Making doctors of medical students

I wonder if any other country has set so many hurdles in the way of students qualifying to become doctors. There was a time when students endowed with the necessary talent to take up the profession of treating diseases and healing patients opted for medical courses.

But that was long ago when medical colleges were not money-making machines and medicine was not an avenue to exploit the sick. Students also did not opt for such courses unless they were highly motivated to become doctors. And medical colleges did not churn out half-baked professionals and let them loose on an unsuspecting public.

Those times are over. Now, an 18-year-old can debate with herself whether it is more lucrative to become an engineer or an architect or a lawyer or – a doctor. Should it be information technology or management studies or medicine? They are clubbed together although they are poles apart.

The very fact that after obtaining admission to a medical course, a student opts for the Indian Administrative Service (IAS), shows that there was no motivation or passion in the first place for either career. The only motivation is money. It does not matter whether you are a deputy commissioner or a dentist.  

Before the introduction of common entrance tests, students were selected for admission to medical courses on the basis of their performance in the higher secondary or pre-university examinations. Their knowledge and skills in chemistry, biology and zoology were considered the main criteria for selection. The common entrance test (CET) put an end to all that. A student’s skill in answering multiple choice questions became the sole criteria for becoming a doctor.

But whether it is the CET or the COMED or the NEET, a student’s aptitude and inclination to become a doctor is rarely tested. We have failed to evolve a test which determines whether an aspiring doctor has the skills, the patience, the integrity and the selflessness to devote a lifetime to a vocation that calls for compassion, above all else.

Medicine is a humane profession. It is also a profession that calls for dedication, sacrifice and total involvement that excludes everything else. It is a profession dealing with life and death. The sacrifices it demands are exceptional.

Are there any tests to judge whether a student has this motivation to sacrifice her time, other commitments and desires for the welfare of those who place their lives in her hands? Are there tests to judge her critical thinking, her ability to take crucial decisions, her strength of mind to be calm and composed in an emergency?

While colleges are squabbling about the validity of entrance tests for trivial reasons, and the state authorities are taking their fights to courts for their own selfish interests, no one is bothered about the quality of doctors who will finally emerge from our medical colleges. The Medical Council of India (MCI) lost its validity when it lost its transparency.

Quest for purpose

The managements of medical colleges have also lost their credibility with politicians jumping into the fray to establish money-raking institutions. State governments administered by these same politicians are neither interested in medical education nor the state of health of their hospitals. In this sad scenario, does it really matter what any court has decreed? Unless and until we have a revolution of thinking about the nature and purpose of medical education, all else is meaningless.

Countries like Canada and the US have a Medical College Admission Test (MCAT) which is a standardised well-conceived examination that assures a student’s qualification for a medical career. In addition to testing a student’s concepts of the biological and physical sciences, it is also designed to test a student’s problem-solving, decision-making and verbal abilities. Every doctor will face situations that call for these skills in her career.

Unfortunately, neither the CET or NEET has devised methods to test such skills with certainty. The NEET was proposed to replace all individual MBBS entrance examinations.  Conducted by the Central Board of Secondary Education (CBSE), it promised a modicum of transparency. But, colleges, and even states, revolted against this move for their own good reasons.

Medical education is too rich a pie to be given up easily. With controversies and legal cases piling up, and even reaching the apex court, there seems no solution in sight. Why is it so difficult in this country to implement proper reforms in an area that is so crucial to the health and well-being of the nation?

If the very authorities that are established to oversee their proper implementation turn corrupt, there is little hope of any improvement in this vital area of study. The disease is too far advanced to be cured. It calls for ruthless surgery and a strong government at the
Centre to restore credibility to medical education in this country.