Debate on compulsory rural training for MBBS graduates

The five-and-a-half-year long MBBS course is all set to be increased by one more year once the bill making rural service compulsory for all graduating MBBS students gets the official nod.

This bill, which was initiated by the Minister for Medical Education, S.A. Ramdas, last year has not gone down well among students of medicine. Compulsory rural service has been in force only in the case of students who have been admitted through the government quota so far in private as well as Government medical colleges.

According to Dr. O.S. Siddappa, Dean and Director, Bangalore Medical College and Research Institute, this norm should be made applicable to all medical students and not just to meritorious students. While this move is being seen as a desperate attempt by the government to make up for the paucity of doctors in rural areas, students who are at the receiving end of this new norm find it to be a detrimental move.

What's the use?

Dr. Pradeep Kumar, Dean, Kasturba Medical College, Manipal, told The Hindu, “This move will make up for shortage of doctors in rural areas. But without adequate infrastructure, it will not serve any useful purpose.” On the issue of making rural service optional, he said, “In the case of students selected through Government quota, where their education is partly or completely supported by the Government, it is fair to make rural service compulsory. However, for students whose training is entirely self-financed, it may not be reasonable to make it compulsory.”

He further added that unless a doctor is fully trained and qualified, he must not be posted in a rural area. That may result in harm for society.

Speaking on the occasion of the graduation day celebration of BMRCI, Dr. Sriprakash, Vice-Chancellor, Rajiv Gandhi University of Health Sciences, said, “There is a need to think if the one-year rural service period can be made optional with incentives to inspire the young graduates to get into rural service.”

Students’ concerns

Nikhila R., a fresh graduate of BMCRI, says that rural service can be more effective if qualified doctors who have specialised in a particular field like general medicine, paediatrics or surgery are sent to rural areas. She said, “We have completed our MBBS but are not really competent to handle complex issues. In fact I am planning to pursue community medicine after my MD.” Adding that this clause of compulsory rural service was made known only a few months ago, she said, “It would have been nice if we had been informed of this right at the beginning of the course. We would have been mentally prepared to serve in rural areas. Now those who had other plans and have family commitments are in a dilemma.”

Speaking about far more serious issues regarding the rural service stint, Sriram M. Gubbi, another fresh BMCRI graduate, said, “Before sending students to rural areas to treat the people there, the government should provide proper medical infrastructure. That will solve most of the problems. In fact, qualified professionals from various fields must be sent to rural areas. We doctors cannot treat patients when villages do not have basic amenities. When these infrastructure problems are addressed, the rest will fall into place.”

Waste of time

Dr. Sriram, who is planning to take up research in medicine, says, “If this is made optional, it will be better. Many plan to take up Civil Services or research after their MBBS. How will compulsory rural service further their goals? It will be a waste of time. It is understandable that the government is planning to make rural service compulsory because of the lack of doctors in rural areas, but this may not go down well with students. Many may even opt out.” Currently, students are required to pay up a fine of Rs. 1 lakh if they wish to opt out of rural service.