A second-year Emergency Medicine postgraduate trainee (PG) at Madras Medical College (MMC), Chennai, was issued a 7-day suspension on November 19, 2025, for allegedly failing to follow the “emergency patient algorithm” while triaging a critically ill patient, according to a circular issued by the college administration. The decision has sparked strong criticism from medical associations, who argue that the action was taken without due inquiry and places unfair blame on a trainee who works under mandatory supervision.
The Tamil Nadu Medical Officers Association (TNMOA) sharply criticized the suspension, calling it “unfair, unwarranted, and sets a dangerous precedent.” The Association urged the Director of Medical Education (DMER) to intervene, revoke the suspension immediately, and ensure a fair, transparent inquiry.
TNMOA pointed out that the resident was punished without a proper fact-finding process, violating fundamental norms of natural justice. The Association emphasized that suspending a trainee before conducting a full inquiry undermines morale and creates fear among junior doctors working in high-pressure emergency settings.
The doctors’ body also raised two critical questions:
“How can a PG trainee be held solely responsible for a patient’s unfortunate death when they work strictly under supervision?”
“Why was no supervisory accountability fixed before punishing a student still under training?”
Emergency departments in government teaching hospitals function under a tiered hierarchy, where PG trainees manage initial clinical evaluations but must be overseen by senior residents and faculty.
Given this system, medical associations argue that supervisors share direct responsibility for reviewing clinical decisions, especially in emergency triage. Any lapse, they say, should be examined within the context of working conditions, staffing, caseload, and available senior support at that time.
TNMOA insists that disciplinary action cannot be limited to trainees without assessing whether senior oversight, staffing levels, or systemic factors contributed to the incident.
In India, emergency departments (EDs) increasingly rely on formal triage systems to sort incoming patients based on severity, a crucial step given high patient load and limited resources. Many major hospitals now implement protocols like the AIIMS Triage Protocol (ATP), which classifies adult patients into priority categories to ensure those critically ill receive prompt care. 1
Typically, trained nurses or duty doctors conduct the initial triage at arrival, directing patients into “red” (immediate care), “yellow” (urgent but not immediate), or “green” (non-urgent) areas, based on vital signs, injury/illness severity, and required interventions. 2
References
1) Sahu, Ankit Kumar, Sanjeev Bhoi, Sagar Galwankar, Praveen Aggarwal, Lakhiram Murmu, Jamshed Nayer, Tej Prakash Sinha, Prakash Ranjan Mishra, Meera Ekka, and Akshay Kumar. “All India Institute of Medical Sciences Triage Protocol (ATP): ATP of a Busy Emergency Department.” Journal of Emergencies, Trauma, and Shock 13, no. 2 (2020): 107–109. https://doi.org/10.4103/JETS.JETS_137_1
2) Department of Health & Family Welfare, Government of India. Standard Treatment Guidelines for Management of Trauma (Book No. 2-1-1). New Delhi: Ministry of Health & Family Welfare, 2025. https://www.mohfw.gov.in/sites/default/files/Standard%20Treatment%20Guidelines%20Book%20No%202-1-1.pdf
(Rh/TL)
