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Doctors slam Azad order, say not enough PG seats, job opportunities

April 27, 2012

India produces 40,525 medical graduates who vie for 16,088 PG seats every year. The medical education pyramid tapers drastically after that — only 1,555 seats in superspecialities like M.Ch (Master of Chirurgiae) and DM (Doctor of Medicine). Research-based medical specialities like immunology, genetics and physiology are in their infancy in the country with little or no scope for one trained in them to do meaningful work here.

Given this reality, Health Minister Ghulam Nabi Azad’s whip on Monday against medicine students working in the US invited scathing criticism from the medical community, which said that the blanket decision to not process papers for a work visa in the US would only redirect brain drain. They held that in the absence of adequate medical training facilities in the country, the diktat may be high on populism but made little medical or administrative sense.

Azad had said that doctors going to the US for higher studies would have to now sign a bond that they would come back immediately after the course and not work in that country. There would be no option to make a payment to skip the condition.

“Expecting doctors to return to the country after finishing their studies is legitimate but this has to be supplemented by a well-developed framework for their guaranteed and gainful employment so that their knowledge and skills are adequately utilised either in AIIMS-like institutes or the district hospitals or in course of the extensive upgradation planned for medical institutes. It is important to couple regulation with an enabling environment and a positive pullback factor,” said Dr K S Reddy, former head of the department of cardiology, AIIMS, who headed a high-level expert group on universal healthcare.

Moreover medicine is one discipline where education is often half of the training, the other half being experience, said Dr P K Dash, consultant oncologist at Indraprastha Apollo and a former topper at AIIMS of research-based specialities. “There cannot be a blanket diktat on not to work abroad. If a doctor goes to train in disciplines like pharmacovigilance and immunology which are almost non-existent in India, they won’t even be able to apply those skills here because there are no facilities. There are so many departments in the US that do not exist here. What will such people do?”

A former AIIMS doctor who worked for 30 years in a US university said the assumption that brain drain is only of the best is only half true because the stiff competition in PG and superspeciality courses means that a lot of doctors leaving the country are actually from tier two cities and second or third rate medical colleges who are unable to get through to a course of their choice here. The solution to the problem cannot lie in forcing people to come back here, it would lie in investing in medical education, the doctor said.

Terming Azad’s announcement as a “political” one, a senior doctor in MAMC said the government’s heart is in the right place, but the head isn’t. “It is logical that anybody — not just a doctor — who has had a subsidised education should serve the country. But it is equally logical that should they repay that money, they should be free to work anywhere. So the bond should be optional and the money raised from the payouts should be used exclusively for medical education.”

The key to the debate, agreed Dr Anoop Misra, director and head, department of diabetes and metabolic diseases, Fortis Hospital and former professor of medicine at AIIMS, is investment in medical education. “Issue of brain drain is of great importance to India, both from point of view of making Indian medical science robust and economically. A surer way of tackling this problem is building and maintaining academically oriented state-of-the-art medical centres, providing better working environment and increasing emoluments of doctors.”

Categories: PG News
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