Reservations in super-speciality courses: The Dravadian model of public health

News: Supreme Court judgment upholding OBC reservation in NEET is a landmark judgment. Merit has to be contextualized socially and seen as an instrument of advancing social goods like equality. Tamil Nadu model where merit also takes historical privileges into account can be replicated in the rest of India.

What is the model adopted by Tamil Nadu? 

It introduced a scheme that provide 50% reservation of postgraduate and super-speciality medical seats for government doctors. To avail of the reservation, candidates have to serve three years in Primary Health Centres (PHCs) in rural areas.

The scheme also introduced a superannuation bond, to ensure that the doctors who are availing the reservation benefits must serve the government till their retirement. It’s legally binding to prevent the brain drain of the doctors either to the private sector or to places abroad.

How the scheme proves beneficial to Tami Nadu?

Expansion of public health infrastructure: It contributed to a steady rise in the availability of multi-speciality experts in metropolitan cities like Chennai, Coimbatore and in Tier-2 cities. Presently, the public health sector in Tamil Nadu has 900 super-specialists in different disciplines like Urology, Nephrology, Cardiology etc

No shortage of doctors in rural areas: It encouraged young MBBS graduates to serve in rural areas. State PHCs and government hospitals never witnessed a shortage of doctors and people got better healthcare facilities at their doorsteps.

How does the introduction of NEET affect this scheme?

With the introduction of NEET and Regulation 9 by the Medical Council of India (MCI), weightage for government doctors who serve in rural areas has been reduced. According to MCI policy, only 50% of postgraduate diploma seats are reserved for service doctors, and MCI also exempted service doctors for postgraduate degrees.

It is now compulsory for individual States to surrender all the seats of super-speciality courses to the central pool for common counselling. The new rule also abolished the government doctors’ reservation.

What is the Supreme Court view?

Service Doctors and Postgraduates Association filed the case for the reintroduction of 50% of service doctors’ reservations in super-speciality courses. The court has now directed the Centre to provide reservations for service doctors in super-speciality courses.

Source: This post is based on the article “The Dravadian model of public health” published in The Hindu on 27th January 2022.