Needed: A medical education that serves society

While grandiose plans to start super speciality medical courses are being made, the government has forgotten  the need for courses that will generate physicians to treat the common ailments of elderly patients at affordable costs, rues Vatsala Vedantam.

The State government has plans to start six new medical colleges in Karnataka. It already has 10 state medical colleges in addition to the 42 private ones offering graduate and post graduate courses in super speciality courses like cardiology, neurology and gastroenterology among many others.

Its future plans include more super specialities like vascular surgery, pediatric surgery, neurosurgery and even plastic surgery. It may be mentioned in passing that the 17 state teaching hospitals hardly suffice for the number of medical students who need them for their practical knowledge and experience.

While these grandiose plans to expand the scope of medical education are taking shape, the government has forgotten the need for courses that will generate physicians to treat the common ailments of elderly patients at affordable costs. It is true that medical students would opt for the exclusive superspecialities that promise a lucrative career later.

Those who have the money and the inclination to specialise in those courses can do so in the private medical colleges. But, the state has an obligation to societal needs first. If the government opens more and more medical colleges — largely motivated by political expediency rather than altruism — it must at least ensure that they will serve society in the long run.

One of the important areas that medical education should concentrate upon other than child medicare or pediatrics, is medicare of the elderly or geriatrics. Two sections of the population that need urgent medical attention are children and the elderly. They are the most vulnerable and sadly, the most neglected. If the state does not come to their rescue, one can hardly expect private players to do so. There are doctors and doctors in hospitals and private clinics.

There are surgeons of repute and specialists in various diseases. But, there are very few physicians to listen to the pains and problems of the elderly which multiply rapidly as they age. Like children, they are vulnerable to infections, falls and bruises. But unlike children who have the resilience to bounce back to good health, the elderly take longer and longer to recuperate even from minor ailments.

There has been a steep increase in the population of the elderly in this country and state during these last two decades.  One would have expected medical education to keep pace with this rise, and provide for courses that would generate more geriatricians.

During a seminar conducted in Bangalore recently, doctors themselves expressed the need for more and better care of the elderly. They highlighted the lack of proper geriatric medicare which often resulted in wrong diagnosis and prescription of irrelevant drugs. It was pointed out by the Governor who is also the Chancellor of all the state universities that it was high time the government planned a proper system of medicare for the elderly.

Such a system cannot be achieved by mere public utterances alone. They have to be translated into action by careful planning and overhauling the system of medical education itself. It does not help if the same government offers lip sympathy on public platforms to the most vulnerable sections, and simultaneously starts new medical colleges which do not take them into consideration while planning their courses. The Medical Council of India (MCI) has recently announced that medical colleges should extend their courses by one year from 2013-14.

The Karnataka government has declared its adherence to this ruling by making one year of rural service mandatory for all medical students hereafter. Let that one year at least be dedicated to geriatrics, for a beginning.

It is fortunate that the Planning Commission has proposed introducing MD in Geriatric Medicine in all government medical colleges from next year. If the proposal is implemented, these colleges will produce 40 postgraduates in geriatrics every year. It may not be a large number, but at least, it will be a beginning. The State government can prevail upon private medical colleges to do the same.

We will then generate more and more doctors to look after the needs of the elderly. With the rising number of an aging population, this should be the topmost priority for medical institutions. Elderly patients with multiple disabilities also drain the country’s resources in many ways. If they receive proper medicare, they may even be able to contribute to society instead of remaining an economic liability. Their productivity and well being depends on their health, which depends upon good medicare.

The number of elderly persons in this country is estimated to rise to 140 million within the next ten years. Unless there is a simultaneous rise in the number of medical colleges offering both graduate and postgraduate corses in geriatrics to produce more geriatric doctors, the picture will remain bleak. Medical colleges need to consider all these aspects when they plan their courses, and not merely think of income generating specialities. But, when the State itself forgets its responsibilities in this regard, can one expect private colleges to do otherwise?