Expansion of Medical Education in India

“The 75 new medical colleges with facilities for PG medical education under Phase-III by upgrading district hospitals or otherwise will help in upgrading health-care infrastructure. Across the country. #CabinetDecision” – Ministry of Health and Family Welfare, Government of India, August 28, 2019.^[1]

Dear Editor,

Kumar analyses district medical colleges in India which are instrumental in addressing the rural health-care needs of the masses in his Editorial published on December 19, 2022, in the journal.^[2] He emphasizes their requirement in the backdrop of the limited number of available seats for medical education around. When a few medical students returned from Ukraine as a fallout of Russia-Ukraine war, the matter got the attention of the media worldwide.^[3] Despite an unprecedented increase in the number of seats-as highlighted by the author-still, several students are finding it difficult to have one. Nevertheless, we also should think on maintaining the quality of the education provided to these students who sometimes take loans to pay their fees.

Our top-of-the-notch institutions, the world-famous All India Institute of Medical Sciences are unable to fill all the vacant teaching posts,^[4] resulting in a fall in the standards of medical education. The same is true for these district medical colleges which are lower in hierarchy, where it is more difficult to get suitable faculty members. Lately, under a bond policy, State Governments are making attempts to provide the bare-minimum human resource but that process has thrown up unique challenges.^[5] Hence, inputs from all the stakeholders should be obtained and accommodated in real-time to calculate all the factors and derive suitable public policy. If high-quality education is not maintained while expanding, we may lose the edge we are having and our all the plans will suffer setbacks.

The author mentions that “Additional human resources in health generated by the scheme would meet the health-care needs of the growing population and ensure that doctors are available at PHC/CHC/district level to ensure service guarantee under NRHM.” However, how will this happen, I wonder. At present, anybody who got education at any Medical College has the freedom to move and practice at a place of her choice. So who will direct or monitor the evolving scenario, I look for. What we ought to realize is that there is no magical solution for our health-care demands, all the steps should be closely watched for, aberrations should be rapidly detected and fixed, unintended and unforeseen consequences should be widely discussed and mistakes-if any-should be dissected threadbare.

If one misses some vital/crucial point at any stage while acting in good faith, there is no need to crucify her and that may be a learning point for future workforce. Only then we will be able to make a robust system catering to society. Every new discovery/invention or project comes up with its unique set of posers. The more we learn and share with our colleagues/fellow workers without hesitation, the wiser we become. A massive project to prepare skilled medical workers for serving a nation as huge as India-with its people of different pheno/genotypes-is ready to generate a big calculus. We should be ready to learn fast.

Although there is a shortage of trained workforce in our villages, if we hurry up and go with full speed; chances of accident should also be taken into account. Its brake system, rear-view image, and above that, our moral compass, should guide us to take the best route. Our journey is likely to have some road bumps, twists and turns, sometimes sharp ones and occasionally U-turns. And every step provides us an opportunity to know a better way to move.

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