Maharashtra may give MBBS degree only after doctors do rural stint

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The state’s medical education department has proposed to tweak the duration of the MBBS course to 6.5 years from the existing 5.5 in order to leave no room for students to dodge rural postings. The idea is to merge the rural bond service with the course duration so students are awarded degrees only after completion of their one-year stint and before they can go for post-graduation.

Under the current rule, a medical graduate is allowed a window of six additional years after completion of MBBS to pursue post-graduation and super-specialization and is not expected to immediately proceed for the rural posting. But the state has found this clause is being exploited by students, who often skip rural internships in the name of higher education and the absence of a foolproof government mechanism to track their career graphs.

TOI has learnt that medical education secretary Sanjay Deshmukh has sent a proposal to his ministry this month seeking its approval to change the course framework. In an exercise that began in January, the Directorate of Medical Education and Research (DMER) found out around 4,500 doctors may have skipped their rural postings between 2001 and 2011. Maharashtra produces close to 7,000 MBBS graduates every year, of which 2,800-odd pass out of the 19 public medical colleges. A creation of a software application that will make postings and vacancies in the public health department-run hospitals transparent is also in its final stages of trial.

A senior government official confirmed the proposal is under consideration.

“Rules under the Maharashtra University of Health Sciences (MUHS) Act don’t allow us to withhold documents, including mark sheets, for reasons such as non-fulfillment of bonds. If this proposal gets the nod, students will have to go for rural postings before appearing for their PG entrances. This way, once they serve the rural bonds, they are free to do what they want,” the official said.

About two decades ago, this framework was already in use in the state. A GR issued in the late 1990s mandated students to complete their rural stint before going for PG. The system worked smoothly for some time as candidates were placed in rural, district and civil hospitals run by the state’s public health department (PHD). But it had to be scrapped in 1999 after the PHD said it didn’t have vacancies to accommodate all medical pass-outs. The friction between two arms of medical education and public healthcare in Maharashtra—DMER and PHD—has often led to even willing students not finding rural postings of their choice.

Nationally too, the idea of increasing course duration has been discussed time and again. Ex-health minister A Ramadoss was the first to speak in favour of it in 2007. In 2012, it was discussed by then Union health minister Ghulam Nabi Azad and the Medical Council of India (MCI). At that time, amending the MCI Act too was given a thought.

Dr Pravin Shingare, who heads the state’s DMER, said while MCI is the only one that can decide on course duration, MUHS can make “modifications” within the MCI framework. He said most students give the rural stint a slip because there is nothing to hold them back. “While doctors practising in Maharashtra may still be netted at the time of registering with the Maharashtra Medical Council (MMC) as they are required to produce a bond-free certificate, those coming from other states often get away,” Shingare said.

The medical community, however, thinks it would be unfair to increase the duration of medical education. “Why can’t the government break up the one-year internship tenure and incorporate rural posting without increasing the overall course duration,” said Dr Sagar Mundada, who previously led the Maharashtra Association of Resident Doctors (MARD). He added doctors anywhere take around 12 years to complete super-specialization, and any further increase would be exasperating. A senior professor from JJ Hospital concurred the move would be unfair to students of government colleges as those studying in private ones will save a year and have the benefit of appearing for PG before the others.