Reality Check India

Medical students in a limbo

Posted in Uncategorized by realitycheck on December 3, 2007

The politicians are playing with students lives and careers again.  Someone decides that extending the MBBS program to 6 1/2 years is a good and virtuous move and they rush to implement it without any concern for those affected.

Medical colleges in Tamilnadu closed (Tamil)

Thousands of MBBS students protest in Maharashtra and TN

The issue is very simple :

The government plans to impose a compulsory 1 year stint for medical students BEFORE giving them their MBBS degrees. This service is not completely rural with about 6-8 months of service in Taluk and Dist headquarters. 

There is more :

This should be at least three years, the apex planning body has recommended in the draft Eleventh Plan that aims to improve government’s health care services to the public.

The idea is to enable students who get state-subsidised education to contribute to the society by serving the tax payer for a few years. The Commission has also recommended that the pay structure of doctors should be improved.

Source : ET

For a casual observer, this would seem to be a non-issue.

What is wrong with a compulsory service  ? After all the rural countryside is neglected. Having these students will expose them to the problems of the villagers as well as help share the national burden. 

The problem is that the government is passing off its own failures to citizens. It first has to show the country :

1) What steps has it taken to overcome the rural doctors shortage ?

2) Why not provide schemes to attract full doctors with experience to the rural areas ?

3) Why is there such a shortage of medical seats ? Why is medical education largely under the control of capitation fees, religion, and/or politicians ?

4) The agitating students are bending over backwards to say that they are willing to go to rural areas as full doctors. Why is there no positive response to this ?

5) What about the public health system in the cities and towns ? Does any politician go there for treatment anymore ?

Why conscription ? 

The deeper question is one of conscription, of involuntary labour forced by the government on citizens. There is an even more presssing case for conscription in India, do you know what that is ?

It is fighting insurgents. 

The police and para military forces are extremely stretched fighting terrorists from Chattisgarh to Kashmir to Assam. Why not impose a one year “internal security” stint for all graduates ? This one year stint can be split into a three month boot camp followed by light duties such as maintenance and signals, then capped by forward support and offensive operations.

Any takers ? No, because the government must exhaust all avenues of voluntary involvement first. The same applies to medical students as well.

Compulsory service of any form must be the last resort. First explain to us why the situation is so bad that you have to force poor medical students alone to spend one year of their already tight careers. Why not have the IITans work for a year in a rural school teaching kids Maths and Physics ?  Why not have JNU students teach social scienc.. , sorry terrible idea 🙂 (got carried away)

Behind the scenes, rigid votebanks allows political forces to act in a brazen manner disregarding legitimate concerns of citizens. You already knew that right ?

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29 Responses

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  1. Bruno said, on December 3, 2007 at 5:00 pm

    Recommendation 1: //This should be at least three years, the apex planning body has recommended in the draft Eleventh Plan that aims to improve government’s health care services to the public.//

    Recommendation 2://The Commission has also recommended that the pay structure of doctors should be improved.//
    Why this has not been given the same attention as Recommendation 1 🙂 🙂 🙂 Why is no one pushing this 🙂 🙂 🙂

    //However, medical services in Tamil Nadu and Maharashtra have not been affected, as interns do not actively work in hospitals.//
    What is this nonsense…. If not interns, who is working in hospitals

    //The idea is to enable students who get state-subsidised education to contribute to the society by serving the tax payer for a few years.//
    I fully support Rural Service. In fact I have served the greater part of my career in villages…. The experience you get and the job satisfaction you get there is beyond comparison……. But…. It should be left for those who really want that….. I think the main issue is “compulsary” and not “rural” in these strike

    But then, I have serious doubts about the “tax payer” logic… May be you can see this link http://bruno.penandscale.com/2007/01/my-two-seconds-of-fame.html

  2. Bruno said, on December 3, 2007 at 5:03 pm

    There is a scheme of posting doctors for 3 years after PG in Tamil Nadu. No one is opposing that…. See http://bruno.penandscale.com/2007/11/comparing-compulsary-1-year-service-for.html for the difference between these two schemes

  3. Bruno said, on December 3, 2007 at 5:08 pm

    Please note that I support the Rural Service… It will be a lot beneficial to the doctors… I learnt a lot in my 3 years in PHC.. (not only medical but administration, human relationship, disaster management, crisis management etc)… Any one who has worked in a PHC SINCERELY for 2 years will have enough Management Skill to manage 200 people !!!

