August 20, 2024
📰 FEATURE STORY
Is Modi’s ‘75,000 new medical college seats’ proposal the right approach?
Medical education in India is a complicated affair. As the world’s pharmacy, the Indian healthcare sector represents the best and worst of what’s possible. On the one hand, we’ve got world-class facilities, and people from around the world come here for treatment. On the other, the healthcare sector is still plagued by decades-old issues.
But what about the people, the doctors themselves? That’s where medical education comes in. In his Independence Day speech last week, Prime Minister Narendra Modi announced 75,000 medical college seats over the next five years. The main reason he cited was not wanting students to travel abroad for medical education. Is the proposal the right approach, and can it be achieved?
Context
Since Independence, undergraduate medical education hasn’t undergone any significant change. The curriculum has seen some cosmetic changes, and there have been modifications in admissions. Historically, most doctors have come from well-off backgrounds. Rural areas have always faced a shortage of qualified healthcare professionals. It’s easy to see why – urban areas are more attractive for higher earnings, better working conditions, and safer environments.
Since the 1980s, there has been a surge in the number of medical colleges in India, particularly in the private sector. However, some argue this didn’t result in healthcare access in many underdeveloped areas. Over the past decade, there has been a paradigm shift in the medical education landscape.
More public institutions are entering the arena. It’s a shift away from the private sector dominance that began in 2010. One study showed that between 1989 and 2000, 54% of private college graduates went abroad. Private medical colleges seemingly served as a springboard for careers overseas.
India faced the issue of retaining top medical talent. That didn’t stop the number of medical colleges ballooning in the 21st century. There were about 300 by 2009-20, which increased to over 700 by 2023-24. Tamil Nadu, Telangana, and Uttar Pradesh led the charge. This tracks, given India’s efforts to enhance its public healthcare infrastructure and address the physician-to-population ratio.
According to the government, medical seats grew by 61% to over 1.07 lakh in the past five years. The number of postgraduates has doubled in the past eight years. That’s thanks to more government medical colleges and the relaxation of norms to set up new medical colleges.
There was a problem. A study by the Centre for Social and Economic Progress showed that the increase in seats in public and private colleges at the undergraduate level was more than the expansion rate of medical colleges. More colleges admitted more students without augmenting physical and human infrastructure.
With this in mind, let’s get back to the doctor-population ratio. India has 0.9 doctors for every 1,000 people. That’s close to the WHO’s standard of 1:1,000. However, secondary care institutions continue to face a shortage of specialists. The Prime Minister wants to add tens of thousands of medical college seats. Will this be of any help?
VIEW: Much-needed proposal
A country with over a billion people needs more healthcare professionals across the board. If we look at it from a demand-supply issue, there’s a shortage of qualified doctors. While improving the doctor-patient ratio is one thing, the availability of nurses is even lesser, with the nurse-physician ratio at about 1.5:1 compared to 3:1 mandated by international norms. A couple of years ago, government data showed that the number of practising doctors and nurses was far fewer than those registered.
The government’s efforts at improving these indicators have paid off to some extent, thanks to more public medical colleges. The medical education regulator, the National Medical Commission (NMC), has helped facilitate more medical seats. The goal was to upgrade district hospitals into medical colleges under the Pradhan Mantri Swasthya Suraksha Yojana (PMSSY).
India’s healthcare system is four-tiered – grassroots, primary, secondary, and tertiary. Each level needs an adequate number of medical professionals. The shortage of skilled medical professionals is a big reason for India’s inadequate healthcare system. That’s only amplified in rural areas. The government’s commitment to increase seats is a part of its plan to democratise medical education. Making MBBS seats more accessible to a wider demographic will reduce socio-economic barriers that hamper equal access to medical education.
COUNTERVIEW: Not so fast
The proposal to increase the number of medical seats to produce more doctors might seem like an obvious solution. However, there are concerns about oversupply, lack of faculty, lack of opportunities, and falling standards of medical education. Former Union Health Secretary Sujatha Roa cited Andhra Pradesh’s engineering college boom in the early 2000s. The oversupply of poorly trained IT professionals resulted in the closure of hundreds of these colleges.
There’s no point in announcing and creating new medical colleges without solving the systemic issues like more and better-qualified faculty, increased budgetary allocation and expenditure, and ensuring overall good quality education. This is where the regional disparities in medical colleges come in. A large number of medical colleges are concentrated in South India, something the NMC has acknowledged. Most graduates prefer big cities for obvious reasons.
Indiscriminately creating new seats could become part of the problem. While most MBBS seats are occupied, a sizeable number at the PG level remain vacant. Also, the rural doctor shortage isn’t an issue of supply. It’s just that most aren’t willing to practise in those areas. Medical education is becoming expensive in public colleges. The fees at private institutions are already high. The result could be a business model where doctors want to only serve people who can pay.
Reference Links:
- Medical education in India: Democratisation through public infrastructure creation – ORF
- India Has Recorded 110% Rise In MBBS Seats Since 2014, Parliament Informed – NDTV
- India is increasing medical institutes and seats but that will not be enough to improve healthcare – Scroll
- Data: MBBS Seats have doubled in the last 10 years; Huge Regional Disparities with South Leading in Availability – Factly
- Modi promises 75k new medical seats so students need not go abroad. Why this may become ‘part of problem’ – The Print
What is your opinion on this?
(Only subscribers can participate in polls)
a) Modi’s ‘75,000 new medical college seats’ proposal is the right approach.
b) Modi’s ‘75,000 new medical college seats’ proposal is the wrong approach.
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