SOS from Medicos.. Is anybody listening???

While talking to a set of young freshly passed out batch of medicos who had just completed their MBBS, i could sense their disillusionment with their choice of a career. While their IT schoolmates were earning lumpsums, they were getting peanuts in terms of salary and had to grind their books overtime now if they were aiming for a post graduate seat.I too went through the same emotions at that stage and so did many of my friends. 

There are many problems with the way medical education is imparted in India. When i ask around my medical friends circles, what they would like to change about medical education, i am flooded with a volley of ideas!. Its a pity, no body up there is listening!

Here are a few interesting ideas from people who had "been there. done that"...

• Many doctors agree that 5and a 1/2 year course (invariably 6!) for MBBS is a waste of time.(Now there is even talk of another year- for a rural posting!). The entire course can be cut short by at least a year- taking off 6 months in 2nd year (Patho/Phrm/MicrB/FM) and another 6months in 3rd year (ENT/Ohpl/SPM). Even the truncated 4 and 1/2 year would drag on for 5 years.. taking the slow rate of admissions to the courses and examination schedules!
• In fact most doctors feel direct MD degree (maybe then the 5 and 1/2 year course is warrented!) is the need of the hour rather than a preliminary MBBS degree. This will reduce the burden on students preparing for MD entrances.
• Diplomas must be abolished and all degrees must be given as Masters only. It will save the poor diploma holder the discrimination he/she will face in the job front.
• After MD medicos must be encouraged to work  and gain in experience rather than slogging it off in college libraries over entrances!. Why don't we have Campus placements in medicine? Hospitals must hire on campus. The salary and perks must be on par with any fresh graduate from a professional stream which is sadly lacking here.
• Personally Im one for rural medical service. But with the pathetic state of health centers in the periphery, I don't think freshly passed out medicos are the best answer to improving health care in rural areas. And making it compulsory for them in order to obtain their degrees, amounts to exploitation! Instead the service should be voluntary with incentives greater than what one can expect in the cities- like a sponsered fellowship program at the end of 2 years of rural service. Also, these facilities must be linked up by telemedicine units to a head hospital where all experts reside- so that speacialized consltation can be availed of when needed.  Needless to say, PHCs (Primary health centers) must be transformed on the lines of well equipped mini-nursing homes!.
• Spealization is a must nowadays with the explosion of information, leaving no single individual a master of the whole of medicine. Specialization courses must be need based- there is no point having umpteen number of seats for say OBG, if the jobs are already saturated. Yes, we have a dismal doctor to population ratio in India, but part of the reason is poor dispersion of healthcare to all areas. And of course, the number of seats per field must be updated on a regular basis.
• Now the biggest hurdle that a medico needs to cross is the entrance exams for getting INTO a post graduate course. Why is this so tough? Because the number of MBBS seats far out number the number of MD seats. So in effect, its a rat race out there!. Well there are 2 solutions for this-1. The logical solution would be to increase the number of post graduate seats within the limits of the need based approach, in propotion to the MBBS seats (because everyone needs to speacialize in medicine in the future!)-this will ensure that everyone gets a post graduate seat but still leaves the rat race open to choices of seat. so the other solution is 2. Scrap the entrances as a whole. Follow a fellowship pattern for speacializtion. Allow the doctor to work in an institute with that speacialization for a minimum period of time .. say 3 years.. and then test is/her acumen at the end of the period both theoretically and practically (includes monitored surgeries!) before awarding him/her the degree. If the institute traing is on par with the degree requirements, the candidate is sure to pass.. if not he/she should be asked to reappear for the test. (no need to regulate the number persons in training for that spealization.
• Do you have any suggestions to improve the medical education in this country? Fill me in!