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Acknowledging the scarcity of qualified doctors in rural India, the central government has decided to introduce a three-and-a-half-year medical course for doctors who will be posted at primary health centres and sub-centres that are currently manned by only one auxiliary nurse midwife
The Indian government has decided to introduce a short-term medical education course in government-run schools at the district level, in a bid to reach out to rural populations across the country. Doctors holding a short course degree will have to practise only in notified rural areas; they will not be allowed to work in urban or semi-urban areas. To ensure this, the Medical Council of India (MCI) will renew their licences every year, and only on submission of a certificate from the district health officer. The short medical course, which includes medicine and surgery in the curriculum, will be offered only at government-run schools; the degree will be awarded by local universities. A certain number of beds in district hospitals will be utilised to train the rural doctors. The government will start by picking up 25 students from each of India’s 300 districts that do not have medical colleges, says India’s Union Health and Family Welfare Minister Ghulam Nabi Azad. MCI president Ketan Desai said: “Only 300 out of India’s 604 districts have medical colleges. There are 34,000 medical seats available at the MBBS level, out of which only 10,000 are left for general students after quotas. Some very good students are left out due to stiff competition where urban students score better due to better coaching facilities.” The MCI is expected to meet with the vice-chancellors of various universities and state health secretaries in the first week of February to fine-tune the modalities. It has almost finalised the rural medical course which appears to be a revival of the Licentiate Medical Practitioners (LMP) scheme that prevailed before Independence. “The syllabus will be the same (as a full medical course). We have only condensed the new course by removing certain things like kidney transplant, angiography, MRI, and radiology from it. All we require at the village level is a doctor who can immediately attend to a patient. This doctor can refer serious patients to district or bigger hospitals,” Desai said. Desai added that the doctors could handle common ailments like asthma and abdominal problems. They could also attend to normal deliveries, although they would not conduct surgeries or look into complicated cases. In the LMP scheme students were trained as medical doctors for around three years, awarded a diploma and then asked to fulfil the needs of rural healthcare as a way to bridge the gap between demand and supply of skilled doctors outside metropolitan India. Last month, the West Bengal government came up with a similar proposal of creating a rural cadre of doctors through a separate and shortened medical course. Though it was passed by the Assembly, the proposal faced a lot of opposition with critics charging the government with treating villagers like second-class citizens. In pre-Independence times, LMPs outnumbered MBBS graduates and served largely in rural areas. The Bhore Committee report of 1946 unified medical courses into the standard five-and-a-half-year MBBS degree course, abolishing the LMP option. The central government then proposed a one-year rural stint for fresh MBBS graduates, which would have given them additional weightage during their post-graduation. Sadly, this scheme did not work out and rural India continues to face a severe shortage of qualified doctors. “The Indian public healthcare system has an estimated shortfall of 6 lakh doctors and 9 lakh nurses despite the fact that the number of government hospitals has increased from 4,571 in the year 2000 to over 8,500 in 2009,” says the industry body Assocham. According to a Planning Commission report, while India is short of doctors, Indian doctors who have migrated to developed countries form nearly 5% of the medical workforce there. Almost 60,000 Indian physicians are estimated to be working in countries like the US, UK, Canada and Australia. India, on the other hand, has a dismal patient-doctor ratio. According to the report, for every 10,000 Indians, there is one doctor. In contrast, Australia has 249 doctors for every 10,000 people, Canada has 209, the UK has 166, and the US 548. Source: Press Trust of India, January 18, 2010
The Hindu, January 18, 2010
Deccan Herald, January 17, 2010
The Indian Express, January 16, 2010
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