The recent brouhaha against Health Ministry's petition promoting Compulsory Rural Stint for medical students merits attention and sound debate.
At first glance, I felt it was the right thing to do and why should all the wannabe docs refute such a noble proposal? Is 365 days too much to offer your country which subsidizes your education?
Its said, about 8% of primary health centres in rural areas do not have any doctors ! If this young force lent their assistance for a year, it would greatly reduce the burden on the already cracking health infrastructure.
When these young doctors work under such dire conditions, their learnings and observations can lend a great insight into the health care system and the requirements to provide basic health care to rural areas.
Moreover, their stint in the hinterlands would come in handy later on - they would have learnt to function with limited professional help and medical supplies, thus helping create a sound judgment.
Yes, all of the above and a lot more can be said in favor of a compulsory stint in rural areas.
However, when we look at the other side of the coin, the situation appears dismal !
The Health ministry wants all the students to go in for a compulsory internship for 2 years (1 in a rural area of their choice), only after which shall they be given their official doctoral degrees.
Now, most medical students hail from middle class families. Such a compulsion would mean they would end up getting their MS/MD only when they turn 32/33...Follow this up with paltry remuneration they are offered in their initial years. Making a 5.5 years' course (inclusive of 1 year of internship) into a 6.5 years course would only add fuel to the raging discontent amongst medical students.
Just how does one manage taking care of one's family, meeting financial demands and clearing off educational debts?
Moreover, if we were to put our minds to the situation - how do we expect 23 year olds to face the pathetic, almost non existent infrastructure in most rural areas? If we want these people to learn and have an impressive take home, shouldn't the government be working on the basics at least?
Also, if we were to question the commitment of the government, what explains the penalty of 3/5/15 lakhs for students who want to do away with rural stint? Only a select percentage can afford such exorbitant penalty. What about the majority? Why should they alone suffer? Also, why should graduates with foreign university degrees be spared the rural stint?
Rules should apply to all.
I feel to make the initiative successful a mix and match of the following could be used -
- Increase the Stipend of interns
- More credits for students who come out with executable solutions/innovations to solve health care issues
- Instead of the suggested 2 years, break the existent 1 year into various weeks of working in cities, towns and most affected rural areas
- For better performance and encouragement, senior doctors or guides should spend a week/two with these interns. This shall ease away the fears of the fresh graduates and provide them an understanding of what's expected from them.
- Tie-Ups with foreign medical universities, preferably, with countries which have similar health care set up. Our graduates could intern with them, study and learn how these countries deal with health care problems and help infuse fresh ideas in our decaying system
- Adoption of a cluster of villages - In this case, the government could target the worst affected villages first instead of pseudo villages. While a group of interns work there, the government could build up clinics, mobile vans, sanitation camps across the village
- Tie Ups with private sector for establishment of clinics, medical supply and so on
