There has been a very significant rise in the number of aspirants for the MBBS/undergraduate medical courses in India over the last few years.
From about 11.4 lakh registrations in 2017, the NEET-UG 2021 registrations have increased to around 16.1 lakh.
Even the pandemic year could not dampen the spirit as it witnessed a significant increase in registrations.
The doctor population ratio in the US is around 2.6:1000. In India, it is 0:9:1000. This indicates that India needs many more doctors to be on a par with the first world countries.
On many occasions, even if the child is not much interested in becoming a doctor, some parents tend to force him or her in the hope of a safe and secure future, though the student may be of average merit.
Although there is a demand to increase the number of doctors, the issue of merit and social commitment remain unanswered on many occasions.
The question remains whether the deficiencies in merit or social commitment, which are indispensable for this discipline, can be compensated with financial considerations. There is no doubt
that government medical colleges cannot produce the quantity of doctors necessary today and private medical colleges are necessary, but the question we tend to avoid is whether the quality of the medical profession gets compromised.
The present situation is challenging for all medical professionals. The present number of undergraduate seats exceeds 83,000 annually.
There are around 275 government medical colleges and a similar number of private colleges.
Those graduating from government colleges need to serve a bond, the duration of which varies from state to state. Similar rules apply after postgraduation.
However, it is true that MBBS candidates can easily get a government or corporate job without any campus interview as in many other professions. The common notion of many parents that their children who will earn a huge income initially is a total misconception.
The salaries of corporate or government medical officers are reasonable but nothing fantastic. Even most of the specialists or superspecialists, in government or corporate jobs, earn reasonable salaries only.
There are of course a few superspecialists who earn a higher income but the number is too few.
Success in corporate hospitals largely depends on commercial viability. In spite of seniority or many years of excellent performance, some become liable under the consumer act for compensation or the respective medical councils if found guilty in case of complaints.
Unlike the earlier days, workplace violence is also a critical issue today.
Merit or money
The introduction of private medical colleges has brought about a conceptual change in the medical system of our country. A few years back, a parent approached me to know which superspeciality can provide the maximum income in a short time as their daughter had opted for a private college admission with a huge cost. I explained that earning back the crores spent in an ethical manner would be difficult. My effort to dissuade the parents failed as this was their cherished dream. Such is the craze.
There are some private colleges that have adequate infrastructure and faculty, but not all. There have been many complaints in this regard. According to an estimate, Rs 300 to Rs 400 crore is necessary to develop a private medical college with an annual expenditure of at least Rs 50 crore. It is really difficult to maintain this without charging exorbitant fees. In general, the infrastructure and facilities of government medical colleges are superior compared to many private colleges. There have been complaints that clinical training in some private colleges is inadequate because of low patient volume, though the students earn the same degree after clearing the requisite examinations.
In general, graduates from government medical colleges are held in high esteem for both merit and clinical experience.
Patients and their families have many queries but they hesitate to ask. Whenever a patient consults a doctor, he or she is keen to know the training and expertise of the person, which on many occasions is unclear to them. They can always make a better choice if all information is laid bare to them.
The extent and quality of training of a doctor in the speciality is considered crucial by the patients.
These uncomfortable questions are nothing unusual today as patients pay significantly in the corporate sector and are entitled to know. Compensating merit with money is probably not welcome.
Parents who are so keen to see their children as doctors must realise that unlike many professions, it may take 15 years of intense study and training to be a superspecialist in India.
This involves huge sacrifices both in personal and professional life. Keeping focus and commitment for such long years is difficult. Forced entry to the MBBS course can affect mental health and unfortunate events have been reported.
However, there are many achievers and they are an invaluable asset to society and the country.
⚫ Gautam Mukhopadhyay is secretary of the Bengal Oncology Foundation and clinical director of the department of surgical oncology, Peerless Hospital