[Answered] Discuss the potential implications of introducing a three-year diploma course for medical practitioners to serve in primary health centres (PHCs). Analyze both the potential benefits and drawbacks of such a proposal.

Introduction: What is the proposal for a 3-year diploma course?

Body: What are its benefits and drawbacks?

Conclusion: What should be the way forward?

Recently, West Bengal Government proposed to start a 3-month diploma course for medical practitioners who would then serve in PHC. The main reason given for such an initiative is to address the shortage issue of medical professionals in rural areas.

What are the benefits of this proposal?

  • Rural area centric: The proposal plans to address the problem of rural aversion in the medical field. The focus will be on Primary Health Centre which is a crucial infrastructure for rural areas.
  • Continuity: The proposal ensures that continuity in healthcare is maintained as these practitioners will coordinate with ASHA workers to spread health awareness.
  • Experience from other countries: Various short-term courses in developed and developing countries have shown that these courses can provide good care of good quality at the primary level.
  • Rural Retention: The focus on rural retention of practitioners is a vital step to decentralizing health infrastructure which is largely concentrated in top cities and towns.

What are the drawbacks of this proposal?

  • Inadequate training: A diploma course may prove to be inadequate as rural areas offer multiple challenges which go beyond training and require efforts to deal with critical care situations, tackling transport and infrastructure challenges that a basic diploma course may not be able to cater to.
  • Focus on physician assistants: Need is to train them so that they can provide emergency support and later bring the patient in contact with a professional doctor.
  • Discrimination of rural areas: By providing mid-level practitioner who is diploma holder rather than full-fledged doctor there is discrimination between rural and urban areas and these diploma holders may not be adequately qualified to deal with health situations.
  • Future of practitioners: The major drawback of the proposal is what will be the future of these practitioners once they have completed a certain period of service. Whether they will be considered a full-fledged doctor or they have to again appear for exams is a big question mark. Also is the question of their acceptance into the medical fraternity.
  • Disincentives for doctors to practice in rural areas: The proposal may lead to doctors neglecting the rural areas as they will feel that alternates in the form of practitioners will be available in rural areas. More and more doctors will opt for urban areas.
  • Medical colleges: There is a need to address the disparity in the density of medical colleges in the country.


This proposal should not stop the need for private investments in healthcare which is needed to address the issue of lack of medical colleges in Eastern and Northern India. There should be a focus to redistribute colleges in rural areas and hire doctors from rural areas as the only solution to retain healthcare providers in rural areas.

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