India - Medical Madness

Every now and then, I read something in the news that makes me mad. Then I stew over it, getting madder and madder. And when this happens, sometimes I connect two otherwise unconnected bits of information to make one unified sore point. Here is a prime example.

A couple of days ago, there was a little snippet of news about medical graduates in Maharashtra — apparently, only three out of 109 students that passed out of a reputed medical college in Mumbai opted for the mandatory one year's practice in rural Maharashtra. The rest paid Rs 1,00,000 to break this bond. The NGO that disclosed this news said that the story was being played out in the 13 other medical colleges in the state as well. It is obvious that new medical graduates prefer the advantages of a city practice to the discomforts of village life. I guess one can't force someone to go practise in a village if he doesn't want to — but since I've lived in a rural area where medical facilities continue to be non-existent, this news item really got my goat.
Just as I was stewing over this, I had a call from Naval, a Bihari migrant in Delhi whom I've known for many years. He sounded very agitated. "My younger brother, who's always dreamt of being a doctor," he told me, "is having a hard time." The boy had appeared for pre-medical tests in many states this year for the third time, after having spent what must have been quite a fortune on preparing for them. "My brother is very bright," said Naval, "and of course a doctor in the family would raise our status tremendously in our village — so we all supported him as best as we could." The entire process of applying for a seat in a medical college, said he, was so expensive that most village students just could not afford it. "Every exam you take, every college you apply to, charges a hefty fee. To even stand a chance, especially if you have been to school in a village or small town, you need extra coaching. I'd say that just the process of appearing for medical entrance tests, you need at least Rs 50,000 ," said he.
Anyway, Naval's brother was eventually offered a seat in a medical college, and the family was ecstatic. The boy was keen to return to his village home after graduating, and wanted to set up practice there.
Not surprisingly, this made the family happier.
However, when Naval and his brother reached the college, they were in for a rude shock. They'd come a day late, they were told, and the college had given his seat to someone else. "But we weren't told that attending the orientation was mandatory!" Naval protested. Apparently, said the college authorities, it was, and they were just following the rules. The distraught pair asked around, and discovered that medical seats were still available, but at a price of about Rs 12 lakh , while dentistry seats were available at half the price. The only other option, they were told, was to get someone influential to plead their case. Which is why Naval was calling up everyone he knew, including me.
I've no idea what will happen to Naval's brother. But when I think of how difficult it is for villagers like him to even dream of becoming doctors and then read about those Mumbai medics who are too squeamish to practise in the villages, it seems to me that our medical system is diseased …and the entire medical community will need to come up with a cure.