What’s in store for this generation of medical students?

Even before a medical student finishes her five-and-a-half-year MBBS course, she starts worrying about the future because there's very less scope for a regular MBBS doctor in today's competitive world. According to third year KMC, Manipal student Abhijeet Sharma, the only options are to either serve as a resident medical doctor or to start a private practice. But that's extremely difficult considering everyone wants to go to an MD or MS.

Another third year Manipal student, Nikita Agarwal agrees, 'These days every person wishes to avail the best of all facilities. Sadly, they judge a doctor, not by his experience, but by the number of letters after his name on the letterhead. It, in a very subtle way, kills the passion that a pre-med had before entering the field of medicine.' Most who can just leave the country for greener pastures, but it's not only for more money. Not only do doctors have a better standard of living but they also get more clinical hours.

What will happen to rural India?

Another major bone of contention for MBBS students all over the country is the proposed compulsory rural service for medical students. While the government is hell-bent on sending all MBBS doctors for a rural stint, most observers and experts disagree. Renowned medical researcher and academician Dr Madhav G Deo spoke out against it claiming that sending inexperienced MBBS doctors is madness. (Read: Save the Doctor: The burden of being a doctor)

What do the medical students think about this?

They feel working in rural India is not a problem but it should be on their own terms. Spandita Ghosh, a third-year medical student from KPC Medical College, Kolkata says, 'Doctors do want to work in rural India. We just don't want to work in a useless system. If the infrastructure, proper medicines, hygienic conditions, other helping staff are not available, what can we doctors alone do? Forcing doctors to work in hostile conditions is not the way to solve the issues. Corruption has to be cut off at the root level. The funds have to reach the correct hands. Doctors after five-and-a-half years of rigorous training have to be inspired to take up rural practice, not forced into it by some compulsory bond before even guaranteed a PG seat.'

Many feel that rural service should be made part of the PG curriculum. Abhijeet Sharma adds, 'Doctors want to work in rural India but sending fresh graduates isn't the solution. It's not fair on medical students. Why can't the rural posting be part of the PG curriculum? Rural areas have a deficit of specialist doctors, not general physicians'. (Read: 'The Govt's decision to send inexperienced MBBS doctors to rural India is flawed ' (Expert Interview))

Was NEET the solution?

One hope which was recently squashed was NEET an exam for all pre-medical students which looked to level the playing field and make sure that only the meritorious made it to medical school. Sadly, it was scrapped by the Supreme Court who in a split decision ruled against it. The exam would've applied to both government and private colleges. 'It was the one hope to bring transparency to medical education in the country,' says Sharma. Professor Anand Kumar, Professor of General Surgery at Benares Hindu University agrees, 'It would have given the thrust to medical education in a positive direction.' In time it was believed a similar exam would have helped level the PG playing field as well.

Is equalizing the number of UG and PG seats the right solution?

Are we prepared to train such a large number of post graduates? Do we have the required infrastructure? Professor Anand Kumar disagrees. He says: 'It seems the motive isn't to provide quality education. Have people thought of the kind of training being imparted to young post graduates? The institutions are functioning like factories and providing the degrees without a standard evaluation system. There should be a central examination system for the postgraduates as being practised for DNB and then see the impact. Majority of the universities have the examiners whose threshold is so low that they would yield to all kinds of pressures. Imagine what would happen if the number of seats are increased and everyone passes the examination without a proper training and evaluation.'

The problem is compounded by the fact that there are so many seats which are reserved at undergraduate and even postgraduate level (almost 40% by some estimates). 'On one hand the government talks about equality and equity for the people and on the other hand we see it contradicted why is there reservation in professional education? This is the main reason for brain drain in the country,' Dr Anand Kumar asks. It seems like the solution to the medical education isn't simple but we need to solve it soon or suffer the ramifications for years to come.

For more articles on medical education, check out the medical education section.