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Saturday, January 10, 2004

Admission into medical colleges is like an agnipareeksha even to the most motivated teenager.  Even after securing admission, obtaining good quality education remains a dream to many others.  Before entering the IAS, I was trained to be a physician and had to endure a similar procedure. Now, I am deeply concerned by the state of our medical colleges and the quality of education imparted to our medicos.

It is the duty of the concerned authorities to regulate the quality of medical education being imparted to thousands of students.  At the same time, the medicos have to bear in mind that our society invests a lot into the making of a doctor. A successful doctor should turn out to be an investment that is redeemed several times over - not just by her/him but also by the entire society.

The admission of students into a medical college must necessarily follow a transparent, fair and objective process.   As is the case today, it is quite possible that students might be admitted into the same program via different admission routes.   However, it is absolutely necessary to decide on high-enough standards for admitting students and then stick to them. That way the quality of the incoming freshers can be consistently kept high.  Once the admission process is completed, all students must be set equitable education standards, irrespective of which admission route they come from.

Medical students invest enormous amounts of their energies, money and time in obtaining their degree.  The one question that concerns the students and their parents is:  are we getting a learning experience that justifies this huge investment we make? The students must not be made to feel they are being cheated of their investment.  For that, we need medical colleges that have proper equipment in their laboratories, functioning hospitals, reputed teaching faculty, good classrooms and libraries.

We already have more number of medical colleges producing more doctors than necessary.  The United Nations Development Program (UNDP) reported that even as early as in the 1970s India had more doctors than the society could usefully employ them.  According to a study by the Institute of Applied Manpower Research (IAMR) the required doctor to persons ratio is only 1:3,500 while in AP, the actual figure is close to 1:1,587.

The key here is quality, not quantity.

We have an example right in front of us: the number of engineering colleges was drastically increased without ensuring proper standards.  Not surprisingly, the ‘market value’ of an engineering degree has dropped drastically.  What happened next?  At the end of the regular post-EAMCET counseling in 2003, there were more than 11,200 vacant seats because the students refused to get admitted into these sub-standard engineering courses!

In fact, our country urgently needs more and better-trained nurses, paramedics, general practitioners and public health experts.  The world-famous Dr. Arole’s Comprehensive Rural Health Care Project at Jamkhed in Maharashtra proved that well-trained paramedical personnel can competently handle 80 percent of the cases and only 20 percent need the attention of a medical doctor.  Our country does not require large numbers of super-specialized doctors who serve only a small percentage of the population.

Let me end with a thought: the number of private hospitals and nursing homes has increased tremendously in the past decade or so.  Even discounting big private hospitals, the medium and small-sized ones have higher combined bed strength than in the government hospitals.   Today, a private hospital (different from a corporate hospital, let me emphasize) has much better doctors, technicians, nursing staff and facilities than a government hospital of comparable size.

On the other hand, we have some recently established medical colleges that do not have functioning teaching hospitals, as yet.  One option to be explored is whether private hospitals and nursing homes can be utilized as teaching hospitals for students of those newly established medical colleges.  There are many private hospitals and successful practitioners who consider it an honor to share their knowledge and experience with medicos.  At the same time, the students could get the best possible hands-on training, at no additional cost.   We need to explore more of such creative-yet-simple possibilities that offer an enormous scope for improving our medical education system.

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