Modern medical education in Assam
Prof. (Dr.) Dharmakanta Kumbhakar
(drkdharmakanta1@gmail.com)
The history of modern medical education in Assam is a very interesting and glowing one. Modern medical education in Assam started with the establishment of Berry White Medical School in 1900 at Graham Bazar in Dibrugarh. Sir John Berry White, MRCP, a retired brigadier of the British Army and later Civil Surgeon of the Lakhimpur district in 1870, contributed his lifetime savings of Rs 50,000 to establish the medical school. The school conferred the diploma of Licentiate Medical Practitioner (LMP) in old undivided Assam. In 1938, the Assam branch of Licentiate Medical Practitioners, in its annual meeting under the chairmanship of Lokapriya Gopinath Bordoloi, decided to upgrade the Berry White Medical School to a medical college. Accordingly, on November 3, 1947, the Assam Medical College at Dibrugarh was formally inaugurated by the first chief minister of Assam, Lokapriya Gopinath Bordoloi. The establishment of Assam Medical College, Dibrugarh, was a landmark event in the history of modern medical education in Assam as well as in Northeast India. The Assam Medical College now produces medical graduates, MD/MS doctors, and DM/M.Ch. doctors. It has already completed the Platinum Jubilee.
After a long period of 12 years since the establishment of the first medical college at Dibrugarh, the government of Assam felt the need for another two medical colleges in 1959, one at Guwahati and another at Silchar. As a suitable place was not available in Silchar, both the medical colleges, i.e., Gauhati Medical College with sixty seats and Silchar Medical College with forty seats, were started as twin medical colleges in the vacant Ayurvedic College at Jalukbari, Guwahati. On September 20, 1960, the Gauhati Medical College was formally inaugurated, and subsequently, the Silchar Medical College was formally inaugurated on August 15, 1968, at its permanent site in Ghungoor, Silchar. The Gauhati Medical College now produces medical graduates, MD/MS doctors, and DM/MCh doctors, and Silchar Medical College produces medical graduates and MD/MS doctors.
It took nearly thirty-seven years more to realise the need for more medical colleges in the state, and the issue got momentum in 2005, when a Society for Medical Education was launched in Assam, under which the establishment of three medical colleges was planned in Jorhat, Barpeta, and Tezpur. Later, Jorhat Medical College was formally inaugurated on October 12, 2009; Fakhruddin Ali Ahmed Medical College at Barpeta was formally inaugurated on February 11, 2011; and Tezpur Medical College was formally inaugurated on January 30, 2014. All these medical colleges produce medical graduates and MD/MS doctors.
Meanwhile, the Central Government announced a scheme called “Establishment of new medical colleges attached to existing district referral hospitals” in 2014. The Assam government decided to establish new medical colleges in different districts of the state under this scheme. The government formally inaugurated Diphu Medical College on November 25, 2019, Lakhimpur Medical College on October 1, 2021, Dhubri Medical College on October 13, 2022, Nalbari Medical College, Nagaon Medical College, and Kokrajhar Medical College on April 14, 2023. The AIIMS, Guwahati, was inaugurated on April 14, 2023. It is hoped that after a few years, all these medical colleges will have postgraduate courses and will produce MD and MS doctors, along with medical graduates.
Many more medical colleges are coming up in different districts of Assam in the future and are in various stages of development. Guwahati is going to have its second medical college very soon. One can hope that the new medical colleges will be unique on their own.
Earlier, the academics of Assam Medical College, Dibrugarh, were affiliated with Dibrugarh University; Gauhati Medical College was affiliated with Gauhati University; and Silchar Medical College was affiliated with Assam University, Silchar. In 2009, the Government of Assam established the Srimanta Sankaradeva University of Health Sciences at Guwahati to affiliate all the medical colleges of Assam and to bring parity in the quality of modern medical education given in different medical colleges in the state.
In Assam, modern medical education is controlled by the Department of Medical Education and Research and the Director of Medical Education. Currently, twelve medical colleges are fully functioning under the Assam government, with 1,500 MBBS, 722 PG, and 46 DM/MCh seats.
