Studying medicine in India has always been in the news for some reason or the other – whether it is about increasing seats, common entrance tests being introduced, government packages being announced for medical colleges or what not. This time around, the debate is regarding the duration of the currently 5½ year long MBBS course which is being increased to 6½ years due to a mandatory rural service component being introduced.
As reported by TOI, Health Minister Ghulam Nabi Azad and the Medical Council of India (MCI) recently discussed the amendment of the MCI Act, which in simple terms means that all MBBS students will mandatorily have to undergo a year-long rural posting before they officially graduate to become doctors.
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Why does the government want to implement this change?
This proposal was first introduced by former health minister A Ramadoss in 2007, but failed to take off. The reason why this proposal is suddenly being revisited is because India is facing a shortage of human resources in health, especially in rural and tribal areas, where the population remains vulnerable due to lack of medical resources and medical professionals.
Here are some shocking statistics for you…
2006
26% of Indian doctors live in rural areas providing services to 72% of the population. In contrast of this, the urban density of doctors ranged 4 four times to that in rural areas, and that of nurses ranged approximately 3 times higher.
2010
More than 34% of male health workers, 38% of radiographers, 16% of laboratory technicians, 31% of specialists, 20% of pharmacists and 17% of ANMs and 10% of doctors’ posts were lying vacant. This happened due to undue delay of recruitment of medical professionals.
2012
As per a Planning Commission study that TOI reported, there is a current shortage of 6 lakh doctors, 10 lakh nurses and 2 lakh dental surgeons.
What incentives has the government given to Indian MBBS doctors for rural service before?
As per the report by TOI, the health ministry has been continuously giving incentives for MBBS students to be an active part of providing their services in rural areas. According to these incentives, MBBS students who did one full year of rural service would be offered 10 marks as additional weightage.
Those who completed 3 years in the backward and tribal areas would get 30 marks. 50% seats in PG diploma medical courses would be reserved for medical officers in government service who had served for at least 3 years in remote, tribal and difficult areas. MCI chairman Dr K K Talwar told TOI that unfortunately none of these benefits have paid off until now. This could be a major reason why rural service is being made mandatory.
Does this mean good or bad news for MBBS students in India?
It’s a clear division that this if this amendment is implemented successfully, it is going to spell good news for the Indian medical field with more and more medical services penetrating to the poorest of Indian regions. As Dr. Talwar noted, services of 40,000 MBBS students will be utilized for 1 year in the National Rural Health Mission if this proposal is cleared. For MBBS students though, this is a clear flood of bad news for very obvious reasons.
Let’s take a quick snapshot.
The good side of having a rural stint compulsory
- In the whole year of rural posting, students will earn exposure to rural and tribal lifestyles and therefore be exposed to unique medical case studies.
- More students entering rural areas will mean more facilities being generated by the government for accommodation, clinic set ups, medical equipment, services, drugs and so on. This will in effect bring more development in those areas.
- Students will not be paid as interns but as doctors during that extra year of rural posting.
- Currently, in order to fill in the compulsory short term requirement of the rural services component, MBBS students are generally known to create fake papers, bribe rural representatives who fill in false attendance for students and so on. Fake entries, bureaucracy and bribery in this area will decrease if rural services are made compulsory.
- India will be at par with the norms of many other countries overseas such as Australia, where a compulsory component of rural service is to be completed before the student can graduate as a doctor.
The good side of having a rural stint compulsory
- The most obvious flipside for any MBBS student is going to be the herculean increase in the duration of the program. The Asian Age reported the sentiments of a few doctors on this issue. The current MBBS course is 5.5 years for MBBS, add 3 years of PG and then 3 more years for super specialization. This way, the total duration of study for becoming a doctor would come to almost 11.5 years.
- If the amenities and facilities for MBBS students to work and stay in rural and tribal areas are not set up reasonably well or if the environment for them to dispatch their services is not congenial due to whatever reason, there may an outrage in student community for adding a wasteful year in the already long and arduous coursework.
Let’s see what 2012 brings for all MBBS students in India. What do you think?