What ails medical education? Unlike engineering education, medical education in this country is still limited by number. While there are thousands of engineering colleges, starting a medical college is still governed by rather strict MCI norms and requires huge financial and infrastructure commitments, including setting up a hospital that the college will be attached to. In May this year, there were 355 recognised medical colleges in India and a total of 43,890 MBBS seats. Since then sanction has been accorded for a few new colleges, and some colleges were allowed to up the number of seats by the Medical Council of India (MCI). The three southern States of Tamil Nadu, Karnataka and Andhra Pradesh have amongst them the largest number of colleges, and consequently, MBBS seats. This year, Tamil Nadu alone was granted an additional 410 seats in government medical colleges, (while the fortunes of a few private colleges have waned). In the last two years, Tamil Nadu has been sanctioned an additional 610 seats, and the State has also committed to increasing the number of MBBS seats, by building additional infrastructure, including new colleges. Frenetic activity has ensued. The most daunting aspect today in medical education is the lack of trained, qualified human resources. Recently, Tamil Nadu Chief Minister Jayalalithaa, speaking at the convocation of the State’s medical varsity, remarked on the issue: “The role of the university in integrating the development of health manpower, with relevance to the real health needs and demands of the people of the State, has become accentuated in the present context. This should be the focus and direction of the education system.” MANPOWER SHORTAGE The fact is that we do not have enough health manpower in the country. Not for looking after patients and, certainly, not for teaching students. Most of the 40,000-odd students’ who pass out every year, prefer to go in for higher education and then super specialisation, only to take on a lucrative professional career in the private sector. A small percentage gets into education and goes on to teach in medical colleges. Again, the lucre is better in the private medical colleges, certainly better than the pay scales the Government is able to afford. Which leads us to the crisis that medical colleges, particularly State-run, are facing today. A doctor teaching in a government medical college, on condition of anonymity, says that often the situation is so critical, the same teaching staff of city colleges are taken to the new colleges to show staff strength. In Tamil Nadu, sources in the health department say, recruitments are taking place to teach at the new, to-be-inaugurated, Tiruvannamalai Medical College. Postgraduate “service candidates” are also being taken in, while the government has a policy to re-employ retired staff from “rare specialties”. The staff will be put on government pay scales, and receive all benefits accruing to such employment. The solution However, these measures are unlikely to sustain recruitment in the long term. While medicine is still being classified as a ‘noble’ profession that requires its practitioners to be in service mode, the reality is that unless teaching is made attractive, shortages will continue. Take the facts into consideration: A number of students taking up MBBS at private medical colleges have to take huge loans to fund their education. There are private colleges where upto Rs. 80 lakh is being charged as capitation fee, and anywhere upto Rs. 9 lakh per annum for the next five years. Further specialisation is bound to be more expensive. A doctor however committed he or she is at the end of the rather long journey, is forced to consider the financial side of things as well. Employment as a consultant in a major corporate hospital seems, at that time, the pot at the end of the rainbow for him or her. In a radical shift from the norm, the Tamil Nadu Government is considering employing “consultants” at market rates to staff the proposed new medical college to be attached to the multi-specialty hospital being readied at Anna Salai. This was proposed as a measure to attract top-quality professionals to an institution that is hoping to be like the All India Institute of Medical Sciences, Delhi. The other option is to use technology, where and when possible. If connectivity is established between all Government medical colleges and some private colleges, then tele-classes can be held in areas where specialists are rare, or students from Kanyakumari can also benefit from a guest lecture by a top subject expert or a guest from a foreign university, delivered in Chennai. Tele-linking is no stranger to medicine, and it is perhaps time that the classrooms in medical colleges pick up lessons from the way in which their hospitals have improved their accessibility.
Posted on: Mon, 26 Aug 2013 02:27:03 +0000
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