The main aim of medical colleges is to provide quality medical education to students. A sufficient number of qualified and skilled faculty, proper infrastructure, diagnostic laboratories, research labs, library facilities, etc. are the keys to providing quality medical education. The Government of Assam has provided sufficient infrastructure, diagnostic laboratories, research labs, library facilities, etc., to all the medical colleges in Assam. But it is seen that a few medical colleges are facing the problem of a lack of sufficient faculty in some subjects. Of course, it is not a unique problem for Assam. It is a common problem for all medical colleges in India. The government must take steps to shorten the shortage of faculties for quality medical education.
The shortage of faculties is mostly in non-clinical subjects (basic sciences), anesthesiology, and radiology. Nowadays, non-clinical postgraduate seats remain vacant in most of the colleges even after zero NEET-PG score eligibility and zero fee offer. Medicos pick up these subjects with great difficulty and a heavy heart. Graduating MBBS students hardly opt to study non-clinical subjects further and don’t choose non-clinical postgraduate courses, which are often chosen by underperforming students. Therefore, most of the time, the posts of faculties in non-clinical subjects remain vacant due to a lack of qualified candidates. There is a need to attract faculties in non-clinical subjects, providing extra salary and benefits, so that young medical graduates prefer to undergo PG courses in these subjects and join as faculty in the medical colleges of Assam. Otherwise, the National Medical Commission must increase the permissible intake of non-medical faculty in medical colleges to 100 percent to get a sufficient number of faculties in non-clinical subjects. Moreover, the faculties of anesthesiology and radiology should be provided extra monetary benefits so that they join medical colleges instead of joining in a private setting. As per a report, the government of Assam is thinking in this regard.
It is also seen that most of the faculties of medical colleges in Assam have opted either for voluntary retirement or resignation. The super-specialist faculties are leaving medical colleges to join corporate and private hospitals. Along with better pay, these faculties get a chance to showcase their expertise in corporate and private hospitals. To stop this, the government must adopt some policies for the faculties, like a fair and transparent transfer policy, a higher salary, better accommodation, recreational scope, proper working facilities, etc. One hopes the government will take the necessary steps in this regard. However, the state government has already increased the retirement age of medical college faculty to 70 years, which will partially fill up the shortage of faculties. Of course, for a long time, the young faculties will not get a chance to be professors as the government is increasing the retirement age and appointing retired faculties in medical colleges. Moreover, regular departmental promotion should be assured.
The way reservation is implemented in faculty recruitment and promotion also causes problems in achieving sufficient faculties in medical colleges. Advertisements seek candidates from historically marginalised Scheduled Castes, Scheduled Tribes, and Other Backward Classes, including females and persons with disabilities. If they are unable to find candidates, those posts go vacant. The government needs to have special drives to fill the vacant posts, as many medical colleges have had backlogs for many years. If no eligible candidates are available in the reserved category, then posts should be offered to general category candidates.
The medical college faculties perform double duties: teaching and patient care. However, the pay structure of medical college faculties is the same as that of faculties of other educational institutes, despite different criteria in entry level, duration of courses, profession, etc. The faculties of medical colleges feel deprived regarding salary and other facilities in comparison to the faculties of other educational institutions. An individual needs economic security to give their best in any profession. Due to their low salaries, the faculties of the medical colleges in Assam are unable to do justice to their profession. They need to do private practice for extra income. There is a need for a higher pay structure for the faculties of medical colleges. One hopes the government will take the necessary steps in this regard.
It is seen that many posts in faculties in medical colleges remain vacant at entry level. Young medical postgraduates don’t want to join medical colleges as they get lucrative offers from the private sector. They don’t join medical colleges due to the low salary scale. The true economic status of medical college faculties of Assam is really pathetic as per their status. As teaching in government medical colleges is not rewarding in material terms, the profession doesn’t attract the brighter and more dynamic young medical postgraduates. There is a need to attract fresh minds in medical teaching by offering attractive salaries, job security, provident funds, post-retirement benefits, etc., so that the profession attracts the best and brightest medical postgraduates in Assam, which will give a great boost to modern medical teaching in the coming days.