The Telangana government’s decision to ban private practice by soon-to-be recruited doctors for State-run hospitals has sparked a discussion on the disparity in salaries in the government and corporate healthcare sectors.
While the ban on private practice does not apply to the existing doctors, the recent order has triggered an uproar among students pursuing medicine, senior residents, and even some doctors, who wondered if aspiring medicos would now prefer to take up jobs in government hospitals.
A discussion with senior government doctors, officials, management heads of corporate hospitals, post-graduates and super-specialists, threw up a unanimous viewpoint — very few stop their academic journey after completing MBBS. The reason is that corporate hospitals in Hyderabad pay only ₹25,000 to ₹40,000 monthly salary to those with just an MBBS degree, which takes 5.5 years to achieve.
Senior doctors opine that most medicos now aspire to pursue a super-specialty course. “Salaries of those with only an MBBS degree might not increase as they quit the job within a few months or a year of joining. They usually do not plan to settle down in the job with just an MBBS degree,” says the CEO of a corporate hospital.
Payment for doctors with post-graduation or super-specialty degree is broadly covered under two or three categories — fee for service (a certain percentage in charges per case goes to the doctors); a monthly salary; and then there is another form of payment in which a team of doctors is paid a fixed package.
Senior doctors and hospital CEOs said the ‘fee for service’ is usually opted for by experienced medical professionals since they can get patients based on their prominence — an advantage not available to newbies.
‘It’s all subjective’
But what are the salaries offered by corporate hospitals to post-graduates, and those holding a super-specialty degree? “It is all subjective” was the common response of most corporate hospital managements and doctors.
“The salary depends on the specialisation that a doctor has, skill level, institute they have graduated from, years of experience, the place they opt for, like a city or a faraway district. Of all, specialisation plays a key role,” says the CEO of another corporate hospital.
Others, too, say that the salary structure is determined by the specialisation. For instance, a post-graduate in General Medicine who begins his/ her career at a corporate hospital gets around ₹75,000 to ₹1.5 lakh a month, while a Pulmonologist draws a monthly salary of ₹80,000 to ₹1 lakh. A post-graduate in Radiology gets anywhere around ₹2-3 lakh. The variation is huge, which was observed from the salaries offered to super-specialists.
“It is not so easy to secure a well-paying job at corporate hospitals immediately after completing post-graduation or a super specialty course because of the rigorous selection process. Usually, post-graduates with work experience of around two years or more, or with a fellowship, are offered jobs at such places. A few choose to work in a team headed by an eminent doctor to gain experience,” says a senior pulmonologist at a corporate hospital.
So one has to put in 5.5 years for MBBS and then three years for post-graduation. That works up to around nine years of studies if there are no breaks in between. And if one chooses to pursue a super-specialty course, the time invested in academics goes up to 11 years at the very least. Fellowships thereafter could range from six months to two years. It is only after this stage that they can aspire to earn fat pay cheques.
A senior resident doctor points out that there is a difference in salaries offered by corporate hospitals and private hospitals. “While a Pulmonologist is paid only around ₹80,000 per month by a corporate hospital, private hospitals offer ₹1.5 lakh to ₹2 lakh. It is more for someone who chooses to work in a faraway district. This applies to other specialisations too,” says the senior resident doctor.
Salaries in govt. sector
Government hospitals have a hierarchy of doctors, who are placed at different levels as per their experience and responsibilities. Vice-president of Telangana Teaching Government Doctors Association, Kiran Madhala, who compiled salaries offered to government doctors in different States, says that an assistant professor at a Telangana government hospital starts out with a gross salary of around ₹94,000 to ₹1.07 lakh, an associate professor makes ₹1.08 lakh to ₹1. 22 lakh, and professors draw a salary of ₹1.98 lakh to ₹2.23 lakh. “These are the starting gross salaries,” reveals Dr Kiran.
The salary for specialists and super-specialists is the same. It was learnt that all faculty members receive an annual increment of 3%. Officials say that the pay structure is similar to the University Grants Commission scale.
Director of Medical Education K. Ramesh Reddy says Career Advancement Scheme (CAS) is applicable here which ensures that the doctors get an increment even without promotion.
“As per CAS, an assistant professor who has worked for four years will get salary on par with an associate professor and will be a designate associate professor. After three more years, they will draw the salary of a professor-rank doctor and will become designate professor. Since there are more medical colleges now, there is no delay in promotion. There is a big demand for faculty,” explains Dr. Ramesh Reddy, adding that salaries in Telangana government hospitals are among the highest in the country.
Listing out the advantages, officials say doctors and health staff get 35% of the money earned through Aarogyasri scheme. “Besides, a government job comes with an undeniable sense of security,” says an official.
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