqv
hv‡e| G‡Z ejv _v‡K †Kvb avc †_‡K †Kvb kZ© c~iY n‡j †Kvb av‡c †h‡Z
n‡e, †ewk wPšÍvi cÖ‡qvRb nq bv, fz‡ji m¤¢vebvI Kg| †hgb, GKUv DcmM©
hv cÖvqB †`Lv hvq-Kvwk| GUv †_‡K K‡qKwU kvLvi nüv ev bv DË‡ii gva¨‡g
AMÖmi nIqv hv‡e| †hgb, K‡di is njy` wKbv, i³ †`Lv †M‡Q wKbv, †gqv`
`yÕmßv‡ni †ewk wKbv, R¡i Av‡Q wK bv BZ¨vw`, Gfv‡e GwM‡q AviI c‡i i³
I Kd cixÿvi dj, ey‡Ki G·-‡iÕi dj-G¸‡jv a‡i GwM‡q †ivM wbY©q n‡e|
A‡bK mvaviY mgm¨vi Rb¨ algorithm h‡_ó| wKš‘ wKQz wKQz mgm¨v Q‡K
†djv hvq bv ev Q‡K †dj‡jI mwVK mgvavb cvIqv hv‡e bv| GUv N‡U hLb
DcmM©¸‡jv wbw`©ó ev ¯úó bq, GKvwaK mgm¨v i‡q‡Q ev †U‡÷i dj e¨vL¨v
Kiv hvq bv, ZLb we‡kølYag©x c‡_i ìKvi nq|
AviI GKUv aviv cÖwZwôZ-‡mUv n‡”Q evidence based medicine|
GUv hLb †Kvb cwiw¯’wZ‡Z GKvwaK c_ AbymiY Kiv hvq ZLb GKUv c_
†e‡Q †bIqvi †ÿ‡Î cÖ‡hvR¨| †h ai‡bi wPwKrmv êÁvwbK c×wZ AbymiY
K‡i statistical evidence Gi wfwË‡Z mePvB‡Z †ewk Kvh©Ki Rvbv hvq,
ZvB †e‡Q †bIqv n‡e| Wv³v‡ii f‚wgKv Kg| Avevi A‡bK †ÿ‡Î cÖgv‡Yi
gvÎv GKvwaK wPwKrmvi †ÿ‡Î cÖvq mgvb nq| †Kvb †Kvb †ÿ‡Î we‡klZt
RwUj mgm¨vi †ÿ‡Î cwimsL¨vb wfwËK cÖgvY bvB| G cÖgvYmg~n AwaKvsk
†ÿ‡Î clinical trial Gi d‡ji Dci wbf©i K‡i| KL‡bv †h we‡klZ¡ m¤úbœ
†ivMx‡ì Dci trial Kiv n‡q‡Q, Zvi PvB‡Z Avjv`v we‡klZ¡ m¤úbœ †ivMx
n‡j Zvi †ÿ‡Î †m wPwKrmv djcÖm~ n‡e wKbv, Zvi wbðqZv _v‡K bv| †mLv‡b
Wv³v‡ii AwfÁZv ev wPšÍvi AeKvk _v‡K|
Wv³vi †ek wKQz mgq BwZnvm †kvbvi ci weQvbvq ïB‡q cixÿv Ki‡jb|
nvZ I cv‡qi Av½yj GKUz mgq wb‡q †`L‡jb| †cUI †`L‡jb wU‡c wU‡c,
Zvici †Pqv‡i em‡Z e‡jøb| me KvMRB †`L‡jb, G·-‡i ¸‡jvI †`L‡jb|
Zvici kvgmyb bvnvi‡K wKQzUv Avðh© K‡i w`‡q e‡jøb, Avcbvi †ivMUv
Functional Bowel Disorder g‡b n‡”Q bv| GUv Ab¨ wKQz n‡Z cv‡i|
Avcbvi G·-‡i‡Z ÿz`ªvš¿‡K ¯^vfvweK ejv n‡jI Avgvi Kv‡Q wKQz cwieZ©b Av‡Q
g‡b nq| Avcbvi Av½y‡jI wKQzUv A¯^vfvweKZv-Avgiv ewj clubbing Av‡Q|
me wKQz wgwj‡q Avgvi g‡b nq Av‡iKUz cixÿv Kiv ìKvi| †h¸‡jv Kiv
n‡q‡Q Zv Avevi Kivi ìKvi bvB| Z‡e K‡qKUv Ab¨ cixÿv ìKvi| Gi
g‡a¨ GKUv Avcbvi ÿz`ªvš¿ †`Lvi Rb¨ enteroscopy| Gici G cixÿvUv
wK I wKfv‡e Ki‡Z nq Zv eY©bv w`‡jb| kvgmyb bvnvi cÖvq e‡j D‡VwQ‡jb

Avi cixÿv Ki‡Z Pvb bv| wKš‘ ejvi Av‡MB Wv³vi e‡jøb Avcbvi †h AvZ¥xq
Wv³vi Avgvi Kv‡Q cvVv‡jb Dbvi †Uwj‡dvb b¤îUv AbyMÖn K‡i w`b| ZLbB
wZwb †Uwj‡dv‡b Zuvi †è‡ii m‡½ `yÕwZb wgwbU K_v e‡jøb| Gici kvgmyb
bvnvi‡K e‡jøb, ÒAvcbvi †èi‡K e¨vL¨v K‡iwQ wK Kiv ìKvi Ges †Kb?
Avcwb A‡bKw`b Kó cv‡”Qb, hw` ¯^vfvweK Rxe‡b wd‡i Avmvi m¤¢vebv _v‡K
Zvi †Póv Kiv DwPZ| G cixÿvUv n‡j †ivM m¤^‡Ü AviI Rvb‡Z cvie Avkv
KiwQ| Avcbvi †èi‡K cixÿv †Kv_vq I wKfv‡e Kiv hv‡e ZvI e‡jwQ|Ó
evox‡Z G‡m †è‡ii m‡½ K_v nj| wZwb e‡jøb, cixÿvUv KivB ìKvi|
Avwg eë¯’v KiwQ|
jÿ¨ Kiv hvq kvgmyb bvnv‡ii †ÿ‡Î, wZwb †ek K‡qKRb Wv³v‡ii Kv‡Q
hvIqv I BwZnvm †Ìqvi ci Avi K_v ejvi e¨vcv‡i Drmvn cvw”Q‡jb bv|
GgbwK Avevi Av‡iv GKRb Wv³v‡ii civgk© wb‡ZI AvMÖnx wQ‡jb bv| Z‡e
Wv³vi me KvMRcÎ mwi‡q †i‡L †iv‡Mi weeiY ïb‡Z AvMÖn cÖKvk Kivq
wZwb ejv ïiæ K‡ib| Wv³vi av‡c av‡c cÖkœ K‡i Zv‡K GwM‡q wb‡Z _v‡Kb|
Zvici Wv³vi Zuvi †cÖmwµckb, wi‡cvU©, G·-‡i meB †`L‡jb| †Kvb †Kvb
Wv³vi me †`‡Lb wb| G‡ZI Zuvi Av¯’v evoj| wKš‘ Dc‡`k †Ìqvi mgq †h
cixÿvi K_v wZwb e‡jøb, †mUvI nq‡Zv wZwb ivwR n‡Zb bv| ïaygvÎ eySvbi
ci Ges Zvi †è‡ii mv‡_ GUv wb‡q K_v ejvi ci wZwb ivwR n‡jb|
`yÕmßvn ci cixÿvUv nj| cixÿvq ÿz`ªv‡š¿i gvSvgvwS RvqMvq ulcer cvIqv
†Mj| ev‡qvcwmi Rb¨ †h tissue †mLvb †_‡K †bIqv nj †mUvi djvdj I
Ab¨ cixÿvi dj¸‡jv wgwj‡q Wv³vi †ivM wbY©q Ki‡jb, GUv Crohn’s
disease bv‡g GKUv †ivM| Zvici †cÖWwb‡mvjb bv‡g GKUv Jla w`‡jb|
wKQzw`b Lvevi ciB g‡b nj Av‡Mi Amyweav¸‡jvi DbœwZ n‡”Q|
Wv³vi‡ì `yB ai‡bi wm×všÍ wb‡Z nq| cÖ_gUv †ivMwbY©q, wØZxqUv wPwKrmv|
cÖ_gUv wVK n‡j wØZxqUv wVK nIqvi m¤¢vebv| kvgmyb bvnvi Gi †ÿ‡Î †ivM
Av‡M wbY©q bv nIqvi KviY we‡kølY Ki‡j K‡qKUv Dcv`vb cvIqv hvq|
Av‡M †h me wPwKrmK †ivMx‡K †`‡L‡Qb Zuviv Anaemia I osteoporosis
I clubbing †h kix‡ii organic (A_©vr functional bq) †iv‡Mi Bw½Z
†`q Zv we‡ePbv K‡ib wb| GUv Z_¨ msMÖn K‡i Zvi ga¨ †_‡K ¸iæZ¡c~Y©
Dcv`vb †e‡Q †bIqvi fzj| wØZxqUv nj †Kvb we‡kl Ae¯’v wK wK Kvi‡Y n‡Z
cv‡i (differential diagnosis) †m¸‡jv ˆZwi K‡i Zv h_vh_ hvPvB Kivi
Av‡MB †ivM m¤^‡Ü wm×v‡šÍ †cuŠQvb| GUvi bvg premature closure|

wkÿv_©x‡ì †kLvbi Rb¨ †gwWK¨vj K‡j‡R wkÿK e‡jb †ivMxi BwZnvm
I kvixwiK cixÿvq wK cvIqv †Mj (physical finding) G cÖwµqv m¤úbœ
Ki‡Z| †kl n‡j †h wkÿv_©x GUv K‡i‡Q †m eY©bv †`q, Gici wkÿK Rvb‡Z
PvB‡eb G¸‡jv mwVK wK bv| Zvici wRÁvmv Ki‡eb Gi g‡a¨ †Kvb †Kvb
Dcv`vb ¸iæZ¡c~Y©| GK GK K‡i †m¸‡jv ejv nq I †ev‡W© †jLv nq| wkÿK
Gi ci Rvb‡Z PvB‡eb G¸‡jvi mgš^q †Kvb †Kvb †iv‡Mi m¤¢vebv Bw½Z †`q|
†m¸‡jv wjLv nq; GUvB differential diagnosis| me m¤¢vebv we‡ePbv Kiv
n‡q‡Q wK bv ZvI Av‡jvPbv Kiv nq| Gi ci cÖkœ Kiv nq G¸‡jvi g‡a¨
†KvbUv wVK Zv wbY©q Kivi Rb¨ wK wK cixÿv Ki‡Z n‡e| GLv‡b we‡ePbvq
_vK‡e ¸iæZ¡c~Y© cixÿv hv‡Z ev` bv c‡o, wKš‘ AcÖ‡qvRbxq cixÿv †hb Kiv
bv nq| GKRb †ivMxi Rb¨ G Av‡jvPbv 30 wgwbU ev Zvi †ewkI jvM‡Z
cv‡i| Kwbô wPwKrm‡Kiv †ev‡W© bv wjL‡jI †ivMx †`Lvi mgq Gfv‡eB wPšÍv
K‡i, mgq 20-30 wgwbUB jv‡M| hy³iv‡óªi K‡jviv‡Wv wek¦we`¨vj‡qi
Institute of Cognitive Science Gi Aa¨vcK Robert Hamm e‡jb,
Aa¨vcK I AwfÁ wPwKrm‡Kiv hLb †ivMx †`‡Lb ZLb Gfv‡e wPšÍv K‡ib
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1. Am¤ú~Y© †ivMxi BwZnvm ev kvixwiK cixÿv| mwVK †ivM m‡›`n bv
Kiv I Am¤ú~Y© cixÿv wbixÿv premature closure|
2. Am¤ú~Y© Z_¨ msMÖn I GKUv †ivM m‡›`n Kiv †hLv‡b GKvwaK †ivM wQj|
3. †Kvb ¸iæZ¡c~Y© Z_¨ Avg‡j bv †bIqv| cÖwZ †ivMxi †ÿ‡Î 3.9 ai‡bi
fzj cvIqv hvq| Z‡e †ewkifvM †ÿ‡ÎB G¸‡jvi KviY c×wZMZ
ÎæwU, Áv‡bi Afve bq|
Av‡gwiKvi Rbm& ncwKbm& wek¦we`¨vj‡qi †ivMx‡ì wbivcËv we‡klÁiv 2016
mv‡j cÖKvwkZ GKUv cÖe‡Ü e‡jb, Zv‡ì wnmv‡e cÖwZ eQi Av‡gwiKvq cÖvq
AvovB jÿ gvbyl wPwKrmvq fz‡ji Rb¨ gviv hvq| GUv †gvU g„Zzï cÖvq `k
kZvsk| 1980-1990 Gi `k‡K M‡elYvq †`Lv hvq cÖvq 15 kZvsk †ÿ‡Î
†ivM wbY©q fzj nq|
wPwKrmv weÁv‡bi †K‡›`ª Av‡Q AwbðqZv| kZfvM †ÿ‡Î mwVK wm×všÍ †Ìqv
m¤¢e bq| wKš‘ ev¯Íe Ae¯’v we‡kølY K‡i eë¯’v wb‡j wKQz wKQz †ÿ‡Î fzj
Govb hvq| cwðgv †`‡k †ewkifvM †ÿ‡Î fzj nq c×wZMZ ÎæwUi Rb¨,

Áv‡bi Afv‡e bq| K‡qK ai‡bi eë¯’vq c×wZi DbœwZ K‡i fzj Kgvb
hvq| cÖ_g n‡”Q mwVK I we¯ÍvwiZ BwZnvm †bIqv I c~Y© kvixwiK cixÿv
Kiv| wØZxq n‡”Q Gi †_‡K ¸iæZ¡c~Y© Dcv`vb¸‡jv we‡ePbvq †bIqv| m¤¢ve¨
†iv‡Mi differential diagnosis Gi c~Y© ZvwjKv ˆZwi Kiv Ges cÖ‡Z¨KUvi
m¤¢ve¨Zv hvPvB Kiv, hv‡Z premature closure bv nq| we‡kølY ev wm×všÍ
MÖn‡Yi Rb¨ h‡_ó mgq w`‡Z n‡e| A‡bK †ivMxi Pvc _vK‡j, GKvwaK
mgm¨v GK m‡½ mgvav‡bi †Póv Ki‡j, Zvovû‡ov Ki‡j ev K¬všÍ Ae¯’vq fzj
nIqvi m¤¢vebv †ewk| cÖ‡Z¨‡Ki gvbwmK c×wZ¸‡jv m¤^‡Ü Rvbv ìKvi I
analytical c×wZ h_vm¤¢e †ewk †ÿ‡Î cÖ‡qvM Kiv ìKvi| Debiasing Gi
cÖwkÿY wb‡Z n‡e| cÖvq †ÿ‡ÎB mgq wb‡q wPšÍv m¤^‡Ü wPšÍv Ki‡Z n‡e-fzj
n‡”Q wKbv| GUvi bvg metacognition|
Z_¨m~Î:
1. Croskerry P. From Mindless to Mindful Practice-Cognitive Bias and
Clinical Decision Making. New Eng J Med. 2013;368:2445-2448
2. Berner ES, Graber MC. Overconfidence as a cause of diagnostic
error in medicine. Am J Med, 2008; 121: Suppl: S2-S23.
3. Groopman J. How Doctors Think. 2007, Houghton Mifflin
Company. Boston- New York.
4. Kassier JP. Diagnostic reasoning. Ann Intern Med, 1989; 110:
893-900.
5. Croskerry P. The importance of cognitive errors in diagnosis and
strategies to minimize them. Acad Med, 2003, 78: 775-780.
6. Redelmier DA. Improving patient care. The cognitive psychology
of missed diagnosis. Ann Intern Med, 2005; 142: 115-120.
7. Graber MI, Kissam S, Payne VL et al. Cognitive interventions
to reduce diagnostic error: a narrative review. BMJ Quality and
Safety. 2012; 21:535-557.
8. Croskerry P, Abbass AA, Wu AW. How doctors feel: affective
issues in patient safety. Lancet, 2008; 372:1205-1206.
9. Croskerry P, Singhal G and Mamede S. Cognitive debiasing 1:
origins of bias and theory of debiasing. BMJ Quality and Safety
2013; 22 (Suppl 2): ii 58-ii64.
10. Elstein AS. Clinical Reasoning in Medicine; Higgs J, Jones MA
(eds). Clinical Reasoning in the Health Professions. Woburn,
Mass.Butterworth-Heineman,1995:49-59

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A‡b‡KB mwVK I fzj m¤^‡Ü wb‡R‡ì Abyf‚wZ‡K ˆbwZKfv‡e mwVK I fyj
wbY©‡qi gvcKvwV g‡b K‡ib| GUv wVK bq| A‡bK KvR‡K wb‡R‡ì Abyf‚wZ
mwVK wb‡`©kbv †`q, wKš‘ Zv memgq Kiv hvq bv| A‡bK‡ÿ‡ÎB bxwZwe`¨vi
wb‡`©kbvi m‡½ Abyf‚wZi wgj _v‡K bv| A‡b‡K g‡b K‡ib mvgvwRKfv‡e †h
KvR Aby‡gvw`Z ZvB mwVK| wK¯‘ me wel‡q mvgvwRK Aby‡gv`b wba©viY Kiv
hvq bv| †Kvb †Kvb †ÿ‡Î GKB wel‡q ci¯úiwe‡ivax RbgZ _v‡K| KLbI
KLbI mg¯Í mgvR A‰bwZK n‡q DV‡Z cv‡i| wØZxq gnvhy‡×i mgq bvrmx
Rvg©vbx Gi GKwU D`vniY|
bxwZwe`¨vi ZË¡ wK gvby‡li AvPiY‡K cÖfvweZ Ki‡Z cv‡i? A‡b‡K g‡b
K‡ib cv‡i| Zv‡ì g‡Z e¨w³ hw` †ev‡S †h †Kvb GKUv KvR bxwZMZfv‡e
fvj, Zvn‡j †mUv Zvi bv KivUv A‡hŠw³K n‡e| wKš‘ gvby‡li AvPiY me
mgq †hŠw³K bq| Z‡e bxwZ m¤úwK©Z wel‡q (moral issue) we‡ePbv Kivi
Rb¨ bxwZwe`¨v GKUv fvj c×wZ| bxwZwe`¨v GKUv fvj KvVv‡gv †`q hvi

mvnv‡h¨ KwVb wel‡q wm×všÍ †bIqv hvq| Avevi A‡bK †ÿ‡Î Zv GKvwaK
mgvav‡bi c_ †`Lvq ev †Kvb c_ †`Lvq bv|
bxwZwe`¨vi †K‡›`ª Av‡Q ÔAbïvÕ| Avwg Qvov Ab¨vbïv I mvgvwRK ¯^v_©
GLv‡b we‡ewPZ nq| Kv‡RB bxwZwe`¨v Abyhvqx hLb wPšÍv Kiv nq, ZLb
Ab¨‡ì K_vI Av‡m| eZ©gvb hy‡M GgbwK `vk©wb‡KivI wbwðZ bb †h,
b¨vqbxwZi ZË¡ me wel‡q wm×v‡šÍi w`K wb‡`©kbv w`‡Z cv‡i| Gme w`K
†_‡K bxwZwe`¨vi (ethics) f‚wgKv nj b¨vqbxwZi Z‡Ë¡i †cÖÿvc‡U mgm¨vwUi
we‡kølY †Ìqv| bxwZwe`¨v‡K K‡qKwU kvLvq fvM Kiv nq| Gi g‡a¨ wZbwU
cÖavb kvLv we‡ePbvq Avbv n‡e| GMy‡jv n‡jv meta ethics, normative
ethics I applied ethics.
Metaethicst
GB kvLv bxwZwe`¨vi wewfbœ m~‡Îi DrcwË mÜvb Ges G¸‡jvi A_© we‡kølY
K‡i| Gi g‡a¨ GKUv aviv nj metaphysicalt moral values ¸‡jv wK
k¦vk¦Z mZ¨ hv AvZ¥vi (spirit) gZ Avavi G weivR K‡i, bvwK G¸‡jv gvby‡li
ˆZwi-GUv we‡ePbv Kiv| A¼kv‡¯¿i wnmve¸‡jv wPišÍb Ges wek¦Rbxb| †hgb
`yB Avi `yB †hvM Ki‡j Pvi nq, GUv mKj Kv‡j I wek¦eªþv‡Ûi me©Î GKB|
`vk©wbK †cø‡Uv A¼kv¯¿ Øviv AbycÖvwYZ n‡qwQ‡jb| Zuvi g‡Z A¼kv¯¿ weg~Z©
mËv (abstract entity) wb‡q KvR K‡i| G¸‡jvi Aw¯ÍZ¡ gvby‡li Aw¯Í‡Z¡i
Dci wbf©ikxj bq| †Zgwbfv‡e moral values ¸‡jvI weg~Z© I me©Rbxb|
†Kvb †Kvb `vk©wb‡Ki g‡Z moral values ¸‡jv Ck¦im„ó I ag©MÖ‡š’i gva¨‡g
gvby‡li Kv‡Q †cÖwiZ A_ev gvbeg‡b MÖw_Z| MÖxK `vk©wbK Empiricus Gi
wecixZ gZ †`b| wZwb moral values Gi Aw¯ÍZ¡ ¯^xKvi K‡ib, wKš‘ G¸‡jv
gvbem„ó e‡j g‡b K‡ib| GUv moral relativism bv‡g cwiwPZ| GB g‡Z
`yBwU aviv i‡q‡Q| GK avivq cÖ‡Z¨K gvbyl Zvi wb‡Ri moral value ˆZwi
K‡i| Avi GK aviv g‡b K‡i GUv e¨w³we‡k‡li bq, mvgvwRK gZvg‡Zi
wfwË‡Z wba©vwiZ| †m Kvi‡Y GUv wek¦Rbxb bq Ges wewfbœ †`‡k I mgv‡R
moral values G cv_©K¨ †`Lv hvq| †hgb- eû weevn, mgKvwgZv BZ¨vw`
m¤^‡Ü gZvgZ me mgv‡R GK iKg bq|
Av‡iKUv aviv nj Psychology ev g‡bvwe`¨vi cÖfve| †Kvb †Kvb `vk©wbK
e‡jb, Avgv‡ì ˆbwZK wel‡q wm×všÍ MÖnY I AvPi‡Yi gvbwmK wfwË Av‡Q|
mß`k kZ‡K Thomas Hobbes g‡b Ki‡Zb gvby‡li me KvR nq wbR
¯^v_©wmw×i Rb¨| Ggb wK c‡ivcKvi KivI wb‡Ri ¯^v‡_©i Rb¨, KviY

GUv Avb›` ev mšÍwó †`q| GUv Psychological egoism bv‡g cwiwPZ|
Avi GKRb e„wUk `vk©wbK Joseph Butler e‡jb, Gi m‡½ gvby‡li g‡a¨
civ_©ciZvI (benevolence) AšÍwb©wnZ Av‡Q| Avgv‡ì wKQz Kv‡Ri
wcQ‡b GUvI _v‡K|
‰bwZK Kv‡Ri wcQ‡b hyw³ KZUv KvR K‡i GUv wb‡q wØgZ Av‡Q| Aóv`k
kZvãxi e„wUk `vk©wbK David Hume e‡jb, gvbyl ˆbwZK we‡ePbv K‡i
Av‡eM w`‡q, hyw³ w`‡q bq| wKš‘ Aóv`k kZvãx‡Z Rvg©vb `vk©wbK
Immanuel Kant e‡jb, Av‡eM Avgv‡ì AvPi‡Y cÖfve †dj‡Z cv‡i,
Z‡e GUv cÖwZ‡iva Kiv DwPZ| mwZ¨Kvi ˆbwZK wm×všÍ Av‡eMgy³ I
hyw³wbf©i n‡Z n‡e|
gvb wba©viK bxwZwe`¨v ZË¡ (Normative ethics)t
wK nIqv DwPZ ev DwPZ bq, GUv wba©viY Kiv, †KvbUv fvj ev fvj bq Zv
wbY©q Kiv Ges wKfv‡e Zv g~j¨vqb Kiv DwPZ G me welq wb‡q GB kvLv
KvR K‡i| Gi wZbwU ZË¡ Av‡Q|
Virtue Theoryt A‡bK `vk©wbK wek¦vm K‡ib morality ev bxwZ a‡g©i
A_© nj wbw`©ó KZK¸‡jv bxwZ †g‡b Pjv| Virtue ev m`¸Y ZË¡ wbw`©ó
bxwZ ˆZwii PvB‡Z fvj PwiÎ ˆZwi Kivi Dci †ewk †Rvi †`q| D`vniY
nj c‡ivcKvix g‡bvfve ˆZwi Kiv| GUv ˆZwi Ki‡Z cvi‡j me Kv‡RB
c‡ivcKv‡ii cÖvavb¨ Avm‡e| G ZË¡ wMÖK `k©b †_‡K P‡j Avm‡Q Ges Zv
A‡bK cyi‡bv| ga¨hyM ch©šÍ GUv ¸iæZ¡c~Y© wQj| Dbwesk kZvãx‡Z weKí
wP¯Ívaviv G Z‡Ë¡i ¸iæZ¡ Kwg‡q †`q|
Duty Theoryt G‡K deontological I ejv nq| wMÖK kã deon A_©
duty, gvbyl wnmv‡e wKQz bxwZgvjv cvjb Kiv Avgv‡ì KZ©e¨| †hgb-
wkï‡ì hZœ †bIqv, wcZvgvZvi †`Lv‡kvbv Kiv| G‡Z mgq I A_©e¨q
n‡jI Zv Ki‡Z nq| mß`k kZ‡K Rvg©vb `vk©wbK Samuel Pufendorf
KZ©e¨¸‡jv‡K wZbfv‡M fvM K‡ib| Ck¦‡ii cÖwZ KZ©e¨, wb‡Ri cÖwZ KZ©e¨,
Ab¨vb¨ gvby‡li cÖwZ KZ©e¨|
Av‡iK ai‡bi duty theory nj rights theoryt G‡Z GKRb gvby‡li
AciR‡bi Dci AwaKvi Øviv Zvi AvPiY cÖfvweZ nq| †hgb A‡bï Øviv
ÿwZMÖ¯Í ev AvNvZcÖvß bv nIqvi AwaKvi GKRb gvby‡li Av‡Q| mß`k
kZ‡K e„wUk `vk©wbK John Locke G avivi cÖ_g w`‡Ki cÖe³v| wZwb
e‡jb,GKRb gvby‡li Aci gvby‡li Rxeb, ¯^v¯’¨, ¯^vaxbZv I m¤úwËi

ÿwZ Kiv DwPZ bq| Zuvi g‡Z Gme AwaKvi Ck¦i cÖ`Ë| Rb jKÕ‡K
AbymiY K‡i gvwK©b hy³iv‡óªi ¯^vaxbZvi †NvlYvc‡Îi (Declaration
of Independance) cÖ‡YZv _gvm †Rdvimb wZbwU g~j AwaKvi eY©bv
K‡ibt Rxeb, ¯^vaxbZv I myL A‡š^lY Kivi AwaKvi| Gme AwaKvi †_‡K
AviI Ab¨vb¨ AwaKvi P‡j Av‡m; †hgb evK¯^vaxbZvi AwaKvi, m¤úwËi
AwaKvi, wbR ag© cvj‡bi AwaKvi BZ¨vw`| GB ˆbwZK AwaKvi¸‡jv cÖK…
wZ cÖ`Ë (natural), me©Rbxb (universal), mevi Rb¨ mgvb (equal) I
n¯ÍvšÍi‡hvM¨ bq (inalienable)|
Z…Zxq ai‡bi Duty Theoryt Rvg©vb `vk©wbK Bgvby‡qj Kv›U g‡b Ki‡Zb me
ai‡bi ˆbwZK KvR GKUv bxwZ w`‡q wba©viY Kiv hvq| Zvnj Ab¨ gvby‡li
cÖwZ gh©v`vc~Y© AvPiY Ki‡Z n‡e| †Kvb D‡Ïk¨ mva‡bi Rb¨ Ab¨ gvbyl‡K
eënvi Kiv hv‡e bv|
Consequentialist Theoryt GB gZ Abyhvqx †Kvb Kv‡Ri ˆbwZK Ae¯’vb
wbY©q Kiv n‡e Zvi djvdj Abyhvqx| G gZ Abyhvqx †h †Kvb Kv‡Ri wK wK
fvj dj n‡Z cv‡i I wK wK g›` dj n‡Z cv‡i Zv cÖ_‡g wba©viY Ki‡Z
n‡e| hw` fvj dj g›` d‡ji PvB‡Z †ewk nq Zv n‡j KvRUv Kiv hvq| hw`
g›` d‡ji m¤¢vebv fvj d‡ji m¤¢vebvi PvB‡Z †ewk nq ZvÕn‡j †m KvR bv
KivB fvj| Ab¨vb¨ Z‡Ë¡i PvB‡Z G Z‡Ë¡i we‡ePbvi aviv ¯úó, GUv Zvi
eo AvKl©Y|
D`vniY njt GKRb †ivMxi hš¿Yv`vqK g„Zz¨ cÖZ¨ÿ K‡i wPwKrmK evB‡i
Avm‡jb| g„Zzï K_v †kvbvi ci †ivMxi AvZ¥xq ¯^Rb wRÁvmv Ki‡jb, Dwb
wK Kó †c‡q‡Qb? wPwKrmK ej‡jb, Lye kvwšÍi ga¨ w`‡q wZwb P‡j †M‡Qb|
Consequentialist gZ Abyhvqx †ivMxi AvZ¥xq Kó bv cvb †m Rb¨ G wg_¨v
K_v ejv| Deontological gZ Abyhvqx wg_¨v K_v ejv †Kvb µ‡gB wVK bv|
†ivMxi AvZ¥xq ¯^R‡bi mZ¨ Rvbvi AwaKvi Av‡Q|
eënvwiK bxwZwe`¨v (Applied ethics)t

bxwZwe`¨vi ZË¡ ev¯Íe Rxe‡b cÖ‡qvM G kvLvi welq| wbw`©ó, weZwK©Z ˆbwZK
mgm¨vmg~n G kvLvq we‡kølY Kiv nq| GUv ivóªxq bxwZ (public policy)
wba©vi‡Yi welq n‡Z cv‡i| Avevi GKRb e¨w³i ˆbwZK wm×v‡šÍi welq
n‡Z cv‡i| A‡bK †ÿ‡Î GKUv mgm¨vi mgvav‡bi A‡bK¸‡jv c_ _vK‡Z
cv‡i| Avevi A‡bK mgm¨vq bxwZwe`¨v QvovI Ab¨vb¨ welqI RwoZ _v‡K|

Applied ethics A‡bK¸‡jv kvLvq wef³| Gi g‡a¨ i‡q‡Q Biomedical
ethics, Legal ethics, Business ethics, Environmental ethics,
Media ethics BZ¨vw`|
Biomedical ethicst Rxewe`¨v I wPwKrmv weÁv‡bi `ªæZ AMÖMwZi d‡j
wPwKrmK, wPwKrmv weÁvbx I RxeweÁvbxiv cÖwZwbqZ bZzb bZzb ˆbwZK
mgm¨vi m¤§yLxb n‡”Qb| Gi m‡½ mv¤úªwZKKv‡j `ªæZ cÖmvigvb GjvKv
†hgb gene therapy, cloning BZ¨vw` i‡q‡Q| eënvwiK bxwZgvjvi †h
kvLv wPwKrmv I ¯^v¯’¨‡mevq cÖ‡qvM Kiv nq Zv nj †gwWK¨vj Gw_Km| Gi
m‡½ m¤úwK©Z wKš‘ wKQzUv Avjv`v nj bvwm©s Gw_Km| GQvov wPwKrm‡Kiv
Zv‡ì cÖvZ¨wnK Kv‡RI cÖvqB ˆbwZK cÖ‡kœi gy‡LvgywL nb| wPwKrmK‡ì
ˆ`bw›`b Kv‡Ri ˆbwZK mgm¨v †gwWK¨vj Gw_K‡mi GKUv eo Ask Ges
GUv Av‡jvPbv Kiv n‡e| wPwKrm‡Kiv gvby‡li Rxeb g„Zz¨ wb‡q KvR K‡ib
ZvB Ab¨vb¨ †ckvi Kg©x‡ì PvB‡Z Zv‡ì †ewk msL¨K ˆbwZK mgm¨vi
m¤§yLxb n‡Z nq|
wPwKrmK‡ì ˆbwZK `vwqZ¡ m¤^‡Ü Av‡jvPbv cwðgv we‡k¦ wLª÷c~e© cÂg
kZ‡K Hippocrates Gi †jLvq cvIqv hvq| ivRv Theodoric Gi mgq
cÂg wLª÷v‡ã †gwWK¨vj Gw_Km Gi bxwZgvjv iwPZ nq| †gwWK¨vj Gw_
Km Gi cÖ_g eB beg kZvãx‡Z eZ©gvbKv‡ji Zzi‡¯‹ BmnvK web Avjx
Avj †ivnvqx (Ishaq bin Ali al Rohawi) iPbv K‡ib| 1794 mv‡j
Thomas Percival bv‡g GKRb wPwKrmK cwðgv we‡k¦ †gwWK¨vj Gw_Km
m¤^‡Ü wj‡Lb| Av‡gwiKvb †gwWK¨vj G‡mvwm‡qkb 1847 mv‡j Zvi cÖ_g
Code of Ethics MÖnY K‡i| World Medical Association †R‡bfvq
1947 mv‡j wØZxq m‡¤§j‡b Declaration of Geneva bv‡g bxwZgvjv MÖnY
K‡i| 1948 mv‡j AviI wek`fv‡e International Code of Medical
Ethics MÖnY Kiv nq| GUvi K‡qKwU ms¯‹iY n‡q‡Q| Gi Dci wfwË
K‡i wewfbœ †`‡k Gw_K‡mi bxwZgvjv ˆZwi n‡q‡Q| wPwKrmv †mev w`‡Z †h
mg¯Í mgm¨vwì DrcwË nq, †gwWK¨vj Gw_Km cÖavbZt Zv we‡ePbv K‡i|
Biomedical ethics Gi †ÿÎ AviI cÖmvwiZ: RxeweÁv‡bi wewfbœ kvLvq
AMÖMwZi Kvi‡Y D™¢~Z mgm¨vw` wb‡q Zv KvR K‡i|
†Kb †gwWK¨vj Gw_Km?
wPwKrmv I ¯^v¯’¨‡mev gvby‡li ¯^v¯’¨, Rxeb I g„Zz¨ wb‡q KvR K‡i| †gwWK¨vj
Gw_K‡mi KvR n‡”Q ¯^v¯’¨‡mev I wPwKrmvq ˆbwZKZvi gvb`Û wba©viY Kiv|
¯^v¯’¨Kg©x‡ì wKQz ÿgZv I myweav †Ìqv nq hv Ab¨ gvbyl cvq bv| Zviv

kw³kvjx Jla gvbyl‡K w`‡Z cv‡i, hv mwVKfv‡e cÖ‡qvM Kivi c‡iI ÿwZ
nevi m¤¢vebv _v‡K| Zviv gvby‡li wewfbœ A½-cÖZ¨‡½ Qzwi Pvjv‡Z cv‡i,
GgbwK gw¯Í®‹ I ürwc‡ÛI| meB †ivMxi DcKv‡ii Rb¨| KL‡bv KL‡bv
†Kvb gvby‡li euvwP‡q ivLv n‡e wKbv †m wm×všÍI Zviv wb‡Z cv‡i| A‡bK
†`‡k ¯^v¯’¨‡mevq KZ A_© e¨q n‡e ZvI Zviv wba©viY Ki‡Z ev †ivMx‡ì wK
Z_¨ †Ìqv n‡e ev n‡e bv ZvI Zviv wVK Ki‡Z cv‡i| G¸‡jv me gvby‡li
Rxeb‡K †Kvb bv †Kvb mg‡q cÖfvweZ Ki‡Z cv‡i|
eZ©gvb hy‡M A‡bK kw³kvjx hš¿cvwZ eënvi Kiv hvq †h¸‡jvi mvnv‡h¨
GKRb gvbyl hvi wewfbœ cÖZ¨½ KvR Ki‡Q bv Zv‡K euvwP‡q ivLv hvq|
G¸‡jv RwUj I e¨qeûj| †Kvb gvbyl‡K euvwP‡q ivLv n‡e, GKRb brain
dead gvbyl‡K KLb hš¿cvwZi mvnv‡h¨ (K…wÎg Dcv‡q euvwP‡q ivLv) euvwP‡q
ivLv †_‡K †ei K‡i Avbv n‡e- Gi wm×všÍ †K †b‡e? †ivMxi AvZ¥xq
¯^R‡biv GKgZ bvI n‡Z cv‡ib| A_ev †ivMxi AvZ¥xq ¯^R‡biv GKgZ,
¯^v¯’¨Kg©x‡ì Aci gZ ZLb wK Kiv n‡e? A½ cÖZ¨½ cÖwZ¯’vcb GLb
A‡bK ¯’v‡bB µgea©gvb nv‡i Kiv n‡”Q| wKWbx, wjfvi, ürwcÛ G¸‡jv
cÖwZ¯’vcb GLb Avi bZzb bq| hZ †ivMxi cÖwZ¯’vcb ìKvi †Kvb GK
mg‡q Zvi PvB‡Z A‡bK Kg A½-cÖZ¨½ `vZv (organ donor) cvIqv hvq|
cÖwZ¯’vc‡bi †ÿ‡Î Kviv AMÖvwaKvi cv‡e Ges Zv wbe©vP‡bi bxwZgvjv wK
n‡e, Zvi wm×všÍI wPwKrm‡Kiv †bq|
¯^v¯’¨‡mevi µgea©gvb LiP †K †`‡e? ¯^v¯’¨‡mev cvIqv wK gvby‡li †gŠwjK
AwaKvi? hvi †h wPwKrmv ìKvi †m ZvB cv‡e- Zvi LiP hvB †nvK bv †Kb,
Avi †ivMxi mvg_© hvB †nvK bv †Kb? G LiP †gUvbi Rb¨ wK Ki evovb
hv‡e? †Kvb nvmcvZvj wK me †ivMx‡ì, me ai‡bi e¨qeûj wPwKrmv w`‡Z
eva¨ _vK‡e? G‡Z nvmcvZvj †`bvMÖ¯Í ev †`Dwjqv n‡q †M‡j Zv‡K †K D×vi
Ki‡e? †h me †ivMx ¯^v¯’¨‡mevi LiP w`‡Z cv‡i bv, Zv‡ì NvUwZ †gUvbi
Rb¨ hviv m¤ú`kvjx †m me †ivMxi Kv‡Q †ewk UvKv †bIqv wK wVK? G¸‡jv
Gw_K‡mi mvaviY cÖkœ|
†gwWK¨vj Gw_K‡mi g~jbxwZt

