Medical education and research: India
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Medical education: India
Check on your doc before a check-up
Rema Nagarajan TIMES INSIGHT GROUP
The Times of India 2013/07/21
With the Supreme Court striking down the common entrance test for medical colleges, patients face the growing prospect of being treated by doctors whose merit may not have been adequately tested.
With the creation of more and more private medical colleges, many experts fear students will increasingly buy their way into becoming doctors from such institutes, many of which are notorious for their lack of teaching and training infrastructure.
These students do not have to face any centralized external exam to get their degrees. Exams are conducted internally, most often by private or socalled deemed universities that run medical colleges.
1 in 5 doctors bought a seat in medical school
Back-of-the-envelope calculations show that about one out of every five doctors passing out each year, or around 8,000, could be those who effectively bought seats in medical colleges. The consequences for public health are fairly obvious.
The ‘management quota’
Going by what is allowed under existing rules, nearly 15% of seats in private medical colleges across the country are in what is called the management quota. This term is widely recognized as a euphemism for seats available to those who can pay for the privilege. Estimates of exactly how much a seat costs vary, but the amount could be Rs 30-90 lakh, depending on the location of the college, its reputation and the timing of the booking.
Currently, over 25,000 seats for medical graduate admission are in private medical colleges compared to just over 20,000 in government colleges. The 15% kept aside for the management quota amounts to 3,750 seats. However, the actual quota is usually way higher than 15%. It could go up to a third of the seats, or in some cases, even over half the seats in a private college. Even a conservative third of the seats being sold as management quota would mean that over 8,000 seats are being sold.
Proxy students take the examinations
In a scam uncovered in Bangalore, it was found that qualified people were employed to write the entrance exams and such proxy students after getting allotment of seats through counselling would surrender the seat leaving it available to the management to allot at its discretion, which it would do in return for as much as Rs 75 lakh to Rs 90 lakh. This, according to several admission agents, is still a common practice.
All the money for booking the seat is collected in black and seats are booked as early as December of the year before the year of admission, way before any entrance exam. Of course, they stipulate that the admission is on the condition that the student gets 50% in class XII.
“With increasing variation in the quality of medical education and the unearthing of seat selling scams, we might need an exam for all medical graduates to test and certify their level of knowledge before they are to allowed to practice — something similar to the exam that foreign medical graduates have to clear to be allowed to practice here. Such a proposal had been made before,” said Dr Bipin Batra, executive director of the National Board of Examinations, which conducts the National Eligibility cum-Entrance Test for postgraduate medical education and the examination for FMGs. On grounds of bridging the shortage of doctors, the Medical Council of India has been approving the creation of more medical colleges and expanding the number of seats.
Neglected medical education
1 govt med college seat for 55k people
Massive Shortage Of Seats Allows Private Sector To Jack Up Education Cost
Rema Nagarajan | TIG
The Times of India 2013/08/12
Shortage of doctors
The shortage of doctors in India can be blamed on the government neglecting medical education for three decades from 1970 till 2000. In a 15-year period from 1951 to 1966, sustained investment in medical education led to India having one medical seat in a government college for roughly every 37,000 persons, down from one for every 71,000 in 1951.
Over the 47 years since then, the situation has worsened dramatically with one government medical college seat for over 55,000 today. This has resulted in the private sector taking over medical education in a big way. That, in turn, has meant spiralling costs, question marks over quality and a sharp geographical skew. Even with the private sector included, India now has one MBBS seat for every 26,042 people, only a small improvement from one for every 33,521 in 1966. In contrast, the period from 1951 to 1966 had seen the ratio cut by more than half.
A look at the data on medical seats and colleges available with the Medical Council of India (MCI), the regulator for medical education and doctors, shows that the availability of medical seats has improved in recent years. Almost half (47%) of the available seats have been created since 2000. However, 72% of the seats added since 1970 are in the private sector.
Why should this be a matter of concern? There are several good reasons for this to be cause for worry. For starters, private medical education is expensive making it inaccessible for most Indians. In private colleges, the cost of graduating is Rs 15 lakh-40 lakh or more, not including capitation fees. In a government college, it ranges from a mere Rs 10,000 as tuition fee in Delhi’s Maulana Azad Medical College for the entire MBBS course to about Rs 1.5 lakh in Trivandrum Medical College, one of the more expensive government medical colleges.
The quality of education in private medical colleges, too, has been a matter of great concern as they are less transparent and have proved difficult to regulate. The fact that many are owned by political heavyweights does not help.
