The right prescription

Medical students have an ethical obligation to serve the rural community

Last week, medical students took to the streets of Delhi, protesting against the government's order to extend the rural internship from three months to 12 months. The government had passed such an order to fill up the vacancies in the rural health services. Emotions are running high, and doctors and students have launched a "save the doctor" campaign in response. As a doctor who has worked in rural areas for decades, I would like to shed some light on this debate.

Let us review the arguments raised by the striking students and doctors. The first and most frequently voiced objection to this order is that there is no infrastructure in rural areas for doctors to practise. While this was true a few years ago, the National Rural Health Mission has strengthened the infrastructure, equipment and human resources in rural areas. According to 2013 figures, 92 per cent of primary health centres (PHCs) in the country function from a building. There are more than 2,00,000 nurses working in the 1,70,000 PHCs and sub centres. Each PHC medical officer also receives more than Rs 1 lakh every year to improve health services at the PHC.

The next objection is that the one year rural posting will increase the duration of medical education. The period between entering a medical college and getting the licence to practice will increase from five and a half years to six and a quarter years. However, at this stage, it is important to get an international perspective. German and Brazilian medical students require six years to graduate, while their American and Thai counterparts require seven years. South African students can practise only after eight years of training. It is clear from this that the Indian MBBS doctor has a shorter training period than many high- and middle-income countries.

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