We have a lot of misconceived notions about doctors. We think they live a cushy life that once they've finished their MBBS course they are guaranteed a steady income, a decent quality of life and are assured of a respectable position in society. What we don't know is that even after that they end up swotting for years in classrooms trying to get a post graduate seat.
While various colleges across the country have 45,600 MBBS seats there are only 12,000 PG seats in the various clinical subjects. In comparison, there are 3.5 lakh AICTE approved MBA seats (and many more unapproved ones). Even in comparison with other countries, the US has 19000 UG seats and 32000 PG seats. And that is the wrong that Save the Doctor a massive campaign to get the government to equalise the number of UG and PG seats is trying to undo. The demand is simple equalise the number of UG and PG seats.
The burden
The curriculum is extremely tough, it requires long hours of work and there is no such thing as leisure time at all! It takes almost 12 years to become a super-specialist doctor. In that timeframe, most other professionals (engineers, architects, lawyers, etc.) end up rising to comfortable positions in their own fields with the ability to support their families comfortably and live a quality life.
This is further burdened by expectations society pins on doctors. Dr Suranjana Basak quips, 'There is a certain image of an ideal doctor that the society holds. In the constantly evolving field of medicine, it is difficult to live up to those expectations that common man hold up for a doctor. Everybody tries to live up to them and would love to.'
Inevitably, the long time to train doctors is hurting our healthcare system. Dr Devi Shetty of Narayana Hrudayalaya says, 'It is a sad plight that nearly two lakh young doctors in our country, at the peak of their youth, spend quite a few years in coaching classes mugging multiple choice questions rather than treating patients and learning the art of healing. These doctors, under the right circumstances, can significantly improve the quality of healthcare. Every Indian household once dreamed of making their child a doctor, but today, it is considered a costly and tedious process.'
Useless swotting?
Dr Madhav G Deo, member of the Academic Council of the MCI agrees, 'PG seats are now offered through a common entrance examination often consisting of multiple choice questions (MCQ) which test your knowledge only superficially. Even a mediocre person can make it to the top through coaching classes without much knowledge. It is true that our medical courses tend to be more theoretical. That is necessary as a part of education but medicine cannot be practiced without gaining expertise in patient oriented skills. This is true, more so for all surgical disciplines. You cannot be a surgeon if you lack practical skills. We are extremely poor in this area. Doctors coming out of medical colleges lack practical knowledge.' He believes that the shortfall this country's healthcare sector is facing isn't due to the number of doctors but the scarcity of specialists something he's mentioned in his paper that appeared in the April issue of the ICMR journal. (Read: The government's decision to send inexperienced doctors to rural India is flawed...)
But won't too many doctors ruin the current professor-student ratio in medical colleges?
Campaign coordination Dr Navneet Motreja doesn't think so. He says, 'Right now the teacher-student ratio in majority of the PG courses all over the country is 1:1. Making it 1:2 or 1:3 will not drastically affect the quality of post graduate medical education because for every doctor, the patient is the textbook.'
What happens to the others?
In this day and age, it's become almost impossible for a doctor to practice without specialisation and just an MBBS. Many end up in other streams, while most keep on chasing the elusive dream, wasting years of their lives without anything to show for it. Dr Madhav Deo believes it's essential that everyone who enters a medical seat should be assured a PG seat. 'This needs innovative thinking and ability to bring about drastic changes in our medical curricula which is a difficult task but not impossible. I am not sure if the MCI, which is too traditional, can evolve such a novel system,' he says.
The outcome
In the long the continuation of the current scenario will worsen the nation's health system. Despite having more medical graduates we'll end up with doctors with no specialist training those that don't know how to treat cancer or perform a heart surgery or treat a kidney ailment. We are going to end up with a huge number of MBBS doctors who will either be too disillusioned after repeated attempts to get into a speciality or who seek other career choices which will pay them in tune with their mental faculties. And the country will suffer and journalists will keep on writing editorials that will harp on about how after so-so years of Independence we don't have enough quality doctors for our ever-increasing population.
So please log onto www.savethedoctor.in and SEND THE APPEAL to the honourable Union Health Minister Ghulam Nabi Azad to save the country's healthcare system.
To those that are too lazy to do, I would like to quote a line from Dante's Inferno, 'The hottest rung in hell is reserved for those who, in times of great moral crisis, maintain their neutrality.'
For more articles on medical education, check out the medical education section.