The lost states, the lost decades
The private sector has also led to a geographical skew in the distribution of seats. Over half the private sector seats are concentrated in just four states—Karnataka, Tamil Nadu, Andhra and Kerala—though they account for just 21% of India’s population. In Karnataka, for every government seat, there are almost four private medical seats, while in Kerala there are two private seats for every government seat. However, in the poorer states like Bihar, UP, West Bengal, Rajasthan, Assam, Jharkhand, Chhattisgarh, and in the northeast, medical education remains largely dependent on government medical colleges. In most of these states, no new government medical colleges were created for decades between 1960s and 2000. In over two decades following Independence, the government created 69 medical colleges with over 8,500 seats. This was followed by three decades (1970-99) of utter neglect, when the population almost doubled from 548 million to over a billion, while the government added barely 2,000 more medical seats. The surge of the private sector started in the 80s as government investment in medical education declined drastically, but it has accelerated since the turn of the century.
After the government woke up to the crisis in medical education and took steps to increase government investment and also relaxed the norms for running a medical college, there has been a surge in the number of medical colleges, both public and private, especially in the last three years.
Aformer member of the Board of Governors of the MCI, Dr Ranjit Roychoudhury, had this to say: “We lost three decades starting from the 70s. The government stepped back from medical education thinking that the private sector would be able to fill in. At the time, the problems of private medical education were not envisaged, such as the question of inequity, quality of education and the geographical skew. We are now trying to rectify this problem.”
2000-2013
Since 2000, the government has created 9,300 medical seats, almost as many as it did in half a century from 1950 till 2000. But the 9,300 seems a pittance compared to the 17,700-plus private sector seats created in the same period. Almost 60% of the latter were in four southern states. In 2013, for the first time since 1975, the government has created more medical seats than in the private sector. In 2013, Centre created 1,300 seats in 14 new colleges. Another 3,013 have been added to existing colleges. Thus, in just this year, the government has created twice as many seats as it did in 30 years from 1970 to 2000. Is the trend finally changing for the better? Let’s hope so.
2012-14: Indian doctors with foreign medical degrees
The Times of India, Nov 06 2015
Sushmi Dey
China beats all to be biggest doctor factory for Indians Not just Chinese consumer products, India also receives thousands of “made in China“ doctors. China is today the largest contributor of MBBS doctors to India followed by Russia, Ukraine and Nepal, according to data collated by the National Board of Examinations, which conducts Foreign Medical Graduate Examination (FMGE) screening tests. The FMGE is a voluntary entrance test introduced in 2002 as a qualifying exam for Indian students holding medical degrees from other countries and intending to practice medicine in India. The Medical Council of India (MCI) recognises this exam.
As many as 11,825 Indian students, who have Chinese MBBS degrees, took the FMGE test during 2012-2014, while 5,950 were from schools in Russia and 3,163 in Nepal. The rush for foreign destinations, experts say , is fuelled by those who fail to get admissions in Indian colleges. Of over 5 lakh Indian MBBS aspirants each year, about 4,500 get seats in government colleges.
While UK, Germany and Singapore attract candidates, the numbers are comparatively smaller than those who go to China and Nepal for European institutes are costlier. The number of doctors who train in countries like China and Russia has risen sharply in recent years, but they must clear the Foreign Medical Graduate Examination (FMGE) for provisional or permanent registration with Medical Council of India or any state medical council. There's an impression, however, that the calibre of doctors who train in these countries isn't on a par with those qualifying from Indian institutions.
The National Board of Examinations that conducts the FMGE ranks foreign universities or medical institutes on their candidates' performance in the screening test. While the government plans to increase PG seats in some super-specialty departments in a few key institutes, including AIIMS, there are no such plans for basic MBBS course.
PG Medical courses
Jan 13 2015
Admissions to PG medical courses only on merit: SC
Admissions to post-graduate medical courses can be done only on the basis of merit of students appearing in the entrance examination, the Supreme Court said while quashing Kerala government's decision to reserve seats for doctors working in its hospitals and other departments. The apex court said the state overstepped its jurisdiction by making a law earmarking 40% of total seats available to the state quota for its medical officers who were to get admission on the basis of their seniority , without appearing in the entrance examination.
A bench of Justices T S Thakur and R Banumathi said regulations framed by the Medical Council of India were binding and state governments could not make any rule in violation of the regulations. “Regulation 9 (of MCI) is, in our opinion, a complete code by itself inasmuch as it prescribes the basis for determining the eligibility of the candidates including the method to be adopted for determining the inter se merit which remains the only basis for such admissions. To the performance in the entrance test can be added weightage on account of rural service rendered by the candidates in the manner and to the extent indicated,“ it said.
The court said the method, however, was given a go-by by the impugned legislation when it provided that in-service candidates seeking admission in the quota shall be granted such admission not on the basis of one of the methodologies but on the basis of seniority of such candidates.