Gw_K‡mi mgm¨v mgvav‡bi Rb¨ `vk©wb‡Kiv A‡bK c×wZ eënvi K‡ib|
wb‡P ewY©Z bxwZ¸‡jv Gw_K‡mi g~jbxwZ| G¸‡jvi Dci wfwË K‡i cÖwZwU
†ÿ‡Î we‡kølY K‡i wm×v‡šÍ †cŠQvb nq| ¸iæZ¡c~Y© bxwZ¸‡jv njt

1. Autonomyt †ivMxi Zvi wb‡Ri †`‡ni Dci AwaKvi _vK‡e| †h
†Kvb cixÿv ev wPwKrmv MÖnY Kiv ev bv Kivi AwaKvi Zvi Av‡Q|
wPwKrm‡Ki KvR nj †ivMx‡K cixÿv ev wPwKrmv cÖ‡qvRb I
†hŠw³KZv eywS‡q ejv| †ivMx †h wm×všÍ wb‡e Zv wPwKrmv kv¯¿g‡Z
Av`k© bv n‡jI †mB Abyhvqx KvR Ki‡Z n‡e|
D`vniYt GKRb ¯Íb K¨vÝvi †ivMxwbi wPwKrmK wPwKrmvi `yÕ‡Uv c_
ej‡jb; (1) wZwb Total Mastectomy Ki‡Z cv‡ib| (2) wZwb Partial
Mastectomy K‡i radiotherapy wb‡Z cv‡ib| †ivMx Total Mastectomy
Ki‡Z PvBj| GUv nj AutonomyÕi D`vniY| GB †ivMx‡K Ab‡KvjwR÷
ej‡jb, Avcbvi Total Mastectomy Ki‡Z n‡e| GUv nj Paternalism
Gi D`vniY|
2. Beneficencet wPwKrm‡Kiv †ivMxi Ae¯’vi DbœwZ Kivi Rb¨ KvR
Ki‡Z ˆbwZKfv‡e `vqe×| †h c×wZ wb‡j ev †h KvR Ki‡j †ivMxi
DcKvi n‡Z cv‡i Zv bv KivUvI ˆbwZKZv weiæ×| mgv‡Ri Ab¨vb¨
gvbyl‡K mvaviYZt fvj KvR bv Kivi Rb¨ `vqx Kiv nq bv| wKš‘
wPwKrmK Zv Ki‡j Ae‡njvi (negligence) Rb¨ `vqx Kiv n‡Z cv‡i|
3. Nonmaleficencet †Kvb ÿwZ bv Kiv| wPwKrmvi †ÿ‡Î ÿwZ nj
Ggb wKQz Kiv hv †ivMxi Ae¯’vi AebwZ NUvq| wKš‘ ev¯Í‡e †Kvb
Kv‡R ÿwZ n‡e Zv wba©viY Kiv mnR bq| A‡bK †ivM wbY©q ev
wPwKrmv c×wZ cÖ‡qv‡M †ivMxi A¯^w¯Í, e¨_v, Kó GgbwK kvixwiK
AÿgZv ev weK…wZI n‡Z cv‡i| GUv †g‡b †bIqv hvq G hyw³‡Z
†h DcKv‡ii m¤¢vebv †ewk|
D`vniYt GKRb eq¯‹v gwnjvi Rheumatoid Arthritis n‡q‡Q| wPwKrmK
e¨_v I cÖ`vn Kgvbi Rb¨ non- steroidal anti inflammatory MÖæ‡ci
Jla w`‡Z Pvb| GUv nj beneficence Gi D`vniY|
Avi GKRb wPwKrmK Zv‡K GB Jla w`‡Z Pvb bv, KviY †ivMxi cvk¦©
cÖwZwµqv wnmv‡e cwicvKZ‡š¿ i³cvZ nIqvi m¤¢vebv †ewk| GUv nj
nonmaleficence Gi D`vniY|
HwZnvwmKfv‡e wPwKrmK †ivMx m¤^‡Ü KiYxq wm×všÍ wb‡Zb Ges †ivMxiv
cy‡ivcywi Av¯’vi m‡½ †g‡b wb‡Zb| wm×všÍ †bIqvi †cÖÿvcU, hyw³ ev KviY
†ivMx‡K eySvbi ìKvi nZ bv ev †ivMxi m¤§wZ †bIqvi ìKvi nZ bv|
†ivMxi c‡ÿ wPwKrmKB wm×všÍ wb‡eb| GUv‡K paternalistic ai‡bi wm×všÍ

MÖnY Kiv ejv nq| A_©vr †ivMx‡K wkï a‡i wb‡q wPwKrmK Zvi Awffve‡Ki
f‚wgKvq _vK‡Zb| wKš‘ weMZ K‡qK `k‡K †ivMx I ¯^R‡biv †ivM m¤^‡Ü
Rv‡bb I Rvb‡Z Pvb Ges wm×všÍ MÖn‡Yi fvi wPwKrm‡Ki Dci †Q‡o bv
w`‡q wb‡Riv wm×všÍ MÖn‡Y Ask wb‡Z Pvb|
4. Justicet mxwgZ m¤ú` ev my‡hvM myweav wKfv‡e e›Ub Kiv n‡e
Ges †Kvb ai‡bi wPwKrmv †K cv‡e? G¨vwi‡÷vU‡ji g‡Z b¨vq
wePvi nj GKB mgm¨vi Rb¨ `yÕ GKUv e¨wZµg Qvov me gvbyl
GKB wPwKrmv cv‡e| cÖvq AvovB nvRvi eQ‡ii GB bxwZ A‡b‡KB
mwVK g‡b K‡ib| Distributive justice weZi‡Yi b¨vq wePvi-
Rb‡Mvôxi me AskB ¯^v¯’¨‡mevi m¤ú` weZi‡Yi †ÿ‡Î mgfv‡e
weZi‡Yi AwaKvi †fvM Ki‡e|
5. Honesty ev mZZv t †ivMx‡ì Kv‡Q wg_¨v ejv DwPZ bq| †ivMx‡ì
Zv‡ì †ivM I wPwKrmv m¤^‡Ü m¤ú~Y© mZ¨ Rvbvi AwaKvi i‡q‡Q|
6. Respect for Human Rightst 1945 mv‡j RvwZmsN cÖwZwôZ
nIqvi ci Zvi GKUv `vwqZ¡ wQj gvbevwaKvi iÿv Kiv| 1948
mv‡j RvwZms‡Ni mvaviY cwil` Universal Declaration of
Human Rights MÖnY K‡i| G‡Z gvby‡li †gŠwjK AwaKvi¸‡jv‡K
¯^xK…wZ †Ìqv n‡q‡Q| wPwKrmK‡ì ˆbwZK `vwqZ¡ gvbevwaKvi iÿv
Kiv| Gi m‡½ †ivMx‡ì m¤§vb I gh©v`v (dignity), †MvcbxqZvI
iÿv Ki‡Z n‡e|
wPwKrmv †ckv eûKvj †_‡K mywbw`©ó ˆbwZK bxwZgvjv †g‡b KvR K‡i Avm‡Q|
†ckv wnmv‡e †ivMx‡ì cÖwZ Ges mgv‡Ri cÖwZ wPwKrm‡Ki †h KZ©e¨ Zv
bxwZgvjv AbymiY K‡i cvjb Kiv nq| GKwU †ckvi †ek wKQz êwkó¨ _v‡Kt
(K) †ckvi m`m¨‡ì we‡kl Ávb I `ÿZv _v‡K, (L) †ckvi m`mïv e¨w³
I mgv‡Ri cÖwZ Zv‡ì KZ©e¨ ¯^xKvi K‡i, (M) cÖwZwU †ckvq cÖwkÿY w`‡q
bZzb m`m¨ MÖnY Kiv nq| Zv‡ì Kg©`ÿZv I AvPiY ch©‡eÿY Kiv nq
I e¨Z¨q NU‡j eë¯’v †bIqv nq| wPwKrmv, wkÿKZv, AvBb cÖf…wZ G¸‡jv
†ckvi AšÍf©~³| Ab¨me †ckvi gZ wPwKrmv †ckvi m`mïv my`„p wbðqZv
†`q †h, cÖ‡qvR‡b Zvi wb‡Ri ÿwZ ¯^xKvi K‡iI Zv‡ì Kg©KvÛ †ivMx‡ì
Kj¨v‡Yi Rb¨ wb‡qvwRZ _vK‡e|
†ckvMZ AvPiYwewa (Professional Code of Conduct)t wewfbœ †ckvi
msMVb †mB †ckvi m`m¨‡ì Rb¨ †ckvMZ AvPiYwewa ˆZwi K‡i|
wPwKrmK‡ì Rb¨ wewfbœ msMVb †h AvPiYwewa ˆZwi K‡i‡Qb G¸‡jvi

wfwË †gwWK¨vj Gw_Km| `vwqZ¡ cvj‡bi mgq Zv‡ì AvPiY †Kgb nIqv
DwPZ Zv GB wewagvjv wba©viY K‡i| A‡bK KZ…©cÿ Code of conduct I
Code of ethics G `yÕ‡Uv Avjv`v ˆZwi K‡ib| Code of ethics mvaviYZt
KZK¸‡jv mswÿß ˆbwZK wewa eY©bv K‡i hv mvaviY w`K wb‡`©kbv †`q|
Ab¨w`‡K Code of conduct AviI wbw`©ófv‡e Ges AviI wek`fv‡e
KiYxq m¤^‡Ü eY©bv †`q| World Medical Association wPwKrmK‡ì
Rb¨ International Code of Medical Ethics ˆZwi K‡i| wb‡P 2006
mv‡ji ms¯‹i‡Yi mvi ms‡ÿc †Ìqv njt
GKRb wPwKrm‡Ki KZ©e¨t Zuvi AvPiY m‡e©v”P †ckvMZ gvbm¤úbœ n‡Z
n‡e| wZwb wPwKrmvi e¨vcv‡i †ivMxi wm×všÍ †bIqvi AwaKvi †g‡b wb‡eb;
e¨w³MZ jvf Zuvi wm×všÍ †bIqvi Dci cÖfve †dj‡e bv| wZwb †ivMxi
AwaKvi I gh©v`v iÿv Ki‡eb| †ivMxi m‡½ Zvi AvPiY n‡e mr| wZwb
A‰bwZK KvR cwinvi Ki‡eb| Ab¨ wPwKrmK A‰bwZK AvPiY Ki‡j wZwb
Zv KZ…©cÿ‡K Rvbv‡eb| †ivMx cvVvbi Rb¨, ev we‡kl cixÿv Kivbi Rb¨
wZwb Avw_©K ev Ab¨ †Kvb myweav wb‡eb bv| Rb¯^v¯’¨ m¤^‡Ü wkÿv`v‡bi
e¨vcv‡i `vwqZ¡ cvjb Ki‡eb| bZzb †ivM wbY©q I wPwKrmv c×wZ Avwe®‹vi
m¤^‡Ü MYgva¨‡g cÖPv‡ii wel‡q mZK© _vK‡eb| m¤ú‡ì eënv‡ii mgq
hv‡Z mgv‡Ri m‡e©v”P DcKvi nq Zv †g‡b Pj‡eb| Rxeb iÿvB n‡e g~j
D‡Ïk¨ Ges †ivMxi ¯^v_©‡K AMÖvwaKvi w`‡Z n‡e| †ivMx wPwKrmvi mgq
wb‡Ri me Ávb I `ÿZvi m‡e©v”P cÖ‡qvM Ki‡eb| †h wPwKrmv wZwb w`‡Z
cv‡ib bv, †m Rb¨ h_v‡hvM¨ wPwKrmK I ¯’v‡b cvVv‡eb| †ivMxi Z_¨ I
weeiY †Mvcb ivL‡eb| Riæwi wPwKrmv †Ìqv Zvi KZ©e¨| †ivMxi m‡½
†hŠb m¤úK© ¯’vcb Ki‡eb bv ev †Kvb ¯^v_© D×v‡ii Rb¨ †ivMx‡K wZwb Kv‡R
jvMv‡eb bv| Ab¨ wPwKrm‡Ki m‡½ †ivMxi m¤ú‡K©i ÿwZ Ki‡eb bv|
D`vniYt GKRb Acute appendicitis Gi †ivMxi Kv‡Q cixÿvi Rb¨
i³ cvVv‡bvi D‡Ï‡k¨ wPwKrmK i³ †bIqvi wmwiÄ wb‡q †M‡Qb, †ivMx
nvZ evwo‡q w`j| GUv nj implied consent| wPwKrmK †ivMx‡K wRÁvmv
Ki‡jb, Avwg wK Avcbvi eøvW †cÖmvi †`L‡Z cvwi? †ivMx nüv ejj, GUv nj
expressed oral consent| Zvici †ivMx‡K kj¨ wPwKrmvi cÖ‡qvRbxqZv,
Zvi myweav, Amyweav wPwKrmK eywS‡q ej‡jb I m¤§wZi dg©wU c‡o
†kvbv‡jb| d‡g© wPwKrmK ¯^vÿi Ki‡jb I †ivMxI ¯^vÿi Ki‡jb| GUv nj
wjwLZ informed consent Gi D`vniY|

GKRb †ivMxi epilepsy wbY©q Kiv nj| wPwKrmK ej‡jb, H †ivMxi Mvox
Pvjvb wb‡la| †ivMx †g‡b Pj‡e ejj| K‡qKw`b c‡i wPwKrmK †`‡Lb
†ivMx Mvox Pvwj‡q hv‡”Q| gvby‡li wbivcËvi K_v we‡ePbv K‡i wPwKrm‡Ki
DwPZ n‡”Q WªvBwfs KZ…©cÿ‡K GUv Rvbv‡bv| GUv nj †Kvb cwiw¯’wZ‡Z
†MvcbxqZv (confidentiality) f½ Kiv hv‡e Zvi D`vniY|
GB ˆbwZKZvi bxwZgvjvi Dci wfwË K‡i me †`‡kB wPwKrmK‡ì †ckvMZ
AvPiYwewa ˆZwi Kiv n‡q‡Q| hy³iv‡R¨ General Medical Council
cÖKvk K‡i‡Qb Good Medical Practice; hy³iv‡óª Av‡gwiKvb †gwWK¨vj
G‡mvwm‡qkb wPwKrmK‡ì Rb¨ Code of Medical Ethics ˆZwi K‡i‡Qb|
fvi‡Zi †gwWK¨vj KvDwÝj cÖKvk K‡i‡Qb Code of Medical Ethics|
evsjv‡`‡k G `vwqZ¡ cvjb Ki‡Qb Bangladesh Medical and Dental
Council (BMDC)| Zviv Code of Professional Conduct, Ettiquette
and Ethics cÖKvk K‡i‡Qb (www.bmdc.org.bd)| AvšÍR©vwZK bxwZgvjv
AbymiY K‡i GUv Kiv n‡q‡Q| AZGe Abykvmbmg~n G ch©šÍ hv Av‡jvPbv
Kiv n‡q‡Q Zvi m‡½ m½wZc~Y©| evsjv‡`‡ki me wPwKrmK G bxwZgvjv †g‡b
Pj‡Z A½xKvive×| bxwZgvjvi e¨Z¨q NUv‡j BMDC eë¯’v †bIqvi AwaKvi
iv‡Lb| G bxwZgvjv wPwKrmK‡ì D‡Ï‡k¨ Kiv n‡jI wPwKrmK‡ì Kg©Kv‡Ûi
ˆbwZK bxwZgvjv m¤^‡Ü mgvR‡K Rvbv†bv Gi D‡Ïk¨| GB bxwZgvjv AvBb
bq| Z‡e ¯^v¯’¨‡mev msµvšÍ AvBb m¤^‡Ü wPwKrmK‡ì AewnZ _vK‡Z ejv
n‡q‡Q| †Kvb †ÿ‡Î AvBb I bxwZgvjvi êcixZ¡ _vK‡j AvBb cÖvavb¨ cv‡e|
hwÌ G bxwZgvjv wek` wKš‘ ˆbwZKZvi mg¯Í w`K m¤^‡Ü wb‡`©kbv †Ìqvi
`vex K‡i bv| †mevi gv‡bi mg¯Í w`KI Av‡jvPbv Kiv nq wb| GLv‡b †ckvi
Ab¨vb¨ msMV‡bi bxwZgvjv I w`K wb‡`©kbvi mvnvh¨ wb‡Z ejv n‡q‡Q| m¤ú~Y©
Code BMDC Gi website G †`Lv hv‡e (www.bmdc.org.bd)| GLv‡b
wKQz ¸iæZ¡c~Y© Ask Zz‡j aiv nj|
wPwKrmK‡ì cÖ‡qvRbxq KZ©e¨t †ivMxi cÖ‡qvRb‡K mewKQzi Dc‡i ¯’vb
†Ìqv Ges Z_¨vw` †Mvcb ivLv| wb‡Ri Ávb I `ÿZv memgq nvj bvMv`
(update) ivLv, mZZv I mngwg©Zv _vKv, †ivMxi `ye©jZvi my‡hvM bv †bIqv|
†ivMxi Kv‡Q wbR¯^ ag©xq, ivR‰bwZK ev ˆbwZK gZvgZ cÖKvk Kiv hv‡e
bv| eë¯’vcbv, M‡elYv I wkÿKZviI `ÿZv _vKv cÖ‡qvRb| †ivMxi Ae¯’v
we‡ePbvi mgq Zvi c~Y© BwZnvm I kvixwiK cixÿvq cÖvß Z_¨vwì wfwË‡Z
wm×všÍ wb‡Z n‡e Ges cÖ‡qvRbxq cixÿv wbixÿv I wPwKrmvi civgk© w`‡Z

n‡e| cÖ‡qvR‡b Ab¨ wPwKrm‡Ki Kv‡Q cvVv‡Z (refer) n‡e| cixÿv,
wbixÿv I wPwKrmv †Ìqvi Av‡M †ivMxi m¤§wZ m¤^‡Ü wbwðZ n‡Z n‡e|
RvwZ, ag©, eY©, wj½, cÖwZeÜxZ¡, ivR‰bwZK wek¦vm I Avw_©K m½wZ BZ¨vw`
Kvi‡Y êlg¨g~jK AvPiY Kiv hv‡e bv| †ivMx‡K Zvi †iv‡Mi cÖK…wZ m¤^‡Ü
Rvbv‡bv, cixÿv wbixÿvi cÖ‡qvRb I wPwKrmvi †hŠw³KZv m¤^‡Ü h_vm¤¢e
mnRfv‡e eySv‡bv ìKvi| †ivM wbY©q m¤^‡Ü cÖ‡qvRbxq cixÿv wbixÿvi
mvnv‡h¨ h_vm¤¢e wbwðZ n‡Z n‡e|
we`¨gvb mePvB‡Z cÖgvYwfwËK (based on the best available evidence)
wPwKrmv †Ìqv cÖ‡qvRb| AbygvbwfwËK ev mwVKfv‡e cÖgvwYZ bq Ggb
wPwKrmv mycvwik Kiv hv‡e bv| †ivMxi wØZxq gZ †bIqvi AwaKvi †g‡b
wb‡Z n‡e| wb‡Ri A_ev wb‡Ri Nwbô AvZ¥xq ¯^R‡bi wPwKrmv wb‡R bv
KivB fvj| bZzb cixÿv ev wPwKrmv c×wZ World Medical Association
Gi Declaration of Helsinki (www.wma.net) wbqgvejx Abyhvqx
w`‡Z n‡e Ges G wel‡q cÖ‡qvRbxq KZ…©c‡ÿi Aby‡gv`b wb‡Z n‡e|
Complementary ev alternative wPwKrmv †Ìqv hv‡e bv|
g„Zz¨c_hvÎx †ivMxi e¨_v ev Ab¨vb¨ DcmM© jvNe Kivi eë¯’v wb‡Z n‡e I
Zvi gh©v`v iÿv Ki‡Z n‡e| Euthanasia (hš¿Yv`vqK I `~iv‡ivM¨ †iv‡M
†fvMv †ivMxi g„Zz¨ NUvb ev Zv‡Z mvnvh¨ Kiv) †eAvBwb I AˆbwZK| Z‡e
g„Zz¨c_hvÎx †Kvb †ivMx artificial life support G _vK‡j Zv cÖZ¨vnvi Kiv
Euthanasia bq| †ivMxi Ae¯’v we‡ePbv, Zvi AvZ¥xq ¯^R‡bi B”Qv G¸‡jv
we‡ePbv K‡i wm×všÍ wb‡Z n‡e| A½-cÖZ¨½ ms‡hvRb m¤^‡Ü me©‡kl AvBb
(Transplantation of Human Organs (Amendment) Bill, 2018)
AbymiY Ki‡Z ejv n‡q‡Q|
Termination of Pregnancyt me©‡kl AvBb AbymiY Ki‡Z ejv n‡q‡Q|
AšÍZt c‡ÿ `yB Rb wPwKrmK‡K GKgZ n‡Z n‡e †h, (1) Mf©ve¯’v Pj‡Z _
vK‡j †ivMxi Rxeb wecbœ n‡e Zvi kvixwiK ev gvbwmK ¯^v‡¯’ï ÿwZ n‡e, A_ev
(2) Mf©¯’ wkï R‡b¥i ci ¸iæZi kvixwiK ev gvbwmK cÖwZeÜx nIqvi m¤¢vebv
Av‡Q| Mf©ve¯’vq Rb¥MZ ev eskMZ †iv‡Mi Dcw¯’wZ Rvbvi Rb¨ †ivMxi m¤§wZ
wb‡q prenatal diagnosis Gi c×wZ MÖnY Kiv hv‡e| †gwWK¨vj KviY Qvov
Mf©¯’ wkïi wj½ wba©viY Kiv hv‡e bv| wbh©vZ‡bi Av‡M A_ev wbh©vZbKvjxb
mg‡q kvixwiK †hvM¨Zv hvPvB Gi Rb¨ ¯^v¯’¨ cixÿvq Ask MÖnY wbwl×|
Z‡e wbh©vwZZ e¨w³i wPwKrmv †Ìqvi Rb¨ wPwKrmK‡K kvw¯Í †Ìqv hv‡e bv|
wbh©vZb Kivi mgq A_ev wbh©vZ‡bi fq †`Lvbi mgq Dcw¯’Z _vKv hv‡e bv|

†ivMxi BwZnvm, kvixwiK cixÿvi (physical examination) weeiY,
cixÿvi djvdj, wPwKrmv BZ¨vw` wjwce× Kiv DwPZ| GUv nv‡Z wjLv
n‡Z cv‡i, UvBc ev wcÖ›U Kwc n‡Z cv‡i| nv‡Z †jLv n‡j ¯úó n‡Z n‡e|
e¨w³MZ †P¤^v‡i †`Lv n‡j GB †iKW© †ivMx‡K w`‡q †Ìqv hvq| nvmcvZv‡j
n‡j Zv msiÿ‡Yi eë¯’v _vK‡Z n‡e| †ckvMZ Rvb©vj ev Ab¨ †Kv_vI
†ivMx‡K †Pbv hvq Ggbfv‡e Zvi Qwe cÖKvk Kiv hv‡e bv| †ivMxi wbivcËv
wbwðZ Kivi Rb¨ wPwKrmK ¸YMZgvb Dbœq‡bi (quality development)
D‡Ï‡k¨ Kg©KvÛ (mfv, †mwgbvi, Av‡jvPbv, gZwewbgq BZ¨vw`) Av‡qvRb
Ki‡eb I AskMÖnY Ki‡eb|
†Kvb Kvi‡Y hw` †ivMx h_vh_ wPwKrmv cv‡”Q bv e‡j wPwKrm‡Ki g‡b nq
Z‡e Zv h_vh_ KZ…©cÿ‡K Rvbv‡Z n‡e| GUv ¯’v‡bi Afve, hš¿cvwZi Afve
ev nvmcvZv‡ji bxwZi Kvi‡Y n‡Z cv‡i| mnKg©x wPwKrm‡Ki Abychy³Zvi
(unfit) Kvi‡Y †ivMx‡ì SuywK evo‡Q g‡b Ki‡j Ab¨ mnKg©x‡ì civgk©
wb‡Z n‡e| cÖ‡qvR‡b KZ…©cÿ‡K Rvbv‡Z n‡e| wPwKrmK wb‡R Amy¯’ n‡j
Zvi †mev †Ìqvi ÿgZv K‡g †h‡Z cv‡i ev msµvgK †ivM n‡j Zvi
†ivMx‡ì msµgY n‡Z cv‡i| h_vh_ wPwKrm‡Ki civgk© wb‡Z n‡e Ges
Zvi Dc‡`k Abyhvqx †ivMx †`Lv eÜ ev cwieZ©b Ki‡Z n‡e|
†ivMxi e³e¨ †kvbv cÖ‡qvRb, †ivM wbY©q I wPwKrmv msµvšÍ Z_¨ Rvbv‡Z
n‡e| G‡Z †Kvb SuywK _vK‡j Zv Av‡M Rvbv‡Z n‡e| †ivMxi AbygwZ wb‡Z
n‡e, †ivMxi ¯^Rb‡ì m‡½I mnvbyf‚wZ m¤úbœ eënvi Ki‡Z n‡e Ges h_
vm¤¢e Z_¨ w`‡Z n‡e| wkÿKZv I cÖwkÿ‡Y Ask wb‡Z n‡e| †Kvb wkÿv_©x ev
mnKg©x m¤^‡Ü reference †jLvi mgq e¯‘wbôfv‡e w`‡Z n‡e| †ivMxi DcKvi
nIqvi m¤¢vebv _vK‡j Ab¨ wPwKrmK ev ¯^v¯’¨Kg©xi Kv‡Q †ivMx cvVvb hv‡e|
hvi Kv‡Q cvVvb n‡”Q wZwb GB †mev w`‡Z cvi‡eb G m¤^‡Ü wbwðZ n‡q
cvVv‡Z n‡e| GRb¨ †Kvb A_© ev Ab¨ myweav (percentage) †bIqv wbwl×|
cixÿvi Rb¨ †Kv_vI cvVv‡j †mRb¨ †Kvb A_© ev Ab¨ myweav †bIqv hv‡e bv|
†gwWK¨vj M‡elYvi Rb¨ World Medical Association Gi Declaration
of Helsinki Ges Bangladesh Medical Reasearch Council Gi
wb‡`©kbv AbymiY Ki‡Z n‡e| Gi g~j w`K eY©bv Kiv n‡q‡Q| we`¨gvb Z_¨
I Áv‡bi wfwË‡Z M‡elYv cÖ¯ÍvewU êÁvwbK w`K w`‡q †hŠw³K n‡Z n‡e|
M‡elYv cÖK‡í hy³ cÖ‡Z¨K e¨w³i Dchy³ `ÿZv _vK‡Z n‡e| †Kvb Jla
ev wPwKrmv c×wZ m¤^‡Ü M‡elYv n‡j Zvi weiƒc cÖwZwµqv nIqvi m¤¢vebv

m¤^‡Ü Rvbv _vK‡Z n‡e I M‡elYvq DcKvi nIqvi m¤¢vebvi Zzjbvq †hŠw³K
n‡Z n‡e| wbqg Abyhvqx wjwLZ cÖ¯ÍvewU h_vh_ mv‡qw›UwdK KwgwU I Gw_
K¨vj KwgwU KZ…©K Aby‡gvw`Z n‡Z n‡e| †h me †ivMx A_ev gvbyl M‡elYvq
Ask wb‡eb Zv‡ì G m¤^‡Ü eySvbi ci AbygwZ (informed consent) wb‡Z
n‡e| cÖ¯Íve Abyhvqx M‡elYv cwiPvjbv Ki‡Z n‡e| djvdj wjwLZfv‡e
msiÿY Ki‡Z n‡e I Zvi †MvcbxqZv iÿv Ki‡Z n‡e| M‡elYvq cÖPviYv
†ckvMZ Am`vPiY (professional misconduct) wn‡m‡e MY¨ n‡e|
wPwKrm‡Kiv Zv‡ì †cÖmwµckb c¨v‡W, wfwRwUs Kv‡W© wK wjL‡Z cvi‡eb
Zvi wb‡`©kbv Av‡Q| bv‡gi Av‡M Wv³vi _vK‡e; ïaygvÎ KvDwÝj KZ…©K
Aby‡gvw`Z wWwMÖ ev qualification wjLv hv‡e| KvDwÝj KZ…©K Aby‡gvw`Z
we‡klÁ wWwMÖ _vK‡jB ïaygvÎ †mB wel‡q we‡klÁ wjLv hv‡e| †iwR‡óªkb
b¤î wjL‡Z n‡e| cÖwZôv‡bi bvg wjLv hv‡e| AwZiwÄZ Z_¨ †Ìqv hv‡e
bv| †ivMx AvKl©Y Kiv n‡”Q A_ev Ab¨ wPwKrmK‡ì Dci †kÖôZ¡ `vex Kiv
n‡”Q Ggb wKQz wjLv hv‡e bv| mvBb‡ev‡W©i AvKvi wK n‡e Ges †Kgb n‡e
Zv ejv Av‡Q| ïaygvÎ cÖ_g cÖvKwUm ïiæ Kivi mgq A_ev wVKvbv cwieZ©b
n‡j Zv cÎ cwÎKvq †Ìqv hv‡e| GUvi AvKvi wbw`©ó Kiv Av‡Q| Qwe †Ìqv
hv‡e bv| cÖvKwUm msµvšÍ Z_¨ Ab¨fv‡e cÖPvi Kivi wbqgvejxI wbw`©ó Kiv
Av‡Q| ¯^v¯’¨‡mevq eëüZ †Kvb mvgMÖxi MYgva¨‡g cÖPviYvq Ask †bIqv
hv‡e bv| MYgva¨‡g ¯^v¯’¨ m¤úwK©Z Abyôv‡b Ask †bIqv hv‡e, wKš‘ Zv‡Z
e¨w³MZ ev wb‡Ri cÖwZôv‡bi evwYwR¨K cÖPvi bv nq, Zv wbwðZ Ki‡Z n‡e|
†ivMx †`Lv I wewfbœ procedure, kj¨wPwKrmv BZ¨vw` I wd †ivMx‡K Av‡M
Rvbv‡Z n‡e| Ab¨ wPwKrmK I Zv‡ì cwiev‡ii m`m¨, †gwWK¨vj ev †W›Uvj
wkÿv_©x‡ì †ivMx wnmv‡e †`Lvi wd †bIqv hv‡e| Z‡e wd bv †bIqv we‡kl
AwaKvi (previlege) e‡j MY¨ Kiv nq|
†ckvMZ AvPiYwewa j•Nb (professional misconduct) Gi Kvi‡Y
BMDC kvw¯Íg~jK eë¯’v wb‡Z cv‡i| A‡kvfb ev wnsmvZ¥K AvPiY,
†ckvMZ `vwqZ¡ cvj‡bi mgq gv`K `ª‡eï cÖfv‡e _vKv, gv`K `ªe¨
eënv‡ii Kvi‡Y †ckvMZ `vwqZ¡ cvj‡b AÿgZvI kvw¯Íg~jK eë¯’v †bIqvi
KviY n‡Z cv‡i| †gwWK¨vj mvwU©wd‡K‡U fzj Z_¨ †Ìqv, Ab¨ wPwKrm‡Ki
A‡hŠw³K mgv‡jvPbv KivI kvw¯Í‡hvM¨ Aciva| ¯^v¯’¨‡mev Qvov Ab¨ †Kvb
Kvi‡Y we‡klZt AmZZvi Kvi‡Y †Kvb wPwKrmK Kviv`Ûv‡`k †c‡j ZvI
k„•Ljvf½ wnmv‡e MY¨ n‡e|

`kg Aa¨vq
¯^v¯’ëë¯’v I me©Rbxb ¯^v¯’¨‡mev
(Universal Health Care-UHC)
1950 mvj †_‡K 1992 mvj ch©šÍ c„w_exi A_©bxwZi AvKvi cuvP ¸Y
†e‡owQj| wKš‘ GLbI we‡k¦i GK kZvsk gvbyl 50 kZvs‡ki †ewk m¤ú‡ì
AwaKvix| we‡kî 2 nvRvi †KvwU gvbyl `vwi`ª mxgvi wb‡P evm K‡i| cÖwZw`b
1000 wkï, hvi †ewkifvMB Avwd«Kvq evm K‡i, g¨v‡jwiqv †iv‡M gviv hvq|
cÖvq 15000 wkï I gwnjv cÖwZw`b cÖwZ‡iva‡hvM¨ A_ev wbivgq‡hvM¨ †iv‡M
g„ZzëiY Ki‡Q| eZ©gv‡b c„w_exi A‡a©‡Ki †ewk gvbyl cÖ‡qvRbxq ¯^v¯’¨‡mev
†_‡K ewÂZ| Gi †ewkifvMB Dbœqbkxj I Kg m¤ú` m¤úbœ †`k¸‡jv‡Z evm
K‡i| ¯^v¯’¨‡mev cvIqvi Rb¨ e¨q K‡i cÖwZ eQi cÖvq 10 †KvwU gvbyl `vwi`ª
mxgvi wb‡P †b‡g hv‡”Q| 93 †KvwU gvbyl ¯^v¯’¨‡mevi Rb¨ Zv‡ì Av‡qi 10
kZvs‡ki †ewk LiP Ki‡Z eva¨ nq|
1948 mv‡j cÖYxZ wek^ ¯^v¯’¨ ms¯’vi (WHO) MVbZ‡š¿ gvby‡li †gŠwjK
AwaKv‡ii g‡a¨ ¯^v¯’¨ GKwU, Zv ¯^xK…Z| 1978 mv‡j Avjgv-AvZvq ¯^vÿwiZ
Ômevi Rb¨ ¯^v¯’¨Õ (Health for All) †NvlYv‡ZI GUv AšÍf©y³| 2015 mv‡j
RvwZm‡•N †h †UKmB Dbœq‡bi jÿ¨gvÎv (Sustainable Development
Goals) wba©viY Kiv nq, Zvi ¯^v¯’¨ m¤úwK©Z jÿ¨¸‡jvi m‡½ GUv
m¤úwK©Z| RvwZm‡•Ni me m`m¨ †`k 2030 mv‡ji g‡a¨ me©Rbxb ¯^v¯’¨‡mev
(Universal Health Care-UHC) Pvjy Kivi A½xKvi K‡i‡Q| †h mg¯Í
†`k 2030 mv‡ji g‡a¨ UHC Pvjy Ki‡Z cvi‡e Zviv ¯^v¯’¨ m¤úwK©Z Ab¨vb¨
jÿ¨¸‡jvI AR©b Ki‡Z cvi‡e| wkïiv my¯^v¯’¨ AR©b Ki‡Z cvi‡j, Zviv
†jLvcov Ki‡Z cvi‡e, cÖvß eq¯‹iv A‡_©vcvR©b Ki‡Z cvi‡e, `vwi`ªgy³
n‡Z cvi‡e I `xN©¯’vqx DbœwZi wfwË iPbv Ki‡Z cvi‡e|
me©Rbxb ¯^v¯’¨‡mev (UHC) wK? †`‡ki me ¯’v‡bi me ¯Í‡ii gvbyl cÖ‡qvRbxq
†ivM wbivgq, †ivM cÖwZ‡ivag~jK, †iv‡Mi ci cybe©vmb I †ivM cÖkgbg~jK
¸YMZ gvb m¤úbœ †mev cv‡eb| G‡Z †mev MÖnYKvix A_©K‡ó co‡eb bv|

