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Why this malaise in medical education?

Recently there was a detailed report in The Hindu on the problems faced by hundreds of medical graduates who had their higher education in foreign countries, to get registered for practice in India. This situation calls for a closer look at the present status of medical education in the country. IE has pointed to the lop-sided development in this field of higher education with the southern states and Maharashtra accounting for bulk of the medical college seats with states like Bihar lagging far behind, even, the tiny UT of Puducherry.

Not all these colleges in the southern states and Maharashtra offer quality education. The vast gap between the fee structure of government-run and private medical colleges is too glaring. While the government-run colleges charge ridiculously low fees that do not cover even a fraction of the expenses involved, private medical colleges charge hefty capitation fees. Students with high marks are able to get admission in government colleges or offered seats in private colleges through government allocation. But others have to pay a hefty capitation fee, which is in excess of Rs 50 lakh in several private colleges.

Apart from the cost of creating quality infrastructure and assembling talented faculty, there are also the malaise of the promoters of such colleges paying hefty sums to the decision makers. An estimate puts such payments in excess of Rs 200 crore. Such costs are recovered through capitation fees.

Annamalai University, one of the earliest private-run institutions, set the pattern for these. The university offered medical seats for a high price(in black). Unfortunately, with the poor quality of admissions,the system got corrupted, whereby even annual promotions and degrees were got on payment. There was understandably lot of favouritism involved in admissions; children of bureaucrats and politicians, contractors and wealthy doctors gained admissions. This trend spread to other private medical colleges in the state. Times of India did sting operations that showed such hefty capitation fees collected by a couple of medical colleges in the state. These included one run by a politician who was a Union minister.

 The recent report points to the cost of getting medical education in China in the region of Rs 15 lakh to Rs 25 lakh including boarding, lodging, tuition fees, travel... whereas capitation fees in India, in some colleges is in excess of this amount. While countries like China and Russia are able to attract large number of Indian students to pursue higher education in medicine, it is tragic that in India medical education should cost so high. Over 9000 students leave India every year to pursue medical education.

Instead of looking at the cost of such education within the country, the Medical Council of India and other controlling bodies try to discourage Indian students pursuing medical education overseas, by putting lot of restrictions in granting them eligibility to practise within the country. The report suggests that just around 25 per cent of Indian graduates who obtain degrees overseas get qualified for practice within the country; the figure for last year appears miserable: just 4000 passing the eligibility test against 14,000 that took the test. Imagine the frustration and wastage involved in such talent rusted! Also imagine the ability of China to build such large capacity for medical education and offering it at such affordable cost! The situation needs to change and change quickly.

 

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