Scrap seat-leaving bond in PG medical education: National Medical Commission

Students facing stress, seats no longer going waste, says NMC

New Delhi: Following complaints of mental stress from post-graduate students, the National Medical Commission has asked states and union territories to do away with the practice of “seat-leaving bond” in PG medical colleges, which ask students to pay hefty fees if they leave midway for any reason including ragging, work stress or toxic environment.

The medical education regulator said such bonds cause mental harassment to students and their families triggering “alarming levels of stress, anxiety and depression” among students and the “unlucky one may commit suicide in such mental health condition.”

With the number of PG medical seats witnessing a 117 per cent jump in the last ten years, the issue of a seat going waste – main reason for states to introduce such a bond - was not of much importance nowadays, Aruna Vanikar, president of the Under Graduate Medical Board at NMC wrote in her letter to the states.

A copy of her letter – written to the states and UTs on January 19th – was released by the Commission here on Tuesday.

According to the Union Health Ministry data, the number of PG seats in medical streams rose to 67,802 by August 2023 from 31,185 before 2014.

For years the signing of the seat-leaving bonds had been a common practice for post graduate medical students as states devised specific penalty rules if a student wanted to leave his/her courses midway.

Because of the legal bond, the students have to pay a certain amount if they leave the courses and don’t complete their tenure as junior residents. The amount varies from state to state.

The NMC released seven specific case studies of students some of whom had to pay a penalty of Rs 30 lakh, forcing at least one family to sell its land and another to write to the Prime Minister, flagging his concerns. One student expressed suicidal thoughts.

The cases cited by the regulator are from Madhya Pradesh, Maharashtra, Uttar Pradesh and Telangana. The examples range from a student who has to work for a “gruelling 36-hour duty shift without rest” to “ill-treatment by seniors” and “toxic work environment.”

With ragging and hostile work place being some of the key factors forcing students to contemplate a change of the institution in the first place, the NMC’s anti-ragging panel discussed the issues on January 9 following which Vanikar recommended to the states to do away with such a practice.

"The elimination of seat leaving bonds is a strategic move to prioritise the well-being of resident doctors, empowering them to provide optimal patient care. A supportive and stress-free work environment for resident doctors translates directly into improved healthcare outcomes and the quality of patient care," says the letter.

While the basic purpose of having such a fee was to secure commitment, discourage abrupt resignations and a PG seat remaining vacant, the regulator noted that the issue of a seat becoming waste was not of much importance in view of the increased number of medical seats.

Urging the states to review the policy and drop the bond, Vanikar said such a move would foster a positive transformation of the medical education system.