    Not every one wants to do PG after MBBS. Some prefer to work (family reasons). Let those who want to go for PG go, Let those who want to come to villages come…

    A very simple question
    Why do you want to compel a person who wants to go to PG to work and not give job opportunity to those who want to work

  4. Bruno said, on December 3, 2007 at 5:10 pm

    There are some very good questions / doubts given at
    http://www.tngda.in/2007/12/press-release-2007-dec-02-ec-meeting-at.html
    That is the official press release of Tamil Nadu Government Doctors Association. Please share your comments

  5. Bruno said, on December 3, 2007 at 5:11 pm

    Recommendation 1: //This should be at least three years, the apex planning body has recommended in the draft Eleventh Plan that aims to improve government’s health care services to the public.//

    Recommendation 2: //The Commission has also recommended that the pay structure of doctors should be improved.//
    Why this has not been given the same attention as Recommendation 1 🙂 🙂 🙂 Why is no one pushing this 🙂 🙂 🙂 I am sure that no one will go one strike when this second recommendation is implemented

    //However, medical services in Tamil Nadu and Maharashtra have not been affected, as interns do not actively work in hospitals.//
    What is this nonsense…. If not interns, who is working in hospitals

    //The idea is to enable students who get state-subsidised education to contribute to the society by serving the tax payer for a few years.//
    I fully support Rural Service. In fact I have served the greater part of my career in villages…. The experience you get and the job satisfaction you get there is beyond comparison……. But…. It should be left for those who really want that….. I think the main issue is “compulsary” and not “rural” in these strike

    But then, I have serious doubts about the “tax payer” logic… May be you can see this link http://bruno.penandscale.com/2007/01/my-two-seconds-of-fame.html

  6. Barbarindian said, on December 3, 2007 at 10:54 pm

    They should take a vote and send only those to rural areas who support social justice.

  7. Kumar said, on December 4, 2007 at 3:08 pm

    The quack’s back after he struted out of here a few threads ago.
    Those ruffled feathers back in tact? 🙂 Huh? 🙂 Huh? 🙂 Huh? 🙂

  8. realitycheck said, on December 4, 2007 at 3:11 pm

    Bruno,

    Rs 8000 stipend is atrociously low for these docs who have already completed 5 1/2 years. What is the government response to hiking it to say around 20K + accomodation (on par with IT freshers) ?

    No one should be forced to be an angel. It is the government’s job to create the right incentives to lure students to rural service.

    You are correct. The “taxpayer” logic is not relevant.

  9. realitycheck said, on December 4, 2007 at 3:22 pm

    Kumar,

    Perhaps you need to give Bruno some credit.

    He has helped many medical students with PG guidance and is service minded. I know nothing about medicine but I have seen his posts on many forums helping out people with genuine guidance. Much respect there.

    On areas of disagreement, you have to look at the root positions held by people. I believe he was in support of a generation-based creamy layer exclusion. Eg, doctors children not eligible for social justice.

    When you find middle ground, you have to grab it and try to move up from there.

  10. Bruno said, on December 5, 2007 at 5:30 am

    //I believe he was in support of a generation-based creamy layer exclusion. Eg, doctors children not eligible for social justice.//
    Oops
    Every one is eligible for social justice…
    The reservation should be selective
    —–
    The exclusion (from reservation) should be based on Parents Education and not on economy
    That is my point

  11. Reason said, on December 5, 2007 at 6:37 am

    There was a news item that Ramadoss (the father) was asking ‘how can students who benefitted from government’s reservation protest’. He seems to view the current reservation policy as a concession granted by the politician that takes away any right from the students to protest the politician’s actions. There wasn’t much reaction to that statement – may be because he is right – the current reservation policy is a concession granted by the politician to his vote bank in return for that vote bank, and is understood to be such.

    There was a news item in Indian Express yesterday of a visitor from Kerala infecting a Italian town with chikungunya. Our health minister appears to be in a hurry to leave his ‘stamp’ through his battles in AIIMS and this rural conscription.

