Medical education facing a crisis

The task force constituted to look into the charges of corruption against the MCI, handed in a shocking report of entrenched corruption and mismanagement.

The medical fraternity is not surprised as the MCI does not have much of a reputation with doctors. Quick to impose regulations and codes of ethics, implementation has been weak along with highly questionable decisions in recognition of colleges and awarding of university status. The MCI president was reinstated even after being prosecuted by the Delhi high court.

Our state has the distinction of having the largest number of licensed private medical colleges and nursing colleges. Again, the emphasis has not been on standards of training and many of the nursing colleges were closed down recently after complaints of understaffing and substandard teaching. Some private medical colleges fill their hospital beds just before inspection dates and their faculty are mostly in name only.

Further, corrupt practices abound around the time of examinations. Anyone who has interacted professionally with fresh graduates from such institutes has been appalled at their level of knowledge. These are licensed doctors unleashed on society, treating patients at will.

The selection process for the MBBS course too is extremely cursory. The attributes required to be a good doctor are compassion, a zeal for service, reasonable intelligence and a capacity for hard work. It is not easy to assess these qualities and written tests provide only one facet of the person’s ability. A few medical colleges of excellence conduct their own entrance exams, followed by days of interviews and tests/analysis to try and assess the motivation of the candidates.

This improves the chances that the qualified doctor will be of service to society and a credit to his profession. The rest of the medical colleges admit students mostly on basis of their marks or ability to pay the required fees. What is the social and personal consequence of entering a profession by default?

When the profession in question is medical, it is serious as people’s lives are at stake.

The Consortium of Medical, Engineering and Dental Colleges Karnataka (COMEDK) conducts its own entrance test to private medical colleges where the wealthy have an advantage in being able to land an MBBS seat by paying more for it. The ability to buy the trappings of success clearly sends a totally mercenary message to these young minds. The MCI defends any compromise in the selection of candidates by indicating the huge shortfall of medical seats available in addition to the fact that the doctor-patient ratio in our country is alarmingly low. But are we content to sacrifice quality for quantity?

Rural doctors

Recently there was a suggestion by the health ministry to institute a ‘rural doctor’ training programme in order to ensure the presence of these ‘doctors’ in villages. The medical training would be abbreviated to suit the rural community health requirement. This dilution of the medical degree is extremely dangerous and should not be attempted. The government should instead focus on equipping the primary health centres and rural hospitals and offering incentives to doctors who work in rural areas.

The MCI, or the apical body created to replace it, must provide clear direction and strong leadership in this area of medical education and healthcare personnel development to raise the quality of medical care. Of course, this clean-up act by the MCI will need to begin in-house with a view to re-establish a rapport and credibility with the medical fraternity.