Maha MBBS quota for ru­ral stint, prison if doc­tors breach bond

The Times of India (New Delhi edition) - - Front Page - Su­jit Ma­hamulkar & Su­mi­tra Deb Roy

Mum­bai: In a bid to bridge the doc­tor-pa­tient gap in ru­ral areas, the state govern­ment has pro­posed to re­serve 10% of MBBS and 20% of med­i­cal post-grad­u­a­tion seats for in-ser­vice doc­tors who are will­ing to work in in­te­rior areas for five and seven years, re­spec­tively. The quota seats, though, come with a stringent con­di­tion: Those fail­ing to work in state-run hos­pi­tals af­ter com­ple­tion of the course could face im­pris­on­ment of five years and even can­cel­la­tion of their de­grees.

The state cabi­net ap­proved the de­ci­sion on Mon­day and will in­tro­duce a bill called Ma­ha­rash­tra Des­ig­na­tion of Cer­tain Seats in Govern­ment and Mu­nic­i­pal Cor­po­ra­tions Med­i­cal Col­leges to make it a law. The re­served seats will be avail­able in state and civi­crun med­i­cal col­leges as well for as­pi­rants who want to work for a long pe­riod in govern­ment cen­tres.

By pre­lim­i­nary es­ti­mates, 450-500 MBBS seats could be ear­marked un­der this ru­ral area quota while the count of PG seats for in-ser­vice MBBS grad­u­ates could be around 300.

“The de­ci­sion has been taken to en­sure that we have enough doc­tors to man the pri­mary health cen­tres and other ru­ral health fa­cil­i­ties in ru­ral, hilly or re­mote areas. Stu­dents get­ting a seat un­der the quota will have to sign a bond. Any breach would at­tract im­pris­on­ment of five years as well as can­cel­la­tion of de­grees. Only those with the state’s domi­cile cer­tifi­cate can opt for the quota,” said Dr T P La­hane, head of the Di­rec­torate of Med­i­cal Ed­u­ca­tion and Re­search.

Ac­cord­ing to the lat­est eco­nomic sur­vey of Ma­ha­rash­tra 2018-19, the doc­tor pop­u­la­tion ra­tio in the state is 1:1,330 against the WHO rec­om­mended 1:1,000. In re­mote parts of the state, though, the ra­tio con­tin­ues to be abysmally low with one doc­tor for a pop­u­la­tion of 5,000 or more. Of­fi­cially, the state has over 1.5 lakh al­lopa­thy doc­tors, of whom around 66,081 are PG de­gree hold­ers.

The de­ci­sion has evoked a mixed re­sponse from ex­perts, mainly be­cause of the state’s fail­ure in im­ple­ment­ing the ex­ist­ing bond ser­vices ef­fec­tively. All MBBS and PG stu­dents study­ing in the pub­lic med­i­cal col­leges are sup­posed to serve a manda­tory one-year bond af­ter the com­ple­tion of each de­gree fail­ing which MBBS stu­dents have to pay a penalty of Rs 10 lakh, PG doc­tors Rs 50 lakh and Rs 2 crore by su­per-spe­cial­ity can­di­dates. How­ever, data has shown that less than 10% can­di­dates pro­ceed to fin­ish the bond or even pay the penalty.

“One can’t help but won­der that the state could have got 5,000 doc­tors by im­ple­ment­ing the bond con­cept right. We have al­ready seen that penalty doesn’t work,” said Dr Ab­hay Shukla of Jan Ar­o­gya Ab­hayan. For­mer dean of KEM Hos­pi­tal Dr Av­inash Supe said the de­ci­sion was a bold but must be com­ple­mented by upgra­dat­ing ru­ral in­fra­struc­ture.

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