  12. Revathi said, on December 5, 2007 at 8:13 am

    I dont think that a person can spread chikungunya. It is spread by the AEDES mosquito. So in order for it to spread, there should have been someone from Kerala and mosquitos that bit him. I wonder where the mosquitos migrated from. As far as I know, the anopheles and AEDES mosquitos generally do not survive in Europe, but who knows, with global warming, all these dieseases will move northward.

  13. Bruno said, on December 5, 2007 at 3:57 pm

    //dont think that a person can spread chikungunya. //

    THough the diseases are not contagious, A person can spread Chikungunya / Dengue / Malaria !!!!

    The cylce is very simple

    Man – Mosquito – Man – Mosquito

    So if a persons has Chikungunya virus in his blood, he cannot spread the disease to another person by touch or sharing towels.

    But when an Aedes mosquito bites him, it gets infected with the virus and when the mosquito bites another person, he gets infected
    —-
    Fortunately, AIDS is not spread this way 🙂 🙂 🙂

  14. Bruno said, on December 5, 2007 at 4:01 pm

    //What is the government response to hiking it to say around 20K + accomodation//

    There is no issue of “Hiking”

    At present the pay for a fresh graduate in Government Medical Services is around 18000 to 20000 (depends on state / central)

    The “compulsory” Service of 4 months villages + 8 months cities was in danger of abolishing around 25000 medical officer posts in government sector – not only in PHCs, but in all sectors including medical college (Please note that only 4 months out of this 1 year posting is in PHCs)

    Why do you want to recruit a doctor for Rs 20000 when you can have an Intern do that work for 8000

  15. Kumar said, on December 5, 2007 at 8:52 pm

    RC: thanks for that tit-bit, I wasn’t aware of his work.

    Bruno:
    The exclusion (from reservation) should be based on Parents Education and not on economy
    So, son of an illiterate multi-crore-pati, get’s reservation?

  16. Bruno said, on December 6, 2007 at 5:10 am

    //The exclusion (from reservation) should be based on Parents Education and not on economy
    So, son of an illiterate multi-crore-pati, get’s reservation?//
    A son of a multi crore pathi gets seat in a college under quota IF HIS FATHER HAS NOT COMPLETED College Education.

    And once the son gets the education, INSPITE OF THE FINANCE STATUS, his grandson and further progeny will be considered as general category, whatever be the amount of income shown in their tax returns
    —-

  17. Bruno said, on December 6, 2007 at 5:17 am

    Educational qualification is a permanent stamp. You cannot be literate today and illiterate tomorrow.

    Economy is not like that…. It changes… and the real status can be faked very easily than faking the educational qualification

    It is

  18. Revathi said, on December 6, 2007 at 8:35 am

    Dear Dr. Bruno,

    That was indeed my point- in order for chikungunya to spread we need an infected man and a particular type of mosquito. So, in the middle of winter, where do you think this mosquito came from? May be it came along with him in the plane. This mosquito is probably dead by now. So we hope that there will be no more cases..

  19. Wanderer said, on December 6, 2007 at 8:11 pm

    A son of a multi crore pathi gets seat in a college under quota IF HIS FATHER HAS NOT COMPLETED College Education.

    Absurd to say the least!

    IF the person is a crorepati, it means he has sent his son to the best school in the area and provided him with the best facilities – Why would such a student need reservation? In the frenzy of creating new theories to determine backwardness,you should not forgetting the main AIM of providing reservation which(according to me) is to benefit someone who under normal circumstances would have qualified to enter that university, but has been held back due to a lack of facilities.

  20. Kumar said, on December 7, 2007 at 2:49 pm

    Thanks Wanderer, couldn’t have put it better myself. I’m amused at the number of theories proponents of reservations will come up with that simply can’t stand the common sense muster.
    It’s akin to pouring more bad money on dsyfunctional projects to keep their ego flying high.
    Makes for good time pass on blogs.

