Saturday 13 December 2014

Medicos' mantra to avoid rural areas - will pay, won't serve




Already lagging behind many states on human development index, medical graduates' refusal to serve in rural areas despite signing bond only drags the state. The state's largest medical college, BJ, which was expected to show the way has proved to be a big defaulter on this front: three out of four students refused to serve the mandatory stint in rural hospitals last year.
The trend has been dismal with almost 900 students washing their hands off from the duty to serve the needy patients in rural areas since 2010.

Response to an RTI application revealed that only 61 of the 250 MBBS students took up the responsi bility to serve the mandatory stint in rural hospitals in 2013. In 2012, 175 students refused to take up the compulsory service.
MANY GO SCOT-FREE
Medical students in government-run public-funded medical colleges sign a bond for Rs 5 lakh at the time of admission. When they refuse to serve in rural areas, they are supposed to pay the amount to their respective colleges.
However, only 17 per cent paid the amount as compensation for opting out of the bond in 2013.
If calculated, more than Rs 9 crore should have been collected as compensation from 189 students.
However as the response to RTI application clearly revealed, only Rs 1.63 crore was collected from 33 students who refused to serve the bond.
CAREER OVER NEEDY PATIENTS
Many students after completing graduation prefer going abroad for higher studies so they don't mind paying Rs 5 lakh as compensation. In 2011, speaking in the state assembly, the then health minister Jaynarayan Vyas said that the government recovered Rs 11.49 crore from doctors for breaching the bond to go abroad for studies.
NO INFRASTRUCTURE
Many medical experts highlight the need to update the infrastructure at rural hospitals to encourage young graduates to opt for rural sojourn.
“Before sending any junior doctor to a remote rural hospital, the government should provide proper infrastructure and medical support system.The doctors don't shy away from rural areas. Their problems need to be addressed properly,“ said Dr Rajnish Patel, professor of general surgery at BJ Medical College and president of Gujarat Medical Teachers Association (GMTA).
“Besides, most of the MBBS students aspire for master's programme. After completing MBBS they have to prepare for entrance test for MS and MD and this tops their priority,“ Dr Patel added.
NEED FOR MORE MOTIVATION
In a study published in Human Resource Health, Bhaskar Purohit highlighting the same issue stated, “Despite many efforts from the government to address the shortage of medical officers (MOs) in rural areas, rural health centres continue to suffer from severe shortage of medical officers. Lack of motivation to join and continue service in rural areas is a major reason for such shortage.“
Talking to Mirror, Dr Nitin S Vora, Gujarat Medical Council (GMC) president, said that the junior doctors needed to be made more aware of the needs of the patients in rural areas.“Doctors need to feel more responsible and sensitive,“ he said.
“Health department has identified several hospitals which require doctors and the colleges are supposed to send their students accordingly. In fact, junior doctors are also paid an incentive amount for serv ing in rural hospitals,“ he said.
NEED FOR MORE STRINGENT RULES
Anil Mukim, principal secretary in the health and family welfare department, denied the allegation that the rural health centres lacked physical infrastructure and said that junior doctors were provided with staff quarters with adequate infrastructure. Insisting that all facilities are extended to them, Mukim also laid emphasis on the need for stringent rules to make it compulsory for doctors to serve the bond after their course. “We are looking into the matter and planning to make more stringent rules so that doctors can't avoid rural stint,“ he added.


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