Editorial

Bridging the gaps in medical education

Strengthening of medical education and research is critical to strengthening a country’s healthcare services.

Sentinel Digital Desk

Strengthening of medical education and research is critical to strengthening a country’s healthcare services. Rising population and increasing disease burden in India demand the establishment of more medical colleges and support for medical research to provide better medical care and build a resilient healthcare system. Without adequate budgetary allocation by the central and state governments, persistent problems faced in the sector will remain unaddressed. The central government insists that allocation in the Union Budget for Health Research has increased by 47% from Rs. 2663 crore for the year 2021-22 to Rs. 3,900 crore for the year 2025-26. The Parliamentary Standing Committee on Health and Family Welfare, however, observes that the spending by both the government and the medical colleges on health research has remained stagnant in terms of the percentage of GDP since the last few financial years, which is a cause for concern. Official data shows the actual health research expenditure as a percentage of GDP has constantly remained at an abysmally low 0.02 since 2021-22. The Committee has rightly emphasised that research is an integral part of medical education and has to be sufficiently supported by both the government and medical colleges. A key hurdle in expanding medical education in the country, identified by the parliamentary panel in its recent report, is faculty shortages in medical colleges, especially in remote areas. The recommendation by the Committee for prioritising competitive salaries, job security, and structured career growth over ad hoc or contractual appointments for streamlining and strengthening the faculty deserves urgent consideration by the central and state governments. The Committee holds the view that such measures will ensure the production of qualified doctors and institute a robust medical education system. The committee’s recommendation for special incentives such as housing support, education facilities for children, and rural service allowance to attract and retain faculty in distant locations is a pragmatic suggestion, but implementing it will require massing funding support for required infrastructure. The issue came up for discussion several times in the Assam Assembly in the past, with members of both treasury and opposition benches reaching a consensus about such incentives to attract doctors to strengthen healthcare services in rural areas. The government, however, has practical difficulty in offering special incentives at a much higher level, as not extending similar incentives to government employees of other departments who also serve in difficult and remote locations could have a demoralising effect on employees of other departments extending similar services to the public. Addressing this problem requires building a general consensus among the public and government employees that strengthening healthcare services needs to be prioritised over other services and giving the doctors and faculty of medical education the ability to benefit all sections of the society by strengthening the healthcare services and producing quality medical graduates. The government recognising the dedication of those doctors and other healthcare professionals who have been dedicatedly serving people in remote and difficult areas without any special incentives through the institution of awards and honours can motivate new medical graduates to volunteer to serve in such areas. The Committee has flagged another area of concern – the affordability of medical education – and points out that the cost of medical education is huge and ranges between Rs 60 lakh and Rs 1 crore or even more, making it impossible for students belonging to poor households to pursue medical education. It is essential to have students from all socio-economic backgrounds for a robust medical education, research and healthcare system. The committee’s recommendation for private medical colleges to follow the government fee structure in respect of 50% of seats and for the remaining 50% of seats, the fee structure can be decided in consultation with the fee regulatory committee of the state government concerned can be an effective regulatory measure to curb the skyrocketing of medical education costs. Addressing the problem of uneven distribution of medical seats in the country, as pointed out by the committee, is crucial to ending the shortages of medical faculty and serving doctors in different states. The Committee’s observation that some states have a high concentration of medical seats while some others are severely lacking against the national average of 75 MBBS seats per million population reveals a critical gap in the country’s medical education system which needs to be bridged urgently. Its reference to the Union Budget announcement regarding the addition of 10,000 seats in the medical colleges during 2025-26 and the addition of 75,000 seats in the next five years highlights the intent of the government to address the problem of the shortage of medical graduates and faculty and the problem of the outmigration of MBBS aspirant students to other countries to seek medical education. The committee’s insistence on the National Medical Commission’s responsibility towards strengthening equitable quality education systems across the country with due impetus on evidence-based practices with scientific and modern advancement and critical thinking to imbibe professional pursuit deserves urgent reciprocation by the central government.