Compulsory rural postings for MBBS students are not the answer

Mythili BhusnurmathGuest article by Mythili Bhusnurmath

The government’s plans for a longer – six and a half years against the present five and a half - MBBS course with the additional one year being devoted to compulsory rural posting is like many government plans – well-intentioned but impractical. Unless basic infrastructure facilities are provided in the rural areas, mandatory rural postings will degenerate into postings that are ‘rural’ only on paper.

Few, if any, of today’s MBBS students will be willing to go and rough it out in our villages especially in the heartland where there a lack of basic civic amenities and even law and order is noticeably absent. Much like schools in rural areas where absentee teachers are the norm, compulsory rural postings for MSSB students will only lead to primary health centres with absentee doctors.

What we need in the rural areas is basic health care – it is estimated that 80 % of common medical problems and ailments can be treated at the level of primary healthcare and do not require the attention of highly trained professionals. It would be far better to act on a suggestion made by the Delhi High Court in the course of a PIL in 2010 and introduce a shorter less rigorous three year MBBS course that could turn out doctors who could cater to the needs of the rural areas. Every year there are thousands of students who do not make it through the tough entrance exam for the regular five-year MBBS. These students could be encouraged to pursue the shorter course, with the rural component thrown in. Of course, the government will have to do its bit and ensure minimum infrastructure is provided in the rural areas so that these students can work out of these areas.  

A Planning Commission study estimates the country is short of six lakh doctors, 10 lakh nurses and 2 lakh dental surgeons, giving us one of the worst doctor-patient ratios in the world.  According to news reports in 2006, only 26% of doctors in India lived in rural areas, serving 72% of the population. The urban density of doctors was about four times that in rural areas, and that of nurses about three times higher.

Agreed the National Rural Health Mission is in a shambles. But the way ahead is to ensure that better healthcare become a reality and does not remain on paper. And for that compulsory rural postings of the sort being contemplated are not the answer!      

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