“The only thing more expensive than education is ignorance.” — Benjamin Franklin
Perhaps, there is not a more suitable quote describing the current state of medical education in India. India has an astounding 426 recognized medical colleges imparting training to 53,455 medical students at any given time. Yet, the country has a dismal ratio of 7 physicians per 10,000 population and its major health indicators show it as one of the worst performing nations. India also has a unique and troublesome feature of brain-drain where medical graduates from India migrate to western nations looking for better pay, career opportunities and lifestyle.
Of these 426 medical colleges offering MBBS (Bachelor of Medicine & Bachelor of Surgery) course, majority are private. Except for a handful of exceptionally excellent colleges, private medical colleges in India are infamous for charging capitation fees wherein medical seats are exchanged for a lofty sum of money. These medical colleges function on negligible to basic infrastructure, ghost faculty and vacant wards and OPDs (outdoor patient departments). One can imagine the quality of doctors churning out of these corrupted institutions. Since most of these private medical colleges act as cash cows for political heavyweights, the government has also not done anything significant to adequately address their quality issue. The story is not very sunny in government medical colleges too. Again, other than a few extraordinary performing institutes like AIIMS and PGIMER, most of the government medical colleges are short on infrastructure, facilities and faculty.
Outdated syllabus and encouragement of rote-learning only add fuel to the fire. Medical science needs to be constantly updated to maintain its relevancy and efficiency. But medical education in India follows out-of-date regulations and teaching methodology. Medical students are evaluated on their theoretical knowledge and the ability to rote-learn maximum amount of facts through short and long answers written in response to exam question papers. Their clinical acumen and communication skills are hardly evaluated. Again, there is no special emphasis on research. Research projects by medical students are given no extra credits or support and in some places are even discouraged and frowned upon. Teaching methodology is also of colonial era and is heavily relied upon didactic lectures. There is not much emphasis on the use of modern communication tools and there is no separate training for teaching and innovations. Due to very limited number of residency seats and government reservation policies, medical students start preparing for postgraduate entrance exams right from the second or third year by attending coaching classes (mugging schools), all the while ignoring their clinical duties and bedside learning.
It is high time that India conducts a ‘Flexner reform’ of its own. Research and innovation should be encouraged at student level along with the incorporation of modern teaching and training methodology and tools. The government also needs to crack down on medical colleges working without an infrastructure and either shut them down or revamp them with modern standards. Medical education should transition from singular rote learning to a more holistic approach that can benefit the nation in long run.
The writer, Ankit Raj, is a Final Year MBBS student at Kasturba Medical College, Manipal.