Many Docs but What’s The Prescription? – Breakneck growth in the quantity of doctors is coming at the cost of their quality

Source: The post is based on an article “So Many Docs but What’s The Prescription? – Breakneck growth in the quantity of doctors is coming at the cost of their quality” published in The Times of India on 28^th December 2022.

Syllabus: GS 2 – Governance

Relevance: concerns with increasing medical colleges and doctors

News: India has increased its number of medical colleges and MBBS seats and it is closer to the target of one doctor per 1,000 population on aggregate.

How have medical colleges transformed over years?

Between 1980 and 2010: The private medical colleges increased rapidly between these years. This expansion was accompanied by corruption, substandard colleges that lacked the necessary infrastructure and faculty.

After 2011: A large number of new government colleges opened since 2011, especially in the southern and western states and Uttar Pradesh. The government also decided a policy to convert district hospitals into medical colleges to ensure one for each district causing an increase in the number of colleges.

Moreover, from 2014, 270 new colleges came up but many government colleges started to resemble private ones in having inadequate faculty and poor standards of teaching/ training.

What is the recent decision taken by the government?

The health minister has recently talked of a paradigm shift from an input-based to outcome-based approach. 

The input-based system focuses on ensuring adequate infrastructure, faculty and patient load, all of which impact the quality of teaching and training whereas the outcome-based only focuses on increasing the number of MBBS graduates.

Therefore, this approach of government of increasing doctors and medical colleges have many concerns associated with it.

What are the concerns with medical education and with the increasing number of colleges?

The increase in the number of colleges comes at the price of poor-quality teaching and training and hence poorly equipped doctors as more MBBS seats do not mean greater accessibility.

The fees even for government medical colleges have been increasing and seats being reserved for NRIs.

Further, the current medical entrance exam favours those with access to expensive coaching, richer and more urban households having a better chance of becoming doctors.

Moreover, there has been an irregular distribution of doctors even when the number of doctors has risen from 0. 5 in 2000 to 0. 9 per thousand, closer to the WHO guidelines.

For example, north and northeast India are facing shortage while south and west India have the highest concentration. Therefore, there could be areas where the doctor-population ratio could be as less as one per 10,000.

Moreover, MBBS graduates treating people without proper training is injustice to the citizens as they are expected to take charge in primary health centres to get initial training.

Therefore, bringing in more doctors is not the solution without realising the consequences of poorly trained physicians and taking firm steps to improve the quality of teaching/training along with proper distribution.