By Dr AK Srivastava
“Doctors have a big responsibility to bring smiles to the faces of suffering humanity” – NR Narayana Murthy
There has been a rapid increase in population since independence and now we are the most populous nation in the world. This phenomenon requires massive progress and development in almost all areas of human existence and welfare. Medical education is no exception to this fact. There are many types of treatment available like Homeopathic, Ayurvedic, Unani and Allopathic, etc. Here we will consider allopathic medical education which is the most popular and effective. We have witnessed tremendous growth in medical education and health care services rendered to the citizens of India by the government and private sectors. At the time of independence, we had very few medical colleges producing a limited number of medical practitioners. But the government has tailored a new policy of opening a large number of medical colleges in order to produce more doctors who can improve the health care of the general public. In almost all states, new medical colleges have been set up to meet the growing requirement.
If we analyse the whole situation carefully, we realise that we still have a long way to go and achieve numerous milestones in this field. It is true that “Vision 2015” has brought about a revolution, but the whole scenario has to be monitored and scrutinised discreetly for better results. The traditional and conventional approach has to be replaced by more strategic and modern policies and innovative research. We require dedicated, well-learned, better skilled doctors and other medical professionals who can take us to the status of excellent medical care provided in developed nations.
It is no secret that there is a tremendous craze among the young generation to pursue medical courses and become doctors. It is considered to be a dignified and privileged profession that can provide status, money and fame for youngsters in the future. Hence, every year fifteen to twenty lakh students appear in NEET (entrance exam) for MBBS course and almost three lakh MBBS students appear in NEET (PG) aspiring to achieve MD/MS degree. But the road leading to success is very difficult. Limited number of seats, reservation policy, limited number of government medical colleges, exorbitant fee structure in private medical colleges, shortage of experienced and qualified teachers, lack of adequate infrastructure and labs for internships, language barriers and an old-fashioned curriculum are some of the challenges that give a tough time to students.
As stated earlier, a large number of students aspire for admission to an MBBS course. There are very limited seats in government medical colleges. Hence, it is a big challenge to get a seat in a government college. The second category is private colleges. Here the fee structure is exorbitant, and it is beyond the means of most students. Only those students can get admission who come from affluent families There is no scope for middle or poor class students. The situation is rather tough in private and minority institutions or deemed universities. Reservation policies make the scenario worse for general candidates. It is a highly debated issue whether we should have reservations in the medical field or not. Much can be stated on both sides.
Thousands of MBBS aspirants are forced to go abroad for their degree as they fail to meet exorbitant expenses of private medical colleges in India. Moreover, they don’t get admission in their desired states through NEET. When they come back, their degrees are not recognised by the government of India. Hence, they have to qualify the FMG examination in order to be eligible for jobs and private practice in India. All these things are cumbersome and time consuming.
Sometimes people raise questions about the selection procedure for MBBS/MD/MS candidates. The procedure includes MCQ or answering objective types of questions on OMR sheets. There is no involvement of the practical side or personality test of candidates. It is observed that some students take up this profession simply because it is lucrative, not because they have the human and ethical moral values which are essential for this noble profession.
Recently, the government started numerous medical colleges in order to meet the challenge of the doctor-patient ratio and to enhance the basic medical services in rural areas. But there is a shortage of highly qualified and experienced teachers who can conduct classes and supervise young medical practitioners who are learning the tricks of the trade during their internship. The situation is quite grim in private medical colleges.
Commercialisation of medical education fails to provide ethical and humanitarian values to students. Medical education has become a lucrative and profitable business for the management of private medical colleges. MCI/NMS guidelines and other prescribed norms are frequently ignored. Sometimes it is difficult to observe these norms while other times there are so many financial constraints that force private management to adopt shortcuts.
It is mandatory for a medical college to have a running hospital attached to it. It is a known fact that many private medical colleges have well equipped infrastructure with encouraging inflow of patients but many times it is not possible due to several reasons like location of the college, facilities available and quality of doctors. It has been observed that many medical colleges admit fake patients and ghost facilities are paraded at the time of inspection. All this has a direct impact on the quality of education provided to young doctors pursuing medical courses.
The scenario is worse or more challenging when it comes to admission to MD/MS courses. Here all applicants are MBBS graduates and obviously their level of maturity and knowledge is quite high but government seats are very limited. The second choice is again private colleges or universities. Here the fee is exorbitant, and the stipend is also less. Moreover, the choice of the desired branch for candidates is difficult to get. In most of the cases, students have to fill a bond of serving two to five years (as the case may be). All this makes the situation complicated. There is an urgent need to address these issues in order to encourage more doctors to pursue higher education and research work.
It is true that the government has made tremendous efforts to improve medical education in India. Numerous medical colleges have been opened in different states. It is also true that the government cannot achieve hundred percent success in this field in a short span of time. The reason is very simple, as many factors are correlated and they will develop only simultaneously and in coexistence. Besides the medical colleges, 22 AIIMS have been established in different states within a short span of time. The government has already brought about a revolution by standardising the entrance exam. The students entering the profession should develop the spirit of sacrifice, service to humanity and commitment to patients. Other stakeholders like management of private medical colleges, nursing and supporting staff should try to contribute maximum to the best of their abilities as this is one of the most noble and sacred of professions.
(Dr AK Srivastava is Principal, DAV Inter College, Dehradun.)
