Career options for MBBS
India produces 87000 MBBS every year, 20000 Foreign Medical Graduates come to India every year. Even if only 16% clear the Foreign Medical Graduates exam that still makes the number of qualified and licensed MBBS doctors produced yearly at 70200. Government which is the largest employer has 1750 vacancies every year for MBBS to work in Primary Health Centres. About similar number are employed yearly by various Government agencies like railways, ESI, PSUs, army and other institutions. This leaves 66700 MBBS doctors looking for jobs every year.
Some of them will join post graduation, but even with the increased number of seats still about 35000 MBBS doctors yearly who are unemployed. Since the number of PG seats was limited to about half the current strength upto 2 years ago there is a backlog of previous years which adds to this number which is visible in the 1 lac MBBS doctors appearing for NEET PG entrance exam every year. These 35000 plus the backlog do join some private hospitals as resident doctors for a few months to few years but this is not a career option.
There is no career in being a resident doctor however good in clinical skills you may be. It is not as if it is a permanent job with regular pay scale and yearly increments and stock options. Ultimately after some time you are expected to move on. This is where a problem arises. Those who are left without a post graduation , have tried multiple attempts to crack the NEET PG, done residents job for 3 years or so and are not beneficiaries of any reservation so have not got any Government Job, are the ones who are most vulnerable. Already about 27 -28 years of age and expected by their families and friends to be “settled” they are adrift with no sense of direction.
Some try to go abroad to seek greener pastures. Setting up a practice is easier said than done. To set up a GP practice in a city is no longer a financially viable option for them. Costs are prohibitive in cities and the GP space in suburbs, small towns and villages is firmly occupied by entrenched Government approved quacks and crosspaths. To do in Rome as Romans do , the MBBS in a village would have to resort to the tricks and fraudulent actions of those around them to survive in the quagmire, but then that is not practice of medicine. Many youngsters leave the profession to join IT firms doing medical transcription, others join pharma industry, some try for civil services others opt for management career.
The super specialist culture deeply prevalent in India today encourages treatment of organs rather than the human body. The role of MBBS in clinical practice has been gradually but surely emasculated to the level that a catheterization is to be done by a urologist and an ECG by a cardiologist. We are moving from superspecialities to super super specialities. A DM Gastroenterology today needs a further fellowship to perform EUS and so also POEM and other specialized procedures. In this environment role of MBBS in clinical practice today is that of a glorified clerk and plebotomist. The turf war among specialists has lead to a situation where despite being a graduate in medicine and surgery the MBBS can neither practice medicine nor surgery, obstetrics, ENT, Eye or any other field which today is defined as a speciality. Unfortunately our courts have contributed their might to creating this mess.
Unfortunately this weakest segment of our profession is the one which is least heard in the innumerable conferences and meetings of the professional associations. Is it not our responsibility as seniors to secure the professional needs of your youngsters. But then we are too busy trying to be president / secretary/ B C Roy awardee / nominated member MCI to be bothered about such mundane matters. Should we not have our first and foremost demand as creation of more regular posts for MBBS doctors to serve in our country. We cry hoarse about dearth of doctors but are loathe to provide them a stable career option as doctors to the community.
Dr Neeraj Nagpal
Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,
Ex President IMA Chandigarh