  21. Bruno said, on December 10, 2007 at 7:30 am

    //A son of a multi crore pathi gets seat in a college under quota IF HIS FATHER HAS NOT COMPLETED College Education.//

    Why absurd…

    What if the father was a pauper for 15 years, but suddenly became a crorepathi at the time of admission. –> Will you deny his son reservation

    What if Narayana Moorthy donates all his money and gives you a bank account of Zero –> Is his son eligible for reservation

    If you take education as the criteria, the number of persons needing reservation WILL DEFINITELY Decrease over generation

    By the way, how is reservation based on Education is absurd while reservation based on economy is not absurd.

  22. Bruno said, on December 10, 2007 at 7:35 am

    Educational qualification is a permanent stamp. You cannot be literate today and illiterate tomorrow.

    Economy is not like that…. It changes… and the real status can be faked very easily than faking the educational qualification. If you take Economy as the standard the “salaried class” alone will be affected. More you cannot be sure that the next generation will be outside the purview of reservation

    On the other hand, if you take education as a criteria, the next generation is automatically brought into general pool.

    By the way, Wanderer and Kumar

    Can you answer this simple question

    Exclusion of Creamy Layer – Is that beneficial or Detrimental to the General Caste
    (Let us see whether Wanderer and Kumar are opposing reservation for the cause of merit or something else)
    PS
    (Reality, I will ask a more specific question to you later)

  23. Bruno said, on December 10, 2007 at 3:04 pm

    For information

    http://www.jipmer.edu/PGProspectus08.pdf
    ——
    22.5% of PG seats are reserved for candidates belonging to Scheduled Caste (SC) and Scheduled Tribe (ST) – [15% for SC & 7.5% for ST].

    3% on Horizontal Reservation basis for Orthopaedic Physically Handicapped (OPH.) candidates.

    By way of institutional preference the Institute candidates (I) shall be preferred for admission against 55% of the these 35 seats without any disciplinewise preference. The remaining 22.5% of the seats are for unreserved (UR)
    ——-
    Unreserved (UR) Open to all candidates 8 seats
    Institute (I) Open to candidates who have graduated from JIPMER
    19 seats
    Scheduled Caste (SC) Open to all Scheduled Caste candidates from all over the country
    5 seats
    Scheduled Tribe (ST) Open to all Scheduled Tribe Candidates from all over the country
    3 seats
    OPH Orthopaedic Physically Handicapped on horizontal Reservation basis
    1 seat
    —–
    If some one has been thinking that Institute Quotas are very miniscule, please wake up !!!

  24. Wanderer said, on December 10, 2007 at 3:45 pm

    @Bruno,
    What if the father was a pauper for 15 years, but suddenly became a crorepathi at the time of admission. –> Will you deny his son reservation

    What if Narayana Moorthy donates all his money and gives you a bank account of Zero –> Is his son eligible for reservation

    What if the father is a super-intelligent human ,but has never gone to school and suddenly ,just before his son’s JEE, he( the father) reads all textbooks and becomes educated? Would his son become ineligible for reservation?

    What if the father is a PhD from MIT, but just before his son’s CET, suffers
    a blow to his head ( Bollywood-style) and forgets everything?
    Would his son become eligible for reservation?

    Your “what-ifs” are just as absurd.

    If you take education as the criteria, the number of persons needing reservation WILL DEFINITELY Decrease over generation

    Dude, you have to get the purpose of reservation correct first.

    The purpose as I said earlier, is to benefit someone who under normal circumstances would have qualified to enter that university, but has been held back due to a lack of facilities.

    The purpose is NOT to decrease the number of reservations. Of course, that is an important aspect, but it would be laughable if that were to determine reservation policy.

    Coming to your question,
    Exclusion of Creamy Layer – Is that beneficial or Detrimental to the General Caste

    From what I make of your question, I’d answer
    Exclusion of Creamy Layer is beneficial to non-creamy-layer backward people. More correctly, exclusion of the creamy layer prevents undeserving candidates from usurping reservation benefits (which, going by current observations, they are.)