UHC Gi wZbwU jÿ¨ t
1| UHC Gi AvIZvq mevB me ai‡bi ¯^v¯’¨‡mev cv‡e, ïay weËev‡biv bq|
2| ‡mevi ¸YMZgvb fvj n‡Z n‡e, hv‡Z ¯^v‡¯’ï DbœwZ nq|
3| huviv †mev wb‡”Qb Zuviv †hb Avw_©K w`K w`‡q `~‡f©v‡M bv c‡ob ev
ÿwZMÖ¯Í bv nb, Zvi wbðqZv _vK‡Z n‡e|
UHC Gi Rb¨ A_©vqb GKUv cÖavb Dcv`vb| wKš‘ my¯^v¯’¨ AR©‡bi Rb¨
AviI Ab¨vb¨ Dcv`vb cÖ‡qvRb, †m¸‡jvI wbwðZ Ki‡Z n‡e| Gi g‡a¨
i‡q‡Q ¯^v¯’¨‡mev cÖ`vb eë¯’v ev delivery, ¯^v¯’¨‡mev †K›`ª I nvmcvZvj
mg~‡ni Dbœqb, ¯^v¯’¨ Kg©x ˆZwi, cÖ‡qvRbxq cÖhyw³ I Jl‡ai wbqwgZ mieivn,
†hvMv‡hvM eë¯’vi Dbœqb Kiv, mwVK cwiPvjbv eë¯’v M‡o †Zvjv, cÖ‡qvRbxq
AvBb cÖYqb Kiv, gvb hvPvB Kiv I eRvq ivLvi eë¯’v Kiv, †ivM cÖwZ‡iva
eë¯’v M‡o †Zvjv I Rb¯^v‡¯’ï Ab¨vb¨ w`K wbwðZ Kiv|
A_©vqb wKfv‡e nq? AwaKvsk †`‡kB UHC i e¨q m¤ú~Y© A_ev GKUv eo
Ask enb K‡i miKvi| miKvi G A_© RbM‡Yi K‡ii UvKvq cvq| A‡bK
†`‡k m¤ú~iK ¯^v¯’¨ exgvi eë¯’v _v‡K| G m¤ú~iK ev AwZwi³ exgv e¨w³
wb‡RI Ki‡Z cv‡i A_ev Zvi Rb¨ Zvi PvKzwi`vZv cÖwZôvb Ki‡Z cv‡i|
BD‡iv‡ci †Kvb †Kvb †`‡k miKvi I exgv †Kv¤úvwbi mgš^‡q UHC i LiP
†Ìqv nq| GLv‡b cÖwZôvb I miKvi KZUv †`‡e Zv AvBb Øviv wbqwš¿Z nq|
G exgv cÖwZôvb¸‡jv mvaviYZt AjvfRbK n‡q _v‡K|
wZbwU g‡Wj Av‡jvPbv Kiv hvq
1) Single Payer Systemt G eë¯’vq UHC i m¤ú~Y© e¨q GKwU
cÖwZôvbB enb K‡i _v‡K| †mUv mvaviYZt miKvi| G eë¯’v
hy³ivR¨, KvbvWv, Avqvij¨vÛ, wbDwRj¨vÛ, BZvwj, †¯úb, cZ©yMvj
BZ¨vw` †`‡k Av‡Q| ¯^v¯’¨‡mevi cÖwZôvb I Rbej miKviB eë¯’v
Ki‡Z cv‡i| nvmcvZvj¸‡jv miKvwi gvwjKvbvaxb nq; wPwKrmK,
†mweKv I Ab¨vb¨ ¯^v¯’¨ Kg©x miKv‡ii †eZb‡fvMx nq| GUv
Beveridge g‡Wj, †hgb, hy³ivR¨| ivóª e¨w³ Lv‡Zi ¯^v¯’¨‡mev
cÖwZôvb‡K Pzw³wfwËK `vwqZ¡ w`‡Z cv‡i| G‡Z nvmcvZvj, ¯^v¯’¨
Kg©x Giv e¨w³ Lv‡Zi, wKš‘ †mevi e¨q enb K‡i miKvi| GLv‡b
g~j¨ I gvb wbqš¿‡Yi Rb¨ miKvi eë¯’v †bq| G eë¯’v KvbvWvq
Pvjy Av‡Q|

2) Social Insurance Systemt G eë¯’vq kÖwgK, Kg©Pvwi, †eZb‡fvMx
gvbyl wbw`©ó cwigvY A_© †`q, †h cÖwZôvb wb‡qvM †`q ZvivI wbw`©ó
cwigvY A_© †`q Ges miKviI †`q| Gme A_© GKUv Znwe‡j Rgv
_v‡K| G †_‡K ¯^v¯’¨‡mev †h me cÖwZôvb †`q Zv‡ì Pzw³wfwËK
`vwqZ¡ †Ìqv nq| ¯^v¯’¨‡mev cÖwZôvb¸‡jv miKvwi †emiKvwi ev
`yÕiKgB n‡Z cv‡i| miKvi g~j¨ I gvb wbqš¿Y K‡i| Rvg©vbx cÖ_g
G eë¯’v Pvjy K‡i| GQvov d«vÝ, †ejwRqvg, †b`vij¨vÛ I Rvcvb
Gme †`‡kI G eë¯’v Pvjy Av‡Q|
3) National Health Insurance Systemt cÖ‡Z¨K bvMwiK‡K ¯^v¯’¨
exgv Ki‡Z nq miKv‡ii Kv‡Q| †Kvb †Kvb †`‡k miKvi cwiPvwjZ
exgv †Kv¤úvwb ev Znwej _v‡K| G eë¯’v `wÿY †Kvwiqv, ZvBIqvb
G me †`‡k Pvjy Av‡Q|
c„w_exi 33wU DbœZ †`‡ki 32wU‡ZB (hy³ivóª Qvov) †Kvb bv †Kvbfv‡e
UHC i eë¯’v Pvjy Av‡Q| Dbœqbkxj †`k¸‡jvi g‡aÏ A‡bK †`k UHC
Pvjy K‡i‡Q| G‡ì g‡a¨ Av‡Q wKDev, _vBj¨vÛ, wm½vcyi, fzUvb, wPwj,
†ciæ, kÖxj¼v, nsKs BZ¨vw`| Z‡e Dbœqbkxj, ¯^íweË AwaKvsk †`‡k UHC
bvB| Gme †`‡k miKvi wKQz ¯^v¯’¨‡mevi eë¯’v K‡i, wKš‘ AwaKvsk †mevB
†ivMx‡K wb‡Ri ev cwiev‡ii (out of pocket) Li‡P wb‡Z nq| G‡Z `wi`ª
gvbyl mgqgZ ¯^v¯’¨‡mev cvq bv| hLb †ivM RwUj n‡q hvq A_ev KwVb
†ivM †`Lv †`q ZLb wPwKrmv Kivi Rb¨ Zviv Avw_©K wech©‡qi m¤§yLxb nq|
GgbwK Ae¯’vcbœ cwiev‡ii RbÏ RwUj I KwVb †iv‡Mi wPwKrmvi LiP enb
Kiv KwVb n‡q ùvovq; m¤úwË weµq Ki‡Z nq ev FYMÖ¯Í n‡Z nq| A_©vqb
Kiv UHC i GKUv eo Dcv`vb| miKvwi †nvK ev †emiKvwi †nvK †ewk SuywK
I Kg SuywK m¤úbœ gvby‡li KvQ †_‡K exgvi UvKv GKÎ K‡i ¯^v¯’¨‡mevq e¨q
Ki‡j Mo LiP Kg nq| ¯^fveZB hv‡ì SuywK Kg (†hgb Kg eq‡mi gvbyl)
Zv‡ì exgv Kivi cÖeYZv Kg _v‡K| GRb¨ AvBwb evaëvaKZv Av‡ivc
Ki‡Z nq| UHC i myweav nj GiKgt G‡Z RbM‡Yi mevi ¯^v‡¯’ï DbœwZ nq,
†gvU e¨q Kg nq, cÖkvmwbK e¨qI K‡g| mgqgZ wPwKrmv nIqvq fwel¨‡Zi
e¨qI K‡g| ¯^v¯’¨‡mev gvbm¤úbœ nq| KwVb I RwUj †iv‡Mi wPwKrmvi Rb¨
D‡jøL‡hvM¨ msL¨K gvbyl `wi`ª n‡q hvq bv|
Amyweav njt hv‡ì AmyL Kg nq Zv‡ì wKQzUv e¨q †ewk nq| wPwKrmvi LiP
Kgvbi Rb¨ wPwKrmv KvU-QuvU Ki‡Z nq| e¨qeûj ev mdj nIqvi m¤¢vebv
Kg Ggb wPwKrmvi Aby‡gv`b miKvi bvI w`‡Z cv‡ib|

GKUv ¸iæZ¡c~Y© welq nj UHC †Z wK wK †mev _vK‡e Zv cÖ‡Z¨K †`k
Zvi wb‡Ri cÖ‡qvRb, mÿgZv I cvwicvwk^©KZv we‡ePbv K‡i wba©viY Ki‡eb|
cÖ_‡g mdj cÖv_wgK ¯^v¯’¨‡mev Pvjy Kiv †h‡Z cv‡i| Gi ci mÿgZv evovi
m‡½ m‡½ Ab¨vb¨ †mev †hvM Kiv hvq| Dbœqbkxj †`kmg~‡n ¯^v¯’¨‡mevi Amvg¨
GZUvB †ewk †h Rb‡Mvôxi GKUv eo Ask †h mg¯Í †iv‡M †fv‡Mb Zv we`¨gvb
KvVv‡gvi wKQz DbœwZ I m¤úªmviY Ki‡j A‡bKUv AR©b Kiv hvq| mevi Rb¨ me
ai‡bi ¯^v¯’¨‡mev ˆbwZKZvi w`K †_‡K Av`k© n‡jI Zv UHC ïiæ †_‡K m¤¢e
bvI n‡Z cv‡i| ˆbwZKfv‡e me ai‡bi †mevq me©RbxbZv Av`k©| ¯^v¯’¨‡mevq
Amvg¨ wewfbœ ai‡bi mvgvwRK mgm¨v evovq, †hgb, A¯^v¯’¨Ki Lv`¨vf¨vm I
Rxeb hvÎv, gv`K I ZvgvKRvZ mvgMÖxi eënvi| G¸‡jv `~i Ki‡Z n‡j
UHC i PvB‡Z A_©‰bwZK I mvgvwRK cwieZ©b ìKvi| Zvi Av‡MB UHC
Pvjy Kiv †h‡Z cv‡i| A‡bK †ivM cÖwZ‡iva Kvh©µg e¨w³i PvB‡Z mgv‡Ri
Rb¨ †ewk cÖ‡qvRb, †hgb gkK wbab Kvh©µg| A‡bK msµvgK †ivM cÖwZ‡iva
mvgvwRK ÿwZ I e¨q Kwg‡q †`q| GUv UHC i AšÍf©y³|
me©Rbxb ¯^v¯’¨‡mev †Ìqvi †Póv bv Kivi †h cÖavb KviY †`Lvb nq Zv nj
`vwi`ª| wKš‘ gvwK©b hy³ivóª Ab¨Zg m¤ú`kvjx †`k nIqv m‡Ë¡I wewfbœ
RwUj mvgvwRK, A_©‰bwZK Kvi‡Y †mUv w`‡Z cvi‡Q bv, hwÌ cÖvq mviv
BD‡iv‡c UHC cÖwZwôZ| Avevi A‡bK¸‡jv Kg m¤ú`kvjx †`k, †hgb,
wKDev, _vBj¨vÛ, †ciæ, kÖxj¼v, UHC Pvjy K‡i‡Q| mviv c„w_exi UHC
i AwfÁZv K‡qKUv ¸iæZ¡c~Y© welq Zz‡j a‡i‡Q| UHC i Kvi‡Y gvby‡li
Rxeb hvÎvq weivU AMÖMwZ nq| Gi cÖgvY Gwkqvi K‡qKwU †`kt Rvcvb,
`wÿY †Kvwiqv, wm½vcyi, Pxb| UHC gvby‡li A_©‰bwZK I mvgvwRK DbœwZI
Zivwš^Z K‡i| GQvov K‡qKwU ¯^í m¤ú`kvjx †`k †`wL‡q‡Q ivR‰bwZK
wm×všÍ wb‡q mvwe©Kfv‡e AMÖmi n‡j Kg Li‡PB UHC AR©b Kiv hvq| G
†`k¸‡jvi AR©b ÎæwUgy³ bq| wKš‘ G‡ì mvdj¨ cÖgvY K‡i UHC AR©b
`wi`ª †`‡ki c‡ÿI m¤¢e| †Kvb †`k m¤ú`kvjx bv n‡j UHC w`‡Z cvi‡e
bv, cÖPwjZ G aviYv fzj| cÖv_wgK ¯^v¯’¨‡mev UHC i Ab¨Zg Dcv`vb| Avi
cÖv_wgK ¯^v¯’¨ GKUv kÖgNb †mev| kÖg DbœZ †`kmg~‡n hZ g~j¨ w`‡q Kv‡R
jvMv‡Z nq, Dbœqbkxj †`‡k Zvi PvB‡Z A‡bK Kg e¨q Ki‡Z nq| GQvov
G‡Z gvby‡li Kg©ms¯’vbI ev‡o|
A_©bxwZwe` Kenneth Arrow e‡jb, mymsMwVZ me©Rbxb miKvwi ¯^v¯’¨‡mev
bv _vK‡j RbMY Kg Kvh©Ki I Pov`v‡g †emiKvwi ¯^v¯’¨‡mev (ineffiecient
overpriced private care) wb‡Z eva¨ nb| Gi KviY nj asymmetric

information| Ab¨vb¨ cY¨ ev †mevi †ÿ‡Î (†hgb, GKUv Rvgv ev GKUv
QvZv) gvbyl Zvi `vg m¤^‡Ü †gvUvgywU aviYv iv‡L Ges ¸YMZ gvbI †gvUvgywU
hvPvB Ki‡Z cv‡i| wKš‘ †Kvb †iv‡Mi wPwKrmv, †KvbUv fvj Ges KZ LiP
n‡Z cv‡i,(†hgb wK wK cixÿv jvM‡e, wK wK Jla jvM‡e) GUv †ivMxi c‡ÿ
Rvbv m¤¢e bv| Kv‡RB †emiKvwi ev evwYwR¨K ¯^v¯’¨‡mev evRvi cÖwZ‡hvwMZvi
hyw³‡ZI Kg Kvh©Ki (inefficient)| GUv AviI cÖKU nq hLb ¯^v¯’¨ Kg©xi
msL¨v Kg, hv Dbœqbkxj †`k¸‡jv‡Z nq| d‡j gvby‡li †e‡Q †bIqvi my‡hvM
_v‡K bv| mxwgZ msL¨K wPwKrmK ev †mev †K‡›`ªi `vi¯’ n‡Z nq| miKvi
cwiPvwjZ UHC G‡Z GKUv wbqš¿Y Avb‡Z cv‡i| GUv fvi‡Zi †Kivjv
A½iv‡Rï D`vni‡Y AviI fvj eySv hvq| †Kivjvq K‡qK `kK Av‡M
me©Rbxb cÖv_wgK ¯^v¯’¨‡mev Pvjy n‡q‡Q| †Kivjvi gvby‡li Avq I wkÿvi nvi
evovi m‡½ m‡½ ¯^v¯’¨‡mev Pvwn`v ev‡o Ges †emiKvwi ¯^v¯’¨‡mevi cÖmvi N‡U|
wKš‘ miKvwi ¯^v¯’¨‡mevi m‡½ cÖwZ‡hvwMZv _vKvq I mvaviY gvbyl ¯^v¯’¨ m‡PZb
Ges ¯^v¯’¨‡mev e¨q m¤^‡Ü mRvM nIqvq †emiKvwi cÖwZôvb¸‡jv †mevi gvb
fvj ivL‡Z Ges g~jÏ †hŠw³K ivL‡Z eva¨ nq| Zzjbvq fvi‡Zi DËi cÖ‡`k
ev ga¨ cÖ‡`k A½iv‡Rï †emiKvwi ¯^v¯’¨‡mevi gvb fvj bq Ges e¨qI †ewk|
me©Rbxb ¯^v¯’¨‡mev A‡bK †ivM ïiæ‡ZB wbY©q K‡i, d‡j †ivM evovi Av‡M
wPwKrmv †Ìqv nq| G‡Z LiP Kg nq, RwUjZv I g„Zzï nviI Kg nq|
_vBj¨v‡Ûi AwfÁZvq †`Lv †M‡Q, UHC Pvjy nIqvi d‡j nvmcvZv‡j fwZ©
I e¨qeûj wPwKrmvi cÖ‡qvRb A‡bK K‡g †M‡Q| UHC bv _vK‡j `wi`ª
gvbyl mgqgZ wPwKrmv wb‡Z cv‡i bv| †ivM evo‡j wPwKrmvi e¨qI ev‡o,
mvaviY †ivMI RwUj ev KwVb nq|
¯^v¯’¨ I wkÿvi DbœwZi m‡½ A_©‰bwZK DbœwZ m¤úwK©Z| cÖ_g w`‡K †Kivjv
A½ivR¨ wQj fvi‡Zi `wi`ª A½ivR¨¸‡jvi Ab¨Zg| UHC Pvjy Kivi ci
¯^v¯’¨ m~P‡Ki DbœwZ n‡q‡Q| G iv‡R¨ Ab¨vb¨ A½iv‡Rï Zzjbvq wkï g„Zzï
nviI A‡bK Kg Ges cÖZ¨vwkZ Mo Avqy mePvB‡Z †ewk| wkÿv I ¯^v‡¯’ï
DbœwZi d‡j GUv GLb D”P Av‡qi ivR¨| ZvwgjbvWz I wngvPj cÖ‡`k A½ivR¨
GKBfv‡e ¯^v¯’¨ I wkÿvi DbœwZi c_ a‡i A_©bxwZ‡Z DbœwZ Ki‡Q| UHC ïay
†h RbM‡Yi Rxeb hvÎvi gvb evovq ZvB bq, A_©‰bwZK DbœwZ‡ZI Ae`vb
iv‡L| Kv‡RB me †`‡ki ivóªxq bxwZ‡Z UHC AMÖvwaKvi cvIqv DwPr|
cÖv_wgK ¯^v¯’¨‡mev (Primary Health Care)t cÖv_wgK ¯^v¯’¨‡mev I Rb
¯^v¯’¨‡mev G `yÕ‡Uv UHC i g~j wfwË| 1978 mv‡j KvRvL¯Ív‡bi Avjgv-AvZv

kn‡i cÖv_wgK ¯^v¯’¨‡mev msµvšÍ AvšÍR©vwZK m‡¤§j‡b cÖv_wgK ¯^v¯’¨‡mevi jÿ¨
M„nxZ nq| wek^ ¯^v¯’¨ ms¯’v (WHO) I RvwZm‡•Ni wkï Znwej (UNICEF)
mw¤§wjZfv‡e G m‡¤§jb Av‡qvRb K‡i|
Z…Yg~j ch©v‡qi ¯^v¯’¨ Kg©x‡ì Øviv mevi Rb¨ AwZ cÖ‡qvRbxq ¯^v¯’¨‡mev hv †m
†`‡ki miKvi eë¯’v Ki‡Z cv‡i- A‡b‡K cÖv_wgK ¯^v¯’¨‡mev ej‡Z GUvB
g‡b K‡ib| wKš‘ cÖv_wgK ¯^v¯’¨‡mevi Dcv`vb¸‡jv AviI we¯Í…Z| †h mg¯Í
Kvh©µg AšÍf©y³ Zv njt 1) mgv‡Ri ¯^v¯’¨‡mevi gvb Dbœqb, 2) cÖwZ‡iva
†hvM¨ msµvgK I AmsµvgK e¨vwai cÖv`yf©ve Kgvb, 3) wkï I gvZ… g„Zzï
nvi Kgvb, 4) ewÂZ Rb‡Mvôx‡Z †mevi cÖmvi, 5) cqtwb®‹vkb I eR©¨
wb®‹vkb eë¯’vi DbœwZ, 6) cÖ‡qvRbxq Jla I cÖhyw³i cÖvc¨Zv, 7) mgZvi
wbðqZv: wj½, eqm, eY©, ag©, mvwe©K m½wZ wbwe©‡k‡l mevB‡K †mev †Ìqv,
8) ¯^v¯’¨ Qvov mgv‡Ri Ab¨vb¨ Kg©‡ÿ‡Î Ae`vb ivLv, 9) mwVK Abycv‡Z
¯^v¯’¨ Kg©x wbwðZ Kiv, 10) mgwš^Z wUKv`vb Kg©m~wP, 11) cwievi cwiKíbv
Kg©m~wP, 12) cvwb I Lv‡`ï wbðqZv weavb|
WHO K‡qKwU bxwZgvjv wba©viY K‡it 1) mvgvwRK Amvg¨ Kgvb, 2)
RbM‡Yi cÖ‡qvRb I cÖZ¨vkv Abyhvqx ¯^v¯’¨‡mev M‡o †Zvjv, 3) wbqg bxwZ
cwieZ©b K‡i Rxe‡bi cÖwZwU †ÿ‡Î ¯^v‡¯’ï cÖ‡qvRb‡K ¯’vb †Ìqv, 4)
mswkøó mK‡ji m‡½ Av‡jvPbvi gva¨‡g bxwZ wba©viY Kiv, 5) Askx`vwi‡Z¡i
wfwË‡Z Kvh©µg Pvjvb| bxwZgvjv I Kvh©µ‡gi jÿ¨ h‡_ó we¯Í…Z| A‡bK
†`k wKQz wbw`©ó jÿ¨ w¯’i K‡i GwM‡q‡Q I Z…Yg~j ch©vq ch©šÍ ¯^v¯’¨‡mev I Zvi
m‡½ cÖZ¨ÿfv‡e m¤úwK©Z †mev¸‡jv mevB‡K †Ìqvi †Póv K‡i‡Q| AmgZv
`~i Kiv meviB jÿ¨ wQj| †mev¸‡jvi g‡a¨ mvaviY †iv‡Mi wPwKrmv, †ivM
cÖwZ‡iva I wUKv`vb, gv I wkïi †mev, wkï‡ì gvZ…`y»cv‡b Drmvn †Ìqv
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miKvwi ms¯’v The National Agency for Accreditation and Health

Care Evaluation wPwKrmvi MvBWjvBb ˆZwi K‡i †`q| †gvU RvZxq Av‡qi
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ch©šÍ 10 †_‡K 60 kh¨vi †Rjv nvmcvZvj wbg©vY Kiv nq| 1970 mv‡j MÖnY
Kiv nq RvZxq cwievi cwiKíbv Kg©m~wP| 1977 mv‡j m¤úªmvwiZ wUKv`vb
Kg©m~wP Pvjy Kiv nq| 1992 mv‡j Health Systems Research Institute
Act Gi gva¨‡g M‡elYv cÖwZôvb Pvjy Kiv nq| GLv‡b me©Rbxb ¯^v¯’¨‡mev
Pvjy Kivi e¨vcv‡i Z_¨vw` wb‡q M‡elYv K‡i mycvwik ˆZwi Kiv nq| 1990
mv‡ji g‡a¨B KZK¸‡jv ¸iæZ¡c~Y© KvR, †hgb webvg~‡j¨ cÖm~wZ †mev, cwievi
cwiKíbv I wUKv`vb G¸‡jv cÖvq mviv †`‡k ïiæ Kiv nq|
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MÖv‡gi ¯^v¯’¨‡mev fvj wQj bv| 1960 Gi `k‡K miKvwi Kg©Pvix, Kg©KZ©v
I Zv‡ì cwievie‡M©i Rb¨ Medical Benefit Scheme Pvjy Kiv nq|
1970 Gi `k‡K ïiæ nq Low Income Card Scheme, hvi gva¨‡g `wi`ª
gvbyl, wkï I cÖwZeÜx‡ì webvg~‡j¨ miKvwi ¯^v¯’¨‡mevi eë¯’v nq| 1980
Gi `k‡K Voluntary Health Card Scheme Gi gva¨‡g †h †Kvb bvMwiK
¯^v¯’¨ exgv Kivi my‡hvM †cj| G‡Z exgvi UvKvi A‡a©K w`Z bvMwiK, A‡a©K
w`Z miKvi| 1990 Gi `k‡K Pvjy Kiv nq Social Security Scheme|

G‡Z †emiKvwi kÖwgK‡ì ¯^v¯’¨ exgv Kivi eë¯’v nq| GB PviwU cÖK‡íi
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MÖvRy‡qU bvm© nZ| GUv 1982 mv‡j ïiæ nq| G¸‡jv Pvjy Ki‡Z †Kvb mgm¨v
nqwb| Z‡e GRb¨ ¯^v¯’¨ Kg©x‡ì cÖ‡Yv`bv †Ìqv nq| 1961 mv‡ji Av‡M me
bvwm©s K‡jR wQj wkÿv gš¿Yvj‡qi Aaxb| bvm©‡ì msL¨v evovbi Rb¨ 1960
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h‡_ó M‡elYv K‡i wb‡ew`Z †bZ…Z¡ wm×všÍ wb‡q wb‡R‡ì mÿgZvi g‡a¨B
¯^v¯’¨‡mevi DbœwZ NUv‡Z cv‡i| _vBj¨v‡Û RbMY, ¯^v¯’¨ Kg©x I miKvi mevB
UHC mg_©b K‡i| Gi LiP †gUvbi Rb¨ GLbI miKv‡ii mgm¨v nqwb|
†Kivjv A½ivR¨, fviZ
†Kivjvi gvbyl eû kZvãx a‡i mgy`ª c‡_ A‡bK †`‡ki m‡½ evwYR¨ K‡i
Avm‡Q| Gi g‡a¨ Av‡Q Avie †`k, wgki, Pxb, MÖxm, BZvwj, cZ©yMvj,
nj¨vÛ| †KvwP‡b GLbI 2 nvRvi eQ‡ii cyi‡bv GKUv wmbvMM (Bû`x‡ì
cÖv_©bvjq) Av‡Q| †Kivjv †_‡K gkjv wb‡Z AvmZ Ab¨ †`‡ki ewY‡Kiv,
wewbg‡qi Rb¨ Ab¨vb¨ cY¨ wb‡q AvmZ| wKš‘ c‡Yï m‡½ m‡½ wewfbœ gZev`
I a¨vb-aviYvI P‡j AvmZ| Gme gZ I aviYv Av‡jvPbvi d‡j †Kivjvi gvbyl
D`vi n‡q I‡V| Zviv wb‡R‡ì mgv‡Ri I wPšÍv-fvebvi m‡½ wgwj‡q †`‡L,
wb‡R‡ì ms¯‹viI K‡i| wLª÷vbiv wKQz wKQz RvqMvq emevm Ki‡Z _v‡K|
Zviv ¯‹zj †Lv‡j hv wQj ag©, eY© wbwe©‡k‡l mevi Rb¨| wb¤œe‡Y©i wn›`y‡ì
†Q‡j †g‡q‡ìI †jLvcov wkLvi GUvB wQj GKgvÎ c_| iv‡Rï kvm‡KivI
cÖfvweZ nq| `vmcÖ_v Zz‡j †Ìqv nq| A‡bK Av‡M †_‡KB cwðgv †`‡ki
AbymiY K‡i wePvi eë¯’v M‡o †Zvjv nq| mvaviY gvbyl Zv‡ì AwaKvi
m¤^‡Ü m‡PZb nq| Dbwesk kZvãxi cÖ_gw`‡K A¯ú„k¨ I wb¤œe‡Y©i gvby‡liv
Av‡›`vjb K‡i| `vex wQj Zv‡ì gw›`‡i cÖ‡ek Kiv I †jLvcov wkÿvi

AwaKvi w`‡Z n‡e| Gi Av‡M ch©šÍ †Kivjvi mgvR iÿYkxj I †kÖYxwef³
wQj| Av‡›`vj‡bi d‡j D”P e‡Y©i gvbyl I Rwg`vi †kÖYxi ÿgZv Kgj|
fvi‡Zi Ab¨ †Kvb ¯’v‡b A¯ú„k¨Zv `~i nqwb| 1989 mv‡j †Kivjvi mvgvwRK
msMVb¸‡jv ivR¨ miKv‡ii mn‡hvwMZvq wbiÿiZv `~i Kivi D‡`¨vM wbj|
wZb eQi a‡i cÖvq mv‡o wZb jÿ †¯^”Qv‡meK mg¯Í iv‡Rï cÖwZwU GjvKvq
cvVëB I eø¨vK‡evW© wb‡q Qwo‡q coj| iv¯Ívq, gv‡V Zviv wkÿvi g~j¨ m¤ú‡K©
†cŠivwYK I AvaywbK bvU‡Ki Ask Awfbq K‡i Drmvn m„wó Kij| Mv‡Qi
wb‡P, N‡ii g‡a¨ K¬vm n‡Z _vKj|
msMwVZ ¯^v¯’¨‡mevi BwZnvmI †Kivjvq `xN©Kv‡ji| cwðgv wPwKrmv eë¯’v
Avmvi Av‡MI RbMY Avqy‡e©`x c×wZi wPwKrmv wbZ| RbmvaviY wPwKrmvq
AvMÖnx wQj| BD‡ivcxq Dcwb‡ekKvixiv cwðgv wPwKrmv eë¯’v wb‡q Gj|
Dbwesk kZvãx‡Z †Kivjvq `yÕwU ivR¨ wQjt Uªvfvb‡Kvi (wÎev¼zi) I †KvwPb|
cieZ©x‡Z G `yÕwU ivR¨ I ZvwgjbvWÕzi gvjvevi †Rjv wb‡q †Kivjv MwVZ nq
1956 mv‡j| G iv‡Rï ivRviv cwðgv ¯^v¯’ëë¯’v MÖnY K‡ib| 1879 mv‡j
Zuviv Zv‡ì iv‡R¨ me miKvwi PvKz‡i I QvÎ‡ì Rb¨ wUKv †bIqv eva¨Zvg~jK
K‡i †`b| wewfbœ †gjv I Drm‡e K‡jiv cÖwZ‡iv‡ai Rb¨ eë¯’v †bIqv nq|
ïay †ivM cÖwZ‡iva eë¯’vB bq, GB `yB iv‡R¨ `yÕ‡Uv eo nvmcvZvj M‡o †Zvjv
nq| cwðgv wPwKrmv eë¯’vq wkwÿZ wPwKrmK‡ì Kv‡R jvMvbi D‡`¨vM
†bIqv nq| Wvt †gix jy‡Kvm-†K cÖavb wPwKrmK (Surgeon General) wb‡qvM
†Ìqv nq| wesk kZvãxi cÖ_g w`‡K gwnjv wPwKrmK cwðgv †`‡kB weij
wQj| Rxeb hvÎvi Ab¨vb¨ †ÿ‡ÎI AMÖMwZi †Póv PjwQj| cÖ_‡g Uªvfvb‡Kvi
(wÎev¼zi) kn‡i Ges cieZ©x‡Z Ab¨vb¨ ¯’v‡b weï× cvwb mieiv‡ni eë¯’v
Kiv nj| cÖv_wgK wkÿv I bvix wkÿvi cÖmv‡ii RbÏ D‡`¨vM †bIqv nj|
wLª÷vb ag©cÖPviKMY iv‡Rï wewfbœ cÖZ¨šÍ AÂj¸‡jv‡Z wgkb nvmcvZvj
¯’vcb K‡i| wLª÷vb ag©vej¤^x †g‡qiv bvwms© †ckvq Avmv ïiæ K‡i|
1956 mv‡ji 1jv b‡f¤î †Kivjv A½ivR¨ MwVZ nq| Gi Av‡M †òkÕ eQ‡ii
†ewk mgq a‡i ivR‰bwZK mvgvwRK Av‡›`vjb I wkÿv we¯Ív‡ii d‡j mvaviY
gvbyl Zv‡ì AwaKvi we‡klZt ¯^v¯’¨ AwaKvi m¤^‡Ü m‡PZb wQj| 1957
mv‡ji wbe©vP‡b iv‡R¨ KwgDwb÷ †bZ…‡Z¡ evgcš’x miKvi MVb Kiv nq| ¯^v¯’¨
I wkÿvi DbœwZ G miKv‡ii GKUv jÿ¨ wQj| ev‡R‡Ui GKUv eo Ask ¯^v¯’¨
I wkÿvi Rb¨ e¨q Kiv nZ| ivR¨ miKvi cwieZ©b n‡jI Avwki `k‡Ki cÖ_g
w`K ch©šÍ cÖwZ eQi cÖvq 13 kZvsk nv‡i ¯^v¯’¨ Lv‡Z ev‡RU ev‡o| 1960
†_‡K mË‡ii gvSvgvwS ch©šÍ ¯^v¯’ëë¯’vi AeKvVv‡gv `ªæZ evovb nq| 1960

mv‡j miKvwi eë¯’vq kh¨v msL¨v wQj 13 nvRvi; 1986 mv‡j GUv †e‡o nq
36 nvRvi| 2018 mv‡j mvaviY nvmcvZvj wQj 18wU, we‡klvwqZ nvmcvZvj
wQj 21wU, †Rjv nvmcvZvj wQj 18wU, ZvjyK nvmcvZvj wQj 79wU, cÖv_wgK
¯^v¯’¨ †K›`ª wQj 682wU| RbmsL¨v wQj 3 †KvwU 34 jÿ|
cÖv_wgK ¯^v¯’¨‡mev n‡”Q ¯^v¯’ëë¯’vi wfwË| GB †mev †Ìqvi Rb¨ 27 nvRvi
¯^v¯’¨ Kg©x (wPwKrmK bq) MÖvgvÂ‡j Av‡Q| G‡ì Accredited Social
Health Activist ev ASHA ejv nq| Zviv mvaviY †iv‡Mi wPwKrmvi m‡½
Mf©eZx gv I wkï‡ì wPwKrmv †`q| Zviv cÖZ¨šÍ AÂj¸‡jv‡Z _v‡K Ges
evwo evwo wM‡q †mev †`q| cÖv_wgK ¯^v¯’¨ †K‡›`ª Ab¨ ¯^v¯’¨ Kg©xivI _v‡K|
†Rjv ch©vq ch©šÍ we‡klvwqZ wPwKrmv (†hgb KvwW©IjRx, †bd«jRx BZ¨vw`)
cÖmvwiZ n‡q‡Q|
A_©‰bwZK g›`vi Rb¨ mË‡ii `k‡Ki gvSvgvwS †_‡K cÖvq GK `kK cÖe„w×
Kg nq| GB mgq ewa©Z msL¨K ¯^v¯’¨ Kg©x I ewa©Z †eZ‡bi d‡j Ab¨vb¨
†ÿ‡Î (weQvbv, evwjk, Jla cÎ, hš¿cvwZ) LiP K‡g hvq| †mevi gvb Avwki
`k‡K wKQzUv K‡g hvq| GB mgq †_‡K †emiKvwi nvmcvZv‡ji msL¨v evo‡Z
_v‡K| Gi Ab¨vb¨ KviYI wQj| wkÿvi cÖmvi I gvby‡li Avq evovi m‡½
m‡½ ¯^v¯’¨‡mevi Pvwn`v evo‡Z _v‡K| eq¯‹ RbmsL¨v evov (RbmsL¨vi 12
kZvsk) AviI GKUv KviY| Z‡e miKvwi ¯^v¯’¨‡mevi fvj gvb I wb¤œ e¨q
m¤^‡Ü mvaviY gvbyl AewnZ _vKvq †emiKvwi ¯^v¯’¨‡mev fvj gvb I hyw³m½Z
g~j¨ ivL‡Q|
1996 mv‡j fvi‡Zi msweav‡b 73 I 74Zg ms‡kvab Avbv nq| G‡Z
we‡K›`ªxKi‡Yi myweav nq| Ab¨vb¨ A½iv‡Rï PvB‡Z †Kivjvi ¯^v¯’ëë¯’vq
we‡K›`ªxKiY A‡bK GwM‡q hvq| cÖv_wgK ¯^v¯’¨ †K›`ª¸‡jv‡K ¯’vbxq miKvi,
cÖkvmb I RbM‡Yi m‡½ m¤ú„³ Kiv nq| ¯’vbxq ch©v‡q Av‡jvPbv K‡i eZ©gvb
Kg©KvÛ cwiPvjbvi ZË&¦veavb, fwel¨‡Zi cwiKíbv, cÖKí ev¯Íevqb Kiv
nq| MÖvg mfv I cÂv‡qZ mwgwZ Kv‡Ri ¸Yv¸Y I djvdj g~j¨vqb K‡i Ges
NvUwZ _vK‡j Zv c~iY Kivi mycvwik K‡i| `xN©w`b KvR Kivi d‡j ¯’vbxq
miKvi I mvaviY gvbyl AwfÁZv AR©b K‡i ¯’vbxq Pvwn`v I m¤ú` Abyhvqx
Pjgvb KvR I fwel¨r cwiKíbvi mwVK wm×všÍ wb‡Z cv‡i| GQvov weï×
cvwb mieivn, cqtwb®‹vkb I eR©¨ wb®‹vkb Gme e¨vcv‡iI Zviv wm×všÍ †bq
I Kvh©Ki K‡i|
Ardrom bv‡g Dbœq‡bi Kg©m~wP †bIqv n‡q‡Q| miKvwi ¯^v¯’¨‡mevi gvb

