The proposed legislation to make rural services compulsory for graduating doctors has triggered a nationwide agitation by medical students. This reaction actually stresses the need to revamp medical education in all its aspects.

If medical undergraduates are made to realise in the first place that they have chosen a service oriented career unlike other money raking professions, they would not protest so strongly against working for a few months in the neglected government hospitals and clinics in rural areas, especially when they have reaped the benefits of a subsidised medical training funded by the government.

Even if their expertise is minimal and experience almost nil, these doctors in the making would gain both in terms of practice and professional attitudes after serving in villages where patients are deprived and medical help is scarce. However, for that to happen, the very concept of medical education must go through a sea change.

Complete change

The curriculum, the admission process and the teaching have to be geared to inculcate certain values in the graduating doctors. These values cannot be forced through legislation or by making rules and regulations.

Coming to the admission processes, the CET may test the academic calibre of students. It hardly reflects their aptitudes or attitudes towards social issues like health. The very fact that candidates opt for both engineering and medicine – or even branch out to the civil services after completing the MBBS course, shows their lack of focus in these matters.

The medical profession is a dedicated profession that calls for humanity and concern in addition to academic skills.
Leading medical schools in other countries test a candidate for these virtues by examining his leanings towards social service, his concern and interest in people's problems and his non curricular activities in his school days.

Their yardstick for measuring future doctors includes such human values in addition to academic excellence. It is time we restructured our admission norms as well to prevent the entry of unsuitable and undesirable candidates into our medical schools. If the admission policies and the curricula are reformed, the teaching will also improve in the right direction. 

Every year, more than 30,000 students pass out of nearly 270 medical schools in the country. Has the Government of India made a study as to how many of these doctors serve in State hospitals, how many set up private practice, how many work in corporate hospitals and yet how many more leave the country to lend their expertise in their lands? What is the commitment of these doctors who have benefited from a costly medical education at State expense?

Rural service

As medical educationist, Dr. M S Valiathan once pointed out, we have a long tradition of not counting the costs of educating a doctor. That is why we have allowed a country like America, where such costs are prohibitive, to reap the benefits of our medical schools by using the expertise of Indian doctors in their hospitals and clinics without spending a cent on their education.

Under such circumstances, the government’s move to make rural service compulsory for a limited period before awarding medical degrees is not unreasonable. When developed countries like the UK and US insist on doctors working in underserved areas before they are posted to cities, and thousands of Indian medical graduates accept this condition meekly, why this hue and cry to do the same in their own country which qualified them in the first place?

All these anomalies will set themselves right once the government endorses a policy saying that all medical schools be regarded as a national resource as is done in other countries. Since the exchequer pours public money into this resource, it becomes incumbent on its beneficiaries to serve the same public in return. It is a small price o pay when they are getting a prized medical education at one tenth the cost compared to other countries.

But that brings us back to the same point. Unless medical education in India is restructured to make it a tool to improve the basic health of the country as a whole and not just be a means to provide high end medicare to a few, our schools will only churn out medical professionals instead of caring doctors.