More of these doctors won’t make India healthier.

GUEST COLUMN: Dr N Prabhudev

Bengaluru, June 21: Substandard medical colleges produce substandard medical graduates!

• 612 medical colleges with under graduate 92,793 Medical seats a year and 64,559 post-graduate seats. India to get 50 new medical colleges; 8195 UG seats to be added. The number of medical colleges in the country now stands at 702. There are 733 AYUSH medical colleges and 53,000 graduates a year!
• The Indian public health sector encompasses 18% of total outpatient care and 44% of total inpatient care.
• India will need 2.07 million more doctors by 2030.
India is racing to touch the magic target of producing a lakh and more doctors every year to achieve the WHO recommendation of one doctor for 1,000 population. Yes, we need adequate health personnel. India has 12.68 lakh registered allopathic doctors and 5.65 lakh AYUSH doctors for a population of about 1.3 billion – one doctor for 1450 population! 2 of 3 ‘doctors’ in rural India have no formal medical degrees.

At this rate, by the year 2030, India will have a million and a quarter additional doctor. A large section of young medical students.

India cracks down on admissions to substandard medical schools- this is for public consumption. There are hundreds of colleges not worthy of being a Medical college. Still the managements get the necessary licence to run these unworthy medical colleges.  They are in profit mode! Neither Patients nor the students are their concern.
Then the big elephant in the room – reservations, quotas and cash merit. The NEET-UG score range – the cut-off percentile for reserved category candidates — is at an all-time low this year- 116-93/720. The general category AFMC cut off for boys was 618/720 – Look at the range between reserved and general categories! The complexity of the quota system has only decreased the availability of ‘general’ or ‘open-merit’ postgraduate seats by a whopping 42%.

The medical interns often struggle to record the vital signs or put central lines – a mirror to the current system of medical education in our country. The medical teacher is a sage on the stage rather than guide by the side.
Unprofessional and ineffective training programs, lack of patient load and ghost faculties make the students learning experience suspect.  Hospitals only treat patients rather than teaching new doctors. Systems and structures for facilitating education have tended to be poor, with substandard learning environments, and reports of unsatisfactory teaching quality.

Unless urgent action is taken, India in the next few years will have a vast pool of mediocre, unemployable doctors.
In India, the weakening of the public health system and collapse of the three-tier health system, combined with rampant privatisation of healthcare, has been disastrous especially for the poor.
Will city kids trained in technology-intensive settings and metropolitan tertiary care centres ever work in rural areas? Will these doctors understand the health problems of the rural folks and challenges of rural health issues with inadequate infrastructure? These questions appear to be ignored in the rush to open private medical colleges! The system of medical education needs to adapt itself to the rapid changes taking place in the area of medical science and health care.

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