Dbœqb, AviI RbevÜe Kiv, AeKvVv‡gv AviI evovb Ges `wi`ª gvby‡li
†mev AviI Dbœqb Kiv Gi D‡Ïk¨| †Rjv ch©v‡q we‡klvwqZ wPwKrmv evovb
I ZvjyK ch©vq ch©šÍ †bIqvi cwiKíbv Av‡Q| cÖwZwU gvby‡li Rb¨ GKUv
Electronic ¯^v¯’¨ KvW© Kivi D‡`¨vM †bIqv n‡”Q| GB Kv‡W© cÖ‡Z¨‡Ki ¯^v¯’¨
msµvšÍ Z_¨ _vK‡e| d‡j wZwb †hLv‡bB hv‡eb †mLv‡b Zvi ¯^v¯’¨ m¤úwK©Z
Z_¨ †c‡Z Amyweav n‡e bv| ¯^v‡¯’ï A‡bK m~P‡K fvi‡Zi Ab¨vb¨ iv‡Rï
PvB‡Z †Kivjv GwM‡q Av‡Q| 2018 mv‡j wek^ e¨v¼ I fviZ miKv‡ii †hŠ_
D‡`¨v‡M GKUv mgxÿv nq| Zvi wi‡cv‡U© †Kivjvi ¯^v¯’ëë¯’v‡K fvi‡Zi
A½ivR¨¸‡jvi g‡a¨ †kÖô ejv nq|
wKDevt
1959 mv‡j †Mwijv hy‡×i ga¨ w`‡q mvgwiK GKbvqK evwZ¯Ív‡K DrLvZ
K‡i bZzb miKvi MwVZ nq| †bZ…‡Z¡ wQ‡jb wd‡`j K¨v‡÷ªv, †P ¸‡qfviv
I K¨vwg‡jv wm‡qbdz‡Mvm| f‚wg ms¯‹vi I Kj KviLvbv RvZxqKiY Kivq
hy³ivóª 1961 mv‡j K~U‰bwZK m¤úK© wQbœ K‡i I miKvi DrLv‡Zi Rb¨
mk¯¿ AvµgY Pvjvq| Gi Av‡M 1960 mvj †_‡KB Avg`vwbi Dci Ae‡iva
Av‡ivc K‡i|
wecø‡ei ci ciB wKDevq wkÿv we¯Ív‡ii Kvh©µg †bIqv nq| ¯‹z‡ji 12 †MÖW
ch©šÍ †jLvcov eva¨Zvg~jK I A‰eZwbK Kiv nq| †`‡ki cÖZ¨šÍ AÂjmn
me©Î ¯‹zj †Lvjv nq I wkÿK cvVvb nq| UNESCO i g‡Z 1999 mv‡j
cÖv_wgK wkÿvq wkwÿ‡Zi nvi cÖvq kZfv‡M †cŠu‡Q| GLbI wek^we`¨vjq †_‡K
†h †Kvb wel‡q DËxY© wkÿv_©x‡ì `yB eQi MÖv‡g eva¨Zvg~jK KvR Ki‡Z nq|
Zvici Zviv Ab¨ PvKzwi Ki‡Z cv‡i| wecø‡ei K‡qK gv‡mi g‡a¨ AvBb
K‡i evwo fvov Kgvb nq I miKvwi M„n wbg©vY ïiæ nq| eZ©gv‡b wKDevq
†Kvb ew¯Í bvB, †KD M„nnxb bq| ¯^v¯’¨‡mev mevi Rb¨ Db¥y³ †NvlYv Kiv nq|
kvmbZ‡š¿ ejv Av‡Q, ÒcÖ‡Z¨K gvby‡li ¯^v¯’¨ iÿv I †mev cvIqvi AwaKvi
Av‡Q|Ó wecø‡ei Av‡MI wKDevq RbmsL¨v Abycv‡Z wPwKrm‡Ki msL¨v jvwZb
Av‡gwiKvi Ab¨vb¨ †`‡ki Zzjbvq †ewk wQj| wKš‘ wecø‡ei mgq cÖvq A‡a©K
wPwKrmK wKDev †Q‡o P‡j hvq| miKvi ¯^v¯’¨ Kg©x M‡o †Zvjvi D‡`¨vM
†bq| GLb c„w_exi mePvB‡Z †ewk ¯^v¯’¨ Kg©x wKDevq| wKDevi cÖwZ 30 Rb
gvby‡li Rb¨ Av‡Q GKRb wPwKrmK, hy³iv‡óª cÖwZ 300 R‡b GKRb|
1978 mv‡j Avjgv-AvZv †NvlYvi ci wKDev multispeciality cvwievwiK
wPwKrmv †K›`ª mviv †`‡k Pvjy K‡i| GLb 95 kZvsk RbmsL¨v Gi

AvIZvq| 1984 mv‡j KwgDwbwU ¯^v¯’¨‡mev Pvjy Kiv nq| 2004 mv‡j
National Renewal Kg©m~wPi Aax‡b 444wU cwj wK¬wb‡Ki gvb Dbœqb
Kiv n‡q‡Q I 52wU Z…Zxq ¯Í‡ii nvmcvZvj AvaywbK Kiv n‡q‡Q I Center
of Excellence wnmv‡e M‡o †Zvjv n‡”Q| 2007 mvj †_‡K RvZxq
Kw¤úDUvi †bUIqvK© ˆZwi K‡i †ivMxi Z_¨, image, ¯^v¯’¨ eë¯’vcbv,
¯^v¯’¨ wkÿv cÖmvwiZ n‡q‡Q| 1984 mvj †_‡K ¯^v¯’¨ eë¯’vcbv K‡qKwU
¯Í‡i mvRvb n‡q‡Q| ¯^v¯’¨‡mev m¤ú~Y© webvg~‡j¨ Ges miKvwi| †Kvb
†emiKvwi wPwKrmK, wK¬wbK ev nvmcvZvj bvB|
1) cÖ_g ¯Íi n‡”Q cvwievwiK wPwKrmK I bv‡m©i gva¨‡g cÖv_wgK
¯^v¯’¨‡mev| G iKg cÖvq 33 nvRvi wK¬wbK Av‡Q| wK¬wbK¸‡jv mviv
†`‡k we¯Í…Z| cÖwZwU wK¬wb‡K wPwKrmK I bv‡m©i evm¯’vb Av‡Q Ges
†mLv‡b _vKv eva¨Zvg~jK| 24 N›UvB Zv‡ì cvIqv hvq| GLv‡b
wPwKrmv ïay wbivgqB bq-†ivM cÖwZ‡iva, ¯^v¯’¨ wkÿv, mvgvwRK
I cwi‡ek msµvšÍ mgm¨vmg~n mgvav‡bi D‡`¨vM †bIqv nq|
†ivM‡K mvgwMÖK †cÖÿvc‡U †`Lv nq- Zvi cvwievwiK, mvgvwRK I
cwi‡ekMZ Dcv`vb¸‡jvI we‡ePbv K‡i Zv mwVK ivLvi †Póv Kiv
nq| cÖ‡qvR‡b Ab¨vb¨ ms¯’vi mvnvh¨ †bIqv nq| wK¬wb‡K mKv‡j
AvMZ †ivMx‡ì wPwKrmv †Ìqv nq| cÖvq 80 kZvsk †ivMxi
mgm¨vi mgvavb GLv‡b Kiv nq| cÖ‡qvRb n‡j Zv‡K cieZ©x
avc cwj wK¬wb‡K cvVvb nq| weKv‡j ¯^v¯’¨ Kg©xiv evwo evwo hvb|
†ivMx †`Lv QvovI Zv‡ì cwi®‹vi cwi”QbœZv, mvgvwRK, cvwievwiK
cwiw¯’wZ meB †`Lv nq| eQ‡i AšÍZt GKevi cÖwZwU evwo cwi`k©b
Ki‡Z nq| cÖ‡Z¨K gvby‡li eQ‡i AšÍZt GKevi cixÿv Kiv
eva¨Zvg~jK| hv‡ì `xN©¯’vqx †ivM Av‡Q (†hgb, Wvqv‡ewUm,
eøvW †cÖmvi BZ¨vw`) Zv‡ì wZb gvm ci ci †`L‡Z nq| wkïi
R‡b¥i ci cÖ_g eQ‡i 20 evi †`L‡Z nq| cÖv_wgK †mev †K‡›`ª †m
GjvKvi †ivMx I ¯^v¯’¨ msµvšÍ me Z_¨ msMÖn I msiÿY Ki‡Z nq|
2) wØZxq ¯Í‡i cwj wK¬wbK-cÖwZ 30 †_‡K 60 nvRvi gvby‡li Rb¨
GKwU cwj wK¬wbK| GiKg cÖvq 500 cwj wK¬wbK Av‡Q| 20
†_‡K 40 Rb wewfbœ wel‡qi we‡klÁ GLv‡b †mev †`b| cÖv_wgK
wPwKrmv †K›`ª †_‡K †ivMx cvVvb nq, Avevi †ivMx wb‡RI mivmwi
Avm‡Z cv‡i| GLv‡b AvMZ †ewkifvM †ivMxi wPwKrmv GLv‡bB
Kiv nq| Kg msL¨K RwUj †ivMx Z…Zxq ¯Í‡i cvVvb nq| GLvbKvi

wPwKrm‡Kiv cÖv_wgK wPwKrmK‡ì m‡½ †hvMv‡hvM iv‡L I Zv‡ì
KvR g~j¨vqb K‡i|
3) Z…Zxq ¯Í‡i †gwWK¨vj K‡jR nvmcvZvj I Bbw÷wUDU mg~n msL¨vq
52wU| me PvB‡Z RwUj †ivMx‡ì wPwKrmv GLv‡b Kiv nq|
1991 mv‡j mgvRZvwš¿K we‡kî cZ‡bi ci wKDevi Avw_©K msKU †`Lv
†`q| evwY‡Rï mePvB‡Z eo Ask wQj G †`k¸‡jvi m‡½| we‡klZt
R¦vjvbx †Zj †mvwf‡qZ BDwbqb cvVvZ Kg g~‡j¨| Kj-KviLvbv, K…wl
hš¿cvwZ, mvi G¸‡jv meB wQj R¦vjvbx †Z‡ji Dci wbf©ikxj| A‡bK
gvbyl †eKvi n‡q †Mj, Lv`¨ Drcv`b K‡g †Mj| Gi Dci Avevi gvwK©b
hy³ivóª, 1992 mv‡j Ae‡iva AviI k³ Kij| JlacÎ I wPwKrmv hš¿cvwZ
Avg`vwb eÜ K‡i w`j| e„wUk †gwWK¨vj Rvb©vj I j¨vb‡mU cwÎKv Gi wb›`v
Kij| AM©vbvB‡Rkb Ad Av‡gwiKvb †÷Um ejj GUv AvšÍR©vwZK AvB‡b
êa bq| wKš‘ †Kvb dj nqwb| mvaviY gvby‡li Lv`¨ MÖnY K‡g †Mj|
K‡qK eQ‡i gvby‡li Mo IRb 20 cvDÛ K‡g †Mj| miKvi wkï‡ì Rb¨
`ya, Mf©eZx gwnjv, eq¯‹ †jvK I wkï‡ì Rb¨ we‡kl Lv`¨ eivÏ Kij|
miKvwi Rwg gvbyl‡K webvg~‡j¨ w`‡q AM©vwbK (KxUbvkK e¨ZxZ) Pvl Kivi
Rb¨ Drmvn †Ìqv nj| GK `k‡Ki g‡a¨ Lv`¨ Drcv`b †e‡o wKDev Lv‡`¨
¯^qsm¤ú~Y© nj|
wb‡R‡ì A‡bK mgm¨v _vKv m‡Ë¡I wKDev Ab¨vb¨ †`‡ki msK‡U GwM‡q
†M‡Q| 1991 mv‡j †bjmb g¨v‡Ûjv e‡jb, c„w_exi Avi †Kvb †`k AvwdªKvi
†`k¸‡jvi cÖwZ wKDevi PvB‡Z †ewk mngwg©Zv †`wL‡q‡Q? wKDevi ¯^v¯’¨
Kg©xiv wec‡ì mgq Av‡m cÖ_g Avi hvq †k‡l| wecø‡ei ci ciB 1960
mv‡j wPwjÕ‡Z f‚wgK¤ú nq| †mLv‡b ¯^v¯’¨ Kg©x cvVvb nq| 1963 mv‡j
Avj‡Rwiqvi ¯^vaxbZvjv‡fi ci †mLv‡b ¯^v¯’ëë¯’v M‡o †Zvjvi Rb¨ Kg©x
hvq| 1986 mv‡j †Pi‡bvwej AvYweK Pzjøx `~N©Ubvi ci †mLvbKvi 26000
wewKiYcÖvß (†ewkifvMB wkï) gvbyl‡K wKDevq wb‡q G‡m webvg~‡j¨
wPwKrmv Kiv nq| 1998 mv‡j ga¨ Av‡gwiKvq n¨vwi‡K‡b e¨vcK ÿwZ
nq| GLvbKvi †ewkifvM †`k wKDevi cÖwZ êwi wQj| K‡qKwU †`‡ki
m‡½ K~U‰bwZK m¤úK©I wQj bv| n¨vwi‡K‡bÕi ci ciB 424 Rb ¯^v¯’¨
Kg©x cvVvb nq| K‡qKw`‡bi g‡a¨ G msL¨v †e‡o 2000 nq| 2004 mv‡j
`wÿY Gwkqvq mybvwgÕi ci †gwWK¨vj wUg cvVvq| 2005 mv‡j cvwK¯Ív‡b
f‚wgK‡¤úi ci 2250 Rb ¯^v¯’¨ Kg©x KvR K‡i| we‡`kx ¯^v¯’¨ Kg©x‡ì

g‡a¨ GUvB wQj me‡P‡q eo `j| Ab¨vb¨ `j gvmLv‡bK c‡i P‡j †M‡jI
wKDevbiv Qq gvm a‡i †mLv‡b KvR K‡i| 2005 mv‡j hy³iv‡óª n¨vwi‡Kb
K¨vwUªbv AvNvZ nv‡b| wKDev 1500 ¯^v¯’¨ Kg©x cvVv‡Z Pvq| hy³ivóª MÖnY
K‡iwb| 2010 mv‡j nvBwZ‡Z f‚wgK¤ú nq| cÖvq AvovB jÿ gvbyl gviv
hvq| K‡qK gvm ci †`Lv †`q K‡jiv gnvgvix| wKDev 1000 Rb ¯^v¯’¨
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GKkÕiI †ewk wKDevi ¯^v¯’¨ Kg©x †ivMx‡ì wPwKrmvq KvR K‡i|
2004 mv‡j wKDev I †fwbRy‡qjv †hŠ_fv‡e Acv‡ikb Miracle bv‡g
webvg~‡j¨ Pÿz wPwKrmvi Kg©m~wP ïiæ K‡i| 34wUi †ewk †`‡k Pÿz wPwKrmv,
K¨vUviv±, Møy‡Kvgv Acv‡ikb Kiv nq| Pkgv †Ìqv nq webvg~‡j¨| 2011
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RvwZm‡•N evsjv‡`‡ki c‡ÿ MDG Award MÖnY K‡ib cÖavbgš¿x †kL
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Digital Health for Digital Development Award MÖnY K‡ib| 2009
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AR©‡bi Rb¨ Global Alliance for Vaccination and Immunization
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K‡i| GQvov Association for Social Advancement (ASA), MÖvgxY
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evsjv‡`‡k wUKv`vb Kg©m~wPi mvdj¨ DbœZ †`k¸‡jvi mgvb| GRb¨ 2009
I 2012 mv‡j evsjv‡`k GAVI Best Performance Award cvq| cuvP
eQ‡ii Kg eq‡mi wkï‡ì g„Zzï nvi Kgvbi Rb¨ 2001 mv‡j miKvi
Integrated Management of Childhood Illness (IMCI) ïiæ K‡i|
†h K‡qKwU †ivM wkï‡ì g„Zzï Rb¨ †ewk `vqx †m¸‡jvi wPwKrmv AviI
we¯Í…Z I Kvh©Ki Kivi D‡Ï‡k¨ G cÖKí †bIqv nq| cÖvq me ¯^v¯’¨ Kg©x‡K
G †ivM¸‡jv m¤^‡Ü cÖwkÿY †Ìqv nq|
¯^v¯’¨ Lv‡Zi evB‡i Ab¨vb¨ Lv‡Zi DbœwZI ¯^v‡¯’ï Dci cÖfve †d‡j|
wkÿv‡ÿ‡Î DbœwZ n‡q‡Q| 1999 mv‡j cÖv_wgK wkÿvq fwZ© nZ 74 kZvsk
†Q‡j‡g‡q| 2019 mv‡j GUv nq 97.7 kZvsk| cÖv_wgK wkÿv (8eQi eqm
ch©šÍ) 2017 mv‡j m¤ú~Y© K‡i 84 kZvsk †Q‡j I 86 kZvsk †g‡q| D‡jøL¨
†h cÖv_wgK I gva¨wgK wkÿv A‰eZwbK| cvVëBI webvg~‡j¨ †Ìqv nq|
¯^vÿiZvi nvi 1980 mv‡j wQj 38.9 kZvsk, 2017 mv‡j Zv nq 72.89
kZvsk|
bvix ÿgZvqbI ¯^v¯’¨ Lv‡Zi DbœwZ‡Z f‚wgKv iv‡L| 1978 mv‡j gwnjv
I wkï gš¿Yvjq ¯’vwcZ nq| PvKzwi‡Z gwnjv‡ì msL¨v evovbi †Póv
Kiv nq| ÿz`ªFY cvIqvi e¨vcv‡i bvix‡ì AMÖvwaKvi †Ìqv nq| gvV
ch©v‡q ¯^v¯’¨ Kg©x‡ì AwaKvskB gwnjv| A_©bxwZ‡Z gwnjv‡ì AskMÖnY
2011 mv‡j evsjv‡`‡k wQj 57 kZvsk, fvi‡Z 29 kZvsk, cvwK¯Ív‡b
22 kZvsk, kÖxj¼vq 35 kZvsk| 1980 mvj †_‡K `~‡h©vM cÖ¯‘wZ I
†gvKv‡ejvq evsjv‡`k c„w_ex‡Z D`vniY wnmv‡e ùvwo‡q‡Q| NywY©So
AvkÖq‡K›`ª ˆZwi Kiv, NywY©So m¤^‡Ü gvbyl‡K m‡PZb Kiv, R¦‡jv”Qvm
†iv‡ai Rb¨ euva ˆZwi Kiv, NywY©S‡oi AvMvg ms‡KZ †Ìqv- G¸‡jvi
gva¨‡g NywY©S‡oi AwfNvZ A‡bK Kgvb n‡q‡Q| eb¨v †gvKv‡ejvi †ÿ‡ÎI
AvkÖq, Lv`¨ mieivn, †ivM cÖwZ‡iva G¸‡jvi eë¯’v wb‡q ÿqÿwZ I
Rxebnvwb Kgvb n‡q‡Q|

miKvi I †emiKvwi ms¯’v¸‡jv ¯^v¯’¨‡ÿ‡Î eo c`‡ÿc †bIqvi Av‡M A‡bK
†ÿ‡Î cixÿvg~jK M‡elYv K‡i †m¸‡jvi g~j¨vq‡bi wfwË‡Z AMÖmi n‡q‡Q|
¯^v¯’¨ msµvšÍ mgm¨vejx wb‡q AvšÍR©vwZK Dìvgq †K›`ª ev ICDDRB,
BRAC, Bangladesh Institute of Development Studies (BIDS)
BZ¨vw` ms¯’v cwiKwíZ M‡elYv K‡ib| †h me M‡elYvq fvj dj cvIqv
hvq †m¸‡jv e„nËi cwim‡i Pvjy Kivi D‡`¨vM †bIqv nq|
mgm¨vmg~nt
1) †`‡ki AwaKvsk gvbylB `wi`ª| wKš‘ ¯^v¯’¨ Lv‡Z LiP †gvU
RvZxq Av‡qi gvÎ 2.64 kZvsk| GUv `wÿY Gwkqvq Ab¨vb¨
†`‡ki Zzjbvq mePvB‡Z Kg (cvwK¯Ívb 2.9 kZvsk, fviZ 3.89
kZvsk)| Avevi Gi g‡a¨ gvÎ GK Z…Zxqvsk miKvwi LiP|
67 kZvsk LiP †ivMx I Zvi AvZ¥xq ¯^R‡bi wb‡R‡ì (out of
pocket expenditue) I c„w_exi me‡P‡q †ewk nv‡ii Ab¨Zg|
†iv‡Mi Kvi‡Y wech©qg~jK wPwKrmv e¨‡qi (catastrophic
expenditure) Rb¨ cÖwZ eQi 5 jÿ gvbyl `vwi`ªmxgvi wb‡P P‡j
hvq| 7 kZvsk gvbyl wPwKrmv e¨q †gUvbi Rb¨ FYMÖ¯Í nq A_ev
m¤ú` wewµ Ki‡Z eva¨ nq| evsjv‡`‡k gv_vwcQz ¯^v¯’¨ Lv‡Z e¨q
2017 mv‡j wQj 36 Wjvi, hvi `yB-Z…Zxqvsk †ivMxi wb‡Ri ev
Zvi AvZ¥xq ¯^R‡bi| hy³iv‡óª gv_vwcQz ¯^v¯’¨ Lv‡Z e¨q 2017
mv‡j wQj 9536 Wjvi, hy³iv‡R¨ wQj 4356 Wjvi| ¯^v¯’¨-exgvi
e¨vcv‡i mgm¨v nj wb¤œAv‡qi gvbyl exgvi wKw¯Í w`‡Z cvi‡eb
bv| mÿg e¨w³‡ì g‡aÏ fwel¨‡Zi Amy¯’Zvi Rb¨ GLb A_©
e¨q Kivi e¨vcv‡i †bwZevPK g‡bvfve Av‡Q| A‡b‡K g‡b K‡i
miKvwi ¯^v¯’¨‡mev nIqv DwPr webvg~‡j¨|
2) miKvwi A_© eë¯’vcbv RwUj, A‡b‡Ki g‡Z Dcwb‡ewkK Avg‡ji
PwiÎ AcwiewZ©Z i‡q †M‡Q| ¯^v¯’¨‡mevi cÖ‡qvR‡b eivÏ I e¨‡qi
Avjv`v mgš^‡qi eë¯’v bvB| miKv‡ii me †ÿ‡Î GK wbqg cvjb
Ki‡Z nq| †`‡ki wewfbœ ¯Í‡ii ¯’vbxq mgm¨v I Pvwn`vi cÖwZdjb
†K›`ªxf‚Z wbqš¿‡Yi Kvi‡Y eivÏ I e¨q m¤¢e nq bv| mgqgZ e¨q
Kivi A‡bK wewa wb‡la we`¨gvb| `~b©xwZ eÜ Kivi D‡Ï‡k¨ wbqg
Kvbyb ˆZwi n‡jI `~b©xwZ bv K‡g, `ÿZv K‡g‡Q| AcÖ‡qvRbxq
miÄvg ev hš¿cvwZ, wb¤œgv‡bi hš¿cvwZ µ‡qi Awf‡hvM MYgva¨‡g

cÖvqB cÖKvwkZ nq| mwVK iÿYv‡eÿY I †givg‡Zi eë¯’v bv
_vKvq A‡bK hš¿cvwZ AíKv‡jB A‡K‡Rv n‡q c‡o|
3) evsjv‡`‡k miKvwi ¯^v¯’¨‡mevi AeKvVv‡gv `wÿY Gwkqvi
†`k¸‡jvi g‡a¨ mePvB‡Z kw³kvjx| MÖvg ch©v‡q cÖwZ 6 †_‡K
8 nvRvi gvby‡li Rb¨ GKwU KwgDwbwU wK¬wbK i‡q‡Q, hvi †gvU
msL¨v 14 nvRvi| cÖwZ gv‡m M‡o GK †KvwU gvbyl KwgDwbwU
wK¬wb‡K wPwKrmv †bq| 20 kZvsk KwgDwbwU wK¬wb‡K ¯^vfvweK
cÖm‡eiI eë¯’v Av‡Q| BDwbqb ch©v‡q GKwU K‡i ewnwe©fvM
wK¬wbK Av‡Q, msL¨v 1312| Dc‡Rjv ¯^v¯’¨ †K›`ª Av‡Q 424wU,
†ewkifv‡MiB 30 †_‡K 50 kh¨vi nvmcvZvj Av‡Q| †Rjv
nvmcvZvj 59wU (cÖvq `k nvRvi kh¨v) Av‡Q| miKvwi †gwWK¨vj
K‡jR Av‡Q 36wU, RwUj †ivMxi wPwKrmv eë¯’vi Rb¨ †gwWK¨vj
wek^we`¨vjq I †cv÷MÖvRy‡qU Bbw÷wUDU 39wU Av‡Q| XvKv
†gwWK¨vj K‡jR nvmcvZv‡j 2017 mv‡j †gvU 935876 (M‡o
cÖwZw`b 3 nvRvi) †ivMx ewnwe©fv‡M wPwKrmv wb‡q‡Q| ivRkvnx
†gwWK¨vj K‡jR nvmcvZv‡j wb‡q‡Q 720558 (M‡o cÖwZw`b
cÖvq 2400) Rb wPwKrmv wb‡q‡Q| PÆMÖvg †gwWK¨vj K‡jR
nvmcvZv‡j 620667 (M‡o cÖwZw`b cÖvq 2 nvRvi) Rb wPwKrmv
wb‡q‡Q| 2017 mv‡j XvKv †gwWK¨vj K‡jR nvmcvZv‡j fwZ©
n‡q wPwKrmv wb‡q‡Q 172343, ivRkvnx †gwWK¨vj K‡jR
nvmcvZv‡j 170596, PÆMÖvg †gwWK¨vj K‡jR nvmcvZv‡j
237222 Rb| XvKv †gwWK¨vj K‡jR nvmcvZv‡j 2017 mv‡j
kh¨v msL¨vi 133 kZvsk †ivMx fwZ© wQj, gqgbwmsn †gwWK¨vj
K‡jR nvmcvZv‡j kh¨v msL¨vi 238 kZvsk, ivRkvnx †gwWK¨vj
K‡jR nvmcvZv‡j 145.8 kZvsk fwZ© wQj| XvKv †gwWK¨vj
K‡jR nvmcvZv‡j 2017 mv‡j M‡o cÖwZw`b 90wU eo Acv‡ikb
I 113wU †QvU Acv‡ikb webvg~‡j¨ n‡q‡Q| 2017 mv‡j PÆMÖvg
†gwWK¨vj K‡jR nvmcvZv‡j M‡o cÖwZw`b 50wU eo Acv‡ikb
I 40wU †QvU Acv‡ikb n‡q‡Q webvg~‡j¨| Ab¨vb¨ †gwWK¨vj
K‡jR¸‡jv‡ZI Zzjbvg~jKfv‡e GKB wPÎ|
miKvwi wK¬wbK I nvmcvZvj¸‡jv †ewkifvM ¯’v‡bB Zv‡ì
mÿgZvi PvB‡ZI †ewk KvR Ki‡Q| GKRb ¯^v¯’¨ gš¿x e‡jb, Mixe
†ivMx‡ì wPwKrmv cvIqvi †kl fimvi ¯’vb miKvwi nvmcvZvj|
wKš‘ miKvwi nvmcvZv‡ji †mev gvbm¤§Z bq| cÖwZôvb¸‡jv wewfbœ

mgm¨vq RR©wiZ| cÖv_wgK †mev ch©v‡q Rbe‡ji ¯^íZv Av‡Q|
cÖ‡qvRbxq msL¨K wPwKrmK, bvm©, †UK‡bvjwR÷ bvB| c`vqb
n‡jI A‡b‡K _v‡Kb bv| hš¿cvwZi ¯^íZv I Jl‡ai ¯^íZv
i‡q‡Q| †gŠwjK myweav A_©vr cwi®‹vi cwi”QbœZv, Lv`¨, Uq‡jU,
cvwb G¸‡jvI A‡bK ¯’v‡b bvB A_ev eënv‡ii A‡hvM¨| wPwKrmv
Kg©x‡ì AvPiYMZ mgm¨vI i‡q‡Q| wØZxq I Z…Zxq ch©v‡qI
mgm¨v cÖej| G¸‡jv‡Z Rbe‡ji Afve bv _vK‡jI Ab¨vb¨
mgm¨v¸‡jv cÖKU| Zvi Dci G¸‡jv‡Z mÿgZvi PvB‡Z †ewk
†ivMxi wPwKrmv †Ìqvq mgm¨v AviI ev‡o| A‡bK nvmcvZv‡j
†ivMx †g‡S‡Z _v‡K|
4) †emiKvwi wK¬wbK I nvmcvZvjmg~‡ni wbqš¿Y `~e©j| A‡bK
Aby‡gv`bwenxb wK¬wbK I nvmcvZvj eëmv‡q RwoZ| G¸‡jv
wbqš¿Y msµvšÍ AvBb A‡bK cyi‡bv, weMZ kZvãxi Avwki `k‡Ki,
eZ©gvb cwiewZ©Z cwiw¯’wZi m‡½ m½wZ bvB| AvB‡bi cÖ‡qvM
wbqwgZ bq, cÖ‡qvRbxq Rbej I AeKvVv‡gv bvB| RbmsL¨v
evo‡Q, gvby‡li AvqI †e‡o‡Q, ¯^v¯’¨‡mevi Pvwn`v evo‡Q|
miKvwi cÖwZôvb¸‡jv‡Z Av¯’v bv _vKvi I RvqMv bv cvIqvi
Kvi‡Y AwaKvsk gvbyl †emiKvwi wK¬wbK I nvmcvZv‡j hvb|
A‡bK †ÿ‡Î GLv‡bI gvbm¤§Z †mev cvIqv hvq bv| AcÖ‡qvRbxq
cixÿv, AcÖ‡qvRbxq wPwKrmvI A‡bK‡ÿ‡Î †Ìqv nq| G¸‡jv
myivnv Kivi eë¯’v bvB| mviv‡`‡k wbewÜZ wPwKrm‡Ki msL¨vi
AšÍZt `k¸Y †ewk unqualified practitioners (quack)
wPwKrmv eëmv Pvwj‡q hv‡”Q| G‡ì A‡b‡KB Jla weµq ev
dv‡g©mxi m‡½ RwoZ| dv‡g©mx¸‡jvI A‡bK †ÿ‡Î wbewÜZ bq|
G‡ì ¯^xK…Z †Kvb cÖwkÿY bvB| A‡b‡Ki †Kvb cÖwkÿYB bvB|
G‡ì Kv‡QB †`‡ki mvaviY gvby‡li GKUv weivU Ask wPwKrmv
†bq, A‡bK mgq ÿwZKi wPwKrmvi wkKvi nq| kn‡ii eo
nvmcvZvj I wK¬wbKmg~n weËevb gvbyl‡ì MšÍe¨¯’j| AZ¨waK
g~j¨, AcÖ‡qvRbxq cixÿv I wPwKrmvi Awf‡hvM GLv‡bI Av‡Q|
5) wek^ ¯^v¯’¨ ms¯’vi Joint Learning Initiative Gi Report
on Human Resources for Health 2004 G AZ¨vek¨Kxq
¯^v¯’¨‡mevi (Essential Health Intervention) Rb¨ cÖ‡qvRbxq
by¨bZg Rbe‡ji mycvwik K‡i‡Q cÖwZ 10 nvRvi gvby‡li Rb¨ 23
Rb| evsjv‡`k miKvi 2012 mv‡j ¯^v¯’¨ Kg©x‡ì AbycvZ wba©viY

K‡i wPwKrmKt bvm©©t Ab¨vb¨ ¯^v¯’¨ Kg©x 1t3t 5| GB Abyhvqx
cÖwZ 10 nvRvi gvby‡li cÖv_wgK ¯^v¯’¨‡mevi Rb¨ wPwKrmK
cÖ‡qvRb 2.5 Rb| evsjv‡`k 2004 mv‡j GUv AR©b K‡i‡Q|
2018 mv‡j cÖwZ 10 nvRvi gvby‡li Rb¨ wPwKrmK wQj 6.3 Rb|
2011 mv‡j cÖwZ 10 nvRvi gvby‡li Rb¨ bvm© wQj 1.007 Rb|
cÖv_wgK ¯^v¯’¨‡mevi Rb¨ cÖwZ 10 nvRv‡i 7.5 Rb bvm© _vKv
ìKvi| evsjv‡`‡k cÖwZ 10 nvRvi gvby‡li Rb¨ †UK‡bvjwR÷
Av‡Q 0.32 Rb| cÖ‡qvRb cÖwZ 10 nvRv‡i 12.5 Rb|
msL¨vi AcÖZzjZv QvovI wkÿvi gvb wb‡q cÖkœ Av‡Q| wPwKrmK‡ì
GgweweGm ch©v‡q wkÿv m¤^‡Ü †h mgxÿv n‡q‡Q, Zv‡Z gvb
m¤^‡Ü DwØMœ nIqv DwPZ| wKš‘ G e¨vcv‡i †Kvb c`‡ÿc †bIqv
n‡”Q bv| ¯œvZ‡KvËi ch©v‡q †Kvb mgxÿv bvB, wKš‘ GLv‡bI
AvšÍR©vwZK gv‡bi Kv‡Q †cuŠQvb †M‡Q wKbv Zv ejv hvq bv| bvwm©s
I †UK‡bvjwR÷‡ì wkÿvi e¨vcv‡iI gvb hvPvB Kiv cÖ‡qvRb|
eZ©gvb hy‡M wPwKrmv we‡klvwqZ I cÖhyw³ wbf©i n‡q †M‡Q| bvwm©s
I †UK‡bvjRx‡Z we‡klÁ cÖwkÿ‡Yi eë¯’v bvB| DbœZ †`kmg~‡n
KvwW©IjRx, wbD‡ivjRx, M¨v‡÷ªvG›Uv‡ivjRx, wbD‡ivmvR©vix G
iKg we‡klvwqZ †ÿ‡Îi cÖwZwU‡Z bvm© I †UK‡bvjwR÷‡ì we‡kl
cÖwkÿY cÖ‡qvRb nq I Zv ¯^xK…wZ †èvi eë¯’v Av‡Q| Avgv‡ì
†`‡k wPwKrmK‡ì †ÿ‡Î we‡klÁ eë¯’v wKQzUv M‡o DV‡jI bvm©
I †UK‡bvjwR÷‡ì we‡klÁ cÖwkÿ‡Yi D‡`¨vM LyeB Kg| GUv
Qvov fvj gv‡bi we‡klÁ wPwKrmv eë¯’v M‡o DV‡e bv|
wkÿv KvwiKzjv‡g ÎæwU Av‡Q| MÖvgvÂ‡j ev †QvU kn‡ii †ivMx‡ì
wPwKrmv †Ìqvi Rb¨ wPwKrmK‡ì ˆZwi Kiv nq bv e‡j A‡b‡K
g‡b K‡ib| A‡bK Dbœqbkxj †`‡k GRb¨ we‡kl eë¯’v †bIqv
nq| wKQy we‡kl‡Ái g‡Z, ¯^v¯’¨ Kg©x‡ì motivation Gi mgm¨v
Av‡Q| Communication I Ethics m¤^‡Ü wkÿv`v‡bi eë¯’vI
h‡_ó bq e‡j A‡b‡K g‡b K‡ib|
6) ¯^v¯’¨‡mevi LiP w`b w`b evo‡Q| 2003 mv‡j ¯^v¯’¨ Lv‡Z gv_v
wcQz LiP wQj 10 gvwK©b Wjvi, 2017 mv‡j Zv n‡q‡Q 36 Wjvi|
wKš‘ G Li‡P miKv‡ii Ask Kg‡Q| †gvU Li‡Pi cÖvq 41 kZvsk
wQj miKv‡ii 2000 mv‡j, 2012 mv‡j Zv nq 32 kZvsk|
¯^v¯’¨ m~P‡Ki A‡bK¸‡jv‡Z evsjv‡`k GL‡bv wcwQ‡q| cÖvq 4.5
jÿ wkï severe acute malnutrition G fzM‡Q| cÖvq 20 jÿ

wkï moderate malnutrition Gi wkKvi, 15 jvL wkï GLbI
cÖwZeQi Wvqwiqvq gviv hvq| cuvPeQi eq‡mi wb‡P wkï‡ì 41
kZvsk D”PZv Abycv‡Z IRb Kg| gvZ…g„Zzï nvi GLbI A‡bK
†ewk| wkï Rb¥`v‡bi mgq GLbI gvÎ 42.1 kZvsk gwnjv
cÖwkwÿZ ¯^v¯’¨ Kg©xi mvnvh¨ cvq| i³ïb¨Zv I micronutrient
deficiency i‡q‡Q 33 kZvsk wK‡kvixi| 14 †_‡K 44 eQi
eq‡mi gwnjv‡ì 25 kZvs‡ki D”PZvi Zzjbvq IRb Kg|
mgv‡R A_©‰bwZK êlg¨ GLbI A‡bK †ewk| wRwb mnM A‡bK
eQi a‡i 0.46 Gi KvQvKvwQ Av‡Q| A_©‰bwZK mÿgZv, wkÿvMZ
†hvM¨Zv, wj½, †fŠMwjK Ae¯’vb Abyhvqx ¯^v‡¯’ï wewfbœ m~P‡K
AmgZv we`¨gvb| GK eQ‡ii Kg wkï‡ì g„Zzï nvi D”P Av‡qi
cwiev‡iI 14 cÖwZ nvRvi RxweZ R‡b¥; wb¤œAv‡qi cwiev‡i GUv
35 kZvsk| wbiÿi gwnjv‡ì Mo mšÍvb msL¨v 2.4; gva¨wgK I
D”P wkÿv Av‡Q Ggb gwnjv‡ì Mo mšÍvb 2.0| †gvU cÖRbb nvi
kn‡i 2.0, MÖv‡g 2.3|
AmsµvgK e¨vwai nvi µ‡gB evo‡Q| cÖvßeq¯‹ RbmsL¨vi 25.4
kZvsk D”P i³Pv‡c fzM‡Qb, 6.4 kZvs‡ki Av‡Q Wvqv‡ewUm|
i‡³ D”P †Kv‡j‡÷ij Av‡Q 30 kZvsk gvby‡li| g‡bv‡iv‡M
fzM‡Qb 16.1 kZvsk cÖvßeq¯‹ gvbyl| Fatty liver G fzM‡Qb
20 kZvsk gvbyl| `xN©¯’vqx wKWbx †iv‡M AvµvšÍ 16 kZvsk
gvbyl| cÖvq 30 nvRvi †ivMxi cÖwZeQi wKWbx A‡K‡Rv nIqvi
Rb¨ Wvqvwjwm‡mi ìKvi nq| G‡ì 66 kZvs‡ki Wvqvwjwmm
Kivi eë¯’v †`‡k bvB| hviv Wvqvwjwmm K‡ib Zv‡ì 10 kZvsk
A_©vfv‡e Zv eÜ K‡i w`‡Z eva¨ nb| cÖwZeQi cÖvq 1 jÿ 50
nvRvi gvbyl K¨vÝv‡i AvµvšÍ nb| †`‡k gvÎ PviwU we‡klvwqZ
K¨vÝvi nvmcvZvj Av‡Q| `xN©¯’vqx †ncvUvBwUm we I wm †iv‡M cÖvq
GK †KvwU gvbyl fzM‡Q|
7) c„w_exi †h 10wU †`k Pig cÖvK…wZK `~‡h©v‡Mi Øviv ÿwZMÖ¯Í,
evsjv‡`k Zvi g‡a¨ Ab¨Zg| DcK~j AÂ‡ji 28 jÿ 50
nvRvi †n±i Rwgi 12 jÿ †n±i Rwg BwZg‡a¨B jeYv³Zvq
AvµvšÍ| International Development Monitoring Center
Gi cÖwZ‡e`b Abyhvqx cÖvK…wZK `~‡h©v‡Mi Kvi‡Y cÖwZ eQi 7
jÿ gvbyl M„nnviv n‡”Q| G‡ì g‡a¨ A‡b‡KB bMigyLx n‡”Q|
M„nnviv nIqvi Kvi‡Y A_ev Av‡qi c_ bv _vKvi Rb¨ XvKvq

cÖwZeQi 4 jÿ wb¤œAv‡qi gvbyl Av‡m| †gvU 60 jÿ gvbyl
BwZg‡a¨B cÖvK…wZK `~‡h©v‡Mi Rb¨ M„nnxb n‡q‡Q| evsjv‡`‡ki
`yB Z…Zxqvsk f‚wg mgy`ªZ‡ji 15 dzU D”PZvi wb‡P Aew¯’Z|
RvwZm‡•Ni Intergovermental Panel on Climate Change
Gi cÖwZ‡e`b Abyhvqx 2050 mv‡ji g‡a¨ evsjv‡`‡ki 17
kZvsk f‚wg cvwbi wb‡P P‡j †h‡Z cv‡i| Lv`¨ Drcv`b GK Z…
Zxqvsk K‡g hvIqvi m¤¢vebv| wek¦ e¨vs‡Ki g~j¨vqb Abyhvqx
2050 mvj bvMv` evsjv‡`k 171 wewjqb Wjvi ÿwZi m¤§yLxb
n‡e|
XvKv kn‡ii GK-Z…Zxqvsk Awaevmx ew¯Í‡Z evm K‡i| ew¯Íevmx
gvby‡li GK PZz_©vsk weï× cvwb cvq bv, GK-PZz_©vsk gvby‡li
Uq‡jU bvB| ¯^v¯’¨‡mevi eë¯’v bvB e‡jøB P‡j| weï× cvwbi Rb¨
K‡qK `kK †_‡K Mfxi bjK~‡ci gva¨‡g f‚Mf©¯’ cvwb D‡Ëvjb
Kiv n‡”Q Ges cvb Kiv I ivbœv Kivi Rb¨ eënvi Kiv n‡”Q|
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Z_¨m~Ît
1. https://www.who.int/health_financing/universal_coverage_
definition/en.
2. https://www.who.int/en/newsroom(fact-sheets)detail/universal-
health-coverage-uhc.
3. UN General Assembly. Transforming Our World:the 2030 Agenda
for Sustainable Development. United Nations. New York 2015.
4. Boerma T, Eozenou P, Evans D et al. Monitoring Progress Towards
Universal Health Coverage and Country at Global Levels (2014).
PLOS Medicine 11 (9) 1001731.
5. https://www.gov.uk/government/publications/the-health-and-
care-system-explained/
6. https://en.wikipedia.org/wiki/healthcare_in_Germany.
7. https://about-france.com/health-care.htm
8. https://en.wikipedia.org/wiki/healthcare_in_Thailand.
9. https://www.searo.who.int/.../hibs/hit_thailand/en.

