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Context: India’s medical education system has attracted a lot of adverse attention due to the medical students being evacuated from Ukraine. There are issues like delay in post-graduate counselling because of reservation-related litigation. Also, Tamil Nadu legislating to opt out of NEET.
Issues in Indian Medical Education
A serious demand-supply mismatch: The MBBS degree continues to be an attractive option and there are inadequate seats in terms of population norms. The seats in the private college are priced between Rs 15-30 lakh per year.
Paucity of Faculty: The government’s initiative to open new medical colleges has run into a serious faculty crunch. All that the new colleges do is poaching faculty from a current medical college.
Academic quality continues to be a serious concern. There are loopholes of ghost faculty and corruption.
Salaries of Faculty: In many states’ government-run and private colleges, the faculties are low and private practice is common. This ruins the academic atmosphere.
A complete disregard for students’ welfare: The private institutions do not treat students and their parents who come for counselling in a well way. The system is designed for non-resident and other wealthy Indians to capture the seats left unfilled due to their high prices. This is done using a percentile system for defining eligibility and not per cent, so that students with money and low scores can get through.
Mushrooming of dental colleges of dubious quality: Many students who don’t get seat in medical colleges settle for a Bachelor in Dental Surgery degree. Such colleges in number and of poor quality. Thus, India produced far more dental surgeons than were in demand.
Middlemen problem: The aspiring students are bombarded with offers from agencies ensuring seats in Nepal, Mauritius, Ukraine, Russia, China and so on. Many students who get admitted, often fail to clear the foreign medical graduate examination (pass rate of 15%).
Corporatisation of the health sector: The health sector is treated like a service industry with a profit motive, medical education provides human resources — like business managers. Universal need and information asymmetry are among the many reasons often cited to make the case for the exclusion of market forces in health services and medical education.
Increasing need for specialisation: It leads students to prove their worth at every level or pay through their noses. This explains the decline in attraction for the MBBS among a section of students.
So, what needs to be done?
Increasing Medical seats: It can be done by converting district hospitals into medical colleges through private-public partnership model (NITI Aayog seems to be moving in this direction).
A functional regulatory framework: Recent efforts by the National Medical Council (NMC) to regulate college fees is a step in the right direction.
Subsidising medical education: The government can do so even in the private sector, or look at alternative ways of financing medical education for disadvantaged students.
Quality assessments of medical colleges should be regularly conducted, and reports should be available in the public domain. The NMC is proposing a common exit exam for all medical undergraduates as a quality control measure.
Conclusion
It is hoped that the current scaling up efforts, which are most welcome, are re-envisaged to focus on quality and societal needs along with commercial viability.
Source: The post is based on an article “What ails medical education in India?” published in the Indian Express on 10th March 2022.
