New Delhi: Recently, Goldfield Institute of Medical Sciences and Research, Ballabhgarh (Faridabad) was in news for shutting down its operations and Gian Sagar Medical College and Hospital, Banur (Patiala) was not even able to pay the salary to its faculty and other staff leading to general strike and suspension of the classes. Are these isolated cases or just an indication of harsh and unpleasant things to come?
Speaking to India Medical Times, Dr Raman Kumar, President, Academy of Family Physicians of India, said, “I don’t think the medical field is leading towards recession or is facing some sort of a downfall. At least not at the moment but it might happen in the coming times.”
According to Dr Raman Kumar, some medical colleges are shutting down because of the traditional process of recognition of medical colleges by the Medical Council of India (MCI). “They keep giving recognition to the colleges in every one or two years. There are different reasons for this, most of the time it is the lack of faculty which is the most common reason for the pending of recognition of medical colleges.”
He further said, “In the last five years, the number of MBBS seats has been almost doubled, like in 2010 there were 25,000 medical seats in India and the current number is almost more than 50,000. The number of medical seats has been increased but further job prospects have not been increased. The fruitful engagement of medical graduates in health sector is still missing.”
“The concept of campus placement is not at all there in medical field; they have to look for jobs on their own. You will never hear that some residents were hired on a nice package,” said Dr Raman Kumar.
He also said, “In India there are almost one-lakh vacancies in the public health sector but the production of doctors is of only 50,000 per year. Though the population has increased in the last 20-30 years but the hospital infrastructure is still based on the old population records; even the number of working doctors or recruitment plans is formed based on the old records which leads to the long working hours of doctors.”
“It’s paradoxical. If the demand is high then their requirement must be there but it’s not like that. There are only one lakh job vacancies for doctors in the public health sector, which should be increased as per the increase in population. But in most of the states, doctors are hired on an 11-month contract basis under the NRHM (National Rural Health Mission). Doctors don’t go for this, as this is not sufficient for normal survival. Gradually, the interest of students in medical field is decreasing,” added Dr Raman Kumar.
Dr Manoj Sharma, Professor of Radiotherapy, Maulana Azad Medical College, New Delhi, told India Medical Times, “Dental colleges are shutting down and many other colleges might face this situation as the new NEET (National Eligibility cum Entrance Test) rule has been cleared by the Supreme Court which will keep a strict eye on the process of admission.”
However, he said, “I don’t think that the zeal for medical profession is decreasing among students, you can easily see the enthusiasm among students who appear for the medical entrance exams.”
He said there might be a few possible reasons affecting the smooth running of medical colleges. “First is the increase in capitation fees. Second is unavailability of faculties, colleges must have specialist faculty for different departments as shortage of faculties will lead to shutdown of the college.”
Dr Sharma said it would be ideal if the kids from down fortune families are taught in some Kendriya Vidyalaya like school and then they are made to compete in the entrance exams like the CMC Vellore. This model of CMC Vellore is a very important model as this will also lead to the production of quality products. District medical colleges should be started in district hospitals; this will also solve the issues of shortage of doctors.”
Dr Ashok Kumar Tiwari, a Chief Medical Officer attached with the Bihar Government Health Services, told IMT, “People do have interest in medical field. If you ask school going children they still want to be a doctor. So, I don’t think the medical profession has lost its values in anyway.”
“But then if we see that many medical colleges are shutting down it has got different reasons; in government medical colleges less number of doctors are produced but there are huge demands for doctors in different parts of the country. The demand for doctors is more at the district level but the supply of doctors is not even sufficient at the PHC (primary health centre) level. Our structure of distribution of doctors is very old, that too of the British time but our population has increased since then,” said Dr Tiwari.
He further said, “In my view, there must be something like medical school at the block level. And the students from such medical schools should be placed in the primary health care system. The other MBBS and MD/MS doctors can be directed to other medical colleges and hospitals. This will strengthen the medical and health sector. We do have medical colleges but at the same time we do need faculties to run classes. However, due to unavailability of specialist faculties in medical colleges many colleges are shutting down.”
“Also, private medical colleges pay more to their faculties compared to government medical colleges which is also one of the reasons of unavailability of faculties and other doctors in government health sector,” he added.
Dr Narendra Malhotra, an IVF specialist and endoscopic surgeon based in Agra, told IMT, “Definitely people are less interested in this field as compared to earlier as earlier doctors were seen as God but nowadays this profession has lost its value.”
He said, “The medical profession is viewed more as a business profession which might make this profession to face some sort of a downfall. Nowadays other professions like engineering and computer science have got more value as compared to medical profession and it takes a very long time for a doctor to get settled like they have to do MBBS then MD and then go for practice, whereas other professionals like engineers get settled soon. And even then there are a lot of laws for medical practitioners to follow.”
Dr Malhotra further said, “Less interest of students towards medical education will probably be good initially as there will be only interested candidates in medical profession.”
Not agreeing with the common perception of lack of sufficient doctors, he said, “We don’t have less number of doctors; we do have sufficient number of doctors. It’s just that doctors are not distributed properly in urban and rural areas. Our population has to travel a long distance to get good treatment. We have to strengthen the rural healthcare centres. The government has to think of putting good and experienced doctors in rural centres to strengthen it.”
Speaking about the compulsory rural service mandated in some states, Dr Malhotra said, “I think rural posting for fresh graduates are not a good decision as the junior most doctors don’t have that much patient handling experience and practical experience. The government must make it compulsory for senior doctors to have a rural posting to get promotion, this way more experienced doctors will get to work in rural parts of the country and that will strengthen the rural medical centres also.”
He said, “Though less doctors are currently interested in working in government health departments since the government does not provide that much facilities to its doctors as in private hospitals, but soon there will be saturation in private hospitals; they will not need that much doctors, so doctors will have to look for work in government hospitals. But still the government must do few things to increase the standards of government hospitals and at the same time must be more supportive and understanding towards doctors.”
by Pooja Pandey