Course correction

The Union health ministry’s proposal to start a new medical degree course of shorter duration to produce doctors who will serve in rural areas is a realistic move. Efforts to persuade doctors who qualify from medical colleges to serve in rural areas have consistently failed. Governments have employed methods of compulsion and temptation to make medical graduates do rural service. A mandatory short-term rural service, incentives in the form of high monetary rewards and quotas in post-graduate courses and even penalties for refusal to work in villages have not had much impact. Most doctors are either from an urban background or find it professionally and commercially better to practise in towns and cities. Since it has become clear that these attitudes cannot be easily changed, it is better to look for other methods to meet the health needs of the rural sector.

The plan, which has been approved by the Medical Council of India, is to start a medical degree course of three-and-a-half years exclusively for students from villages who will serve the rural population. The course, to be called Bachelor of Rural Medicine and Surgery (BRMS), will be oriented to the medical needs of villages. The students will be coached in nodal medical institutes to be set up in rural areas and will be trained in district hospitals. The programme is similar to the Licentiate Medical Practitioners (LMP) scheme which existed in the country before independence and discontinued later in favour of a single medical course. Efforts since then to create professionals who would meet the needs of the rural areas in medicine, midwifery, nursing, etc have not succeeded.

A shortened course would be enough to cater to the basic health needs in the villages. The heath care system is most deficient and dysfunctional at that level, with the result that nearly 80 per cent of the population goes without basic health care. People in many villages still depend upon untrained people or quacks for their medical needs. The national rural health mission is not making progress because of the lack of qualified personnel willing to work in villages. The proposal has been under discussion for some time. It is well-conceived, though all the details are yet to be finalised. If the details are properly worked out and the scheme implemented well, it will give a big boost to the health care system in villages.

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