In the past few months of 2021, enormous and elongated research to prognose and diagnose the areas of concern in the health infrastructure of the country have been conducted. Various concerns like shortage of doctors, materialistic resources, inadequate training, etc have been raised time and again. It was hoped that after such a grand uproar in the months of April, May and June, when the covid crisis was at its peak, things would soon face a reformation. However, in the span of just 3 months, the country has seemingly backflipped to its ‘usual’ norms. Proof of that is the recent announcement of the Centre Government.
The centre has announced 27% and 10% All India Quota (AIQ) in all the state government medical colleges for OBC and Economic Weaker Sections (EWS) respectively. The decision seemingly is along the lines of Madras High Court directing the Union Government to implement the AIQ in the National Entrance Cum Eligibility Test (NEET) last year.
The decision follows the earlier decision of the Apex Court in 2007 in the Abhay Nath case- deciding the 85% reservation in Undergraduate medical studies and 50% in post-graduate medical studies for scheduled castes and tribes in their domicile states.
With all the recent additions by the centre, approximately 2050 seats (1500+550) in UG courses and 3500 (2500+1000) in the PG courses would further be reserved for the OBC and EWS categories. The number may seem small at first hand, but with just 85000 UG seats and 55000 PG seats all over the country. for over 7 lakh NEET-UG qualified students, significantly shrinking the entire pool of merit several folds. Though the decision may aim to provide better access to the economically and socially marginalised groups, there are high chances that it can further dilute India’s intellectual capital.
The creeping advances of reservation from education to jobs to promotion is a representation of how flawed the existing system is. What is even more disheartening is the fact that despite knowing where the fault lies, we are still moving forward with the same approach. Surprising enough, India is one of those countries having the highest number of medical universities in the world and still is second only to China in the number of students flying abroad for an international degree with approximately 75% of students studying MBBS abroad.
The fundamental deformity in the current medical education system in the country is that medical education is seen merely as an opportunity for certain individuals to prosper in life like a 9 to 5 job. On a broad spectrum, the nationwide need is to provide equitable distribution of physicians and quality health care for all citizens. Overlooking the limitations and challenges actually hinders the nation in the way of achieving an important national goal—that of ensuring a relatively equitable distribution of physicians and quality health care.
As for the students, this decision of the centre is like slashing the space of merit further resulting in many deserving aspirants to either drop their dream of becoming a doctor or seek admission in the other countries and often join the research and medical practices there only.
Countries like Russia, China and the USA have been investing heavily in research and talent cultivation in the fields of contemporary medicine whereas India seems to be focusing on representing instead of overcoming the social and economical bias prevailing in the society. Already due to limited seats in the medical universities of India, around 8000 students from India depart to countries like Russia, Bangladesh, Ukraine, China, etc to pursue medical studies
As of 2021, there are almost 45000 Indian students currently studying MBBS abroad in the now-defunct Medical Council of India approved universities. Among the top names, MBBS in Russia, China, Ukraine, etc are the preferable choices for affordable education. The universities in these countries not only provide a feasible option to study MBBS, especially MBBS in Russia, but also provide ample opportunities for global exposure and personal growth to the students.
As a result, many students discover more opportunities with their MBBS abroad and may decide to settle there. Commonly referred to as the medical brain drain. The few who return to India, have to sit through and qualify the Foreign Medical Graduate Exams (FMGE). National Exit Test (NExT) in order to practice or pursue further studies in India.
What is required at this time is to relax the regulation regarding medical education and training within the country. Steps are already being taken to ensure more universities are available for the students, however, no step is taken to increase the number of seats for the unserved students. Instead, the already limited seats are further on the decline. As far as the problem of medical brain drain is concerned, it can be easily solved by providing a little leniency in the FMGE score to encourage the students to join the mainstream medical fraternity of the country.