Kanka Pandita
Getting quality healthcare service at affordable cost is our fundamental right. But mostly we are unable to get this important facility, primarily due to lack of less manpower in this sector.
On an average, India has one medical doctor for 1400 citizens as compared to 250 persons in developed nations. This ratio further varies due to its urban versus rural dichotomy. Two third of our country’s population reside in rural area, where there are less than thirty percent allopathic doctors compared to the rest of our country. As per Rural Health Statistics 2021-22, there is more than fifty percent shortage of doctors in rural India. Unfortunately under prevailing healthcare scenario, existence of specialised medical professionals mostly remain restricted to our metro and mega cities. Additionally, the distribution of healthcare workforce across the states also varies from state to state. Kerala, Tamil Nadu, Karnatka, Andhra Pradesh and Delhi have one doctor for about 600 persons compared to one doctor for more than 3000 persons in the states of Bihar, Jarkhand and U.P. We all know it but we don’t resolve to solve this vital issue.
The Minister of State for Health and Family Welfare in June, 2022 informed Parliament that there are more than 13 lakh registered allopathic doctors in India. Assuming their thirty percent non availability due to death, retirement or migration, that makes practically ten lakh active doctors available for one hundred and forty crore population of our country, which is far behind than WHO norms.
At the current rate of nearly one lakh allopathic doctors graduating every year, in the next five to seven years, there will be about 15 lakh of them for approximately 1.5 billion population of India, giving one doctor available for about 1000 persons, which is again less than prescribed WHO standards. The system is also facing peculiar situation of tremendous difficulty in ensuring uniform distribution and presence of doctors all across the rural and urban areas of our country. Hesitation by the doctors to serve in rural areas mainly due to lack of infrastructure or support system pose tough challenge to healthcare management in India indicating development of healthcare infrastructure too. Rural jobs in the government sector with inadequate remuneration is probably also one of the reasons of this avoidance.
Under prevailing medical curriculum, MBBS students get little exposure to practical aspects of medicine as they remain preoccupied to get into their post graduation courses. Majority of the undergraduate students aspire to do PG in the subject of their choice immediately after completion of their graduation, so uniform presence of specialized healthcare professionals as a whole is an additional challenge, thereby creating exponential need of specialized doctors also. Introduction of simplified NExT ( National Exit Test ) by National Medical Commission ( NMC ) as single common examination for registration of medical professionals to practice medicine and undertaking post graduation course is one positive step in this direction.
With the recent sanction of increasing 50 new medical colleges by the government that would produce nearly one lakh fifty thousand doctors per year within next five years, but at the same time, about 100 existing medical colleges failed to meet the laid down norms by NMC resulting into abolishing of prescribed criteria for the continuation of their recognition to admit fresh students, thereby affecting final outcome of number of trained medical professionals being admitted into the system.
So we need not only to increase the number of allopathic doctors by increasing the number of medical colleges but equally to focus on their advancement in technical competence through higher studies also. We need not only to be practical but flexible too in this direction. Thus our existing medical education system requires urgent much needed revamping.
India needs to realize the number of functional medical colleges both private and government and their intake, taking into account the future need of doctors at primary, secondary ( Specialists ) and tertiary ( Super specialty ) levels in order to ensure delivery of quality healthcare facility to its large population scattered all over rural and urban locations. This type of reformation in medical education as is being periodically done in the countries like as big as United States and as tiny as Singapore that requires to be undertaken by us also.
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