IMA slams plan for 3.5-year medical course for rural India

The Indian Medical Association, the umbrella body for over quarter of a million doctors in India, have come out with all its guns blazing against Centre’s plans for starting three and a half year course for producing medical practitioners for the rural areas.

The plan of the Centre is to set up 300 rural medical schools with each one picking up 30 students from rural areas to be made ready to deliver healthcare and dispense allopathic medicines.

Initially, the Centre had announced plans to start the Bachelor of Rural Health Care, a three and a half year course exclusively meant for producing healthcare personnel equivalent of doctors who can practice allopathic medicines. The argument was that the traditional MBBS was producing doctors too slowly to meet the needs of the country. “The argument,” said D R Rai, the honorary secretary-general, Indian Medical Association, “is that the traditional MBBS doctors are not ready to work in the villages and hence much of the rural India is deprived of healthcare services. The government says the only solution is to have a two tier system, where one will be to produce healthcare professionals to serve only the rural populace.”

“This will only produce quacks,” contended a fellow doctor. Vajpayee government had announced plans to start seven institutions similar to the AIIMS across the country. But, nothing has come of the plans, he added.

China had devised practical ways to deliver healthcare to rural populations by deploying its ‘barefoot doctors’ from the 1960s. It later went on to expand full-fledged medical education facilities that enabled national coverage to a great degree. But, chronic shortage of doctors in rural India even six decades after Independence remains a worry. The allopathic doctor-patient ratio is a dismal 1:1,722. Nevertheless, the Medical Council of India’s proposal for a three-and-a-half-year course leading to a diploma in Bachelor of Rural Medicine and Surgery (BRMS) to produce a class of allopathic practitioners who hail from rural areas and will serve in notified rural areas may turn out to be a cure worse than the disease.

Chhattisgarh’s experiment with a three-year medical course (introduced in 2000 and scrapped in 2004) should provide a cautionary tale. The key question, said Rai, is should rural folk be short-changed when it comes to the education, training, and calibre of medical practitioners?