Medical education: Time for collective action

Dr Arun Mitra & Dr GS Grewal

Admission to medical colleges has been a contentious issue for quite some time. At one time medical education in our country used to be within the reach of students from ordinary families too. This was the time when medical colleges were in the state sector. Going by the information from the website of Medical Council of India, at the time of Independence, there were 20 medical colleges out which only one was in private sector. Most of the new additions were in the state sector till late eighties. But after the shift in economic policies the scenario changed. We find that between 1990 and 2017 the number of colleges opened in private sector was 238 while only 115 were in the state sector. Not only that, many of these were made as deemed universities with their own examination and admission system and fee structure. 
Most of the private sector colleges developed their own fee structure and many were charging under hand money as capitation fee. Merit was completely ignored and money became supreme. Presently seats in the private colleges are split into different categories. One category seats have to be filled under the government quota. These will be charged tuition fee at par with the government medical colleges in the respective states. For example in the state of Punjab the tuition fee in the government colleges is Rs.13.4 lakh for the full course of MBBS for 4.5 years. In the private colleges 50% of the seats are to be filled under this category. The private colleges are free to fill other seats under the management and the NRI quotas. The fee structure in this second category is variable from college to college.
In the Guru Ramdas Medical College, Amritsar the fee is Rs.35.4 lakh for the full course. In Adesh University of Medical Sciences, Bathinda it is Rs.63.9 lakhs; in the Punjab Institute of Medical Sciences it is Rs.35.46 lakhs. Astonishingly, telephonic enquiry from the Era’s Medical College, Lucknow revealed the tuition fees to be Rs17 lakh per annum, which with 10% increase every year, comes to nearly Rs.91.34 lakh for MBBS course. The PG seats tuition fee in this college is up to Rs.49 lakhs per year. That means if one wants to do MBBS and MS/MD both from this college, he or she will have to pay nearly 2.5 crore rupees and also the additional costs for books, travel etc. This means the student has to spend nearly 3 lakh rupees per month or Rs.10, 000 per day.
This is a cruel joke. In our country where the vast majority of population is devoid of even basic needs, it is literally impossible for them to imagine to send their wards to the medical college even when they are on merit. There was hope that after the introduction of NEET, capitation fee will end. But what has happened is to the contrary. The private colleges increased their tuition fee and are now earning legally in white money.
Now some private medical colleges in Punjab have decided to do away with the category of government quota. The state government should have taken action against such colleges. But instead Health and Family Welfare  Minister  Brahm Mohindra, for reasons best known to him, issued a statement in  their defence  and justified the illegal, unlawful and unethical decision of scrapping the government quota in two privately run medical colleges in the state. This means now the student does not necessarily need to be meritorious as long as she/he can manage to fill the deep pockets of the medical college managements. This will simply undermine the quality of medical education and services we are striving to achieve.
Medical education and health services need an overhaul. But the steps like allowing private medical colleges a free run does not indicate any such intentions of the governments. It rather reflects badly and poorly on the government that instead of taking measures to improve the system, it has succumbed and submitted to the unjustified and unlawful demands of the managements of some privately managed medical colleges. This is indeed a sad day for medical education in Punjab. Such exorbitant fee enhancement will be a doomsday for students with merit. And when in medical education merit will be replaced by money, God save our health system.
As such private medical institutions have problems of fake faculty and lack of patients flow added to that will be suicidal. With the new National Medical Commission in the offing, the situation may get worse. This bill gives preference to private sector to open medical colleges with profit motive. It is time medical organizations, student bodies and academicians raised their voice forcefully to save the country. The silence of Indian Medical Association on issue of such vital importance is intriguing. (IPA)

Sunday, 1 July, 2018