Create more regular posts for MBBS docs
India produces 67,000 MBBS a year and 20,000 foreign medical graduates return annually. Even if 16% (one-sixth) of these foreign medical graduates clear the Foreign Medical Graduate Screening Exam (FMGE) that allows them to practice in India, the number of qualified and licenced MBBS doctors produced annually is 70,200.
The government, the largest employer, has 1,750 vacancies a year for MBBS doctors at Primary Health Centres. Other government agencies like the Railways, the Employees’ State Insurance (ESI), Public Sector Units (PSUs) and the army etc. employ a similar number. This leaves around 66,700 MBBS doctors looking for a job every year.
Some of these join postgraduation. Here, even with the increased number of seats, about 35,000 MBBS doctors remain unemployed. Till two years ago, even the number of PG seats was half of the number today, so there is also a backlog of unemployed MBBS from the previous years. This is reflected in the fact that around 1 lakh MBBS doctors appear for NEET-PG exam every year. Some of the unemployed join private hospitals as Resident Doctors for a few months to a few years. However, this is not a long-term solution.
THE GENESIS OF THE PROBLEM
There is no future in being a resident doctor, however good you may be in clinical skills. It is not as if it is a permanent job with regular pay scale, yearly increments and stock options. Ultimately, you are expected to move on. This is where the problem arises.
Those who are left without a postgraduation, have tried multiple attempts to crack the NEET PG, done a resident’s job for 3-odd years and are not beneficiaries of any reservation (thus not getting a government job), are rendered most vulnerable. Already about 27 -28 years, and expected by their families and friends to be “settled”, such MBBS doctors are left adrift with no sense of direction.
Some try to go abroad to seek greener pastures. Setting up a practice is easier said than done. To set up a General Practice (GP) in a city is no longer a financially viable option. Costs are prohibitive and the GP space in suburbs, small towns and villages is firmly occupied by entrenched government-approved quacks and others.
To survive in the quagmire, an MBBS in a village would have to resort to tricks and fraudulent actions that those around him are indulging in. This, however, is not the practice of medicine. Many youngsters get frustrated and leave the profession to join IT firms and do medical transcription; others join pharma industry; some try for civil services, some opt for a career in management.
SUPER-SPECIALIST CULTURE
Today, the super-specialist culture deeply prevalent in the country encourages treatment of organs rather than the human body. The role of MBBS in clinical practice has been gradually, but surely emasculated to a level where a urologist is to do a catheterisation and a cardiologist is doing an Electrocardiography (ECG).
We are moving from super specialities to super-super specialities. A DM Gastroenterology needs a further fellowship to perform other specialised procedures. The role of an MBBS, in clinical practice, is demoted to that of a glorified clerk and phlebotomist (people trained to draw blood for clinical or medical testing). The turf war among specialists has led to a situation where despite being a graduate in medicine and surgery, an MBBS can neither practice medicine nor surgery, obstetrics, ENT, eye or any other field which is defined as a speciality. Unfortunately, our courts have contributed their might to creating this mess.
SENIORS MUST TAKE ACTION
Unfortunately, this weakest segment of our profession is seldom heard in the innumerable conferences and meetings of professional associations. Is it not our responsibility as seniors to secure the professional needs of our youngsters?
But then, we are busy trying to be president /secretary/BC Roy awardee/nominated member of the Medical Council of India (MCI) to be bothered about such mundane matters. Should we not have as our first and foremost demand the creation of more regular posts for MBBS doctors? We cry hoarse about dearth of doctors, but are loath to provide them with a stable career option as healers to the community.
WE CRY HOARSE ABOUT DEARTH OF DOCTORS, BUT ARE LOATH TO PROVIDE THEM WITH A STABLE CAREER OPTION AS HEALERS TO THE COMMUNITY; WE NEED TO SECURE THE PROFESSIONAL NEEDS OF OUR YOUNGSTERS