    Draw your conclusions about whether I’m “opposing reservation for the cause of merit or something else”

  25. Wanderer said, on December 10, 2007 at 3:47 pm

    And I forgot, you haven’t answered Kumar’s question.
    So, son of an illiterate multi-crore-pati, get’s reservation?
    Answer please. No counter “what-ifs”

  26. Bruno said, on December 10, 2007 at 4:33 pm

    So, son of an illiterate multi-crore-pati, get’s reservation?
    Yes… But only for one generation. …..
    I have given the answer.. After the son gets reservation, his entire progeny will be treated as general quotas…

    So the son of an illiterate crore pathi gets reservation, but not his grandsons or great grandsons.
    —–
    //What if the father is a super-intelligent human ,but has never gone to school and suddenly ,just before his son’s JEE, he( the father) reads all textbooks and becomes educated? Would his son become ineligible for reservation?//
    The father reading books is not at all a criteria. Since he has not gone to “College”, the son is eligible for reservation. Full stop. But further generations are not eligible

    //What if the father is a PhD from MIT, but just before his son’s CET, suffers a blow to his head ( Bollywood-style) and forgets everything?
    Would his son become eligible for reservation?//
    Since the father has been already educated, the son is not eligible. this is very simple.

    The fact is very simple –> Once educated is ALWAYS educated. You can go from illiterate to literate, but not the other way round. on the other hand you can go from rich to poor or poor to rich. Worse still, you can pretend to be poor when you are rich

    If you read my entire post, you will see how this is better than creamy layer on economy…..
    (the best will be no quotas – but the question is not that – the comparison is between quotas based on economy and quotas based on education – compare these two and answer. Don’t compare quotas based on education with no quotas.)
    —-
    //Your “what-ifs” are just as absurd….//
    Unfortunate (for you), they are not absurd. They are valid questions.
    —–
    I very well know that exclusion of creamy layer is beneficial to the non-creamy layer BC. My question is not that

    My question is “Exclusion of Creamy Layer – Is that beneficial or Detrimental to the General Caste”

    Please answer

  27. realitycheck said, on December 11, 2007 at 5:30 am

    >> Unreserved (UR) Open to all candidates 8 seats
    Institute (I) Open to candidates who have graduated from JIPMER
    19 seats >>

    Ok, I had the opportunity of checking out your earlier details of AIIMS and now JIPMER institute quotas. I have to agree that given the tiny number of seats – the institute quota is way over the top.

    If they really want to guarantee their UG students seats when it comes to PG admissions, they must clearly advertise in the UG admission forms for that it is a “integrated UG+PG” course.

    If it is true that slackers (with low UG marks) get into the PG medical programs of premier institutes – just because they cracked an entrance exam five years ago. It seriously undermines the claims to excellence of these institutes.

    If you know the facts, I believe a PIL should be in order. Everyone should support this PIL irrespective of caste/religion/whatever.

    In this country of severe scarcity, you cant have such a quota that

    1) shuts out meritorious students from PG programs just because they did not clear an entrance exam for the UG program.

    2) offers extended rewards for students in the form of a PG seat. while they only cleared the UG exam.

    If the government wants to keep this system. They have to clearly advertise that the program is an integrated course. This will prevent false hopes among other students.

  28. Bruno said, on December 11, 2007 at 2:07 pm

    Hi Reality Check, You have called a spade a spade….

    There are a lot of quota. Tamil Nadu even used to have quotas for children born out of intercaste marriage once. I can list many such “un common” quotas…

    But none is so bizarre as this Institute Quota, which surprisingly consumes the maximum number (contrary to the popular belief) of seats compared to the other quotas

    But still I am not able to understand the logic behind this quota.

    //If they really want to guarantee their UG students seats when it comes to PG admissions, they must clearly advertise in the UG admission forms for that it is a “integrated UG+PG” course.//
    Good Idea !!!
    As You have rightly said, may be they should tell that JIPMER UG Entrance is for admission to both UG as well as PG 🙂 🙂 🙂

  29. Barbarindian said, on December 12, 2007 at 6:55 am

    But none is so bizarre as this Institute Quota

    Nothing really is so bizarre as the interepretation of Institute quotas. Specifically for AIIMS: the fact is that the entrance to the UG is excruciatingly tough. But – the UG degree by itself has hardly any value. On the other hand, you have to see the hospital workload of AIIMS to believe it.

    If the AIIMS institute quota is repealed, it would be like asking 3rd year Engineering students of all schools to regroup on the basis of grades earned and complete the 4th year in the institute they get according to grade ranking.


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