The serious shortage of health workers, especially doctors, in some northern States is a major impediment for achieving the health-related Sustainable Development Goals. Health workers are critical not just for the functioning of health systems but also for the preparedness of health systems in preventing, detecting and responding to threats posed by diseases such as COVID-19. This shows the inherent issues in medical education in India.
- Inter-state and intra-state inequality in the distribution of manpower and resources: There is a huge disparity in availability of opportunities for students across states. 2010 report by MHRD had stated that four states – Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu – account for 1.3 lakh out of 2.4 lakh medical seats across India.
- There is also a glaring rural-urban disparity in both availabilities of health care and colleges.
- A blanket standard for starting a medical college leads to neglect of states like Arunachal Pradesh, Mizoram, Nagaland etc. and rural areas.
- Amidst this situation, new medical colleges can bring in uniformity of access across sates and fill the demand-supply gap.
- MCI regulations prevent experienced MBBS doctors from carrying out procedures like cesareans and ultrasound tests. Experienced nurses are barred from administering anaesthesia. This leads to failure of utilizing the experienced manpower to increase the service delivery.
- Another casualty of the Super-specialty craze is Research and teaching, as no one is choosing research or teaching as their preferred career.
- To meet the significant shortfall of qualified doctors in northern States, scaling up of medical education is warranted.
- However, the NITI Aayog’s proposal of allowing private entities to take over district hospitals for converting them into teaching hospitals with at least 150 MBBS seats, may sound attractive but there are reasons to be deeply concerned.
- Through the implementation of such a policy, the private sector in medical education will be encouraged.
- It will also directly aid the corporatisation processes of healthcare provisioning while the under-resourced public health system will be a collateral damage.
- District hospitals are considered as the last resort for the poor.
- The corporatisation will make the services very costly and exclude them from getting care.
- Even from the perspective of producing more doctors to meet the shortages in under-served areas, this is unlikely to yield the desired result.
- Private players treat medical education as a business.
- Additionally, the medical graduates trained in such private sector ‘managed’ medical colleges will prefer to find employment in corporate hospitals and not in rural areas to regain their investment.
- Further, this proposal is not aligned with India’s national health policy goals like achieving universal health care and health equity.
- Instead, it will widen health inequalities further.
- The National Medical Commission Bill, 2019 was passed recently by the parliament. The bill sets up the National Medical Commission (NMC) which will act as an umbrella regulatory body in the medical education system. The NMC will subsume the MCI and will regulate medical education and practice in India. Apart from this, it also provides for the reforms in the medical education system.
- To meet the significant shortfall of qualified doctors in northern States, scaling up of medical education is warranted.
- However, the NITI Aayog’s proposal of allowing private entities to take over district hospitals for converting them into teaching hospitals with at least 150 MBBS seats, may sound attractive but there are reasons to be deeply concerned.
- Through the implementation of such a policy, the private sector in medical education will be encouraged.
- It will also directly aid the corporatisation processes of healthcare provisioning while the under-resourced public health system will be a collateral damage.
- District hospitals are considered as the last resort for the poor.
- The corporatisation will make the services very costly and exclude them from getting care.
- Even from the perspective of producing more doctors to meet the shortages in under-served areas, this is unlikely to yield the desired result.
- Private players treat medical education as a business.
- Additionally, the medical graduates trained in such private sector ‘managed’ medical colleges will prefer to find employment in corporate hospitals and not in rural areas to regain their investment.
- Further, this proposal is not aligned with India’s national health policy goals like achieving universal health care and health equity.
- Instead, it will widen health inequalities further.
- There should be a substantial step-up in public investment in medical education.
- By establishing new medical colleges, the government can increase student intake as well as enhance equitable access to medical education.
- Besides, it must allocate adequate financial resources to strengthen the overall capacity of existing medical colleges to enrich student learning and improve output.
There should be a substantial step-up in public investment in medical education. By establishing new medical colleges, the government can increase student intake as well as enhance equitable access to medical education. Besides, it must allocate adequate financial resources to strengthen the overall capacity of existing medical colleges to enrich student learning and improve output.
