Wednesday, December 30, 2009

The Changing face of Medical Education in India

The Changing face of Medical Education in India

The Union Health Minister, Gulam Nabi Azad has announced a series of
measures to improve rural health care facilities. Shortage of doctors
willing to work in rural areas and shortage of hospitals are two main
problems affecting the proper implementation of National Rural Health
Mission. Most Primary Health Centers (PHC)s are under staffed. In
order to address this serious lacuna several measures have been
initiated by the government.

1. Private Medical Colleges and Hospitals are being encouraged. Rules
for setting up Medical colleges have been amended under MCI.
Government has sanctioned opening of 19 Institutions on par with AIMS
and 250 Nursing Colleges. The latter move will provide an output of
20000 nurses in forthcoming years. Of the 300 medical colleges in the
country, 150 colleges are in the private sector, with 80-85 per cent
of the colleges located in south India, mainly in Karnataka, Andhra
Pradesh, Maharashtra, Tamil Nadu and Kerala. To offset this imbalance
of heavy growth in southern and western side, medical colleges in
hilly regions will be given additional incentives. Now it would be
enough to have 20 acres of land instead of 25 cares to start a medical
college in hilly areas.
2. A new Cadre of doctors, especially to serve only in rural areas has
been proposed. There will be a "four-year-first-level" degree in
medicine. Three years of Education and one year of Internship is
planned. Syllabus has been framed and State governments have to take
action. This cadre will be lower in status than regular MBBS and those
who qualify will have to stick to rural areas only.
3. To encourage MBBS doctors to work in rural areas, some additional
grace marks will be given in the National (Medical) Entrance
Examination for PG courses in Medicine. Grace marks vary from 10% to
30% depending upon the number of years (1 to 3) the doctor serves in
rural areas. If a doctor fails to get a seat in PG diploma even with
this grace marks, then he can be considered for admission under 50%
reservation of seats for those who have rural practicing experience.

While I welcome above measures, the last one makes me a little
skeptical. Does this mean that low quality doctors are OK for rural
masses? For instance, let us assume that a doctor is asked in the
entrance examination the following question:
Where is kidney located?
a) In the head
b) In the feet
c) In the abdomen
d) Near the heart
If he answers anything other than "C" then he is doubly at fault – Not
knowing where kidneys are located and not knowing various parts of
abdomen. By giving grace marks and pushing him up to do PG in medicine
is atrocious to think of. Quality should not be sacrificed at any
cost. Opening more colleges and creating more seats is fine.
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(Published by PVM in his blog and Merinews as well)

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