- Email: [email protected]
Rural MBBS degree in India: ignoring the real problem?
Correspondence
There is no doubt that Desai’s long bull-run is one of the main factors behind the deterioration of medical education in India. With the mushrooming of private medical colleges and the various policies of the government, the standard of medical education has been compromised. Of course there are many exceptionally good teaching and non-teaching institutes which are encouraging medical tourism in the country, but they are not a true reflection of the prevailing conditions in our country.3 Even this fast-growing medical tourism is at stake after the report of a new superbug from India.4 I am sure this post-MBBS test will never come into force and even if by chance it does, it will further add to the misery of the already deteriorating medical education in India. If you look into the current trend of students opting for medical fields, it is evident that most are average or belowaverage students. This exit test will add to this adverse situation. Even the reservation policy of the government will be a big hurdle. What will happen to those who will not be able to clear the test? They have after all put in more than 5 years of time, labour, and more importantly money. How will the Indian Government, which has failed to control the rampant quackery that prevails in rural as well as urban areas, be able to prevent these qualified quacks from practising medicine? The members of the newly formed board of governors at the MCI should look deeply into the reasons that have led to the deterioration in standards of medical education in general rather than coming up with an absurd idea which is hard to implement. At the same time the government should give serious thought to attracting brilliant brains to this profession and to stopping the exodus of doctors from this country, particularly to the UK and USA. The health of the common man should be the priority rather than medical tourism. I declare that I have no conflicts of interest.
www.thelancet.com Vol 376 December 4, 2010
Sudhir Kumar Thakur
for the MBBS and probably more than just kidney transplantation and angiography has to be excluded to condense the course. Reducing the study of basic sciences will make BRMS graduates no different from quacks, who have practical knowledge but lack scientific rigor.
[email protected] Santosh Medical College, Shipra Sun City, Indirapuram, Ghaziabad, UP 201014, India 1
2 3 4
Times News Network. Post-MBBS: an exit test before docs can practise. Times of India 2010; Sept 18: 10. Chatterjee P. Trouble at the Medical Council of India. Lancet 2010; 375: 1679. Thakur SK. Responsible writing. Ind J Surg 2010; 72: 278. Kumarasamy KK, Toleman MA, Walsh TR, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis 2010; 10: 597–602.
I declare that I have no conflicts of interest.
Debajyoti Datta [email protected] NRS Medical College and Hospital, Kolkata, West Bengal 700014, India 1
Rural MBBS degree in India: ignoring the real problem?
2
3
In their Comment (Oct 16, p 1284), Sanjay Kinra and Yoav Ben-Shlomo praise the introduction of the Bachelor of Rural Medicine and Surgery (BRMS) degree in India. However, this stop-gap approach masks the real problem of lack of infrastructure in the health delivery system. Recently, junior doctors in Kolkata protested against the lack of infrastructure in top government hospitals.2 When the premier hospitals are in this state, the rural scenario can easily be understood, although it gets little media attention. Medical services are not an island that would function without overall rural development. Moreover, the possibility of a dichotomy will always persist. Those who are capable of qualifying for the MBBS will do so, leaving those who are not to study the BRMS. The BRMS course is to be taught in rural settings by retired professors,3 but it is naive to assume that professors of medical colleges in urban areas will relocate to rural areas if even junior doctors are unwilling to do so. With only a 6-month internship, BRMS graduates would be responsible for managing a primary health centre, whereas subordinate nurses would have studied for 5 years.4 Overall, the duration of study is 1 year less than 1
4
Kinra S, Ben-Shlomo Y. Rural MBBS degree in India. Lancet 2010; 376: 1284–85. Anon. SSKM junior doctors call strike after assault, ire at lack of security. The Telegraph Sept 26, 2010. http://www.telegraphindia. com/1100926/jsp/bengal/story_12983286. jsp (accessed Oct 20, 2010). Mascarenhas A. MCI’s proposal to start rural MBBS invites sharp criticism. Indian Express Jan 19, 2010. http://www.indianexpress.com/ news/mcis-proposal-to-start-rural-mbbscourse-in/569099 (accessed Oct 20, 2010). Prakash D, Samaram G. IMA opposes govt proposal of “Bachelor of Rural Medicine & Surgery (BRMS)—3 ½ yrs course”. http:// imampstate.com/circulars/IMA_ Memorandum.pdf (accessed Oct 20, 2010).
