The Road Ahead: IAM and Beyond…

Institute of Aerospace Medicine (IAM), in its more than five decades of existence has done yeoman service to the growth of Aviation Medicine / Aerospace Medicine in India. Starting as the School of Aviation Medicine, the founding fathers of this prestigious institute envisaged a multiple role of training, research and consultancy for it, which continues unfettered till date. Besides, IAM has kept pace with the changing times, including upgrade of its infrastructure, to offer the latest and the best to its primary clientele, the Indian Air Force. Training of the aircrew and the doctors in uniform has evolved constantly. Though the research has taken a back seat due to focus on other activities and paucity of manpower, yet efforts are in the right direction. It is the consultancy which has remained unsung, what with all the glory going to the developing agencies, be it the Light Combat Aircraft (LCA) or the Light Combat Helicopter (LCH).

IAM cannot continue to bask in its past glory but has to change with the times. The two major determining factors shall be the commercial aviation and the Human Spaceflight Programme.

It is the pressures of the commercial aviation, with the regulator, the DGCA, requiring institutional support, including advisory, research and in accident investigation, that shall help institutionalise the active practice of Civil Aviation Medicine. As a corollary, there is bound to be an increase in demand for Aviation Medicine Specialists in civil sector, both by the airlines and the airports. To cater for such a need of national importance, there shall be a need for allocation of resources, budgetary and human, at IAM. The need of the hour is to establish a department of Civil Aviation Medicine at IAM to coordinate the academic and research needs of the Civil Aviation Medicine in the country. This department needs to start focussing on human performance and limitations in commercial aviation, with different operational conditions faced by the pilots operating domestic and international flights. The question of optimal hours on duty without compromising performance needs to be answered – the ideal work-rest schedule; prospective effects of lifestyle illnesses, including metabolic syndrome or fatty liver, on employability and longevity needs to be probed; enhancing aviation safety while giving fitness to pilots with disabilities, including those on medication, needs to be worked upon. The scope of activities in the field of Civil Aviation Medicine is so profound that in the long run, the Ministry of Civil Aviation and DGCA must consider setting up an independent Institute of Civil Aviation Medicine, with support and expertise from IAM. This Institute shall be the nodal agency for training and research in the field of civil aviation medicine. Besides, this Institute can also become the apex regulatory body for medical licensing of the civil pilots in India, with DGCA recognised regional centers at major aviation hubs for supervision of licensing undertaken by corporate hospitals with dedicated department of Aviation Medicine or independent Designated Aviation Medical Examiners.

The manned space flight is the next most fascinating task imminently at hand for IAM. The hard work of laying the foundations of space medicine related activity has commenced in earnest at IAM. Here the synergy of concerned departments must evolve into a harmonized effort towards a dedicated School of Space Medicine within the campus of ISRO’s Star City. This shall be manned by IAM trained Space Physiologists and Physicians with the state of the art laboratory facilities. Although ISRO needs to formulate the kind of symbiotic relationship that it wishes to build with IAM, it shall be prudent for IAM to play second fiddle, akin to being a guide and mentor to ISRO’s designs in this particular area. In the early years, IAM can provide all the necessary technical and human resource, especially the latter. ISRO too must chart out its long term plan for the onerous task of training and preventive care of the Indian astronauts for the space missions in the decades to come. Such a road map is essential, if we wish to see Space Medicine coming on its own in India.

As far as conventional practice of Aerospace Medicine at IAM is concerned, there is a need for introspection and then defining the road ahead. But before that there is a need for continuity and prolonged tenures for those devoted and dedicated to the practice of this fascinating speciality. Constrains of career planning has taken its toll on a good specialist striving to transform himself into a brilliant academic or a researcher. As a result, there is continuity but no growth; there is research but no application; there are instructors but no teachers; there is consultancy but no consultants of repute. IAM needs to look beyond being a conventional Air Force unit, for it is destined for glory beyond the national boundaries. For attaining its rightful place as a centre of excellence, the faculty needs to work towards specialisation beyond the conventional, say into accident investigation, human factors, cognitive sciences including decision making etc. There in a need for integration of other fields into the practice of Aviation Medicine, e.g. Rehabilitation Medicine, Diagnostic Radiology, Nuclear Medicine, Interventional Cardiology, etc. There is also a need for active research into use of drugs, e.g. use of Glucagon Like Peptides 1 (GLP1) in treatment of Type 2 Diabetes Mellitus; acceptance of interventional cardiology or use of rate-responsive pacing in pilots, to name a few.

Considering the political will to usher in changes in the field of higher education, one never knows that one day IAM may be recognised as an University of Aerospace Medicine, with individual Institutes of Military and Civil Aviation Medicine, along with the School of Space Medicine.