10. Kutty VR. Historical analysis of the development of health care
facilities in Kerala state, India. Health Policy and Planning,
2000,15:103-109.
11. Kapur A. Poor but Prosperous. The Atlantic, September 1998.
12. https://en.m.wikipedia.org/wiki/Kerala_model.
13. https://www.huffingtonpost.com. 8 August 2014. Lamrani S.
Cuba’s Health Care System. A Model for the World.
14. https://www.huffingtonpost.com. 15 March, 2016. Almendrala A.
Cuba has Made At Least 3 Major Medical Innovations That We Need.
15. S. Farouq. Cuba’s Health Care System. A Political Social and
Economic Revolution. Berkeley Political Review, 9 February
2019.
16. https://en.wikipedia.org//wiki/Primary-health-care.
17. Chowdhury AMR, Bhuiya A, Chowdhury ME, Rashed S, Hussain Z,
Chen LC. Bangladesh: Innovation for Universal Health Coverage.
1 The Bangladesh Paradox: Exceptional Health Achievements
Despite Economic Recovery. Lancet, 2013:382:1734-1735.
18. Balabarcova D, McKee M, Mills A (Eds). ‘Good Health at Low
Cost’ 25 years on. What Makes a Successful Health System? 2011,
London School of Tropical Medicine and Hygeine, London. P.47-
82,193-234.
19. Joarder T, Chowdhury TZ, Mannan I. Universal Health Coverage
in Bangladesh: Activities, Challenges and Suggestions. Advances
in Public Health, 2014 (3):1-12.
20. Cockcroft A, Milne D, Olofsen M, Karim E and Anderson N.
Health Services Reform in Bangladesh: Hearing the Views of
Health Workers and Their Professional Bodies. BMC Health Serv
Res. (Internet) 2011,September,2.
21. Health Bulletin, 2018. Government of the People’s Republic of
Bangladesh. Ministry of Health and Family Welfare.
22. Islam MA, Akhter S, Islam M. Health Financing in Bangladesh:
Why Changes in Public Financial Management Rules Will be
Important. Health System and Reform, 2018; 4:65-68.
23. https://www.theguardian.com. 6 January 2015. Amartya Sen.
Universal Healthcare: the Affordable Dream.

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fvimvg¨ nvivj, A‡b‡K gviv †Mj| 1960 Gi `k‡Ki gvSvgvwS Rb¯^v¯’¨
wefv‡Mi GKRb M‡elK Peter Buxton G M‡elYv m¤^‡Ü Rvb‡Z cv‡ib|
wZwb DaŸ©Zb KZ…©cÿ‡K Rvbvb, GUv A‰bwZK| Zviv ch©v‡jvPbv Kivi Rb¨
GKwU KwgwU MVb K‡i| KwgwU wm×všÍ †bq me AskMÖnYKvixi g„Zz¨ bv nIqv
ch©šÍ M‡elYv Pj‡e| ev·Ub G NUbv GKRb mvsevw`K‡K Rvbvb, hvi gva¨‡g
Ab¨vb¨ mvsevw`‡KivI Rvb‡Z cv‡ib| 1972 mv‡ji 25†k RyjvB G msµvšÍ
cÖwZ‡e`b cÖKvk K‡i G‡mvwm‡q‡UW †cÖm| cÖwZev‡ì So I‡V| gvwK©b
Ks‡MÖ‡m Z`šÍ c¨v‡bj MwVZ nq| g¨vmvPz‡mUm Gi wm‡bUi GWIqvW© †K‡bWx
e‡jb, GUv GKUv RNb¨ I Amn¨ KvR| A‡±vei 1972 mv‡j Ks‡MÖ‡mi
c¨v‡bj e‡jb, G A‰bwZK M‡elYv eÜ K‡i w`‡Z n‡e| M‡elYv eÜ nq|
BwZg‡a¨ 128 Rb wmwdwjm ev Zvi RwUjZvi Kvi‡Y g„ZzëiY K‡i‡Q,
40 R‡bi ¯¿x msµwgZ n‡q‡Q Ges 19 Rb wkï R‡b¥i mgqB msµwgZ
n‡q‡Q| hviv RxweZ wQ‡jb Zv‡ì c‡ÿ class action suit ïiæ Kiv nq|

RxweZ I g„Z‡ì eskai‡ì †gvU 10 wgwjqb Wjvi ÿwZc~iY †Ìqv nq|
Ks‡MÖm M‡elYv wbqš¿Y Kivi Rb¨ National Research Act cvm K‡i|
G‡Z miKvwi A_©vq‡b gvby‡li Dci M‡elYv Ki‡Z n‡j Av‡M Institutional
Review Board Gi Aby‡gv`b †bIqv eva¨Zvg~jK Kiv nq| G NUbvi ci
†_‡K Avwd«Kvb- Av‡gwiKvbiv miKvwi wPwKrmv eë¯’v m¤^‡Ü mw›`nvb n‡q
c‡owQj| †cÖwm‡W›U wej wK¬bUb 1997 mv‡j G e¨vcv‡i cÖKv‡k¨ ÿgv Pvb,
ÒgvwK©b miKv‡ii GB KvR ˆbwZKfv‡e m¤ú~Y© fzj wQj, G j¾vRbK BwZnvm
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†kl AskMÖnYKvixi g„Zz¨ nq 2004 mv‡j|
gvwK©b miKv‡ii A_©vq‡b I ¸qv‡Zgvjv miKv‡ii mn‡hvwMZvq 1946 mvj
†_‡K 1948 mvj ch©šÍ ¸qv‡Zgvjvq GKUv M‡elYv cÖwZôvb Pvjvb nq| G‡Z
700 Rb gvbyl‡K wmwdwjm †iv‡Mi RxevYy Øviv msµwgZ Kiv nq| wKš‘
Zv‡ì Rvbvb nq wb ev AbygwZ †bIqv nq wb| G gvby‡liv †ewkifvM wQ‡jb
e›`x, gvbwmK †ivMx ev wkï| hviv msµwgZ n‡qwQ‡jb Zv‡ì wPwKrmvI
†Ìqv nq wb| Gi djvdj †Kvb êÁvwbK Rvb©v‡j cÖKvk Kiv nq wb|
G M‡elYvi `vwq‡Z¡ whwb wQ‡jb, Dr. John Cutler, wZwbB cieZ©x‡Z
Uvm‡KMx M‡elYvi cÖav‡bi wb‡qvM cvb| 2010 mv‡j Susan Reverby
bv‡g GKRb M‡elK G M‡elYvi Z_¨ D×vi K‡i ZrKvjxb gvwK©b miKv‡ii
bR‡i Av‡bb| 2013 mv‡jB GRb¨ gvwK©b †cÖwm‡W›U evivK Ievgv I
†m‡µUvix wnjvix wK¬bUb ÿgv Pvb|
1950 Gi `k‡K gvbwmK cÖwZeÜx wkï‡ì eënvi K‡i †ncvUvBwUm †iv‡Mi
M‡elYv Kiv nq| wbDBq‡K©i ÷¨v‡Ub AvBj¨v‡Û Willowbrook ¯‹yj Aew¯’Z|
G ¯‹zj wQj gvbwmK cÖwZeÜx wkï‡ì Øviv Dc‡P cov, Ae‡nwjZ I †bvsiv|
†hLv‡b 4000 wkï _vKvi K_v †mLv‡b 6000 wkï _vKZ| Awffve‡Kiv Ab¨
†Kvb ¯‹zj bv _vKvq cÖwZeÜx wkï‡ì GLv‡b ivL‡Z eva¨ n‡Zb| †ncvUvBwUm
†ivM m¤^‡Ü †m mgq Ávb wQj Aí| hwÌ GLb Avgiv Rvwb K‡qKUv fvBivm
G †ivM NUv‡Z cv‡i, ZLb aviYv wQj †ivM GKUvB| Willowbrook ¯‹z‡j
wkï‡ì g‡a¨ †ncvUvBwU‡mi cÖv`yf©ve wQj Lye †ewk, kZKiv 30 †_‡K 50
fvM wkïB msµwgZ nZ| wKfv‡e GB †ivM Qovq, wKfv‡e GB †ivM cÖwZ‡iva
Kiv hvq, GUv wQj M‡elYvi welq| wbDBqK© ¯‹zj Ad †gwWwm‡bi Saul
Krugman G M‡elYvi cÖavb wQ‡jb| wbDBq‡K©i State Department of
Mental Hygiene I Armed Forces Epidemiological Board of the
Surgeon General’s Office G M‡elYvq Aby‡gv`b †`q| M‡elYvi dj

cieZ©x‡Z cÖKvwkZ nq cÖw_Zhkv êÁvwbK Rvb©vj- j¨vb‡mU, wbD Bsj¨vÛ
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bZzb `vjv‡b (A‡cÿvK…Z fvj cwi‡ek) fwZ© Kiv n‡e bv| wZb †_‡K `k
eQi e‡qmx 700 Gi AwaK wkïi Dci G M‡elYv cÖvq 15 eQi a‡i Pvjvb
nq| Wvt µzMg¨vb jÿ¨ K‡iwQ‡jb †h me wkïi GKevi G †ivM nq Zv‡ì
wØZxqevi nq bv| wZwb aviYv Ki‡jb hviv GKevi G †iv‡M †fv‡M Zv‡ì
i‡³ cÖwZ‡ivaKvix antibody _vK‡Z cv‡i| wZwb bZzb `vjv‡b wkï‡ì
mevB‡K †m‡i IVv wkï‡ì i‡³i serum w`‡jb| G‡ì GK MÖæc wkï‡K
AvµvšÍ †ivMxi gj wgé P‡Kv‡j‡U wgwk‡q LvIqvb nj| cyi‡bv `vjv‡bi wKQz
wkï‡K serum †Ìqv nj I wKQz wkï‡K †Ìqv nj bv| mevB‡K bR‡i
ivLv nj| Dr. Krugman †`L‡jb hv‡ì serum †Ìqv n‡q‡Q Zv‡ì
†ivM Kg n‡”Q, n‡jI g„`y| ZvÕQvov Dcm‡M©i wfwË‡Z Zviv wm×všÍ wb‡jb
†ncvUvBwUm `yB ai‡bi|
j¨vb‡mU Rvb©vj Dr. Krugman Gi M‡elYvi dj Qvcvbi cuvP eQi ci
GB A‰bwZK M‡elYv cÖKv‡ki Rb¨ ÿgv cÖv_©bv K‡i| 1972 mv‡j Gerald
Rivera bv‡g GKRb †Uwjwfkb mvsevw`K †Mvc‡b GB ¯‹z‡j cÖ‡ek K‡i me
wkï‡ì Qwe Zz‡j wb‡q Av‡m| †h AeY©bxq Ae¯’vq wkï‡ì ivLv nq Zv
e¨vcKfv‡e wbw›`Z nq| wkï‡ì AwffveK‡ì Av‡›`vj‡bi d‡j 1983
mv‡j G ¯‹zj eÜ K‡i †Ìqv nq| wKš‘ Dr. Krugman cieZ©x‡Z Av‡gwiKvb
†cwWqvwUªK G‡mvwm‡qk‡bi mfvcwZ wbe©vwPZ nb|
wbDBq‡K©i Sloan Kettering nvmcvZv‡j Kg©iZ BwgD‡bvjRx we‡klÁ
Wvt †Póvi mvD_vg Ab¨ Avi GKUv nvmcvZv‡j (Jewish Chronic Disease
Hospital, Brooklyn) GKUv †hŠ_ M‡elYv cÖK‡íi D‡`¨vM wb‡jb| wZwb
†`L‡Z PvB‡jb `ye©j gvby‡li kix‡i hw` K¨vÝv‡ii †Kvl cÖweó Kiv nq,
Zv n‡j Zv‡ì kix‡ii cÖwZ‡iva ÿgZvi cÖwZwµqv my¯’ gvby‡li Zzjbvq
Avjv`v nq wKbv| Wvt mvD_vg AZx‡Z GB ai‡bi M‡elYv K‡iwQ‡jb,
†mUvB Pvwj‡q †h‡Z Pvw”Q‡jb| Gi Av‡Mi `k‡K wZwb Avwd«Kvq K¨vÝv‡i
AvµvšÍ AZ¨šÍ `ye©j †ivMx‡ì kix‡i wewfbœ †iv‡Mi (gv¤úm, †W½y,
I‡q÷ bvBj fvBivm BZ¨vw`) fvBivm XzwK‡q w`‡q M‡elYv K‡iwQ‡jb|
Av‡gwiKvi InvBI A½iv‡Rï GKUv KvivMv‡i GKkiÕI †ewk †ivMxi
kix‡i K¨vÝvi †Kvl XzwK‡q w`‡q M‡elYv K‡iwQ‡jb|

Wvt mvD_vg I Zuvi mn‡hvMxiv wm×všÍ wb‡jb K¨vÝvi †Kvl †Ìqv n‡e GUv ejv
n‡e bv, G‡Z gvbyl AÁZvi Kvi‡Y fq cv‡e| Zv‡ì ejv n‡e †U÷ wUD‡e
evo‡Z _vKv gvbe‡`‡ni †Kvl †Ìqv n‡e| G ai‡bi cÖZviYv †mB mgq
(weMZ kZ‡Ki 60 Gi `k‡K) weij wQj bv| Jewish Chronic Disease
nvmcvZv‡ji wZbRb wPwKrmK G M‡elYvq Ask wb‡Z A¯^xKvi Ki‡jb I
c`Z¨vM K‡i MYgva¨‡g G NUbvi eY©bv w`‡jb| GKRb wPwKrmK ivwR n‡jb
I 22 Rb e„× †ivMx‡K K¨vÝvi †Kvl Bb‡RKkb †Ìqv nj| NUbv cÖKvk
cvIqvi ciI Wvt mvD_v‡gi weiæ‡× AvBbMZ †Kvb eë¯’v †bIqv nq wb|
Board of Regents of the University of the State of New York Zuv‡K
gvÎ GK eQi probation w`‡qwQj| wZwb mvgvwRKfv‡eI †Zgb ÿwZMÖ¯Í nb
wb, K‡qK eQi ciB wZwb American Association of Cancer Research
Gi mfvcwZ wbe©vwPZ nb|
c„w_exi BwZnv‡m mePvB‡Z fqven hy× wQj wØZxq gnvhy×| G hy‡× GKw`‡K
wQj ZrKvjxb †mvwf‡qZ BDwbqb, gvwK©b hy³ivóª, Bsj¨vÛ I d«vÝ Ges
Aciw`‡K wQj Rvg©vbx, BZvwj I Rvcvb| hy‡× cÖvq 5 †KvwU gvbyl gviv
hvq| hy× PjvKvjxb Rvg©vb †mbvevwnbxi wPwKrm‡Kiv A‡bK A‰bwZK
M‡elYv K‡ib| †m‡Þ¤î 1942 †_‡K wW‡m¤î 1943 ch©šÍ Ravensbrook
Concentration Camp G Rvg©vb mvgwiK evwnbxi cÖ‡qvR‡b nvo, gvsm I
¯œvqy regeneration cixÿv I GKRb gvbyl †_‡K Ab¨ gvby‡l nvo cÖwZ¯’vcb
cixÿv e›`x‡ì Dci Kiv nq| A¨v‡bm‡_wmqv bv K‡iB e›`x‡ì nvo,
gvsm, ¯œvqy †K‡U †ei Kiv nq, G‡Z e›`x‡ì AeY©bxq hš¿Yv I A½nvwb nq
Ges ¯’vqx AÿgZvi m„wó nq| A‡b‡K gviv hvq| e›`x‡ì nv‡oi g¾vq
Bb‡RKk‡bi gva¨‡g RxevYy cÖweó Kivi ci Jl‡ai Kvh©KvwiZv †`Lv nZ|
A‡bK e›`x kvixwiK weK…wZ wb‡q gyw³ †c‡qwQ‡jb, †h weK…wZ Zv‡ì mviv
Rxeb enb Ki‡Z nq|
1941 mv‡j Luftwaffe (Rvg©vb wegvb evwnbx) cÖvq wZbkZ e›`xi Dci
freezing experiment (hypothermia) Pvjvq| GUv wQj hypothermia
n‡j wK nq Ges Zv wKfv‡e wPwKrmv Kiv hvq †mUv cixÿv Kivi Rb¨|
e›`x‡ì Pvi †_‡K cuvP wWwMÖ †mjwmqvm VvÛv cvwb‡Z Wzwe‡q ivLv nZ| wKQz
e›`x‡K bMœ †`‡n wngv‡¼i wb‡P 6 wWwMÖ †mjwmqv‡m K‡qK N›Uv †i‡L †Ìqv
nZ, Zvici Zv‡ì wewfbœ Dcv‡q DòZv wdwi‡q Avbv nZ| †mvwf‡qZ
BDwbqb Awfhv‡b Rvg©vb ˆmb¨‡ì kxZj AvenvIqvq hy× Ki‡Z nq| Zviv
†mvwf‡qZ hy×e›`x‡ì Dci cixÿv Pvwj‡q Zv‡ì VvÛv mn¨ Kivi ÿgZv

Rvg©vb‡ì Zzjbvq †ewk wKbv Zv hvPvB KiZ| G cixÿv¸‡jv †ewkifvM
Dachau I Auschtwitz G Kiv nq| Gme cixÿvq Kgc‡ÿ GKkZ Rb
gviv hvq|
Dachau e›`x K¨v‡¤ú 1942 †_‡K 1945 mvj ch©šÍ e›`x‡ì g¨v‡jwiqv †ivM
msµwgZ K‡i (gkv A_ev Bb‡RKk‡bi gva¨‡g) wewfbœ Jla wKfv‡e KvR
K‡i Zv cixÿv Kiv nq| cÖvq 1200 gvby‡li Dci G cixÿv Kiv nq, cÖvq
A‡a©K gviv hvq| GQvovI wewfbœ K¨v‡¤ú †ncvUvBwUm, UvBd‡qW, UvBdvm,
B‡q‡jv wdfvi BZ¨vw` †iv‡Mi cixÿvg~jK cÖwZ‡laK wUKv e›`x‡ì Dci
cÖ‡qvM Kiv nq| 1939 mvj †_‡K 1945 mv‡ji g‡a¨ K‡qKUv K¨v‡¤ú
e›`x‡ì Dci gv÷vW© M¨vm I Ab¨vb¨ welv³ M¨vm cÖ‡qvM K‡i Gi †_‡K ÿZ
I Ab¨vb¨ welwµqv wKfv‡e wPwKrmv Kiv hvq Zv cixÿv Kiv nq|
1943 †_‡K 1945 mvj ch©šÍ Buchenwald K¨v‡¤ú e›`x‡ì wewfbœ ai‡bi
welv³ c`v_© Lvev‡ii m‡½ wgwk‡q LvIqvb nq| gviv hvIqvi ci Zv‡ì
ke-eë‡”Q` Kiv nZ| gviv bv †M‡j †g‡i †d‡j ke-eë‡”Q` Kiv nZ|
Polygel bv‡g GKUv Jla LvIqv‡j hy‡× AvnZ n‡j i³ÿiY Kg‡e-G aviYv
K‡i G ewo e›`x‡ì LvIqvb nZ| Zvici Zv‡ì nvZ, cv A¨v‡bm‡_wmqv
Qvov †K‡U †d‡j †Kgb i³ÿiY nq Zv †`Lv nZ| G iKg AviI A‡bK
ai‡bi A‰bwZK cixÿv e›`x‡ì Dci †Rvi K‡i Kiv n‡qwQj| G Qvov cÖvq
35 jÿ gvbyl‡K eske„w×‡Z Aÿg (Sterilization) K‡i †Ìqv n‡qwQj|
hy‡× civR‡qi ci Rvg©vb hy×vcivax‡ì wePvi nq wgwjUvix UªvBeybv‡j| ci
ci 13wU Av`vjZ e‡m Rvg©vbxi by‡igevM© kn‡i| g~j gvgjv nq ivR‰bwZK
I mvgwiK †bZ…e„‡›ì weiæ‡× 20 b‡f¤î 1945 †_‡K A‡±vei 1946 ch©šÍ|
G‡Z wePviK wQ‡jb PviwU hy×Rqx †`k †_‡Kt hy³ivóª, ZrKvjxb †mvwf‡qZ
BDwbqb, e„‡Ub I d«vÝ| Gi ci AviI 12wU wePviKvh© nq hy³iv‡óªi wgwjUvix
UªvBeybv‡j, AbywôZ nq by‡igev‡M©i GKB ¯’v‡b wW‡m¤î 1946 †_‡K GwcÖj
1949 ch©šÍ| Gi g‡a¨ GKUv wQj hy×vcivax wPwKrmK‡ì Rb¨, Av‡iKUv
AvBbRxwe‡ì Rb¨, Av‡iKUv eëmvqx‡ì Rb¨ BZ¨vw`|
kxl© ch©v‡qi wPwKrmK hy×vcivax‡ì wePvi AbywôZ nq 9 wW‡m¤î 1946 †_‡K
20 AvM÷ 1947 ch©šÍ| gvgjvi Avmj bvg wQj Kvj© eªvÛ I Ab¨vb¨ ebvg
hy³ivóª| wKš‘ GUv Doctors Trial bv‡g cwiwPZ| 23 Rb Avmvgxi g‡a¨ 20
Rb wQ‡jb wPwKrmK| Gi g‡a¨ wQ‡jb Rvg©vb †mbvevwnbxi †gwWK¨vj †Kv‡ii
cÖavb †jt †Rbv‡ij Siegfried Handloser, Schutzstaffel (SS) Avav

mvgwiK evwnbxi †gwWK¨vj wefv‡Mi cÖavb †jt †Rbv‡ij Karl Genzken,
wnUjv‡ii e¨w³MZ wPwKrmK †jt †Rbv‡ij Karl Brandt BZ¨vw`| 23 Rb
Avmvgxi g‡a¨ 7 wPwKrmK Qvov cvb, 7 R‡bi g„Zz¨`Û nq, evwK‡ì 10 eQi
ev Zvi †ewk †gqv‡ì Kviv`Û nq| 2 Ryb 1948 j¨vÛmevM© KvivMv‡i g„Zz¨`Û
cÖvß Avmvgx‡ì duvmx Kvh©Ki Kiv nq|
wePviKvh© Pjvi mgq Avmvgxiv hyw³ †`q, †h M‡elYvi Rb¨ Zv‡ì wePvi
n‡”Q G ai‡bi M‡elYv wØZxq gnvhy‡×i Av‡M Rvg©vbx I hy³iv‡óª n‡q‡Q|
AviI ejv nq gvby‡li Dci M‡elYvi †ÿ‡Î ¯^xK…Z †Kvb AvšÍR©vwZK AvBb
ev bxwZgvjv bvB| wePviKgÛjx M‡elYvi Rb¨ GKUv bxwZgvjv ˆZwi K‡ib,
†mUv Rgv †Ìqv nq 17 GwcÖj 1947, GUv ˆZwi‡Z mnvqZv K‡ib `yB Rb
wPwKrmK Wvt G¨vÛªy AvBwf I Wvt wjI Av‡jKRvÛvi| Guiv `yÕRb ev`xc‡ÿi
wQ‡jb| †gwWK¨vj M‡elYvi BwZnv‡m ˆbwZKZvi †ÿ‡Î by‡igevM© †KvW
mePvB‡Z ¸iæZ¡c~Y© `wjj| eZ©gvb Kv‡j †gwWK¨vj M‡elYvq ˆbwZKZvq
RvZxq I AvšÍR©vwZK hZ bxwZgvjv AbymiY Kiv nq Zvi me¸‡jviB wfwË
by‡igevM© †KvW|
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1. †h gvby‡li Dci M‡elYv Kiv n‡e Zvi †¯^”QvcÖ‡Yvw`Z AbygwZ e¨ZxZ
M‡elYv Kiv hv‡e bv| M‡elYvaxb e¨w³i AbygwZ †Ìqvi AvBbMZ
mÿgZv _vK‡Z n‡e| AbygwZ †bIqvi Rb¨ †Kvb iKg Pvc, fq-
fxwZ, cÖ‡jvfb †`Lvb ev duvwK †Ìqv hv‡e bv| M‡elYvaxb e¨w³i
†mB wel‡q AbygwZ †Ìqvi gZ Ávb I †eva _vK‡Z n‡e| AbygwZ
†bIqvi Rb¨ †m e¨w³‡K Rvbv‡bv I eySvbi eë¯’v Ki‡Z n‡e| wK
D‡Ï‡k¨ M‡elYv, wK DcKvi n‡Z cv‡i, wK c×wZ‡Z Kiv n‡e,
KZw`b Pj‡e, wK Ki‡Z n‡e, wK Amyweav n‡Z cv‡i BZ¨vw` ey‡S
AbygwZ †bIqv, Gi `vwqZ¡ Ab¨ KvD‡K †Ìqv hv‡e bv|
2. M‡elYvKvh© Ggb n‡Z n‡e hvi †_‡K mgvR DcK…Z n‡Z cv‡i Ges
hv Ab¨ †Kvb Dcv‡q AR©b Kiv m¤¢e bq|
3. cÖv_wgK M‡elYv cÖvYxi Dci n‡Z n‡e| †h †ivM m¤^‡Ü M‡elYv Kiv
n‡e †m †iv‡Mi MwZ cÖK…wZ †R‡b KvR Ki‡Z n‡e, †hb djvdj GB
Kv‡Ri mv_©KZv cÖgvY K‡i|
4. M‡elYvKv‡h© AcÖ‡qvRbxq kvixwiK ev gvbwmK Kó ev ÿwZ †hb
M‡elYvaxb e¨w³i bv nq|

5. g„Zz¨ A_ev gvivZ¥K ÿwZ nIqvi m¤¢vebv _vK‡j M‡elYv Kiv hv‡e bv|
6. M‡elYvi ¸iæ‡Z¡i PvB‡Z †ewk ÿwZ nIqvi m¤¢vebv _vK‡j M‡elYv
Kiv hv‡e bv|
7. M‡elYvKv‡h© †h me ÿwZ ev cÖwZwµqv nIqvi m¤¢vebv Av‡Q, †m¸‡jv
†gvKvwejv Kivi cÖ¯‘wZ _vK‡Z n‡e|
8. ïaygvÎ †hvM¨Zvm¤úbœ I AwfÁ e¨w³B M‡elYv Ki‡Z cvi‡eb|
M‡elYvi me ch©v‡q m‡e©v”P `ÿZv wb‡q KvR Ki‡Z n‡e|
9. M‡elYvKv‡h©i †h †Kvb mgq M‡elYvaxb e¨w³ hw` g‡b K‡ib
kvixwiK I gvbwmKfv‡e M‡elYvq Ask †bIqv Zvi c‡ÿ m¤¢e bq,
ZvÕn‡j wZwb M‡elYv †_‡K m‡i Avm‡Z cv‡ib|
10. M‡elYvKvix Zvi Ávb, AwfÁZv I AvšÍwiKZvi we‡ePbvq †h †Kvb
ch©v‡q hw` g‡b K‡ib M‡elYv Pvwj‡q †M‡j M‡elYvaxb e¨w³i
ÿwZ, AÿgZv ev g„Zz¨ n‡Z cv‡i, Zv nÕ‡j Zv‡K M‡elYv eÜ K‡i
w`‡Z n‡e|
wdbj¨v‡Ûi †njwmswK‡Z 1964 mv‡j Iqvì© †gwWK¨vj G¨v‡mvwm‡qk‡bi
18Zg m‡¤§j‡b M‡elYvi ˆbwZK bxwZgvjv msµvšÍ Declaration cÖ_gev‡ii
gZ M„nxZ nq| by‡igevM© †Kv‡W ewY©Z `kwU bxwZgvjv AviI wek` AvKv‡i
eY©bv †Ìqv nq| wK¬wbKvj M‡elYvi bxwZgvjv †ewk Av‡jvPbv nq| cieZ©x‡Z
G †NvlYvcÎ mvZevi ms‡kvab Kiv nq I `yBUvi e¨vL¨v †Ìqv nq| Gi
K‡jei 1964 mv‡j 11 c¨viv †_‡K 2013 mv‡j 37 c¨viv‡Z e„w× cvq|
Gi c~Y© weeiY cvIqv hv‡et www.wma.net/policies-post/wma-
declaration-of-helsinki-ethical-principles-for-medical-research-
involving-human-subjects/
gvby‡li Dci †gwWK¨vj M‡elYvi †ÿ‡Î G bxwZgvjv cÖavb we‡ewPZ nq|
hwÌ GB Declaration Gi AvšÍR©vwZK AvB‡b wfwË bvB, wKš‘ GUv cÖvq
me †`‡ki †gwWK¨vj M‡elYvi bxwZgvjvi Drm| GUv me wPwKrmK hviv
M‡elYvq RwoZ, Zv‡ì ˆbwZK w`K wb‡`©kbvi Rb¨ AbymiYxq| †Kvb †Kvb
†ÿ‡Î Good Clinical Practice (GCP) AbymiY Kiv nq| International
Conference on Harmonisation of Technical Requirements for
Regulation of Pharmaceuticals for Human use †_‡K GCP D™¢~Z|
Clinical Trial cwiPvjbvi wbqgvejx G‡Z Av‡Q: ema.europa.eu/en/ich-
e6-r2-good clinical-practice| GCP bxwZgvjvq gvbevwaKvi msiÿY

QvovI M‡elYvi bw_ iÿYv‡eÿY, cÖwkÿY I bZzb Jly‡ai Kvh©KvwiZv I
wbivcËvi Dci †Rvi †Ìqv nq|
M‡elYv wK? †Kvb wel‡q bZzb Z_¨ ev ev¯ÍeZv A‡š^lY Kiv, Z_¨ ms‡kvab
Kiv ev †Kvb ZË¡ ev cÖ‡qvM Luy‡R †ei Kivi D‡Ï‡k¨ Aaëmv‡qi m‡½ myk„•Lj
AbymÜvb Kiv| AsKkv¯¿ ev c`v_©we`¨vi gZ wPwKrmv kv¯¿ h_vh_ ev wbf©yj
(exact) weÁvb bq| hwÌ wPwKrmv kv‡¯¿i A‡bK mvaviY wbqgvejx Av‡Q,
wKš‘ cÖ‡Z¨K †ivMB Avjv`v| GKB †ivM wewfbœ gvby‡li kix‡i wewfbœ cÖwZwµqvi
m„wó Ki‡Z cv‡i| A‡bK †ivMxi †Kvb DcmM©B nq bv, †KD g„`yfv‡e AvµvšÍ
nq, Avevi Kv‡iv Rxeb wecbœ nq| GKBfv‡e wPwKrmvi Rb¨ eënvi Kiv
Jla mevi kix‡i mgvb KvR K‡i bv| Kv‡RB †ivM I wPwKrmv m¤^‡Ü M‡elYv
†ekx cÖ‡qvRb nq| wewfbœ eq‡mi gvbyl, wewfbœ RvwZ‡Mvôxi gvbyl ev Ab¨vb¨
cv_©K¨ m¤úbœ gvby‡li †ivM I wPwKrmvi aviv GK bvI n‡Z cv‡i|
gvbe mf¨Zvi AMÖMwZi g~j Dcv`vb M‡elYv| †hvMv‡hvM eë¯’v (†ijMvwo,
†gvUi Mvwo, RvnvR, G¨v‡iv‡cøb) m¤ú~Y©B M‡elYvi dj| †Uwjwfkb,
B›Uvi‡bU, †gvevBj †dvb G¸‡jvI M‡elYvi dj| K…wl‡ÿ‡Î Drcv`b e„w×
I DbœZ Rv‡Zi km¨, dj, meRx D™¢veb, mvi I KxUbvkK cÖ‡qvM G¸‡jvI
M‡elYvi dj| ¯^v¯’¨‡mevi †ÿ‡Î M‡elYvi djI gvbe mf¨Zvq D‡jøL‡hvM¨
cÖfve †d‡j‡Q| nvg, ¸wU emšÍ, †cvwjI BZ¨vw` †iv‡Mi wUKv Avwe®‹vi
gvby‡li Kó jvNe K‡i‡Q Ges gvby‡li Mo cÖZ¨vwkZ Avqy evovbi †ÿ‡Î eo
f‚wgKv †i‡L‡Q| 1900 mv‡j mviv c„w_exi gvby‡li Mo cÖZ¨vwkZ Avqy wQj
50 eQi; 1991 mv‡j Zv n‡q‡Q 76 eQi| A¨vw›Uev‡qvwU‡Ki Avwe®‹v‡ii
d‡j RxevYy msµgYRwbZ †ivM wbqš¿Y Kiv m¤¢e n‡q‡Q| A¨vw›Uev‡qvwUK
bv _vK‡j †h †Kvb Acv‡ik‡b g„Zzï nvi A‡bK †e‡o †hZ| D”P i³Pvc
I ü`‡iv‡Mi wPwKrmvq wewfbœ ai‡bi Jla gvby‡li Avqy evov‡Z mvnvh¨
K‡i‡Q| ü`‡iv‡Mi agbxi †ivM (coronary artery disease) GLb agbx‡Z
wPKb b‡ji gva¨‡g †÷›U ewm‡q ev evBcvm mvR©vix Acv‡ikb K‡i cÖkgb
Kiv hv‡”Q| wKWbx ev wjfvi A‡K‡Rv n‡q †M‡j cÖwZ¯’vc‡bi gva¨‡g Zvi
wPwKrmv Kiv hvq| mšÍvb avi‡Y AÿgZv in-vitro fertilization Gi Øviv
wPwKrmv Kiv n‡”Q| A‡bK ai‡bi K¨vÝvi wbqš¿Y K‡i Avqy `xN©vwqZ Kiv
hv‡”Q| K‡qK ai‡bi K¨vÝv‡ii wbivgqg~jK wPwKrmvI Av‡Q| Ggb AviI
ARmª D`vniY i‡q‡Q wPwKrmv weÁv‡b M‡elYvi mydj m¤ú‡K©| GLbI wewfbœ
ai‡bi †ivM wbY©q I wPwKrmvi DbœwZi Rb¨ M‡elYvKvh© Pj‡Q| gvbe‡`‡ni
¯^vfvweK wµqvKjvc, A‡bK †iv‡Mi Kvh©KviY, A‡bK †iv‡Mi fvj wPwKrmv

