09 Apr Medical Education Dawdle
Medical Education Dawdle – Today Current Affairs
Healthcare has always been a neglected aspect of the Indian economy. The relatively small size of the health sector, the meager government spending on providing healthcare services, and the huge shortage of the health personnel all point to major governmental failure. The availability of adequate health personnel is especially crucial as a quality workforce can not only ensure greater economic stability and security but also boost both inclusive growth and the overall employment creation.
Today Current Affairs
However, successive governments have generally ignored these problems. Even the pandemic failed to trigger any major government interventions in the health sector. Supply-side issues like the non-availability of a skilled workforce, especially doctors, continue to be neglected. Vested interests have successfully sabotaged all state interventions necessary for the expansion of medical education. This is a major reason why tens of thousands of students are forced to take up admission in medical colleges abroad every year. However, the outbreak of the pandemic in China and the war in Ukraine have now forced thousands of medical students in these countries to flee back home, thus jeopardizing their education. The Hindu Analysis
What is surprising is that despite the growing demand for medical education, the supply remains stymied. Most private medical colleges lack basic infrastructure and qualified teachers. Moreover, they charge exorbitant fees that most students cannot afford. The result is a growing gap between demand and supply of medical personnel. Estimates show that the total availability of skilled health personnel is only 1.77 million as against the total requirement of 3.42 million, which means a shortage of an astounding 1.65 million personnel. The density of health personnel in India is only 22 per 10,000 persons as against the World Health Organization (WHO) norm of 44.5. The WHO estimates indicate that India needs around 1.8 million doctors, nurses, and midwives to meet the stipulated norm by 2030.
A recent estimate in the National Health Workforce Accounts shows that the total number of doctors, dentists, and nurses/midwives per 10,000 persons in the country is 8.8, 2.1, and 17.7, respectively. However, the Periodic Labour Force Survey numbers estimate the active number of doctors, dentists, and nurses/midwives per 10,000 persons to be much lower at 6.1, 1.4, and 10.6. They further note that if one uses an adequate qualification criterion, the number of doctors, dentists, and nurses/midwives per 10,000 persons further falls to 5, 1.3, and 6, respectively. Today Current Affairs
Despite such a huge shortage, the annual intake of medical students for the MBBS course in 558 medical colleges is only 83,275. Another 3.39 lakh nursing students are also enrolled annually in 8,859 institutions. In the last seven years, the number of medical colleges has increased by 44% and that of MBBS seats has gone up by around 60%. However, the number of medical colleges per crore population has barely crept up from 3.1 to 4.1 during the period, while the number of medical seats per crore population has increased from 418 to 618, which is still too low to fill up the shortfalls.
Another reason for concern is the skewed distribution of the health personnel across the states. The highest density of allopathic doctors in the country (per 10,000 persons) was in Kerala (25.4), followed by Jammu and Kashmir (14.2), West Bengal (9.5), Madhya Pradesh (8.4), Telangana (8.5), and Tamil Nadu (7.2). In contrast, the number of allopathic doctors per 10,000 persons was less than three in Himachal Pradesh, Punjab, Chhattisgarh, Rajasthan, and Odisha. Similarly, in the case of nurses, the states with the highest numbers per 10,000 population were Delhi (31), Uttarakhand (24.4), Kerala (23.4), Tamil Nadu (20.4), and Andhra Pradesh (17.4). However, the density of nurses was lower than five in Madhya Pradesh, Uttar Pradesh, Bihar, Odisha, and Jharkhand.
Despite these huge disparities in the availability of medical personnel, initiatives to boost their availability in the laggard states have not made much headway. Most of the medical education facilities continue to be disproportionately concentrated in a few states, which will only further accentuate the problem in the coming years. Today, the top six states of Karnataka, Maharashtra, Tamil Nadu, Uttar Pradesh, Gujarat, and Telangana account for around half the medical colleges and the MBBS seats available in the country. And the share of the top 11 states is more than 75% of the seats. While the leading three states account for around one-third of the graduate medical admissions, the share of Punjab, Delhi, Chhattisgarh, Assam, Jammu and Kashmir, Uttarakhand, Himachal Pradesh, and Jharkhand is less than 2% each. The Hindu Analysis
Apart from the skewed distribution, there are also other issues. Recent studies report that the shortage of teaching faculty in medical education is as high as 40%. So, it is often not possible to ensure the 1:10 teacher–student ratio recommended by the Medical Council of India. In many teaching departments, the share of the non-medical teachers has gone up to even 50%. Outdated curriculum and teaching methods and flawed assessment patterns further complicate these issues. It is seen that inadequate facilities have led to the derecognition of as many as 21 private medical colleges in the last decade.
Today Current Affairs
Ironically, it is a lose-lose situation. Despite the huge personnel deficit, the medical education infrastructure remains limited, forcing more and more students to study abroad, and often ends up saddled with poor-quality education and a different skill set than what is needed here. So, it is time the government stepped in to substantially overhaul medical education and significantly boost the annual intake of medical students to ensure adequate health personnel to meet the global norms.
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