Simian viruses and emerging diseases in human beings Recent advances in our understanding of the simian origins of HIV have brought us very close to a comprehensive set of explanatory models and evidence to account for the facts and timing of the emergence of the AIDS epidemic. In response, some of the leading figures doing research and scholarship on this important issue held an international symposium in Paris, France, on June 9–10, 2010. Sponsored by the Paris-Diderot University’s Faculty of Medicine and Department of History and Philosophy of Science, the Symposium featured more than 20 scientists and scholars from Europe, Africa, and the USA, with various disciplinary backgrounds in virology, evolutionary and computational biology, epidemiology, history, and anthropology. The meeting
For the symposium website see http://www.simianvirusesand emergingdiseasesinhumans.org/
1901
There is no doubt that Desai’s long bull-run is one of the main factors behind the deterioration of medical education in India. With the mushrooming of private medical colleges and the various policies of the government, the standard of medical education has been compromised. Of course there are many exceptionally good teaching and non-teaching institutes which are encouraging medical tourism in the country, but they are not a true reflection of the prevailing conditions in our country.3 Even this fast-growing medical tourism is at stake after the report of a new superbug from India.4 I am sure this post-MBBS test will never come into force and even if by chance it does, it will further add to the misery of the already deteriorating medical education in India. If you look into the current trend of students opting for medical fields, it is evident that most are average or belowaverage students. This exit test will add to this adverse situation. Even the reservation policy of the government will be a big hurdle. What will happen to those who will not be able to clear the test? They have after all put in more than 5 years of time, labour, and more importantly money. How will the Indian Government, which has failed to control the rampant quackery that prevails in rural as well as urban areas, be able to prevent these qualified quacks from practising medicine? The members of the newly formed board of governors at the MCI should look deeply into the reasons that have led to the deterioration in standards of medical education in general rather than coming up with an absurd idea which is hard to implement. At the same time the government should give serious thought to attracting brilliant brains to this profession and to stopping the exodus of doctors from this country, particularly to the UK and USA. The health of the common man should be the priority rather than medical tourism. I declare that I have no conflicts of interest.
www.thelancet.com Vol 376 December 4, 2010
Sudhir Kumar Thakur
for the MBBS and probably more than just kidney transplantation and angiography has to be excluded to condense the course. Reducing the study of basic sciences will make BRMS graduates no different from quacks, who have practical knowledge but lack scientific rigor.
[email protected] Santosh Medical College, Shipra Sun City, Indirapuram, Ghaziabad, UP 201014, India 1
2 3 4
Times News Network. Post-MBBS: an exit test before docs can practise. Times of India 2010; Sept 18: 10. Chatterjee P. Trouble at the Medical Council of India. Lancet 2010; 375: 1679. Thakur SK. Responsible writing. Ind J Surg 2010; 72: 278. Kumarasamy KK, Toleman MA, Walsh TR, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis 2010; 10: 597–602.
I declare that I have no conflicts of interest.
Debajyoti Datta [email protected] NRS Medical College and Hospital, Kolkata, West Bengal 700014, India 1
Rural MBBS degree in India: ignoring the real problem?
2
3
In their Comment (Oct 16, p 1284), Sanjay Kinra and Yoav Ben-Shlomo praise the introduction of the Bachelor of Rural Medicine and Surgery (BRMS) degree in India. However, this stop-gap approach masks the real problem of lack of infrastructure in the health delivery system. Recently, junior doctors in Kolkata protested against the lack of infrastructure in top government hospitals.2 When the premier hospitals are in this state, the rural scenario can easily be understood, although it gets little media attention. Medical services are not an island that would function without overall rural development. Moreover, the possibility of a dichotomy will always persist. Those who are capable of qualifying for the MBBS will do so, leaving those who are not to study the BRMS. The BRMS course is to be taught in rural settings by retired professors,3 but it is naive to assume that professors of medical colleges in urban areas will relocate to rural areas if even junior doctors are unwilling to do so. With only a 6-month internship, BRMS graduates would be responsible for managing a primary health centre, whereas subordinate nurses would have studied for 5 years.4 Overall, the duration of study is 1 year less than 1
4
Kinra S, Ben-Shlomo Y. Rural MBBS degree in India. Lancet 2010; 376: 1284–85. Anon. SSKM junior doctors call strike after assault, ire at lack of security. The Telegraph Sept 26, 2010. http://www.telegraphindia. com/1100926/jsp/bengal/story_12983286. jsp (accessed Oct 20, 2010). Mascarenhas A. MCI’s proposal to start rural MBBS invites sharp criticism. Indian Express Jan 19, 2010. http://www.indianexpress.com/ news/mcis-proposal-to-start-rural-mbbscourse-in/569099 (accessed Oct 20, 2010). Prakash D, Samaram G. IMA opposes govt proposal of “Bachelor of Rural Medicine & Surgery (BRMS)—3 ½ yrs course”. http:// imampstate.com/circulars/IMA_ Memorandum.pdf (accessed Oct 20, 2010).
Simian viruses and emerging diseases in human beings Recent advances in our understanding of the simian origins of HIV have brought us very close to a comprehensive set of explanatory models and evidence to account for the facts and timing of the emergence of the AIDS epidemic. In response, some of the leading figures doing research and scholarship on this important issue held an international symposium in Paris, France, on June 9–10, 2010. Sponsored by the Paris-Diderot University’s Faculty of Medicine and Department of History and Philosophy of Science, the Symposium featured more than 20 scientists and scholars from Europe, Africa, and the USA, with various disciplinary backgrounds in virology, evolutionary and computational biology, epidemiology, history, and anthropology. The meeting
For the symposium website see http://www.simianvirusesand emergingdiseasesinhumans.org/
1901