BZ¨vw` m¤^‡Ü gvby‡li Áv‡bi GLbI h‡_ó NvUwZ i‡q‡Q| GKgvÎ M‡elYvi
gva¨‡gB G¸‡jvi DbœwZ Kiv m¤¢e|
mKj wPwKrmKB M‡elYvi djvdj Zvi ˆ`bw›`b †ivMx wPwKrmvq Kv‡R
jvMvb| Zuvi wb‡Ri Ávb I `ÿZv AvaywbK ivLvi Rb¨ cÖwZwU wPwKrmK‡K
Zuvi wbR wel‡q mv¤úªwZK M‡elYv m¤ú‡K© Rvb‡Z n‡e| Gi wewfbœ c×wZ
Av‡Qt wbqwgZ †gwWK¨vj Rvb©vj cov, êÁvwbK m‡¤§jb I Kg©kvjvq Ask
†bIqv, wPwKrmK‡ì Rb¨ Av‡qvwRZ Pjgvb †ckvMZ Dbœqb (Continuing
Professional Development) Kvh©µ‡g Ask †bIqv, wKQzw`b †`‡k ev
we‡`‡k DbœZ †K‡›`ª KvR Kiv BZ¨vw`| wb‡Riv M‡elYv bv Ki‡jI A‡bï
Kiv M‡elYvi djvdj g~j¨vqb Ki‡Z cviv mKj wPwKrm‡Ki DwPZ| Zv bv
n‡j †Kvb M‡elYvi dj KZUv ev¯Í‡e cÖ‡qvM Kiv DwPZ, Zv eySv m¤¢e bq|
hwÌ G e¨vcv‡i civgk© †Ìqvi Rb¨ we‡kølYg~jK wiwfD ev update K‡ib
kxl©¯’vbxq we‡klÁiv, wKš‘ †mUv eySvi RbÏ M‡elYv m¤ú‡K© cÖv_wgK Ávb
Acwinvh©| Avi M‡elYv m¤^‡Ü cÖv_wgK Ávb AR©‡bi fvj Dcvq n‡”Q wb‡R
†Kvb M‡elYvq Ask †bIqv|
M‡elYv cÖwµqvi †kÖYxwefvMt M‡elYv mvaviYfv‡e `yB ai‡bi, cwigvYMZ ev
quantitative, ¸YMZ ev qualitative| cÖ_g ai‡bi M‡elYvq †h me Z_¨
msL¨vq cwigvc Kiv hvq; †m ai‡bi Z_¨ wb‡q M‡elYv Kiv| ¸YMZ M‡elYv
n‡”Q Ggb me Z_¨ wb‡q M‡elYv hv msL¨vq cÖKvk ev we‡kølY Kiv hvq bv|
M‡elYvi cÖK„wZ Abyhvqx †kÖYxwefvM Kiv hvq| eY©bvag©x ev descriptive, hv
†mB mgq we`¨gvb †Kvb wKQzi eY©bvi Dci wbf©i K‡i| GLv‡b cwieZ©bkxj
Dcv`vb¸‡jvi (variables) Dci wbqš¿Y _v‡K bv| we‡kølYag©x ev analytic
M‡elYvq cÖvß Z_¨ mgv‡jvPbvg~jK we‡kølY Kiv nq|
M‡elYvi D‡Ïk¨ Abyhvqx †kÖYxwefvM Kiv hvq| Basic M‡elYv n‡”Q †Kvb
welq, we‡kl †ivM A_ev gvby‡li kix‡ii ¯^vfvweK Kvh©Kjvc m¤^‡Ü Ávb
e„w×i Rb¨| ev¯Íe mgm¨v mgvav‡b G M‡elYvq ZvrÿwYK †Kvb cÖ‡qvM †`Lv
hvq bv| Applied M‡elYv ev¯Íe mgm¨v mgvav‡bi D‡Ï‡k¨ Kiv nq; †hgb,
†Kvb †iv‡Mi wPwKrmvq †Kvb Jly‡ai Kvh©KvwiZv †`Lvi Rb¨|
M‡elYvi †ÿÎ Abyhvqx M‡elYv fvM Kiv hvq| †ivM wPwKrmv QvovI A‡bK
†ÿ‡Î †gwWK¨vj M‡elYv cÖmvwiZ| †Kvb RbmsL¨vi g‡a¨ †Kvb †Kvb ai‡bi
gvbyl (eqm Abymv‡i, Avq Abymv‡i, emev‡mi GjvKv Abymv‡i BZ¨vw`) GKUv

we‡kl †iv‡M fzM‡Qb †mUv Rvbv ¸iæZ¡c~Y©| G‡Z †iv‡Mi KviY m¤^‡Ü m~Î
cvIqv †h‡Z cv‡i| Avevi GUv Rvb‡j ¯^v¯’¨‡mev eë¯’v‡K RbmsL¨vi †h Ask
†ewk AvµvšÍ n‡”Q Zv‡ì Rb¨ ˆZwi Kiv †h‡Z cv‡i| †Kvb †ivM AvµvšÍ
gvby‡li eqm, Lv`¨vf¨vm, AvPvi AvPiY, G¸‡jv ch©‡eÿY K‡i †iv‡Mi
KviY Rvbv †h‡Z cv‡i| G ai‡bi M‡elYvi gva¨‡g m¨vi wiPvW© Wj I m¨vi
Aw÷b eª¨vW‡dvW© wnj 1950 mv‡j aygcvb I dzmdz‡mi K¨vÝv‡ii g‡a¨ m¤úK©
DÑvUb K‡ib| †iv‡Mi MwZ cÖK…wZ I cwiYwZ Rvbvi Rb¨ †Kvb we‡kl †iv‡Mi
†ivMx‡ì `xN©w`b ch©‡eÿY Kivi cÖ‡qvRb n‡Z cv‡i| GB ai‡bi M‡elYvi
†ÿÎ epidemiological M‡elYv ejv nq| ¯^v¯’¨‡mev †Ìqvi mvsMVwbK
cÖwµqv M‡elYv Kiv †h‡Z cv‡i; †hgb, †Kvb GK RbmsL¨vi Rb¨ wK ai‡bi
¯^v¯’¨‡mev (¯^v¯’¨‡K›`ª ev nvmcvZv‡ji MVb, wPwKrmK, †mweKv I Ab¨vb¨
Kg©xi msL¨v I AbycvZ, wK wK ai‡bi cixÿv, wK ai‡bi Jla mieivn
cÖ‡qvRb BZ¨vw`) w`‡j fvj dj cvIqv hv‡e, BZ¨vw` M‡elYv Kiv hvq| G
ai‡bi M‡elYv‡K ¯^v¯’ëë¯’v msµvšÍ (health systems) M‡elYv ejv nq|
Gfv‡e ¯^v¯’¨‡mev eë¯’vq ˆbwZKZv, ¯^v¯’¨‡mev msµvšÍ AvBb, †iv‡Mi mvgvwRK
I b„-ZvwË¡K w`K BZ¨vw` AviI A‡bK †ÿ‡Î M‡elYv Kiv nq|
†ivMx †`Lvi Kv‡R wb‡qvwRZ wPwKrmK‡ì Rb¨ mePvB‡Z †ewk Abym„Z
M‡elYv c×wZ nj bZzb Jl‡ai ev wPwKrmv c×wZi Kvh©KvwiZv hvPvB Kivi
Rb¨ wK¬wbK¨vj Uªvqvj| †h †Kvb bZzb Jla Aby‡gv`b ms¯’vi AbygwZ cvIqvi
Rb¨ wbw`©ó c_ AwZµg Ki‡Z nq| GUv cÖ_g ïiæ nq cixÿvMv‡i ivmvqwbK
M‡elYvq Gi MVb I Dc‡hvwMZv hvPvB Gi gva¨‡g| Zvici GUv cÖvYxi †`‡n
cÖ‡qvM Kiv nq| Jl‡a kix‡i †h cÖwZwµqv nIqvi K_v Zv n‡”Q wKbv Ges
†Kvb welwµqv n‡”Q wKbv-G¸‡jv hvPvB Kiv nq| G‡Z Avkve¨ÄK dj cvIqv
†M‡j PviwU av‡c Jl‡ai wK¬wbK¨vj M‡elYv Ki‡Z nq| cÖ_g av‡c mxwgZ
msL¨K my¯’ fjvw›Uqv‡ii Dci Jla cÖ‡qvM Kiv nq| G‡Z †`Lv nq Kvw•LZ
cwieZ©b Avbvi Rb¨ †Kvb gvÎvq Jla cÖ‡qvM Ki‡Z n‡e Ges cvk¦© cÖwZwµqv
n‡”Q wK bv| Kvw•LZ dj n‡j I cvk¦© cÖwZwµqv bv _vK‡j wØZxq av‡c
†ivMxi Dci cÖ‡qvM Kiv nq| †h †iv‡Mi Rb¨ G Jla eënvi Kivi wPšÍv Kiv
n‡”Q, †m †iv‡Mi wKQz msL¨K †ivMx‡K †Ìqv nq| †`Lv nq †iv‡Mi †Kvb
DcKvi n‡”Q wK bv Ges cvk¦© cÖwZwµqv n‡”Q wK bv| Z…Zxq avc n‡”Q g~j
wK¬wbK¨vj Uªvqvj| G‡Z wbw`©ó msL¨K †ivMx AšÍf©y³ Ki‡Z n‡e| KZ †ivMx
cÖ‡qvRb n‡e Zv wnmve Kivi c×wZ Av‡Q| bZzb Jl‡ai dj Zzjbv Ki‡Z
n‡j Av‡iv GK MÖæc †ivMx wb‡Z n‡e, hviv cÖPwjZ Jla cv‡e| cÖPwjZ

Jla bv _vK‡j Zviv cøv‡m‡ev (placebo) cv‡e| cøv‡m‡ev nj Ggb GKUv
ewo ev K¨vcmyj †Ìqv n‡e hvi †Kvb Kvh©KvwiZv bvB| GUv †Ìqvi GKUv
D‡Ïk¨ †ivMx ev M‡elK †KD hv‡Z bv Rv‡b †K †KvbUv cv‡”Q| Gi AviI
KviY Av‡Q| GUv‡K double blind Uªvqvj ejv nq| cÖvq †ÿ‡ÎB †Kvb †ivMx
†Kvb MÖæ‡c hv‡e Zv M‡elK wba©viY K‡i bv, GUv randomization ev ˆè
Pq‡bi wfwË‡Z Kiv nq| Z…Zxq av‡c cixÿvaxb Jla hw` cÖPwjZ Jl‡ai
(ev Kvh©Ki wPwKrmv Qvov) PvB‡Z fvj dj †`q, ZvÕn‡j wbqš¿Y KZ…©c‡ÿi
Kv‡Q evRviRvZ Kivi Av‡e`b Kiv nq| Av‡gwiKvq wbqš¿Y KZ…©cÿ n‡”Q
dzW GÛ WªvM A¨vWwgwb‡÷ªkb (FDA) Ges evsjv‡`‡k n‡”Q Jla cÖkvmb
Awa`ßi| Jla wbqš¿Y ms¯’vi Aby‡gv`b cvIqvi ci Jla evRviRvZ Kiv
nq| Gi ci nj PZz_© avc| K‡qK eQi a‡i GB Jl‡ai cvk¦©¦ cÖwZwµqv
bR‡i ivLv nq| †Kvb †Kvb Jl‡ai cvk¦© cÖwZwµqv Aby‡gv`b cvIqvi ci
eûw`b eënvi nIqvi ci aiv c‡o| _¨vwj‡WvgvBW bv‡g GKUv Jla 1957
mv‡j Rvg©vbx‡Z evRv‡i Qvov nq| †m mgq Gi cÖ‡qvM wQj `ytwðšÍv, Awb`ªv
I Mf©ve¯’vq gwnjv‡ì egb Kgvbi Rb¨| †cÖmwµckb Qvov GUv dv‡g©mx
†_‡K †Kbv †hZ| 1963 mvj bvMv` G Jla cÖvq 46 †`‡k eënvi ïiæ nq|
gwnjviv G Jla eënvi Kivi ci †h me wkï Rb¥MÖnY Kij Zv‡ì g‡a¨
D”Pnv‡i Rb¥MZ ÎæwU †`Lv †Mj| cÖvq `k nvRvi wkïi G iKg nq, hvi g‡a¨
Pwjøk kZvsk R‡b¥i c‡i gviv hvq| evwK‡ì g‡a¨ †PvL, ürwcÛ I nvZ-cvÕi
MVbMZ ÎæwU †`Lv hvq| A‡bK wkï weKjv½ n‡q †eu‡P _v‡K| 1961 mv‡j
BD‡iv‡ci evRvi †_‡K GUv Zz‡j †bIqv nq| Av‡gwiKvq d«vb‡mm †Kjmx
bv‡g GKRb mvnmx wPwKrmK we‡ivwaZv Kivi Rb¨ _¨vwj‡WvgvBW Aby‡gv`b
cvq wb| G NUbvi ci Av‡gwiKvmn A‡bK †`‡k Jla evRviRvZ Kivi
AbygwZi AvBb I bxwZgvjv AviI KwVb Kiv nq|
M‡elYv Kivi c_‡iLvt M‡elYv Kivi Rb¨ wK c_ AbymiY Kiv ìKvi, Zv
GLb we‡klÁiv êÁvwbK c×wZ AbymiY K‡i wbw`©ó K‡i w`‡q‡Qb| Gi
KZK¸‡jv avc Av‡Q| cÖ_g avc n‡”Q M‡elYvi GjvKv ev welq wba©viY|
cÖwkÿYv_©x ev bZzb M‡elK‡ì GUv Zv‡ì wkÿK ev †R¨ô wPwKrmK wba©viY
K‡i †`b| †Kvb †Kvb †ÿ‡Î cÖwZôvb ev wefv‡M Pjgvb M‡elYvq cÖ_‡g Ask
wb‡Z nq| hw` wb‡R wba©viY Kivi my‡hvM _v‡K ZvÕn‡j KZK¸‡jv welq
we‡ePbv Ki‡Z n‡e| †`L‡Z n‡e welqwU wb‡q KvR Kivi AvMÖn Av‡Q wKbv
Ges welqwU‡Z M‡elYv Kivi h‡_ó Dcv`vb (†ivMx, cixÿv-wbixÿv, Jla
BZ¨vw`) cvIqv hv‡e wKbv| cÖv_wgKfv‡e welq wbe©vPb Kivi ci †m wel‡q

fvj K‡i Rvb‡Z n‡e| Ávb e„w×i Dcvq nj H wel‡q fvj g‡bvMÖvd (GKUv
wel‡qi Dci †jLv eB) †RvMvo Kiv| g‡bvMÖvd bv cvIqv †M‡j H wel‡qi
cÖavb Rvb©vj¸‡jv‡Z wiwfD AvwU©‡Kj (GKvwaK n‡j fvj) cy&•Lvbycy•Lfv‡e
co‡Z n‡e| g‡bvMÖvd I wiwfD AvwU©‡K‡j ¸iæZ¡c~Y© g~j M‡elYvi D‡jøL
ev m~Î cvIqv hv‡e| †m¸‡jv †RvMvo K‡i co‡Z n‡e| AvšÍR©vwZK weÁvb
Rvb©vj covi Rb¨ eZ©gvb B›Uvi‡bU eënvi Kiv fvj| AwaKvsk Rvb©vj
Zv‡ì MÖvnK Qvov AvwU©‡Kj covi AbygwZ †`q bv| Z‡e mvims‡ÿc ev
abstract co‡Z †`q| mvims‡ÿc ev abstract co‡jI A‡bK wKQz Rvbv
hvq| G¸‡jv †bvU K‡i †bIqv DwPZ| A‡bK miKvwi wkÿv cÖwZôv‡b wek¦
¯^v¯’¨ ms¯’vi gva¨‡g Hinari bv‡gi †cÖvMÖvg Rvb©vj AvwU©‡Kj covi AbygwZ
†`q| `yf©vM¨µ‡g Avgv‡ì †`‡k AvaywbK †gwWK¨vj jvB‡eªwii Afve i‡q‡Q|
jvB‡eªwiqvb‡ì mvnvh¨ †bIqv †h‡Z cv‡i| g~j M‡elYv¸‡jv‡Z G wel‡q
Áv‡bi Afve †Kv_vq Zvi w`K wb‡`©kbv _v‡K| GgbwK G wel‡q fwel¨Z
M‡elYv wK n‡e ZviI D‡jøL _v‡K| cÖv_wgKfv‡e welq wbe©vPb Kivi c‡i
cov‡kvbvi GjvKv AviI mxwgZ wKš‘ Mfxi Ki‡Z n‡e| M‡elYvaxb welq
m¤^‡Ü mewKQzB Rvb‡Z n‡e| G‡Z G wel‡q M‡elYv K‡i bZzb Z_¨ DÑvUb
Kivi m¤¢vebv KZUzKz, M‡elYvi Dcv`vb wK, wK cÖ‡qvRb Ges Zv cvIqv hv‡e
wKbv G¸‡jv AviI fvjfv‡e Rvbv hv‡e| G ch©v‡q †h welq wb‡q M‡elYv
Kivi m¤¢vebv we‡ewPZ n‡”Q Zv †R¨ô M‡elK I wPwKrmK‡ì m‡½ Av‡jvPbv
Kiv cÖ‡qvRb| G wel‡qi êÁvwbK m‡¤§j‡b we‡`‡k hvIqvi my‡hvM _vK‡j
Ab¨vb¨ †`‡ki hviv G wel‡q M‡elYv K‡ib Zuv‡ì Luy‡R †ei K‡i Av‡jvPbv
Ki‡Z n‡e| welq wbe©vPb P‚ovšÍ nIqvi ci G wel‡qi me AvwU©‡Kj (AšÍZt
A¨ve÷ªv± AvKv‡i) Kw¤úDUv‡i msiÿY Ki‡Z n‡e| ewa©Z Áv‡bi Av‡jv‡K
G ch©v‡q M‡elYvi jÿ¨, cÖwµqv G¸‡jv wKQzUv ms‡kvab Kivi cÖ‡qvRb n‡Z
cv‡i| Z‡e M‡elYvi jÿ¨ mywbw`©ó nIqv cÖ‡qvRb| M‡elYvi cÖkœ ev cÖkœmg~n
GKUv nvB‡cv‡_wmm AvKv‡i cÖKvk Kiv m¤¢e n‡j Zv Kiv ìKvi|
Gi c‡ii avc n‡e, jÿ¨ AR©b Kivi Rb¨ wK wK jvM‡e Ges M‡elYvKg©
wKfv‡e m¤úv`b Kiv n‡e, G¸‡jv mywbw`©ó Kiv| GUvi bvg †Ìqv n‡q‡Q
†g_WjRx| Kv‡ì wb‡q M‡elYv Kiv n‡e; hw` gvbyl nq ZvÕn‡j Zv‡ì wK
wK êwkó¨ _vK‡Z n‡e Ges wK wK êwkó¨ _vK‡j Zv‡ì AšÍf©y³ Kiv n‡e bv,
Zv wbw`©ó Ki‡Z n‡e| †Kvb †Kvb ¯’vb †_‡K Zv‡ì AšÍf©y³ Kiv n‡e Ges †K
ev Kviv G `vwq‡Z¡ _vK‡e Zv wVK Ki‡Z n‡e| KZRb †ivMx wb‡Z n‡e GK
ev GKvwaK MÖæ‡c GUv wba©viY Kivi Rb¨ ÷¨vwUw÷Km, ev cwimsL¨vbwe`¨vi

c×wZ AbymiY Ki‡Z n‡e| cwimsL¨vbwe`¨vi cÖ‡qvM G M‡elYvq wKfv‡e
n‡e, GRb¨ ïiæ nIqvi Av‡M GKRb cwimsL¨vbwe‡ì civgk© †bIqv
DwPZ| M‡elYvi ci civgk© wb‡j cwimsL¨vbwe‡ì cÖ‡qvRbgZ KvR bv n‡j
cwimsL¨vbwe‡ì ZLb Kivi wKQzB _v‡K bv| wK cixÿvi cÖ‡qvRb n‡e,
†m¸‡jv †Kv_vq Kiv hv‡e; †Kvb wPwKrmv †Ìqv n‡j Zv †K w`‡e G¸‡jvI
wVK Ki‡Z n‡e| Randomisation ev ˆè-Pqb Gi wfwË‡Z †ivMx‡ì wewfbœ
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†mUv wKfv‡e eRvq ivLv n‡e Zv wba©viY Ki‡Z n‡e| Z_¨ msMÖn Kivi c×wZ,
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hw` cÖKvkbv Kivi D‡Ï‡k¨ _v‡K ZvÕn‡j †h Rvb©v‡j cÖKvk Kivi AvMÖn
Zv‡ì wb‡`©kbv Abyhvqx AvwU©‡Kj wjL‡Z n‡e|
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AbygwZ wKfv‡e †bIqv n‡e Ges Zv‡ì †MvcbxqZv iÿvq eë¯’v wKfv‡e Kiv
n‡e; hv‡ì Dci M‡elYv Kiv n‡e Zv‡ì SuywK KZUzKz| M‡elYvq A_©vqb
wKfv‡e n‡e Ges †Kvb ¯^v‡_©i Ø›Ø (conflict of interest) Av‡Q wKbv ZvI
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KwgwUi ch©v‡jvPbvi eë¯’v _v‡K| ˆbwZKZv KwgwU Aby‡gv`b w`‡Z cv‡ib
Avevi bvI w`‡Z cv‡ib| KL‡bv KL‡bv mywbw`©ó mycvwikmn ms‡kvab Ki‡Z
e‡jb| †m‡ÿ‡Î ms‡kvab K‡i Avevi Av‡e`b Ki‡Z nq|
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Zv‡ì ÁvwcZ m¤§wZ wb‡Z n‡e| Gi A_© nj G M‡elYv m¤^‡Ü †ivMx‡K
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Ki‡Z nq| G m¤§wZc‡Î mvaviY fvlvq G M‡elYvi D‡Ïk¨, wKfv‡e Kiv
n‡e, wK mydj cvIqv †h‡Z cv‡i, SuywK Av‡Q wKbv ev KZUzKz, G¸‡jv
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ev wUcmwn _vKv cÖ‡qvRb|
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msL¨vi gva¨‡g kbv³ Kivi eë¯’v Ki‡Z n‡e| M‡elYvi djvdj mwVKfv‡e
wjwce× Ki‡Z n‡e, mwVKfv‡e eY©bv I cÖwZ‡e`b w`‡Z n‡e| AmZZv I

AmvayZv NUvi wb`k©b Av‡Q| hy³ivóª I hy³iv‡R¨ GUv wimvP© misconduct
bv‡g AwfwnZ| Rvcv‡b GKRb A¨v‡bm‡_wU÷ 1991 mvj †_‡K 2011
mvj ch©šÍ cÖvq 250wU M‡elYv AvwU©‡Kj c„w_exi wewfbœ †`‡ki êÁvwbK
mvgwqKx‡Z cÖKvk K‡ib| Gi cÖvq A‡a©K randomized double blind
controlled Uªvqvj| 190wU fzqv AvwU©Kj cÖZ¨vnvi Kiv nq| Rvg©vb M‡elK
Joachim Bolder Gi 88wU AvwU©Kj cÖZ¨vnvi Kiv nq| A¨vÛªy I‡qKwdì
I Zuvi 12 Rb mn‡hvMx 1998 mv‡j M‡elYvq MMR (Measles, Mumps,
Rubella) f¨vKwm‡bi d‡j behavioural regression and pervasive
developmental disorder Gi m¤¢vebv ev‡o GUv cÖKvk K‡ib| Gici
wkï‡ì f¨vKwmb †Ìqvi nvi 1997 mv‡j 92 kZvsk †_‡K 2002 mv‡j 85
kZvsk nq Ges A‡bK wkï Gme †iv‡M AvµvšÍ nq| cieZ©x‡Z Z`‡šÍ cÖgvY nq
D‡Ïk¨g~jKfv‡e Z_¨ cwieZ©b Kiv n‡q‡Q| Rvbv hvq f¨vKwmb cÖ¯‘ZKviK
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General Medical Council-GMC evwZj K‡i| M‡elK‡ì gZ nj hviv
M‡elYvq AmvayZv K‡ib Zuviv Rxe‡bi Ab¨vb¨ †ÿ‡ÎI AmvayZvi AvkÖq †bb,
†hgbt cixÿvq bKj Kiv, fzqv mvwU©wd‡KU †Ìqv, Avw_©K AmZZv BZ¨vw`|
mvaviYZt hviv M‡elYvq AmZZv K‡ib Zv‡ì AmZZv m¤^‡Ü Zvi mnKg©xiv
Rv‡bb| ˆbwZKZvi wbqg n‡”Q AmZZv m¤^‡Ü AewnZ _vK‡j Zv KZ…©cÿ‡K
Rvbvb| 1988 mv‡j weªwUk †gwWK¨vj Rvb©vj Gi m¤úv`K w÷‡db jK
êÁvwbK‡ì g‡a¨ GKUv mgxÿv K‡ib| G‡Z †`Lv hvq cÖvq A‡a©K êÁvwbK
AmZZvi NUbv Rv‡bb| Z‡e gvÎ 8 kZvsk M‡elYv cÖZ¨vnvi Kiv nq|
1997 mv‡j Committee on Publication Ethics ¯’vwcZ nIqvi c‡i cuvP
eQ‡i evrmwiK wi‡cv‡U© 160wU AmZZvi NUbv cvIqv hvq| Kv‡RB M‡elYvq
AmZZv weij bq|
AmZZv ev AmvayZvi aib K‡qK iKg| A‡bï KvR bKj Kiv nj
Plagiarism| eZ©gvbKv‡j software eënvi K‡i GUv kbv³ Kiv hvq|
Z_¨ cwieZ©b Kiv nj data fabrication A_©vr †ivMxi msL¨v cwieZ©b Kiv,
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publication I AmZZv; Kv‡Ri wewfbœ w`K wb‡q wfbœ wfbœ cÖKvkbv n‡Z
cv‡i| M‡elYvq †Kvb f‚wgKv bvB, AskMÖnY K‡i bvB Ggb e¨w³‡K cÖKvkbvq
author †`Lvb nj gift authorship| eZ©gv‡b †K author n‡Z cvi‡e Zvi

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†bIqv, Z_¨ we‡kølY I †jLvq Ae`vb ivLv Gi AšÍf©y³|
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†gvU †iv‡Mi cÖvq 90 kZvskB Giv enb K‡i| Kv‡RB †ewkifvM †ivM m¤^‡Ü
M‡elYv G‡`k mg~‡ni gvby‡li g‡a¨ Ges G‡`k mg~‡ni †ivM I ¯^v¯’¨ mgm¨v
wb‡q nIqv DwPZ| G‡Z we‡k¦i mePvB‡Z †ewk gvby‡li DcKvi n‡e| wKš‘
†`Lv †M‡Q 1975 mvj †_‡K 2004 mvj ch©šÍ 1556wU bZzb Jla evRviRvZ
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Kg _vKvi Kvi‡Y M‡elYvq A_© e¨q Kivi m½wZ Dbœqbkxj †`k¸‡jvi Kg|
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wPwKrmvq DbœwZ nZ, A‡bK ¯^v¯’¨ mgm¨vi mgvavb nZ| Dbœqbkxj †`kmg~‡n
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†ewk, M‡elYv e¨q Kg, wbqš¿Y ms¯’vmg~‡ni bRi`vwii `ye©jZv BZ¨vw`|
1994 mv‡j M‡elYv Kiv nq ÔwR‡WvfvwWbÕ bv‡g Jla Mf©eZx gv‡qi wkï‡ì
HIV msµgY Kgvq wKbv| G‡Z Aci GKwU MÖæc‡K placebo Jla (A_v©r
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†gwWwm‡b cÖKvwkZ nq-msµgY kZKiv 25 fvM K‡g| A_P ZLb Mf©eZx
gv‡q‡ì †_‡K wkï‡ì msµgY Kgvbi Kvh©Ki Jla Av‡MB wQj| G m‡Ë¡I
GK MÖæc gv‡q‡ì placebo †Ìqv I wkï‡ì msµg‡Yi m¤¢vebv evovb ˆbwZK
w`K w`‡q mg_©b Kiv hvq bv| G M‡elYv GKUv Dbœqbkxj †`‡k n‡qwQj|
GiciI _vBj¨vÛ I AvBfwi‡Kvó G HIV M‡elYvq GKUv MÖæc‡K placebo
†Ìqv n‡q‡Q| †Kvb DbœZ †`‡k G ai‡bi M‡elYv AbygwZ †cZ bv|
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gvgjvi cwi‡cÖwÿ‡Z fvi‡Zi †K›`ªxq miKv‡ii ¯^v¯’¨ I cwievi Kj¨vY
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475wU Jl‡ai Uªvqv‡j AskMÖn‡Yi Kvi‡Y 2644 Rb gvbyl gviv hvq| fvi‡Zi
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Jl‡ai Uªvqvj msµvšÍ bxwZgvjv KovKwo K‡i| Gi g‡a¨ wQj ˆbwZK KwgwU
mg~‡ni h_vh_ Aby‡gv`b I Jla Uªvqv‡j ÿwZMÖ¯Í‡ì Rb¨ ÿwZc~i‡Yi eë¯’vi
DbœwZ BZ¨vw`| G‡Z Association of Clinical Research Organization
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Z‡e †gŠwjK M‡elYv †_‡K mvaviYZt wbKU fwel¨‡Z ev¯Íe cÖ‡qv‡Mi m¤¢vebv
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eûRvwZK Jla †Kv¤úvwbmg~n `yB ai‡bi M‡elYv‡ZB A_©vqb K‡i| hy³iv‡óª
†gŠwjK M‡elYvq 2015 mv‡j †gvU LiP wQj 86 wewjqb Wjvi| GUvi cÖvq
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Z_¨m~Ît
1. https://www.history.com/news-the-infamous-40-year-tuskegee-
study/
2. https://www.forbes.com/sites/leahrosenbaum/2020/06/12/
willowbrook-scandal-hepatitis-experiments-hideous-truths-of-
testing-vaccines-on-humans/#5894555d 279c.
3. https://science.education/nih.gov/supplements/web.
4. https://www.nypost.com/2013/12/28/nycs-forgotten-cancer-
scandal/
5. https://en.m.wikipedia.org/Nazi-human-experimentation.
6. https://www.history.com/topics/world-war-II/nuremburg-trials.

7. https://research-methodology.net/research-methodology/
research-types/
8. Neema PK. Dishonesty in Medical Research and Publication
and the Remedial Measures. Annals of Cardiac Anaesthesia,
2013;21:111-113.
9. Lock S. Misconduct in Medical Research. British Medical Journal,
1988; 297: 1531-1535.
10. Lancet Editorial. Dealing with deception, Lancet, 1996; 347:843.
11. Alwan A. Global status report on non-communicable diseases.
2010. Geneva, World Health Organization,2011.
12. Rahman S, Majumdar, Shoban SF et al. Physician participation in
clinical research and trials, issues and approaches. Ad Med Educ
Pract. 2011; 2:85-91.
13. McMichael C. Waters E. Volmin KJ. Evidence-basedpublichealth;
what does it offer developing countries. J Public Health, 2005;
27:215-221.
14. https://minnpost.com/second-opinion/2012/08/big-pharma-claim-
innovation-crises-myth-bmj-authors-say.
15. https://www.science daily.com/
releases/2008/01/080105140107htm.
16. https://www.counterpunch.org. 30 April 2008. Robert Weisman.
Medical R & D That Works in the Developing World.
17. https://www.truthout.org/articles/before-covid-19-big-pharma-
was-neglecting-vaccine-and-antiviral-research.
18. https://www.who.int/bulletin/volumes/92/3/13-128371/en/
19. https://www.impressmagazine.com/ethics-and-exploitation-
conducting-clinical-trials-in-developing-countries/.
20. h t t p s : / / t i m e s o f i n d i a . i n d i a t i m e s . c o m / i n d i a / 2 6 4 4 - d i e d -
drug-clinical-trial-of-drugs-in-7-years-govt-to-sc/
articleshow/19719175.cms.
21. Stone Kathlyn. Who Funds Biomedical Research. The Balance, 13
January 2019.
22. https://mrc.ukri.org/about/our-structure.
23. https://www.bhf.org.uk/what-we-do/news-from-thebhf/news-
archive/2020/july/top-uk-scientists-urge-prime-minister-to-
prevent-catastrophic-fall-in-charity-research-finding.

