Maharashtra faces massive shortage of 4K doctors for public health system

Maharashtra has 43 colleges offeringMBBS degree and over 5,000 doctors graduating every year. It's second only to Karnataka, which has 44 medical colleges and over 6,000 students. Yet, Maharashtra's public health system-made up of primary health centres and district hospitals-faces a shortage of around 4,000 doctors.

The Bombay high Court on Tuesday termed the lack of doctors willing to serve their bond period in a rural medical centre a ''tragedy". The court's remarks came after it was informed that in 2012, of 6,930 candidates available to serve the bond, only 1,730 presented themselves before the allotment panel for being deputed to 4,878 posts in rural areas. Of these only 1,473 were allotted posts, which meant that around 3,405 posts remained vacant.

Public health specialist Dr Abhay Shukla, involved in community monitoring of the National Rural Health Mission (NRHM), said that there was an acute manpower crunch in primary health centres. "The state has to devise ways of improving facilities and policies to get more manpower, including doctors to rural centres," he said. He pointed out that Maharashtra had emerged as an exporter of doctors for the rest of India as well as the world "but our health system doesn't have enough doctors".

Dr Sanjay Nagral, who has written on the brain drain issue in medical journals, said the government should not give an option to students. "The government and the common man support medical education for students by subsidising it. The doctors have to hence give back to society. There should be no paradox here," he said. He pointed out that more than 60% classmates from KEM Hospital were abroad.

A student who has done two rural stints is upset with the poor infrastructure and incentives. "How can the government expect raw MMBS graduates to go out and handle patients? We are not ready for that just after passing out. Moreover, the learning curve for medicine is long. If we keep doing rural stints after graduation, post-graduation and super-specialization, it will take a medical student 13-15 years to step out as a full-fledged professional."

The problems faced by doctors who voluntarily go to the remote health centres cannot be ignored too by the government, according to experts. "The reality is that the young doctors are confronted with an acute lack of infrastructure at these places, including no electricity or telephone connections. In many rural clinics, doctors have to manage the whole show from physician to compounder as staff assigned are not present," said advocate Uday Warunjikar, who is represent-ing the Mahan NGO, which runs a dispensary at Dharani in Amravati.

The advocate said the local tribal population avoided a centre, despite a doctor regularly attending the dispensary. Inquiries revealed that the locals, who spoke only in Kokru dialect, found it difficult to explain their problems to the doctor. "The government should ensure basic infrastructure at rural centres and provide sensitization and basic language information to doctors," Warunjikar said.