The State Government of Maharashtra has decided to increase the MBBS tenure of students in the state from the current duration of 5.5 years to 6.5 years. This is being visualized to ensure that all pass outs complete their rural training before moving onto their Post graduation courses. This change of plan comes after the Directorate of Medical Education discovering that nearly 4,500 MBBS pass outs may have skipped their rural postings between 2001 and 2011. The increase in years will merge the rural postings with the MBBS course duration. This would also mean that degrees get awarded to them only after completion of the rural postings, and prior to entry into post-graduation courses.
Maharashtra produces close to 7,000 MBBS graduates every year, of which 2,800 come out from the 19 public medical colleges.
Presently an MBBS pass out has six long years to pursue a post graduation along with the super specialty specialization. He or she is not bound to complete a rural posting within this time period.
However, the state has of late discovered that this clause has a loophole as students are often found skipping rural internships in the name of higher education. The absence of a tracking system with the government and the absence of a foolproof government mechanism to track their career graphs is resulting in many of them skipping their rural postings without getting caught.
According to TOI, the Medical Education Secretary, Sanjay Deshmukh has submitted a proposal for a change in the course framework this month to the Ministry of Health. An application that will make postings and vacancies transparent in the public health department-run hospitals in the offing, as well; being in the final stages of the trial.
A senior government official confirmed Deshmukh’s proposal being under consideration.
“Rules under the Maharashtra University of Health Sciences (MUHS) Act don’t allow us to withhold documents, including mark sheets, for reasons such as non-fulfillment of bonds. If this proposal gets the nod, students will have to go for rural postings before appearing for their PG entrances. This way, once they serve the rural bonds, they are free to do what they want,” the official said.
Earlier on this framework was being followed in the state. A 1990’s government resolution made it compulsory for students to complete their rural postings before going in for their Post graduation. However, 1999 saw the scrapping of it when the Public Health Department did a “hand up” on being able to accommodate all medical pass outs in the various rural, district and civil hospitals run by the Ph.D.
The friction between two arms of medical education and public healthcare in Maharashtra—DMER and PHD—has often led to even willing students not finding rural postings of their choice.
The idea of increasing course duration at the national level has also been discussed often. Ex-Health Minister A Ramadoss was the first to speak favourably on it in 2007.
In 2012, a discussion in this direction took place between Union health minister Ghulam Nabi Azad and the Medical Council of India (MCI). An amendment in the MCI Act was considered during this discussion too.
According to DMER- Head, Dr Pravin Shingare, while MCI is the only body that can decide on course duration, modifications can be made by the MUHS within the MCI framework. He said most students give the rural stint a slip because there is nothing to hold them back.
“While doctors practicing in Maharashtra may still be netted at the time of registering with the Maharashtra Medical Council (MMC) as they are required to produce a bond-free certificate, those coming from other states often get away,” Shingler told TOI.
The medical fraternity, however, is not in favor of an increase in the course duration. “Why can’t the government break up the one-year internship tenure and incorporate rural posting without increasing the overall course duration,” Dr Sagar Mundada, who previously led the Maharashtra Association of Resident Doctors (MARD) told TOI.