Øv`k Aa¨vq
Avgvi wZbRb wkÿK
RvZxq Aa¨vcK Wvt byiæj Bmjvg

Zuvi Rb¥ 1928 mv‡j PÆMÖvg †Rjvq| 1951 mv‡j wZwb KjKvZv †gwWK¨vj
K‡jR n‡Z GgweweGm cvm K‡ib| hy³iv‡R¨ 1955 mv‡j wZwb eÿe¨vwa‡Z
wW‡cøvgv I 1956 mv‡j GgAviwmwc AR©b K‡ib| 1958 †_‡K 1962 mvj
ch©šÍ wgU‡dvW© nvmcvZvj I XvKv †gwWK¨vj K‡j‡R †gwWwm‡bi mn‡hvMx
Aa¨vcK wnmv‡e KvR K‡ib| 1962 mv‡j PÆMÖvg †gwWK¨vj K‡j‡Ri cÖ_g
†gwWwm‡bi cÖ‡dmi wnmv‡e †hvM †`b| 1965 mv‡j bZzb ¯’vwcZ Bbw÷wUDU
Ad †cv÷MÖvRy‡qU †gwWwmb I wimvP© (AvBwcwRGgAvi), XvKvq cÖ_g hyM¥
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e„wUk KvDwÝ‡ji gva¨‡g mnvqZvi Pzw³‡Z Avmv GwWbeiv i‡qj K‡jR Ad
wdwRwmqv‡Ýi mv‡eK mfvcwZ m¨vi †Rgm K¨v‡gib| 1968 mv‡j m¨vi
†Rgm K¨v‡gib P‡j hvevi ci Aa¨vcK byiæj Bmjvg cÖ‡dmi Ad †gwWwmb
I cwiPvj‡Ki `vwqZ¡ †bb I 1986 mv‡j Aemi MÖnY Kiv ch©šÍ G c‡`B
KvR K‡ib| 1971-1975 mvj ch©šÍ wZwb RvwZi wcZv e½eÜy †kL gywReyi
ingv‡bi e¨w³MZ wPwKrmK wQ‡jb| wZwb †`‡k I we‡`‡k A‡bK ms¯’v I
msMV‡bi m‡½ RwoZ wQ‡jb I ¸iæZ¡c~Y© f‚wgKv cvjb K‡ib| GLv‡b Zvi
AvswkK weeiY †Ìqv n‡”Q| 1992 mv‡j wZwb PÆMÖvg BDwbfvwm©wU Ad
mv‡qÝ GÛ †UK‡bvjRx cÖwZôv K‡ib| wZwb wQ‡jb Gi cÖwZôvZv mfvcwZ I
DcvPvh©| XvKv wek^we`¨vj‡qi d¨vKvwë Ad †cv÷ MÖvRy‡qU †gwWwmb cÖwZôv
nq 1973 mv‡j, wZwb wQ‡jb Zvi cÖ_g Wxb| Avgiv a~gcvb wbeviY Kwi
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welqK Dc‡`óv wQ‡jb|
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GKv‡Wgx Ad mv‡q‡Ýi ¯^Y© c`K (1999), Wvt weavb P›`ª ivq c`K I
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c`K (1990 I 1992), †gix Kzix c`K (2006) AR©b K‡ib| 1987 mv‡j
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we‡klÁ wPwKrmv eë¯’v nIqvq †gvU msL¨v cÖvq c‡bi nvRvi| 1965 mv‡j
ZrKvjxb c~e© cvwK¯Ívb cÖv‡`wkK miKv‡ii D‡`¨v‡M XvKvq AvBwcwRGgAvi
¯’vcb Kiv nq| cÖ‡dmi byiæj Bmjvg Gi Rb¥jMœ †_‡K cieZ©x 23 eQi hver
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†RvMvo Kivi I cÖwZôvb‡K jvjb-cvjb Kivi K…wZZ¡ ZuviB| 1998 mv‡j
G cÖwZôvb‡K e½eÜz †kL gywRe †gwWK¨vj wek^we`¨vj‡q DbœxZ Kiv nq| G
e¨vcv‡iI Zuvi f‚wgKv wQj| 1968 mv‡j cvwK¯Ívb †K›`ªxq miKvi cÖv‡`wkK
miKv‡ii AvBwcwRGgAvi ¯’vcb Kiv I cwiPvjbv Kivi e¨vcv‡i AvcwË
Rvbvq| KivPx‡Z 1963 mv‡j wRbœvn †cv÷ MÖvRy‡qU †gwWK¨vj †m›Uvi ¯’vwcZ
nq †K›`ªxq miKv‡ii ZË¡veav‡b| Zv‡ì hyw³ wQj GK †`‡k `ÕywU cÖwZôv‡bi
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hvIqv kvnevM †nv‡U‡j AvBwcwRGgAvi ¯’vbvšÍ‡ii Rb¨ cÖv‡`wkK miKvi‡K
wZwb ivwR Kivb| 1972 mv‡ji Rvbyqvwi gv‡m ZrKvjxb ¯^v¯’¨gš¿x Avj-nvR¦
Rûi Avng` †PŠayix kvnev‡Mi Am¤ú~Y© gymwjg feb AvBwcwRGgAvi Gi
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K‡ib| Ae‡k‡l 1975 RvZxq A_©‰bwZK KvDwÝ‡j G cÖ¯Íve evwZj K‡i
kvnev‡MB cÖwZôvbwUi cÖKí Aby‡gv`b Kiv nq| 1977 mv‡j G cÖKí eÜ
K‡i †Ìqv nq I Dbœqb KvR eÜ nq| cÖ‡dmi byiæj Bmjvg mv‡n‡ei †Póvq
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cÖ‡dmi Wvt G¨vb dvi¸mb (Anne Ferguson)
Zuvi Rb¥ 1941 mv‡j ¯‹Uj¨v‡Ûi Møvm‡Mv kn‡i| Møvm‡Mv wek^we`¨vj‡qi
†gwWK¨vj ¯‹zj †_‡K wZwb MBChB cvm K‡ib Ges we‡kl K…wZ‡Z¡i Rb¨
c`K cvb| wZwb cwicvKZ‡š¿i BwgDbjRx we‡klZt intra-epithelial
lymphocyte Gi m¤^‡Ü M‡elYv K‡i PhD jvf K‡ib 1973 mv‡j|
1975 mv‡j wZwb I‡q÷vb© †Rbv‡ij nvmcvZv‡ji M¨v‡÷ªvB‡›U÷vBbvj
BDwbU G KbmvjU¨v›U wnmv‡e wb‡qvM cvb| Coeliac disease G
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k‡ZiI AwaK M‡elYvcÎ cÖKvk K‡ib| 1987 mv‡j wZwb ¯‹Uj¨v‡Ûi
cÖ_g M¨v‡÷ªvG›Uv‡ivjRxi Aa¨vcK wnmv‡e wb‡qvM cvb| wZwb †h gwnjv
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w`‡Zb| Clinical I Laboratory research Gi mgš^q NUvb Zuvi we‡kl
Ae`vb| †`k I we‡`‡ki K‡qKRb M‡elK memgq Zuvi ZË¡veav‡b
KvR KiZ| Zuvi M‡elYvi gvb wQj AwZ D”P| 1979 mv‡j wZwb e„wUk
†mvmvBwU Ad M¨v‡÷ªvG›Uv‡ivjRxi m¨vi d«vwÝm G¨vfvix †Rvbm c`K
cvb| wZwb hy³iv‡Rï Committee on Safety of Medicine, Scottish
Biomedical Research Committee mn A‡bK M‡elYvg~jK ms¯’vi
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gvbeZvev`x I b¨vqwfwËK mgvR eë¯’vi c‡ÿ| fv‡Mï cwinvm 1998 mv‡j
AMœvk‡qi K¨vÝvi AKv‡j Zuvi Rxebvemvb NUvq|

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cwi‡e‡ki m‡½ `ªæZ Lvc LvB‡q wU‡K _vKvi Rb¨ RxevYymg~‡ni êwPÎ ˆRe
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GUv‡Z ˆRe c`v_© I RxevYy mePvB‡Z †ewk _v‡K| dmj I MvQcvjv Zv‡ì

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Ask Av‡Q cwicvKZ‡š¿| GUv M‡o †Zvjv I Kvh©Ki ivL‡ZI i‡q‡Q RxevYyÕi
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RxevYy¸‡jv wbqš¿Y K‡i| gvby‡li †gvUv nIqv ev wPKb nIqv, Wvqv‡ewUm †ivM
nIqv G¸‡jvi DciI e„n`‡š¿ emevmKvix RxevYyÕi cÖfve Av‡Q|
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mv¤ªv‡R¨ †cøM gnvgvix ïiæ nq I †_‡g †_‡g n‡Z _v‡K| †m mgq c„w_exi
RbmsL¨vi cÖvq `k kZvsk G‡Z gviv hvq| 1346 †_‡K 1353 mvj ch©šÍ

Gwkqv I BD‡iv‡c ÒBlack deathÓ bv‡g AwfwnZ †cøM †iv‡M BD‡iv‡ci cÖvq
A‡a©K gvbyl gviv hvq| †lvok kZvãx‡Z BD‡ivcxq Dcwb‡ek ¯’vcbKvixiv
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wQj| cÖvq 90 kZvsk AvwèvmxB G †iv‡Mi Kvi‡Y gviv hvq| jÛ‡b 1665
mv‡j †cøM †`Lv †`q Ges 30 eQ‡i cÖvq jÿvwaK gvbyl gviv hvq| 1720
mv‡j d«v‡Ýi gv‡m©B kn‡ii GK-Z…Zxqvsk gvbyl †cø‡M gviv hvq| 1770 mv‡j
ivwkqvi g‡¯‹v‡Z †cø‡M jÿvwaK gvbyl gviv hvq| 1793 mv‡j Av‡gwiKvi
wdjv‡Wjwdqv‡Z B‡q‡jv wdfvi †iv‡M K‡qK nvRvi gvbyl gviv hvq| 1889-
90 mv‡j wekê¨vcx Bbd¬z‡qÄv gnvgvix‡Z cÖvq `k †KvwU gvbyl g„ZzëiY
K‡i| 1916 mv‡j †cvwjI †iv‡M Av‡gwiKvq nvRvi nvRvi gvbyl gviv hvq|
1957-1958 wek¦e¨vcx Bbd¬z‡qÄv gnvgvix‡Z cÖvq 11 jÿ gvbyl gviv hvq|
1981 mvj †_‡K ïiæ nIqv AIDS gnvgvix‡Z (hv GLbI Pj‡Q) G ch©šÍ
cÖvq mv‡o wZb †KvwU gvbyl gviv †M‡Q| 2014-2016 mv‡j B‡evjv gnvgvix
cwðg Avwd«Kvq cÖvq 11 nvRvi gvby‡li g„Zzï KviY| eZ©gvb †KvwfW-19
AwZgvix‡Z 2021 mv‡ji b‡f¤î gvm bvMv` 50 jÿvwaK gvbyl gviv †M‡Q|
A¨vw›Uev‡qvwUK n‡”Q GK ai‡bi Jla hv e¨vK‡Uwiqvi msµgYRwbZ Kvi‡Y
†iv‡Mi †_‡K gvbyl‡K euvPv‡Z cv‡i| 1928 mv‡j A¨vw›Uev‡qvwUK †cwbwmwjb
e¨vcK AvKv‡i ˆZwi ïiæ nIqvi Av‡M A‡bK gvbyl mvaviY RxevYy msµg‡Yi
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e¨vK‡Uwiqvmg~‡ni cÖwZK~j cwi‡e‡ki m‡½ Lvc LvB‡q †bIqvi ÿgZv
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Av‡Q, Zvi g‡a¨ Chromosome Av‡Q| G Chromosome i g‡a¨
Avgv‡ì †`‡ni me wµqv-Kjv‡ci Abykvmb i‡q‡Q| Chromosome ˆZwi
DNA w`‡q| gvby‡li †gvU DNA Gi GK Z…ZxqvskB RxevYy †_‡K Avmv|
êÁvwb‡Kiv GLbI Rv‡bb bv, G¸‡jv wK wbw¯Œq, bv †Kvb KvR K‡i| gvby‡li
weeZ©‡bi mgq AZx‡Zi fvBiv‡mi Ask GLbI Avgv‡ì DNA †Z i‡q‡Q|
RvwZm‡•Ni cwi‡ek Kvh©µg UN Environment Programme I
International Livestock Research Institute hy³fv‡e Zoonotic
Disease (cÖvYx †_‡K DrcwË nIqv †ivM) Gi Rb¨ K‡qKwU cwieZ©b‡K
`vqx K‡i‡Q| Gi g‡a¨ i‡q‡Q µ‡gB evo‡Z _vKv cÖvYxR †cÖvwU‡bi Pvwn`v,
Abevqb‡hvM¨ Pvlvev`, ebf‚wg aŸsm, AvšÍt‡`kxq ågY e„w×, Rjevqy
cwieZ©b| Zviv we‡kî me †`‡ki miKvi‡K G¸‡jv wbqš¿‡Yi Rb¨ c`‡ÿc
†bIqvi Av‡e`b K‡i‡Qb|
Z_¨m~Ît
1. https://www.medicinenet.com/antibiotic_resistance/article.htm
2. https://en.m.wikipedia.org/wiki/Microorganism.
3. https://www.newscientist.com/article/dn17453.
4. https://www.healthline.com/nutrition/gut-microbiome-and-
health#TOC_TITLE_HOR_10
5. https://bio.libertexts.org/Courses/Northwest-University/MKBN
211%.3A_Introductory_Microbiology-(Benzuidenhout)/01%3A_
Evolution-of_Microbiology/1.02%3A_Microbes_and_the_
World/1. 2.3% 3A_Microbes_and _the_Origin_of_Life_on_Earth.

PZz`©k Aa¨vq
wnDg¨vb wR‡bvg I †R‡bwUK BwÄwbqvwis
(Human genome I Genetic engineering)
gvby‡li kixi cÖvq 100,000,000,000wU †Kv‡li mgš^‡q ˆZwi| cÖ‡Z¨KwU

†Kv‡l kix‡ii mg¯Í Ask ˆZwi Kivi Rb¨ m¤ú~Y© ms‡KZwjwc (code) i‡q‡Q|
GB genetic ms‡KZ¸‡jv DNA (deoxy ribonucleic acid) w`‡q ˆZwi|
DNA n‡”Q GKUv `xN© Aby (molecule)| GUv genetic ms‡KZwjwc enb
K‡i| GB DNA ms‡KZwjwc Avgv‡ì kix‡ii MVb, e„w× I KvR wbqš¿Y
K‡i| DNA ms‡KZwjwc PviwU †QvU nucleotide base Gi wbqš¿Y AYyÕi
web¨vm ev µ‡gi Dci wbf©i K‡i| `xN© DNA Aby `yÕ‡Uv cvKv‡bv `woi AuvwU
ev †MvQvi gZ K‡i ivLv _v‡K-Gi bvg chromosome| chromosome
†Kv‡li nucleus Gi g‡a¨ _v‡K| gvby‡li †Kv‡l 23 †Rvov chromosome
Av‡Q| `xN© DNA AYyi GK GKUv Ask hv GK GK ai‡bi †cÖvwUb ˆZwi
Kivi ms‡KZ enb K‡i-Zv‡K gene ejv nq| †h †Kvb Rx‡ei (organism)
m¤ú~Y© genetic ms‡KZwjwci bvg genome|
1990 mv‡j gvby‡li m¤ú~Y© genome Gi MVb DÑvU‡bi Rb¨ Human
Genome Project bv‡g GKUv AvšÍR©vwZK D‡`¨vM †bIqv nq| gvby‡li
†Kv‡li g‡a¨ Aew¯’Z me chromosome G †gvU wZbk †KvwU (3 wewjqb)
nucleotide base †Rvovi MVb I web¨vm wbY©q Kivi Rb¨ 2005 mvj ch©šÍ
mgq wba©vwiZ wQj| 1998 mv‡j J. Craig Venter (whwb wb‡RI G wel‡qi
weÁvbx) Gi †bZ…‡Z¡ Celera Genomics bv‡g GKUv †emiKvwi cÖwZôvb GB
KvR ïiæ K‡i| Zvi D‡Ïk¨ wQj DNA gvbwPÎ Avwe®‹vi K‡i Zv patent
Kiv| Zviv Gi †_‡K †ivM wPwýZ K‡i Ges bZzb wPwKrmv Avwe®‹vi K‡i
GK‡PwUqv eëmv Ki‡Z †P‡qwQ‡jb| wKš‘ Human Genome Project GB
Kv‡R wb‡qvwRZ _vKvq Zv m¤¢e nqwb| c‡i G `yB cÖwZôvb mw¤§wjZfv‡e KvR
K‡i| Gi m‡½ †hvM nq cÖhyw³i DbœwZ| 2000 mv‡ji Ryb gv‡m Lmov †NvlYv
Kiv nq| Gici 2003 mv‡ji GwcÖj gv‡m P‚ovšÍ dj cÖKvk Kiv nq| gvbylB
n‡”Q cÖ_g †giæ`Ûx cÖvYx (vertebrate) hvi m¤ú~Y© genome DÑvwUZ nj|

gvby‡li genome Gi m¤ú~Y© ms‡KZwjwc DÑvUb Kiv n‡jI Gi †Kvb
Ask wK KvR K‡i Zv m¤ú~Y© Rvbv hvq wb| GK ai‡bi †cÖvwUb ˆZwii Rb¨
ms‡KZwjwc aviY K‡i, Ggb gene Gi msL¨v 20000 †_‡K 25000 e‡j
g‡b Kiv nq| G¸‡jv me chromosome G Qovb Av‡Q| G¸‡jvi mw¤§wjZ
ˆ`N©¨ m¤ú~Y© genome Gi ˆ`‡N©ï `yB kZvs‡ki Kg| GUv coding DNA
bv‡g cwiwPZ| evwK 98 kZvs‡kiI †ewk Ask, hv non coding DNA
bv‡g cwiwPZ, wbw`©ó †cÖvwUb ˆZwi K‡i bv| Z‡e gene †K mwµq Kiv I
wbqš¿Y Kiv, chromosome Gi MVb eRvq ivLv, BZ¨vw` Ab¨vb¨ ¸iæZ¡c~Y©
KvR K‡i| GUv GLb ¯^xK…Z †h A‡bK gene Gi mxgvbv cwi®‹vifv‡e wPwýZ
bq| mvgvb¨ wKQz DNA GKUv PµvKvi AYyi AvKv‡i nucleus Gi evB‡i
mitochondrium _v‡K| GUv e¨w³ Zvi c~e©cyiæl‡ì ¯¿xwj½avix‡ì †hgb
(gv, bvbx) BZ¨vwì gva¨‡g cvq| GB wWGbGÕ†Z ÎæwUi Kvi‡Y K‡qKwU †ivM
kbv³ Kiv n‡q‡Q|
G ch©šÍ jÿvwaK gvby‡li m¤ú~Y© DNA GÕi ci¯úiv (sequence) DÑvUb
Kiv n‡q‡Q| c„w_exe¨vcx wPwKrmvweÁvb, b„weÁvb, Aciva weÁvb I Ab¨vb¨
kvLvq Gi eënvi n‡”Q| Zzjbvg~jK we‡kølY K‡i gvby‡li weeZ©b m¤^‡ÜI
Z_¨ Rvbv †M‡Q| AvaywbK gvby‡li wR‡bvg Gi DrcwË †òjÿ †_‡K wZbjÿ
eQ‡ii g‡a¨| International Hap Map Project Avi GKUv AvšÍR©vwZK
D‡`¨vM| Gi D‡Ïk¨ n‡”Q wewfbœ gnv‡`‡ki gvby‡li genome Gi Zzjbv
Kiv| Genetic MV‡b cv_©K¨ †Kvb †Kvb †iv‡Mi m¤¢vebv evovq ev Kgvq wKbv
Zv Rvbvi m¤¢vebv Av‡Q| †Kvb gene Gi KvR wK, †Kvb gene Gi ÎæwU
n‡j †Kvb †ivM nq, Zv †Kvb †Kvb †ÿ‡Î Rvbv †M‡Q| Gi d‡j genetic
ÎæwU Rvb‡j †iv‡Mi DcmM© †`Lv †Ìqvi Av‡M †ivM wbY©q Kiv hvq, †ivM
†`Lv †Ìqvi Av‡M mveavb nIqv hvq, d‡j mgqgZ eë¯’v †bIqv hvq| GUv
colon I breast K¨vÝv‡ii †ÿ‡Î mZ¨|
wKQz wKQz gene Gi MV‡bi wewfbœZv gvby‡li g‡a¨ c„_K c„_K êwkó¨ m„wó
Ki‡jI G¸‡jv †ivM bq, †hgb Pz‡ji is, D”PZv BZ¨vw`| Avevi wKQz wKQz
genetic cv_©‡Kï †ÿ‡Î we‡kl cwi‡e‡ki cÖfve Qvov †iv‡Mi ewntcÖKvk
nqbv| A‡bK mgq gene Gi MV‡b ÎæwU _vK‡jI Zv †iv‡Mi m„wó K‡i bv|
Z‡e †ek wKQz †ivM Av‡Q hv GKUv gene Gi wbw`©ó RvqMvq ÎæwUi Kvi‡Y
nq| †hgb CFTR bvgK gene Gi ÎæwUi Rb¨ cystic fibrosis bv‡g GKUv
†ivM nq| GKB gene G wewfbœ ¯’v‡b ÎæwU _vK‡jI †Kvb †Kvb †ÿ‡Î GKB
ewntcÖKvk A_©vr GKB †ivM nq| hwÌ †Kvb GKUv gene G ÎæwU weij

NUbv, wKš‘ gene Gi msL¨v A‡bK, ZvB †iv‡Mi msL¨vI A‡bK| G ch©šÍ cÖvq
2200wU †ivM GKwU gvÎ gene Gi ÎæwUi Kvi‡Y Rvbv †M‡Q| A‡bK †ivM
Av‡Q †hLv‡b GKvwaK gene Gi ÎæwUi wg_w¯Œqvi d‡j †mB †ivM m„wó nq|
cÖ‡Z¨K gvby‡li gene Gi MV‡b wKQz wKQz Abb¨ êwkó¨ _v‡K| d‡j Lye
mvgvb¨ cwigvY i³, gy‡Li jvjv, Pzj BZ¨vw` cixÿv K‡i GKRb gvbyl‡K
kbv³ Kiv hvq| G cÖhyw³ Aciva Z`‡šÍ cÖ‡qvM Kiv n‡”Q- Zv‡Z A‡bK
†ÿ‡Î cÖK…Z Acivax aiv m¤¢e n‡”Q| G Qvov b„weÁv‡b gene M‡elYv êcøweK
cwieZ©b G‡b‡Q| GUv GLb m‡›`nvZxZ fv‡e cÖgvwYZ †h, gvbe cÖRvwZi
(Homo sapiens) DrcwË Avwd«Kv gnv‡`‡k| cÖvq 60 nvRvi eQi Av‡M
†_‡K ïiæ K‡i Zviv mviv c„w_ex‡Z Qwo‡q c‡o‡Q| mv¤úªwZK eQi¸‡jv‡Z
gvbyl QvovI Ab¨vb¨ †ek wKQz cÖvYxi genome DÑvwUZ n‡q‡Q| G¸‡jvi
Zzjbvg~jK we‡kølY K‡i Gme cÖvYxi weeZ©b m¤^‡ÜI bZzb Z_¨ Rvbv †M‡Q|
†R‡bwUK BwÄwbqvwis (Genetic engineering)

gvbyl cÖv‰MwZnvwmK Kvj †_‡K evQvB K‡i eske„w× Kiv (selective
breeding) c×wZ‡Z cÖvYx I Dw™¢‡ì we‡kl we‡kl êwkó¨ evwo‡q P‡j‡Q|
cÖK…wZMZfv‡e cÖvYx I Dw™¢‡ì wewfbœ êwk‡óï êwPÎ¨ †`Lv hvq, †hgbt
d‡ji †ÿ‡Î AvKv‡i eo ev †QvU, wgwó Kg ev †ewk BZ¨vw`| GB c×wZ‡Z
cÖvYx A_ev Dw™¢‡ì †h êwkó¨ gvby‡li cQ›` nZ, ïay †mB êwkó¨m¤úbœ cÖvYx
ev Dw™¢‡ì eske„w× Ki‡Z mvnvh¨ Kiv nZ| d‡j †mB êwkó¨ †h cÖvYx ev
Dw™¢‡ì _vKZ, †m¸‡jvB msL¨vq evoZ| Pvj©m WviDBb 1859 mv‡j cÖKvwkZ
Zuvi eB On the Origin of Species Gi cÖ_g Aa¨v‡q Miæ, KzKzi, weovj,
KeyZi BZ¨vw` cÖvYxi êwkó¨ evQvB K‡i gvbyl wKfv‡e G¸‡jv‡K M„ncvwjZ
cÖvYx evwb‡q‡Q Zv eY©bv K‡i‡Qb| Zuvi cÖvK…wZK wbe©vPb (natural selection)
Gi ZË¡ e¨vL¨v Kivi Rb¨ wZwb G c×wZi D`vniY eënvi K‡i‡Qb| avb,
Mg, fzÆv BZ¨vw` km¨ Avgiv †hfv‡e cvB Zv †hme cÖRvwZ †_‡K G¸‡jvi
DrcwË n‡q‡Q Zvi †_‡K A‡bK Avjv`v| evQvB K‡i Pvl K‡iB AvaywbK Lv`¨
k‡mï DrcwË n‡q‡Q| k‡mï djb evovb, KxU cZ½ cÖwZ‡iva ÿgZv, Liv
cÖwZ‡iva ÿgZv BZ¨vw` êwkó¨ evQvB K‡i evovb n‡q‡Q| Z‡e GB c×wZ‡Z
†ewk mgq cÖ‡qvRb nq| Avi cÖK…wZMZfv‡e †h me êwPÎ¨ cvIqv hvq, ïay
†m¸‡jvi ga¨ †_‡KB evQvB Kiv nq| eZ©gvbKv‡j K…wÎgfv‡e DNA Gi
cwieZ©b NUv‡Z cvi‡j Kvw•LZ êwkó¨ ˆZwi Kiv hv‡e|

Gene Gi g‡a¨ †h ms‡KZwjwc _v‡K Zv cÖK…wZ‡Z GK ¯’vb †_‡K Ab¨ ¯’v‡b
†h‡Z cv‡i| GUv eû eQi a‡i êÁvwb‡Kiv †`‡L Avm‡Qb| GKB cÖvYxi
†Kv‡l GK chromosome †_‡K Ab¨ chromosome G DNA Gi Ask
¯’vbvšÍi m¤^‡ÜI A‡bK hyM †_‡K Rvbv Av‡Q| MZ K‡qK `k‡K GUvI Rvbv
†M‡Q †h GK cÖRvwZ †_‡K Ab¨ cÖRvwZ‡Z DNA ¯’vbvšÍiI cÖK…wZ‡Z nq|
GK bacteria †_‡K Ab¨ bacteria †Z DNA ¯’vbvšÍi N‡U| GB cÖwµqv
AbyKiY K‡i wbe©vwPZ gene GK cÖvYx †_‡K Av‡iK cÖvYx‡Z ¯’vbvšÍi Kiv
hv‡”Q| GQvov †Kvb GKUv gene Gi wµqv eÜ K‡i †Ìqv hvq| †Kvb gene
KvR Ki‡Q bv Zv wbY©q Ki‡j m¤ú~Y© gene ev Zvi Ask cÖwZ¯’vcb K‡i Gi
KvR wdwi‡q Avbv hvq| K…wÎgfv‡e GKUv cÖvYxi genetic ms‡KZwjwc‡Z
cwieZ©b Kivi cÖwµqv‡K genetic engineering e‡j| GKUv cÖvYxi genetic
ms‡KZwjwc‡K GK RvqMvq (GK base pair) cwieZ©b †_‡K m¤ú~Y© gene
cwieZ©b Kiv †h‡Z cv‡i| mvaviYZt GK cÖvYxi we‡kl êwk‡óï gene Ab¨
GKwU cÖvYxi †Kv‡l ¯’vbvšÍi Kiv nq, †Kvb †Kvb †ÿ‡Î wfbœ cÖRvwZi cÖvYxi
†Kv‡l| †h cÖvYxi †Kv‡l G gene ¯’vbvšÍi Kiv nj, Zv GB êwkó¨ AR©b
K‡i| G cÖvYx‡K (A_ev GB Dw™¢`‡K) genetically modified organism
(GMO) ejv nq|
Plasmid bv‡g GK ai‡bi circular DNA, hv cÖvK…wZKfv‡e bacteria
RvZxq RxevYyi g‡a¨ cvIqv hvq, †mUv evnb wnmv‡e eënvi K‡i DNA
¯’vbvšÍi Kiv hvq| Plasmid j¨ve‡iUwi‡Z ˆZwi Kiv hvq| 1968 mv‡j
myBRvij¨v‡Ûi êÁvwbK Iqvb©vi Avievi restriction enzyme Avwe®‹vi
K‡ib| G¸‡jv cÖK…wZ‡Z bacteria eënvi K‡i| wesk kZvãxi mË‡ii
`k‡Ki cÖ_g w`K †_‡K ïiæ K‡i restriction enyme, DNA Ligase
BZ¨vw` enzme eënvi K‡i cøvRwgW Gi gva¨‡g DNA ¯’vbvšÍi Kiv nZ|
enyme n‡”Q RxešÍ cÖvYxi †`n †Kv‡l Drcbœ ˆRe ivmvqwbK c`v_©, hv wb‡R
cwiewZ©Z bv n‡q Ab¨ c`v‡_©i cwieZ©b mvab K‡i| GKzk kZ‡Ki cÖ_g
`k‡K êÁvwb‡Kiv zinc finger nuclease I TALENS bv‡g KZK¸‡jv
†cÖvwUb ˆZwi K‡ib †h¸‡jv †Kvb DNA chain Gi wbw`©ó ¯’v‡b fv½‡Z cv‡i|
2012 mvj †_‡K CRISPR (Clustered Regularly Interspaced Short
Palindromic Repeats) bv‡g GKUv cÖhyw³ eënvi Kiv ïiæ nq| RxevYymg~n
virus Avµg‡Yi weiæ‡× GB cÖhyw³ cÖwZ‡iva wnmv‡e eënvi K‡i| GUv cÖ_g
Avwe®‹vi nq `ya †_‡K `B ˆZwi Kivi Rb¨ Streptococcus thermophiles
bv‡g GKUv bacteria cÖ‡qvM Kiv nq Zvi g‡a¨| GUv eënvi K‡i Ab¨ cÖvYxi

DNA Gi †h †Kvb ¯’v‡b fv½vi Rb¨ ˆZwi Kiv hvq| CRISPR cÖhyw³I
wbLuyZ bq| Kvw•LZ bq Ggb RvqMvqI GUv fv½‡Z cv‡i, DNA AwZwi³
_vK‡Z cv‡i Avevi KgI n‡Z cv‡i| GUv gvby‡li kix‡ii evB‡i n‡j †e‡Q
†e‡Q †f‡½ ÎæwUhy³ †Kvl¸‡jv ev` †Ìqv m¤¢e| wKš‘ gvbe‡`‡n GB cwieZ©b
Ki‡j Zv m¤¢e bq| G Qvov me gene m¤ú~Y© Avjv`vfv‡e KvR K‡i bv|
GKUv gene Ges Av‡iKUv gene Gi g‡a¨ AvšÍtwµqv _vK‡Z cv‡i| GKUv
gene KvR Kivi Rb¨ Ab¨ gene Gi Dci wbf©i Ki‡Z cv‡i| GKUv êwkó¨
ewntcÖKv‡ki Rb¨ K‡qKUv gene ìKvi n‡Z cv‡i| Kv‡RB †Kvb gene Gi
Kv‡Ri m¤ú~Y©Uv bv †R‡b †mUv cwieZ©b Kiv ÿwZKi n‡Z cv‡i| 2019 mv‡j
Prime editing bv‡g GKUv cÖhyw³ eënvi ïiæ nq| G‡Z CRISPR cÖhyw³i
†h me mgm¨v Zv A‡bKUv Kg nq| cÖvYxi †`‡ni evB‡i †Kv‡li Dci Kv‡Ri
Rb¨ GUv fvj n‡jI cÖvYxi †`‡ni Af¨šÍ‡i wRb cwieZ©b Kivi †ÿ‡Î GLbI
GUv wbf©i‡hvM¨ bq|
Genetic cwieZ©b `yBfv‡M fvM Kiv †h‡Z cv‡i| GKUv somatic cwieZ©b,
Av‡iKUv germ line cwieZ©b| Somatic cwieZ©b Kiv nq †Kvb GKUv
genetic †iv‡M fzM‡Q Ggb GKRb gvby‡li †Kv‡li wfZi| G cwieZ©b cieZ©x
cÖR‡b¥ hv‡e bv| G cwieZ©‡bi cÖ‡Póv gvby‡li †Kvb †Kvb †iv‡M eënvi
Kiv n‡q‡Q, Z‡e GLbI Lye e¨qeûj| Lipoprotein lipase deficiency
bv‡g GKUv eskMZ †iv‡M mwVK enzyme enbKvix AmsL¨ virus kix‡i
cÖ‡ek Kwi‡q AvswkK dj cvIqv †M‡Q| cÖwZevi cÖvq 10 jvL Wjvi LiP
n‡q‡Q| Spinal muscular atrophy †iv‡MI ÎæwUgy³ gene enbKvix
fvBivm kix‡i cÖweó K‡i AvswkK dj cvIqv †M‡Q| G‡Z cÖwZevi 21 jÿ
Wjvi LiP n‡q‡Q| K¨vÝvi †ivMxi T-lymphocyte †ei K‡i G¸‡jv‡K †mB
K¨vÝvi we‡ivax cwieZ©b K‡i Avevi kix‡i wdwi‡q †Ìqv n‡q‡Q| Severe
combined immuno deficiency I Thalassemia †iv‡MI gene †_ivwc
cÖ‡qvM Kiv n‡q‡Q|
Germ line cwieZ©b Kiv nq ïµ‡Kvl, wW¤^‡Kvl A_ev åæ‡Yi cÖ_g w`‡Ki
Ae¯’vq| †h gvbyl ev cÖvYx G cwieZ©‡bi c‡i ˆZwi n‡e Zvi †`‡ni me †Kv‡l
G cwieZ©b cvIqv hv‡e| GQvovI G cwieZ©b cieZ©x cÖR‡b¥I hv‡e| êÁvwbK
ˆbwZKZv we‡klÁ I bxwZwba©viK‡ì g‡a¨ HK¨g‡Zi wfwË‡Z PwjøkwUi †ewk
†`‡k AvBb K‡i gvbe‡`‡n germ line cwieZ©b wbwl× Kiv n‡q‡Q| 2018
mv‡ji b‡f¤î gv‡m Px‡bi GKRb weÁvbx †n wRqvbKzB †NvlYv K‡ib wZwb
gvby‡li `yÕwU åæ‡Y †R‡bwUK cwieZ©b K‡i‡Qb| G cwieZ©‡bi D‡Ïk¨ wQj

wkï `yÕwUi GBWm †iv‡Mi weiæ‡× cÖwZ‡ivaÿgZv evov‡bv| `yÕwU hgR Kb¨v
wkï Rb¥ †bq| †NvlYvi ci ciB Pxb miKvi GUv AMÖnY‡hvM¨ e‡jb| †mB
weÁvbx‡K eiLv¯Í K‡i M„‡n AšÍixY ivLv nq| 122 Rb Pxbv weÁvbx Gi wb›`v
K‡ib, mviv c„w_ex‡ZI wb›`v nq| †mB weÁvbx I Zvi mn‡hvMx‡ì Kviv`Û
I Rwigvbv n‡q‡Q|
Bacteria, Yeast I AviI K‡qK ai‡bi †Kvl I cÖvYx‡Z plasmid Gi
mvnv‡h¨ wbw`©ó gene cÖweô K‡i †ewk cwigv‡Y Drcv`b Kiv m¤¢e nq| 1976
mv‡j Gfv‡e Bbmywjb ˆZwi Kiv nq| 1982 mv‡ji ci †_‡K cÖ‡qvRbxq
Aby‡gv`b cvIqvi c‡i GUv evRv‡i †Ìqv nq| Gi Av‡M Ab¨ Kvi‡Y eënvi
Kiv cÖvYxi (†hgb Miæ) AMœvkq †_‡K Bbmywjb msMÖn Kiv nZ| G‡Z cwigvYI
mxwgZ wQj Ges Ab¨ cÖvYx‡`‡ni Bbmywjb nIqvi Kvi‡Y immunological
cÖwZwµqv nZ| Genetic engineering Gi d‡j Drcv`‡bi cwigvYI
A‡bK †e‡o‡Q Ges GB Bbmywjb gvby‡li gZ ZvB cÖwZwµqvI Kg nq| GKB
ai‡bi cÖwµqvq Ab¨vb¨ ni‡gvb I †cÖvwUb (growth hormone, follicle
stimulating hormone, albumin, tissue plasminogen activator
BZ¨vw`) Gi evwYwR¨K Drcv`b ïiæ nq| 2013 mvj ch©šÍ cÖvq wZbkZ
ai‡bi ni‡gvb I †cÖvwUb ˆZwi Kiv nq, hvi evRvi g~j¨ wQj cÖvq 100 wewjqb
Wjvi|
K…wl‡ZI G cÖhyw³ eënvi n‡”Q| cÖ_g genetically engineered Lv`¨`ªe¨
nj- U‡g‡Uv-GUv cvKv Ae¯’v‡ZI †ewkw`b _v‡K, d‡j cwien‡b myweav nq|
Gfv‡e KxU cÖwZ‡iva ÿgZv †ewk, Liv I eb¨v mn¨ Kivi ÿgZv †ewk I
djbI †ewk nq, DbœZZi ¯^v‡ì dj †`q, GBme ¸Y m¤úbœ Dw™¢` ˆZwi Kiv
nq| eZ©gv‡b avb, Mg, fzÆv, Avjy, U‡g‡Uv, †e¸b, †cu‡c I AviI A‡bK
dj I meRx GB cÖhyw³ eënvi K‡i n‡”Q| c„w_exe¨vcx 1996 mv‡j GK
†KvwU †n±i Rwg‡Z G cÖhyw³‡Z Dw™¢‡ì Pvl nZ| 2015 mv‡j GUv †e‡o
18 †KvwU †n±i Rwg nq| †ek eo K‡qKUv †Kv¤úvwb G ai‡bi Lv`¨km¨,
meRx I dj Drcv`‡b wb‡qvwRZ Av‡Q| fwel¨‡Z Dw™¢‡ì gene cwieZ©b
K‡i dj A_ev meRx‡Z f¨vw·b ˆZwi n‡Z cv‡i| BwZg‡a¨B Hepatitis
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Kivi cÖ‡Póv Pj‡Q| fwel¨‡Z wkï Rb¥MÖnY Kivi Av‡MB Zvi gene cwieZ©b
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cwieZ©b K‡i RxevYymg~n‡K gvby‡li Rb¨ AwaK ÿwZKi K‡i †Zvjv m¤¢e|
GUv biological A¯¿ wnmv‡e eënvi n‡Z cv‡i| Gi f¨vw·b ˆZwi K‡i Av‡M
AvµgYKvix †`k wbR †`‡ki †jvK‡ì wbivc` ivL‡Z cv‡i|
Genetic ms‡KZwjwc, wewfbœ gene, gene Gi evB‡ii DNA, G¸‡jvi
KvR m¤^‡Ü gvby‡li Ávb GLbI Lye mxwgZ| K…wÎgfv‡e DNA †Z cwieZ©b
NUv‡j Zv ¯^í‡gqv‡` DcKvi Ki‡jI Zvi `xN©‡gqv`x cÖfve m¤ú~Y© AwbwðZ|
G cÖhyw³i M‡elYv I ev¯Í‡e cÖ‡qvM wbqš¿‡Yi bxwZgvjv _vKv cÖ‡qvRb| 1975
mv‡j hy³iv‡óª K¨vwj‡dvwb©qvq G m¤^‡Ü cÖ_g bxwZgvjv cÖYqb Kiv nq| 1976
mv‡j Av‡gwiKvi K…wlwefvM, cwi‡ek iÿv G‡RÝx (EPA), Lv`¨ I Jla
wbqš¿Y ms¯’v FDA bxwZgvjv ˆZwi K‡i| 1991 mv‡j wek¦ ¯^v¯’¨ ms¯’v WHO
Ges Lv`¨ I K…wl ms¯’v FAO hy³fv‡e bxwZgvjv cÖKvk K‡i| j¨ve‡iUwi‡Z
G cÖhyw³ eënvi I cÖhyw³jä `ªe¨, cÖvYx ev Dw™¢` cixÿvMv‡ii evB‡i Qvovi
e¨vcv‡i A‡bK †`‡kB wbqg I bxwZgvjv i‡q‡Q| wKš‘ 2019 mvj ch©šÍ G
wel‡q AvšÍR©vwZK AvBbMZ evaëvaKZv cÖwZwôZ nq wb|

Z_¨m~Î:
1. https://www.sciencedaily.com/terms/human_genome.htm.
2. https://www.genome.gov/human-genome-project.
3. https://www.yourgenome.org/facts/what-is-genetic-engineering.
4. https://www.bbc.co.uk/bitesize/guides/2qqs2nb
5. https://open-oregonstate.education/generalmicrobiology/chapter/
genetic-engeneering.
6. Alexander DR. Editorial: Uses and Abuses of Genetic
Engineering. Post graduate Medical Journal.2003;79:249-251.
7. https://techooid.com/genetic-engineering-in-humans.
8. https://www.theguardian.com. 12 April 2020. M.Darkovsky.
Human gene editing is a social and political matter, not just a
scientific one.
9. https://www.theguardian.com. 21 October 2019. Ian Simple.
New gene editing tool could fix most harmful DNA mutations.
10. https://www.theguardian.com. 21 June 2020. Robin Mckie. “The
Wonderous Map”: how unlocking human DNA changed the
course of science.

