According to surveys conducted in various hospitals, it was found that 75% of doctors’ face violence at the workplace. This is mostly due to an underdeveloped, poorly equipped and crippled healthcare infrastructure.
Doctors become the scapegoat of the wrath of public towards the government. Statistics also suggest that in India, there is one government allopathic doctor for every 10,189 people and this is not because doctors don’t want to join government hospitals but due to non-recruitment of doctors against vacant posts. Statistics also suggest that around 80% of specialist posts at community health centres (CHCs) or district hospitals lie vacant. So our CHCs don’t have paediatricians, gynaecologists, general physicians or surgeons. And without them, our government wants to improve infant and maternal mortality rate.
On an average around 7,00,000 enthusiastic students appear for pre-medical entrance test every year against around 64,000 seats. This is roughly 10% of total aspirants. This means 90% of the enthusiastic young and creative minds, who are passionate to serve humanity were discarded by our poor medical education system.
Till 2017, India had 460 medical colleges as recognized by the medical council of India, from where 63,985 graduates pass every year. We need 500 more medical colleges to fulfil the needs of healthcare delivery. The Indian government, with its reluctance to invest in medical education, has built 460 colleges in 70 years. How many years will it take to build another 500 is open to interpretation. This is only one side of the story where India lacks severely in making new doctors. But the agony doesn’t end here because our government is not able to utilize the already trained doctors’ workforce.
Firstly, when it comes to training of specialists, around 90,000 MBBS doctors appear for postgraduate entrance examination out of which only 10% will get admission in specialist courses and 90% doctors are again discarded. This is a situation of the country which lacks 80% of specialist and has one of the highest infant mortality rate and maternal mortality rate in the world. Everyone blames doctors and says that they don’t want to work in rural areas, but the problem is with the cumbersome recruitment process, underdeveloped primary health care system, non-availability of resources and hospital staff, poor referral system, non-livable conditions and many more.
The image of the medical council of India (MCI) which is central regularity authority that maintains uniform standards of medical education in the country and recommends recognition/de-recognition of courses offered by medical colleges, was once described by the court as “a den of corruption”. It is again under the scanner with the arrest of the assessor of the council by CBI on September 19, 2017. The CBI said that he was involved in the leaking of strategic information to the owners/management of medical colleges/institutions in return for huge periodical illegal gratification.
If the regulatory body is becoming the den of corruption then how we can expect good quality medical graduates? Medical education will move into the hands of the rich people, and a corruption driven graduate won’t think about serving the poor. Another increased concern is that lack of doctors is seen as an opportunity by many private sector investors, and many private medical colleges are coming up. With around 1% of GDP investment by government, we can’t expect much. We need more doctors, but not at the cost of corruption. Medical education has become a commodity or investment platform.
The government came with the new formula to increase doctors and medical colleges in India. That formula will work under national medical commission. This commission allows students of alternative medicine or AYUSH to practice evidence-based medicine after bridge course. There is no clear description of the purpose of this course as India still have the sufficient number of medical aspirants and also specialists but denied seats and employment under poor health care system.
The medical education system needs sudden reforms which include enhanced government setups with more investment into healthcare, a strict regulatory system with independent functioning rather than being a puppet in the hands of rich and powerful. We need to ensure the recruitment of doctors on permanent posts rather than contractual or bonded forms, strengthening sub-centres, primary and secondary care centres, developing alternative medicine or AYUSH into an individual way of treatment rather than merging them to allopathy. Last but not the least, we need a sincere and hardworking health minister – preferably a doctor.