Higher education in medicine will never be the same again in Andhra Pradesh from this academic year. The State Government has made it mandatory for all post-graduate medical students, both pursuing degree and diploma, to take up rural service for one-year from this academic year.

This decision has left many questions unanswered. Young doctors, preparing for post-graduate exams, are in a quandary over their future. The medical fraternity is clearly divided over compulsory rural service, with several of them highlighting the pros and cons of such a decision.

According to the new rule, post-graduate doctors will have to sign a bond for one year and join government hospitals as senior residents. Clinical post-graduate doctors will work in Primary Health Centres (PHC), Community Health Centres, District and Area Hospitals while non-clinical PG doctors will be posted to teaching hospitals. On the surface, the plan seems to be simple with a lot of promise to improve health care in tribal regions and far-flung villages and at the same time expose young doctors to clinical experience. And yet, a plethora of questions linger over the success of compulsory rural service.

“What will a super-speciality doctor do in a tribal PHC where he does not have access to a clean syringe, drugs, a table to sit, a fan, nurse? Government is not talking about how it will improve medical infrastructure in tribal regions and villages,” says former member of Medical Council of India (MCI) Dr. C. L. Venkat Rao.

The Government has announced a monthly stipend of Rs. 20,000 for a PG diploma holder and Rs. 23,000 to Rs. 25,000 for PG degree holders. Quite contrastingly, a fresh post-graduate, just out of medical college, can earn anywhere from Rs. 35,000 to Rs. 50,000 in private hospitals. The difference of pay is immense and there is a sense of heartburn among the post-graduate medical students in the State.

Of the 1300-odd PG seats in the State, nearly 900 seats are from private colleges. “Students from these private colleges belong to well-connected families and will go to any length to subvert the system. The idea of compulsory rural service is good but implementation should be strict,” feels president of Andhra Pradesh Doctors Association (APGDA), Dr. Putta Srinivas.

Government health authorities have argued that rural service will make doctors understand health schemes being launched by State and Union Governments. “A PG doctor working in a tribal region has to be paid more than the doctor working in a district. The whole process of posting PG doctors to villages has to be made transparent,” Dr. Srinivas points out.

The junior doctors representing Andhra Pradesh Junior Doctors Association (APJUDA) have chosen to respond guardedly to the rural service rule. “Infrastructure and stipend for a doctor in villages is not sufficient. Thanks to this decision, PG is now a four year course and MBBS is five years, which means students have to invest nine to 10 years of their lives to become a complete doctor. We will definitely take up consultations on this issue with Government,” says Dr. S. Nagesh of APJUDA.

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