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Kiv (validate) n‡”Q bv| Gi †h cixÿv ev clinical trial ¸‡jv n‡”Q Zvi
†ewkifv‡MB wewfbœ M‡elYvq wewfbœ algorithm eënvi Kiv n‡”Q| A‡bK
trial G sample size †QvU, A‡bK trial G selection bias †_‡K hvq| †h
me cixÿvq K…wÎg eyw×gËv I wPwKrm‡Ki Zzjbv Kivi Rb¨ GKB data set
eënvi Kiv n‡”Q, †m¸‡jv‡Z †ewkifvMB K…wÎg eyw×gËv fvj dj K‡i wb|
Zzjbvg~jK cixÿvi PvB‡Z interaction †`Lv cÖ‡qvRb|
gvby‡li Kv‡Ri A‡bK †ÿ‡Îi gZ ¯^v¯’¨‡mev‡ZI K…wÎg eyw×gËv eënvi
µ‡gB evo‡Q| M‡el‡Kiv BwZg‡a¨B K…wÎg eyw×gËv A¨vjMwi`g ˆZwi
K‡i‡Qb, †h¸‡jv gvby‡li gZ wb‡Ri Kv‡Ri we‡kølY K‡i wkL‡Z cv‡i;
†e‡o DV‡Z cv‡i, c~Y©Zv †c‡Z cv‡i| eo eo msL¨v ev eo AvKv‡ii
Z_¨ eZ©gvb kw³i Kw¤úDUvi eënvi K‡iB gvby‡li PvB‡Z A‡bK¸Y †ewk
`ªæZZvi m‡½ K…wÎg eyw×gËv KvR Ki‡Z cv‡i| Quantum Kw¤úDUvi
bv‡g eZ©gv‡bi PvB‡Z A‡bK †ewk `ªæZMwZ m¤úbœ Kw¤úDUvi ˆZwi n‡”Q|
Photonic computer chips Gi DciI KvR Pj‡Q-hv MwZ AviI evov‡e|

wewfbœ Kv‡R GLbB K…wÎg eyw×gËv eënvi Kiv n‡”Q| e„‡U‡bi b¨vkbvj †nj_
mvwf©m (NHS), hy³iv‡óª Mayo wK¬wbK, Memorial Sloan Kettering
K¨vÝvi nvmcvZvj BZ¨vw` cÖwZôvb K…wÎg eyw×gËvÕi eënvi evov‡”Q|
c„w_exi mePvB‡Z eo †Kv¤úvwb¸‡jvi Ab¨Zg, ¸Mj I IBM we‡klfv‡e
¯^v¯’¨‡mevi Rb¨ K…wÎg eyw×gËv ˆZwi K‡i‡Q| cÖkvm‡bI K…wÎg eyw×gËvÕi
eënvi ïiæ n‡q‡Q| A_© eë¯’vcbv, m¤ú‡ì myôz eënvi I weZiY, gvbe
m¤ú` eë¯’vcbv G¸‡jv‡Z K…wÎg eyw×gËvÕi eënvi dj w`‡”Q| 2019 mv‡j
K…wÎg eyw×gËvÕi evRvi g~j¨ wQj GK nvRvi wewjqb Wjvi| Gi GKUv eo
Ask wQj cwiavb‡hvM¨ hš¿ †hgb, ¯§vU©IqvP| G¸‡jv gvby‡li life style Dci
jÿ¨ iv‡L| Zv‡ì nuvUv, Pjv, e¨vqvg, bvoxi MwZ, eøvW †cÖmvi G¸‡jvi Z_¨
msiÿY K‡i|
K…wÎg eyw×gËv eënvi ïiæ nIqvi ci wK ax‡i ax‡i wPwKrmK‡ì
cÖ‡qvRb K‡g Avm‡e? A‡b‡KB Zv g‡b K‡ib bv| GUv n‡e GKUv
g~jëvb ms‡hvRb hv wPwKrmK‡ì Kg©ÿgZvi cwiwa A‡bK evwo‡q
†`‡e| †ivMx‡ì Rb¨ weÁ I AwfÁ wPwKrm‡Ki wePvi ÿgZv,
m„RbkxjZv I mngwg©Zvi †Kvb weKí bvB| GKRb wPwKrmK gšÍe¨
K‡i‡Qb, wPwKrm‡Ki cÖ‡qvRb _vK‡e bv Zv bq| K…wÎg eyw×gËv Rv‡b
Ggb wPwKrm‡Ki cÖ‡qvRb _vK‡e| K…wÎg eyw×gËv m¤§‡Ü Ávb bvB Ggb
wPwKrm‡Ki cÖ‡qvRb _vK‡e bv| wPwKrmK‡ìI wKQz bZzb Ávb I `ÿZv
AvniY Ki‡Z n‡e| BwZg‡a¨B K‡qKwU wek¦we`¨vj‡q †gwWK¨vj cvVµg
cwieZ©b Kiv n‡q‡Q| c`v_©we`¨v, A¼kv¯¿, Kw¤úDUviweÁvb, coding
I algorithomics AšÍfz©³ Kiv n‡q‡Q| A‡bK DbœZ †`‡k wPwKrmK‡ì
continuing medical education Kg©m~Px‡Z G¸‡jv wKQz wKQz BwZg‡a¨B
G‡m †M‡Q|
†ivewUK mvR©vixt
G bvgUv †ewk cwiwPZ n‡jI †iveU GLbI wb‡R wb‡R Acv‡ikb Ki‡Z cv‡i
bv| Robot assisted surgery bvgUv mwVK| eZ©gvb hy‡M †iveU GLbI
AZ¨šÍ my², wbLuyZ I wec¾bK KvR wkíKviLvbvq I M‡elYvq Ki‡Q, hv
gvby‡li c‡ÿ Kiv m¤¢e bq| †iveU wbqwgZfv‡e eënvi Kiv nq Kw¤úDUv‡ii
microprocessor ˆZwi‡Z, Mfxi mgy`ª Zj‡`‡k cixÿv I Z_¨ msMÖn
Ki‡Z| †iveU eënvi Kiv nq gnvï‡b¨| GQvov †h me KvR gvbyl Ki‡Z
cv‡i †m¸‡jv AviI `ªæZZvi m‡½ wbLuyZfv‡e †iveU Ki‡Q, †hgb †gvUi Mvwo
ˆZwi| wPwKrmv †ÿ‡Î Gi cÖ‡qvM GLbI e¨vcK AvKv‡i n‡”Q bv|

1987 mv‡j cÖ_g minimally invasive surgery wnmv‡e laparoscopic
c×wZ‡Z wcËbvjx AcmviY Kiv nq| Gici †_‡K j¨vcv‡iv‡¯‹v‡ci mvnv‡h¨
Acv‡ik‡bi msL¨v A‡bK †e‡o‡Q, GUv †ivMx I wPwKrmK Df‡qB cQ›`
K‡ib| AZ¨šÍ †QvU KvUv nq, cÖvq wQ‡`ªi gZ, nvmcvZv‡j Kg w`b _vK‡Z
nq, RxevYy msµg‡Yi m¤¢vebv Kg| Z‡e G‡Z mgm¨vI Av‡Q| G ai‡bi
Acv‡ik‡b mvR©‡bi ¯^vfvweK nvZ I †Pv‡Li mgš^q _v‡K bv, nv‡Zi Kv‡Ri
`ÿZvI K‡g hvq| gwbU‡i c`©vq Qwe †`‡L hš¿ Pvjbv K‡i Acv‡ikb Kiv
¯^vfvweK bq| ¯úk© Kiv hvq bv e‡j †Pv‡Li †`Lvi Dci wbf©i Ki‡Z
nq| ¯^vfvweK Ae¯’vq gvby‡li nvZ mvgvb¨ Kuv‡c, GUv h‡š¿i ga¨ w`‡q
hvq| Gme mxgve×Zv `~i Kivi Rb¨ mvwR©K¨vj †iveU ˆZwi Kiv ïiæ
nq| cÖ_vMZ j¨vcv‡iv‡¯‹vwci mÿgZv evovb wQj cÖ_g w`‡Ki mvwR©K¨vj
†iveU ˆZwii D‡Ïk¨| 1985 mv‡j Kwoh I Zuvi mnKg©xiv Puma 560
bv‡g †iveU eënvi K‡ib wbD‡ivmvR©vix Acv‡ikb Kivi Rb¨| wZb eQi
ci G h‡š¿i mvnv‡h¨ Davies I Zuvi mnKg©xiv transurethral prostate
Acv‡ikb K‡ib| Gici h‡š¿i AviI DbœwZ K‡i †cÖv‡÷U Acv‡ik‡bi
Rb¨ Probot ˆZwi Kiv nq| Aci GKUv hš¿ Rotodoc ˆZwi Kiv nq Hip
Replacement Acv‡ik‡bi Rb¨| 1980 Gi `k‡K gvSvgvwS National
Aeronotics and Space Administration (NASA) Gi M‡el‡Kiv †Uwj
mvR©vixi aviYv ev¯Í‡e iƒc †Ìqvi †Póv K‡ib, hvi Øviv mvR©b `~‡i †_‡K
Acv‡ikb Ki‡Z cvi‡e| NASA I Stanford Research Institute
wg‡j nv‡Zi mvR©vixi hš¿cvwZ ˆZwi K‡ib| gvwK©b †mbvevwnbx hy×‡ÿ‡Î
AvnZ ˆmb¨‡ì Acv‡ikb `~‡i Ae¯’vbiZ mvR©b wKfv‡e Ki‡Z cv‡ib †m
cÖhyw³ M‡o Zzj‡Z AvMÖnx nq| GiB avivevwnKZvq G cÖhyw³ AmvgwiK
ch©v‡q cÖ‡qv‡Mi Rb¨ Automated Endoscopic System for Optical
Positioning (AESOP) †mbvevwnbxi A_©vq‡b ˆZwi K‡ib| GUv GKUv
Robotic Arm hv mvR©‡bi †gŠwLK Av‡`‡k Endoscopic camera
bovPov Ki‡Z cv‡i| µgvMZ Dbœq‡bi d‡j DaVinci mvwR©K¨vj
wm‡÷g ˆZwi nq| eQi Lv‡b‡Ki g‡a¨ Zeus System bv‡g Avi GK
ai‡bi †iveU Av‡m| 1999 mv‡j cÖ_g Single Vessel Closed Heart
Bypass mvR©vix K‡ib WMjvm e‡qW| 2001 mv‡j `yBRb mvR©b gv‡i‡¯‹v
I Zuvi mn‡hvMx wbDBqK© †_‡K wcË_jx AcmviY K‡ib-†ivMx wQj d«v‡Ýi
÷ªvmev‡M©| GUv D”P MwZ m¤úbœ dvBevi AcwUK †bUIqvK© I Zeus
System eënvi K‡i nq|

†ivewUK mvR©vix wZb ai‡bit
1. Supervisory Control System- me PvB‡Z †ewk ¯^qswµq| wK
Ki‡Z n‡e mvR©b †m wb‡`©kbv †iveU‡K Av‡MB w`‡q‡Qb| Gici
Acv‡ikb PjvKv‡j mvR©b memgq jÿ¨ iv‡Lb, †Kvb Amyweav
n‡j m‡½ m‡½ n¯Í‡ÿc K‡ib| G eë¯’v Hip & Knee joint
Replacement Acv‡ik‡b eënvi nq| †iveU nvo wbLuyZfv‡e wQ`ª
K‡i †`q hv‡Z implant wVKgZ fit K‡i| me gvby‡li nvo ev
†Rvovi gvc GK bq, ZvB mvR©b‡K Av‡M gvç‡jv wVK K‡i wb‡q
cÖwZwU †ivMxi Rb¨ Avjv`v wb‡`©k w`‡Z nq|
2. Telesurgical System- DaVinci System Gi D`vniY|
†ewkifvM AwfÁZv G wm‡÷g Gi gva¨‡g n‡q‡Q| G‡Z †QvU
†QvU wQ`ª (GK †_‡K `yB †mw›UwgUvi) K‡i PviwU wPKb robotic
arm kix‡ii wfZi cÖ‡ek Kivb nq| mvR©b GKUv console
(†QvU †Uwe‡ji gZ) G e‡m wÎgvwÎK c`©vq `k¸Y ewa©Z kix‡ii
wfZ‡ii Qwe †`‡L nvZ I cv w`‡q †ivewUK nvZ¸‡jv robotic
arm cwiPvjbv K‡ib| mvR©‡bi nvZ kix‡ii wfZi cÖ‡ek K‡i bv|
mvR©‡bi nvZ I cv‡qi bovPov robotic arm Gi m~² bovPovq
cwiYZ nq| Robotic arm Gi gv_vq Acv‡ik‡bi hš¿cvwZ _v‡K|
wØZxq GKRb mvR©b Acv‡ikb †Uwe‡j robotic arm ¸‡jv h_v¯’v‡b
emvb n‡q‡Q wKbv Zv wbwðZ K‡ib| wÎgvwÎK K¨v‡givi mvnv‡h¨
†h me ¯’vb mvR©b cÖ_vMZ Acv‡ik‡b †`L‡Z cvb bv, †m¸‡jvI eo
AvKv‡i †`Lv hvq| Robotic arm gvby‡li nv‡Zi gZB bovPov
Ki‡Z cv‡i| wKš‘ G¸‡jv GZ †QvU †h mvR©‡bi nvZ †hLv‡b †h‡Z
cv‡i bv, Ggb †QvU RvqMvq †h‡qI KvR Ki‡Z cv‡i|
3. Shared Control Robotic Surgery System- mvR©b wb‡R
Acv‡ikb K‡ib| †iveU Acv‡ik‡b mxgvbv wbqš¿Y K‡i| †hgb
Hip and Knee Joint Acv‡ik‡bi GKUv GjvKv _v‡K †hLv‡b
mvR©b KvR Ki‡eb| Gi evB‡i tissue †Z AvNvZ jvM‡j ÿwZ
n‡e| mvR©‡bi nv‡Zi hš¿ GjvKvi evB‡i †M‡jB †iveU Rvwb‡q
†`q| GjvKv Av‡MB wVK K‡i †iveU‡K wb‡`©kbv †Ìqv nq|
GLb ch©šÍ †ive‡Ui mvnv‡h¨ †h me Acv‡ikb Kiv n‡q‡Q Zvi g‡a¨ Av‡Q,
ürwc‡Û Mitral valve †givgZ, K‡ivbvix AvU©vwi evBcvm, Atrial Septal
Defect †givgZ, cwicvKZš¿, Abœbvjxi Acv‡ikb, IRb Kgvbi Acv‡ikb

(Bariatric surgery) Achalasia Acv‡ikb, wcË_jx AcmviY, Rivqyi
Fibroid AcmviY, Prolapse Acv‡ikb, Ovary tumor Acv‡ikb,
†cÖv‡÷U Møv‡Ûi Acv‡ikb, wewfbœ R‡q‡›Ui Acv‡ikb| ‡ivewUK mvR©vixi
myweav nj, j¨vcv‡iv‡¯‹vcxi gZ †QvU †QvU wQ`ª K‡i Acv‡ikb Kiv nq,
eo K‡i KvU‡Z nq bv| †ivMx ZvovZvwo †m‡i I‡V, nvmcvZv‡j †ewk w`b
_vK‡Z nq bv| msµg‡Yi m¤¢vebvI Kg _v‡K| Amyweav nj LiP †ewk|
mvR©b‡ì wkL‡Z †ewk mgq jv‡M| A‡bK M‡elYvq long term dj cÖ_vMZ
mvR©vixi PvB‡Z fvj cvIqv hvqwb| RwUjZvI Kg bq| 2000 †_‡K 2011
mvj ch©šÍ 95wU †ive‡Ui mvnv‡h¨ Rivqy Acv‡ik‡b 49wU †ÿ‡Î Ab¨ A‡½i
ÿwZ n‡q‡Q, 34wU ÿwZ wQj ¯’vqx| †cÖv‡÷U Acv‡ik‡bi †ÿ‡ÎI bvf© I Ab¨
A‡½i ÿwZ D‡jøL‡hvM¨ nv‡i cvIqv †M‡Q|
wb‡R wb‡R KvR Ki‡Z cv‡i Ggb †iveU ˆZwi Kiv n‡”Q| G¸‡jv gvby‡li
gZB Zv‡ì mdjZv I wedjZv †_‡K wkÿv wb‡q DbœwZ Ki‡Z cvi‡e|
fwel¨‡Z Network gva¨‡g GK †iveU Ab¨vb¨ A‡bK †ive‡Ui m‡½ mshy³
_vK‡e| Zv‡Z GKUv †iveU nvRvi nvRvi Acv‡ik‡bi AwfÁZv AR©b Ki‡Z
cvi‡e| ¯^qswµq ÿz`ª K¨vcmyj †iveU K¨v‡_Uvi ev wPKb b‡ji gv_vq jvwM‡q
ürwc‡Ûi Af¨šÍ‡i †Q‡o †Ìqv hvq| K¨vcmyj †iveU wb‡R wb‡R c_ Luy‡R
wb‡q wb‡`©wkZ valve G (‡hUv ÿwZMÖ¯Í) P‡j hv‡e| mvR©b evB‡i †_‡K
Ae¯’vb hvPvB K‡i wb‡`©k w`‡j K¨vcmyj valve †givgZ Ki‡e| GUv GLbI
cixÿvg~jK| Z‡e G iKg †ive‡Ui mvnv‡h¨ †mjvB Kiv, wUDgvi AcmviY
KiviI cixÿv Pj‡Q| †ivewUK mvR©vixi GLbI wkïKvj| fwel¨‡Z GUv
DbœZ nIqvi m¤¢vebv I cÖ‡qvM nIqvi m¤¢vebv wekvj|
†Uwj‡gwWwmbt
†ivMx I wPwKrmK hLb GK ¯’v‡b _v‡K bv, ZLb B‡jUªwbK †hvMv‡hvM eë¯’v I
Z_¨ cÖhyw³ eënvi K‡i ¯^v¯’¨‡mev †Ìqv nj- †Uwj‡gwWwmb| GUv †gwWwm‡bi
Avjv`v kvLv bq| GUv GKUv cÖhyw³, †hUv eënvi K‡i cÖ_vMZ ¯^v¯’¨‡mevi
myweav wba©vwiZ ¯’v‡bi evB‡i cÖmvwiZ Kiv hvq| †gwWwm‡bi me kvLvB GUv
eënvi K‡i AviI †ewk gvbyl‡K m¤ú„³ K‡i †mev w`‡Z cv‡i|
†Uwj‡nj_- B‡jKUªwbK †hvMv‡hvM I Z_¨ cÖhyw³i gva¨g eënvi K‡i
cÖZ¨ÿ †ivMx †mev QvovI †ivMx‡ì wPwKrm‡Ki m‡½ ¯^v¯’¨ ev cixÿv
wbixÿvi A¨vc‡q›U‡g›U, †ivMx‡ì †ivM m¤^‡Ü wkÿv †Ìqv, mvaviY gvbyl‡K
¯^v¯’¨ welqK wkÿv ev Z_¨ †Ìqv, ¯^v¯’¨Kg©x‡ì wkÿv I cÖwkÿY G¸‡jv
†Uwj‡nj‡_i AšÍf©~³|

†Uwj‡gwWwmb G K‡qK ai‡bi KvR Kiv hvqt
1. we‡klÁ †idv‡ij (Referrel)-mvaviY wPwKrmK hLb †Kvb †ivMxi
RwUj mgm¨vi e¨vcv‡i we‡kl‡Ái civgk© Pvb, ZLb wZwb wbw`©ó
we‡kl‡Ái m‡½ B‡jKUªwbK †hvMv‡hvM gva¨g eënvi K‡i K_v
ej‡Z cv‡ib, †ivMxi wi‡cvU©, G·-‡i BZ¨vw` †`Lv‡Z cv‡ib I
civgk© wb‡Z cv‡ib| we‡kl‡Ái Kv‡Q †ivMxi weeiY I Z_¨ cvwV‡q
w`‡j wZwb G¸‡jv ch©v‡jvPbv K‡i c‡iI gZvgZ w`‡Z cv‡ib|
2. cÖZ¨ÿ †ivMx †mev- †ivMx wb‡R †hvMv‡hvM gva¨g eënvi K‡i
¯^v¯’¨Kg©xi m‡½ K_v ejv, wi‡cvU© †`Lvb BZ¨vw` Ki‡Z cv‡ib I
civgk© wb‡Z cv‡ib|
3. `~‡i Aew¯’Z †ivMxi kvixwiK Ae¯’v ch©‡eÿY I bRi ivLv- `~‡i
Aew¯’Z †ivMxi kvixwiK Ae¯’vi wewfbœ h‡š¿i mvnv‡h¨ gvcv n‡Z
cv‡i (†hgb eøvW †cÖmvi, BwmwR, eøvW Møy‡KvR)| †m¸‡jv ¯^v¯’¨‡K‡›`ª
cvVvbi eë¯’v _vK‡j ¯^v¯’¨Kg©xiv `~‡i †_‡KB †ivMxi Dci bRi
ivL‡Z cv‡ib I cÖ‡qvR‡b civgk© w`‡Z cv‡ib|
4. ¯^v¯’¨Kg©x‡ì wkÿv I cÖwkÿYI `~‡i Aew¯’Z cÖwkÿK G cÖhyw³
eënvi K‡i Ki‡Z cv‡ib|
5. mvaviY gvbyl‡K ¯^v¯’¨ wkÿv †Ìqv I ¯^v¯’¨ m¤^‡Ü Z_¨ †Ìqvi Rb¨ G
cÖhyw³ eënvi n‡”Q| †hvMv‡hv‡Mi c×wZ K‡qK ai‡bi n‡Z cv‡i|
K. B›Uvi‡bU eënvi K‡i †ivMx ¯^v¯’¨Kg©x ev ¯^v¯’¨‡K‡›`ª †hvMv‡hvM
Ki‡Z cv‡ib|
L. nvmcvZv‡ji m‡½ K‡qKUv ¯^v¯’¨ †K‡›`ªi AvšÍt‡hvMv‡hvM _vK‡Z
cv‡i||
M. nvmcvZvj ¯^v¯’¨‡K›`ª cÖZ¨ÿfv‡e †ivMxi evoxi m‡½ wfwWI ev
†Uwj‡dvb †hvMv‡hvM K‡i civgk© w`‡Z cv‡ib| Gfv‡e evox‡Z
Aew¯’Z †ivMxi cvjm&, eøvW Møy‡KvR BZ¨vw` kvixwiK m~P‡Ki Dci
bRi ivLv hvq| Atrial fibrillation I flutter Av‡gwiKvq ü`wc‡Ûi
ms‡KvPb A¯^vfvweKZvi g‡a¨ mePvB‡Z †ewk †`Lv hvq| G‡Z jÿ
jÿ gvby‡li g„Zz¨SzuwK ev‡o| ïiæ‡ZB aiv co‡j wPwKrmv K‡i g„Zz¨
SuywK Kgvb hvq| ¯§vU©Iqvi eënvi K‡i cvj‡mi Z_¨ cvVvb hvq|
ePatch Gi Øviv GK †_‡K wZb load Gi BwmwR K‡qKw`‡bi Rb¨
†iKW© Kiv I cvVvb hvq| Kardiaband bv‡g h‡š¿i mvnv‡h¨ BwmwR
†iKW© K‡iI cvVvb m¤¢e| ¯§vU©‡dv‡bi GKkiI †ewk ¯^v¯’¨ msµvšÍ

application Av‡Q| Jla LvIqvi mgq Rvbvb, Jla wVKgZ LvIqv
n‡”Q wKbv Zvi Z_¨ msiÿY, eøvW †cÖmvi gvcvi h‡š¿i m‡½ mshy³
K‡i eøvW †cÖmvi †iKW© ivLv BZ¨vw` bvbv Kvi‡Y jvMvb hvq| Gme
Z_¨ ¯^v¯’¨‡K‡›`ª cvVvb m¤¢e|
Pg©‡iv‡Mi Rb¨ A‡bK †ÿ‡Î AvµvšÍ ¯’v‡bi Qwe Zz‡j cvwV‡q w`‡j Qwe
†`‡L wPwKrmv †Ìqv m¤¢e nq| mw`©, Kvwk G¸‡jv A‡bK †`Lv hvq Ges
†ewkifvM †ÿ‡Î K‡qKUv mvaviY fvBivm (†hgb Bbd¬z‡qÄv, wg‡KvfvBivm,
G¨v‡Wv‡bvfvBivm) Gi msµg‡Yi Kvi‡Y nq| G¸‡jv msµvgK Ges
nvmcvZvj ev wPwKrm‡Ki Kv‡Q GUvi wPwKrmv wb‡Z †M‡j GUv Qovbi
m¤¢vebv| cÖv_wgKfv‡e G¸‡jvI †Uwj‡gwWwm‡bi gva¨‡g wPwKrmv †Ìqv
hvq| Acv‡ik‡bi ci †ivMx evox‡Z P‡j †M‡jI bRi ivLvi ìKvi n‡Z
cv‡i| GUv †Uwj‡gwWwm‡bi gva¨‡g Kiv hvq| M‡elYvq †`Lv †M‡Q G‡Z
cybivq fwZ© nIqvi nvi Kg _v‡K| cwicvKZ‡š¿i A‡bK †ivM (†hgb eyK
R¦vjv, †Kvô¨KvwVb¨, †cU duvcv) wPwKrmK †Uwj‡gwWwm‡bi gva¨‡g civgk©
w`‡Z cv‡ib| M‡elYvq †`Lv †M‡Q mvaviY DcmM©mg~‡ni wPwKrmv G
gva¨‡g Kiv n‡j 20 kZvs‡ki gZ †ivMxi wPwKrm‡Ki Kv‡Q ev †hvMv‡hv‡Mi
cÖ‡qvRb nq bv|
†KvwfW-19 gnvgvixi mgq †Uwj‡gwWwmb Gi eënvi A‡bK cÖmvwiZ nq|
G‡Z cÖZ¨ÿ †`Lv bv K‡i cixÿvi djvdjmn †ivMx †Uwj‡gwWwm‡bi wewfbœ
c×wZ eënvi K‡i wPwKrm‡Ki civgk© wb‡Z cv‡i| G‡Z msµg‡Yi m¤¢vebv
_v‡K bv, hvZvqv‡Zi LiP I mgq euv‡P| Z‡e me ai‡bi †ivMxi mgm¨v
†Uwj‡gwWwm‡b †Ìqv hvq bv| Riæix Ae¯’vq (†hgb nvU© A¨vUvK, †÷ªvK)
wPwKrmvi Rb¨ nvmcvZv‡j †h‡Z nq| GQvov †hme †ivMxi kvixwiK cixÿv
(physical examination) Kiv ìKvi Zv‡ì RbÏ GUv cÖ‡hvR¨ bq|
1950 Gi `k‡K †Uwj‡gwWwmb Gi ïiæ| Av‡gwiKvi K‡qKwU wek^we`¨vjq
nvmcvZvj †_‡K `~‡i emevmKvix †ivMx‡ì Kv‡Q ¯^v¯’¨‡mev wKfv‡e †cuŠQvb
hvq, †mUv we‡ePbv Kiv ïiæ nq| Gi Av‡M wesk kZvãxi ïiæ‡Z nj¨v‡Ûi
wPwKrmK William Einthoven †Uwj‡dvb eënvi K‡i BwmwR `~‡i cvVv‡Z
mÿg n‡qwQ‡jb| BD‡iv‡ci Ab¨ wPwKrm‡KivI GUv AbyliY K‡ib| 1920
†_‡K 1940 mv‡ji g‡a¨ d«vÝ, BUvwj I biI‡qi †gwWK¨vj †m›Uvimg~n †iwWIi
gva¨‡g Øxc I Ab¨vb¨ `~M©g AÂ‡j emevmKvix †ivMx‡ì Dc‡`k w`‡q‡Qb|
mgy‡`ª Rvnv‡R Ae¯’vbiZ bvwe‡Ki wPwKrmvI †Ìqv n‡q‡Q| JlacÎ I

Ab¨vb¨ wPwKrmv miÄv‡gi mieivn wbqš¿Y Kivi Rb¨ Av‡gwiKvq M„nhy‡×i
mgq †UwjMÖv‡di eënvi nq| 1950 I 1960 Gi `k‡K Av‡gwiKv I KvbvWvq
co- axial cable Gi gva¨‡g †hvMv‡hvM K‡i †ivMx‡ì civgk© †Ìqv nZ|
G mgq circuit television closed Gi gva¨‡gI †ivMx †`Lv nq| 1980
Gi `k‡K teleradiology system Gi gva¨‡g Radiologist iv G·-‡i Qwe
cvVvb ïiæ K‡ib| 1990 Gi `k‡K B›Uvi‡b‡Ui Afz¨`‡q, `ªæZMwZ‡Z AviI
we¯Í…Z GjvKvq Z_¨ Av`vb cÖ`vb m¤¢e nj| B›Uvi‡b‡U Z_¨ PjvP‡ji MwZ
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AvBb cÖYqb Kiv n‡q‡Q| wPwKrmK‡ì †ckvMZ msMVb Av‡gwiKvb †gwWK¨vj
G‡mvwm‡qkb wPwKrmK‡ì †Uwj‡gwWwmb Kg©Kv‡Ûi bxwZgvjv cÖYqb K‡i‡Q|
Federation of the State Medical Board (FSMB) hviv wPwKrmK‡ì
jvB‡mÝ †`b, ZvivI Gi gv‡bi msÁv wba©viY K‡i‡Qb|
†Uwj‡gwWwmb Zzjbvg~jKfv‡e bZzb eë¯’v Ges Zv †KvwfW-19 gnvgvix
ïiæ nIqvi Av‡MI evrmwiK cÖvq 20 kZvsk nv‡i evowQj| 2018 mv‡j
Av‡gwiKvq GUvi KvRKg© 26.5 wgwjqb Wjv‡ii mgvb wQj| †ivMx‡ì Kv‡QI
Gi MÖnY‡hvM¨Zv evo‡Q| AvMvgx‡Z 24 N›UvB G eë¯’vi gva¨‡g evox‡ZB
A‡bK †iv‡Mi †mev †Ìqv hv‡e| nvmcvZvj, ¯^v¯’¨‡K‡›`ª I wPwKrm‡Ki
†P¤^v‡i wKQz wKQz mgm¨vi Rb¨ †h‡Z n‡e bv| nvmcvZvj¸‡jvi AvšÍt‡hvMv‡hvM
evo‡e- †h me †mev †Kvb nvmcvZv‡j bvB, ZvivI G cÖhyw³i gva¨‡g G †mev
wb‡Z cvi‡e| `~ieZ©x I †QvU nvmcvZvj¸‡jvi †mev evo‡e|
Z_¨m~Î:
1. Topol E. J. A decade of digital medicine innovation-Sci Trans
Med, 2019; 11: 7160.
2. Shah NR. Health Care in 2030: will artificial intelligence replace
physicians? Ann Inter Med, 2019; 170:407-408.
3. Turakhia MP, Desai M, Hedlin H et al. Rationale and design of a
large scale, app-based study to identify cardiac arrhythmias using a
smart watch, the apple heart study. Amer Heart J, 2019; 207:66-75.

4. Dorado-Diaz P1, Sampedro-Gomez J. Vicente-Palacios V, and Sanchez
PL. Applications of artificial intelligence in cardiology. The
future is already here. Revista Espanola de Cardiologia, 2019;
72:1065-75.
5. Neil O, Bastard P. Artificial intelligence in Nephrology: core
concepts, clinical applications and perpectives. Amer J Kidney
Dis, 2019; 54:1900829.
6. Yang YJ, Bony CS. Application of artificial intelligence in
gastroenterology. World J Gastroenterol, 2019;25:1660-1683.
7. Regalia G, Onorati F, Lai M et al. Multimodel wrist-worn
devices for seizure detection and advancing research: focus on
the Empatica wristbands. Epileps Res, 2019;153:79-82.
8. Liu X, Faes L, Kale AV et al. A comparison of deep learning
programme againsthealthcare professionals in detecting diseases
from medicalimaging: systematic review and metaanalysis.
Lancet Digit Health. 2019;1: e 271-297.
9. Kelly CJ, Karthikesalingam A, Selangman M et al. Key challenges
for delivering clinical impact with artificial intelligence. BMC
Med, 2019; 19:195.
10. Vergheese A, Shah NH, Harrington RA. What the computer needs
in a physician: humanism and artificial intelligence. J Amer Med
Assoc, 2018; 319:19-20.
11. https://www.mendeloy.com/careers/article-artificial-intelligence-
in- medicine.
12. https://www.frontiersin.org/articles/10.3389/fmed-2020-00027/full.
13. https://en.m.wikipedia.org/wiki/Artificial_intelleigence_in_
healthcare.
14. Loh E. Medicine and the rise of robots:a qualitative review of
recent advances of artificial intelligence in health. BMJ Leader,
2018;2: 59-63.
15. https://www.biophotonics.world/magazine/article/1100/artificial-
intelligence-will-make-medicine-better-in-the-long-run.
16. https://www.nature.com/article/d 41586-019-03845/
17. Lamfrances A, Castellanos AE, Desai JP, Meyers WC. Robotic
surgery. A current perspective. Ann Surg. 2004; 239:14-21
18. Svoboda E. Your robot surgeon will see you now. Nature, 2019;
573: s110-s111.
19. https://healthcareweekly.com/telemedicine-ultimate-guide/.
20. Morawski K, Ghazinouri R, Krumme A. Association of a
Smartphone Application with Medication Adherence and Blood
Pressure Control. JAMA Intern Med. 2018; 178:802-809.

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1. Paul J and Friedman J. 2006. Globalization and Violence, vol 3:
Globalizing War and Intervention. London,Sage Publications.
2. Grossman D. 1996. On Killing –the Psychological Cost Learning
to Kill in War and Society. Boston, Little Brown and Company.
3. Johan MG and Denven.1995. The origin of War: Evolution of a
Male-Coalitional Reproductive Strategy. Groningen, Origin Press.
4. Montagu A. The Nature of Human Aggression.1976, Oxford,
Oxford University Press.
5. Howell S and Willis R (Eds) 1989. Societies at Peace:
Anthropological Perspectives. London, Routledge.
6. Kissel M and Kim NC. The emergence of human warfare: Current
Perspectives-Yearbook of Physical Anthropology. 21 December
2018. https://doi-org/10.1012/ajpa.2375.
7. Ferguson RB. 2013. The Prehistory of War and Peace in Europe
and the Neareast. InDP Fry (Ed). War, peace and human nature:
the convergence of evolutionay and cultural views. New York,
Oxford University Press.
8. Ferguson RB.2006. Archaeology, cultural anthropology and the
origins and intensifications of war. In E Ankush and M Allen
(Eds). The Archaeology of Warfare: Prehistories of raiding and
conquest. Gramsville. University of Florida.

9. Fry DP and Soderberg P.2013. Lethal aggression in mobile forager
bands and implications for the origins of war, Science, 341:270-
273.
10. Mead M. 1940. Warfare is only an invention, not a biological
neccessity. Asia, 15:402-405.
11. Sponsol L. 1996. The Natural history of peace: The positive View
of human nature and its potential. In T-Gregor (Ed). A natural
history of peace. Nashville, Vanderbilt University Press.
12. LeBlanc S. 2014. Forager warfare and our evolutionay past. In
M. Allen and T. Jones (Eds), Violence and warfare among hunter
gatherers. Walnut Greek, Left Coast Press.
13. Bowles S. 2009. Did Warfare among ancestral hunter gatherers
affect the evolution of human social behaviors. Science; 324:1293-
1298.
14. Grilaine J and Zammit J. 2001. Origins of war: violence in
prehistory. Oxford, Blackwell Publishing.

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