Glut of doctors

NEW DELHI: States like Jharkhand and Bihar with acute shortage of doctors have seen few new medical colleges being opened in the last five years, while those with a glut of MBBS seats and doctors continue to allow new private colleges. This is despite doctors’ associations in these states warning against over-production of doctors.

In Jharkhand, a state with the worst doctor-population ratio of just one doctor for over 8,000 people, no medical college has been started since 1969. Even in the last five years, which saw over 121 colleges being opened nationally, Jharkhand got none.

Similarly, in Bihar with a doctor-population ratio of one for over 3,200 people, none were opened in the last five years and just five in the previous 13 years, 2000-13. Eight government colleges in Bihar and five in Jharkhand have been proposed, but that’s for the future.

In contrast, Kerala, which is already facing a glut with a doctor for 535 people, had nine colleges opening in the last five years, including six private ones accounting for 750 seats. Similarly, Karnataka with a doctor-population ratio of 1:507 opened 11 medical colleges since 2014, five private ones accounting for 750 seats.

But what can states do about where the private sector chooses to open medical colleges? For any medical college to be opened, the state has to issue an “essentiality certificate”, which certifies that a college is needed. The idea is to prevent unhealthy competition. This raises the question of why states producing more than enough doctors continue to hand out essentiality certificates.

The results are showing in Karnataka where many new colleges are poaching faculty from established ones, destabilizing them, and many colleges are in the news for getting fake patients during inspections since they don’t have enough to meet the norms. Many colleges that are allowed to admit students in the first year or for a few years are then derecognized when they no longer meet the MCI norms. The state government then will have to take over the responsibility of students already admitted.

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