Rural stint for docs: Is it forced philanthropy?

MEDICAL ETHICS: CNN-IBN panelists debate if a 'rural bias' prevents docs from opting for a village posting.

          

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Medical students in Tamil Nadu and Maharashtra stepped up their protests on Monday against Health Minister Ambumani Ramadoss’s proposal of a year's compulsory internship in rural areas.

Students say they do not want to do a year's internship in the rural areas but they will go on posting if necessary. They say they are determined about their protests and will even go on hunger strike if necessary.

Meanwhile, Tamil Nadu government has threatened stern action if the strike isn't withdrawn and students will have to vacate hostels and medical colleges would be shut down. As of now, 12 states have joined in the agitation and the students are in no mood to relent.

On the show Face The Nation hosted by Sagarika Ghose, panelists debated whether doctors should be forced to do rural service. To discuss the issue on the show were Dr Abhijit Das, Director of Centre For Health and Social Justice, Dr Ajay Kumar, National President, Indian Medical Association, Anirudha Patil, MBBS final year student at Seth Gordhandas Sunderdas Medical College, Mumbai, and Ashwini Sheoran, a third year medical student at Stanley Medical College, Chennai.

No rural bias?

At the outset, medical student Anirudha Patil clarified that he was against the proposal because it did not make sense for an intern to be posted in a rural area. “An intern is not liable to make any responsible decisions. In case of any negligence, there is no medical officer to supervise us. Instead of sending an under-trainee doctor, we should send an expert who has more experience than a trainee who can serve the community in a better way,” he said.

Abhijit Das, a strong critic of doctors who don’t want to do rural internship, said that argument didn’t hold water.

“Doctors are anyway supposed to receive their degrees after a year of internship. Consider a situation where you are given a posting after that one year. In terms of training, you have received the training you are supposed to receive to function autonomously. You are already a doctor. The question is just of deferring the registration of the certificate. Once the certificate is given, I don’t think the doctor will actually return for rural practice,” he said.

There's a perception that medical students just want to take their degrees and move out of the country as soon as possible. “Right from the beginning, the basics are not very clear. The Minister, without taking any advice from the Medical Council of India, which is the technical body to advice on medical education, has suddenly come out with this funny idea. I don’t think it will hold water at any stage,” said Dr Ajay Kumar.

Socially speaking

Slamming Das’ opinion on medical students, Ajay Kumar said doctors have to work under supervision till they the full registration. “If they work in the rural area, they have to be supervised by a qualified doctor otherwise they will act like quacks. If they are being supervised by qualified doctors in rural areas, it means there are doctors there already. So they are already doing the service, why should one waste the time of the students?” he said.

But the young urban doctors – or for that matter – any doctors have a social responsibility. Shouldn’t they care about what happens to poor people in rural areas and provide them with treatment?

“But they are not still doctors. You can’t get the chicks to work like chickens. I don’t understand this logic at all,” said Dr Ajay Kumar.

To the medical students’ and Dr Ajay Kumar’s argument, Dr Abhijit Das said two different issues were getting mixed up.