Hanging in the balance- A bright future or the doctor’s safety?

Anushka Reddy Marri

Final Year Part II

Rajiv Gandhi Institute of Medical Sciences

Adilabad

India is a developing country facing several health hazards and a high deficit in health care personnel. It has a high scope for growth and progress. Medical education and establishment of a stable health care system will play a major role in achieving this growth because health care is not a luxury anymore. It is a basic need and the progress of our nation requires health to be a part and parcel of the policies laid out. The overall development of our nation will depend on the advancement of our health care system. Currently, only about 1.02% of India’s gross domestic product on health care which is far less than the 5% suggested by the WHO.

The opportunities to enter the medical profession are limited in our country and the aspirants are infinite. To be on top of the competition, kids start preparing from a really young age, as early as 13 in a few states. On one hand, is the never ending competition and on the other are the reservations. The common entrance exam, NEET, has definitely reduced the reservation percents to a lower level than the state exams but it still takes a toll on the aspirants without any reservations. Admission into the 15% All India Quota seats of Government medical and dental institutes of the country has the following reservations: 15% of the total seats offered are reserved for SC candidates, 7.5% for ST candidates, 27% for non-creamy layer OBC candidates and a horizontal reservation of 3% for Physically Handicapped candidates (PH I and PH II). The Creamy layer OBC (Yearly income > 8 lakhs) do not have any reservations. This not only increases stress but also promotes discrimination. The pressure of the national entrance examination has lead hundreds of kids into the verge of depression and suicide.

After clearing the entrance, they are bombarded with mammoth portions and a mountain of books and are expected to get through with it with very little support. The syllabus is ill-defined and there are several books to choose from. Not only is the course hard but also lengthy. The failure rate in first and final prof is high, mainly because of the minimal aid and also the lack of a legit syllabus. After spending four and a half years to get an MBBS degree and one year as an intern, they have to get back onto the stress and pressure of clearing the PG entrance. The time spent in preparing and clearing the PG entrance is like being under a hydraulic press. To have a good practice and a secure future, the Medical students have to go through years of hard work starting long before they enter the field.  

The MBBS degree, as such, has lost its value over the course of years. The patients are more educated and they DEMAND treatments. No one wants to go to an MBBS doctor to get treated. In fact, a majority of people do not even prefer going to a general physician or a general surgeon.  They self-diagnose and approach a super-specialist. Ergo, five and a half years of MBBS, three years of PG are not enough anymore.

To add to all this stress is the stress of super-speciality. Medicine has been branching out like never before. There is a multitude of specializations to choose from and as the world is moving forward, it is slowly starting to become mandatory to do a super-speciality course. The uncanny truth of never ending studies and a far, really far reality of a completely settled life only adds up to the sub-par satisfaction of a medico’s life.

Then there is another reality of ‘BOND’, which is an epitome of strain all in itself. It is mandatory to serve in the vicinity of the college you graduated from in a few places. For example, in the Armed Forces Medical College, doctors who quit after a post-graduate course are asked to furnish Rs 28 lakhs and those who leave the armed forces after an undergraduate course have to pay Rs 25 lakhs for their release. Their certificates are kept as surety. In another case of the bond issue, a statement released by the Mumbai court stated that – “Bond is the only way for doctors to give back to the society” and “Those not willing to serve the bond have the option of paying the indemnity which is a small amount in comparison to the amount spent by the state on their education.” This only adds to the already lengthy course and strain.

There was a time when Doctors were worshipped for saving lives. Now, even though we do the same thing in better equipped and advanced ways, it isn’t appreciated. On the contrary, doctors are being treated with zero respect. The number of cases of violence against health care workers has increased massively. The number of deaths, amputations due to such cases are unbelievable. In most of the cases, the doctor isn’t even at fault. It is a fact that there are cases where the death or disability is the doctor’s fault. And losing a loved one is a disastrous event. But, can these two reasons justify the wrath that the doctor has to face? A profession, previously seen as an equal to God, is now not even getting the respect that a human deserves. It is facing a high rate of work place violence.

Are all the years of hard work put into becoming a successful medical practitioner, only to face the wrath of unsatisfied patients and their families worth it?

There are many professions in the world and most of them require time and hard work before achieving a position with job satisfaction. To a doctor, things like a successful surgery, a completely healthy patient or timely recognition and treatment of a disease would give immense job satisfaction. The feeling that a life has been saved because our work is a pleasure that is beyond measure.  

But with the increasing effect of the mass media outlets, many cases of violence are coming into light. Previously parents would have done anything to make their child a doctor. But, which parent would be ready to send their kids into the arms of Hades? This will affect the choices made by the pre-med students. Weighing the pros and cons will be made very easy by the increasing violence on doctors. This will affect the number of kids choosing medical education as a future. There by affecting the already scarce number of doctors available in our country.

This, of course, can be stopped. We need strongly abiding laws and strict security. We need to start educating people to reduce the number of cases in the long run. It is a necessity but not a reality. We also need to remember that we should always be on-guard. Our safety should be our priority and our responsibility, at least until we can work without a fear of being attacked.

But is it worth saving the lives of thousands while we lose some of our own?

YES! YES! YES!