By Dr. K. Javeed Nayeem, MD
I have this rather odd habit of asking every youngster I meet what he or she wants to become in life. After listening to their dreams I invariably advise them to consider the option of becoming a doctor if it is not already on their menu.
Many parents who want to make their children doctors and who are aware of this bias in me, very often bring them to me with a request that they are in need of that ‘one tiny nudge’ that can help them to overcome their indecision when they are poised over the brink.
Becoming a doctor and a very ‘big’ one at that was my only dream in my childhood which I was thankfully able to realise in full measure, going by my own yardsticks, at least. Ever since I can remember and recall, my daily bedtime prayer among my many other wants, always used to include a very passionate plea to the Almighty to make me a ‘Bada Doctor’! I had even informed my parents the length of the table spread and the exact menu that would have to be there on it for the thanksgiving feast upon my return home as a fully qualified doctor!
With this kind of an affection for my profession it is no surprise that I was very happy to read in my newspaper yesterday that the Government at the Centre was thinking of starting 75 new Government Medical Colleges across the country that would open the doors every year to nearly 16,000 young aspirants wanting to become doctors. This is one of the best things that the Government would be doing and it is actually something that it should have done long ago.
Many of my colleagues may be a little surprised that I am applauding a move that will only be increasing the competition that we doctors will have to face in the coming years. But this is not the right attitude that we should have as human beings as it is very akin to the mentality that we see in an unreserved Railway compartment. The very same people who cling precariously to the hand rails with just one of their feet on the foot boards and plead to be allowed in, themselves try to prevent others from getting in once they are inside! The fact is that there is a very great mismatch in our country between the doctors we need and the doctors we actually have to take care of the health needs of our population. And, this disparity is not good at all for the health of our nation.
While most developed countries have more and the WHO recommends a minimum of ten allopathic doctors for every ten thousand people, this figure is just four or even less in our country which is abysmally low and inadequate. When you also take into account the great disparity that exists in the concentration of doctors between our cities and rural areas, the latter are almost bereft of bare minimum medical care. To serve the medical needs of all our citizens reasonably well, we need many more doctors coming out of many more medical colleges than what we are seeing at present.
To view this as something that will lessen the opportunities for existing doctors is a very selfish attitude. We doctors should understand that it is our competence, bedside manners and the quality of the care we provide that will eventually decide whether patients come to us or not. And, it is also very fair that our earnings should depend on these three factors and certainly not on a scarcity of doctors! Doctors would therefore do well to welcome more new entrants into their fold in the interests of the needs of our country while keeping their own work ethic in good health.
While most doctors these days lament that the going is not very good anymore with the many restrictions that are being imposed on private medical practice, it is strange that there is still such a great demand for the study of medicine in our country. It is so difficult for our youngsters to enter the medical stream that the announcement of the selection lists is undoubtedly the biggest annual source of frustration and grief for all those who fail to make it. I feel that a medical career should be more accessible to all our youngsters both in terms of competition and the cost too.
Today it is one of the most expensive courses to pursue both in Government and Private Colleges and only those who have the wealth to afford it can enter its hallowed portals. But there is no denying the fact that many join the medical course just because they qualify in the entrance examinations while not being cut out by their personalities to become good doctors.
There have been times when I have been compelled to feel that one needs to have a calling to become a doctor. So I feel that in addition to merit there should also be some kind of a screening process to assess the aptitude of a candidate on the lines of what we have in the civil services selection process. While welcoming the move of the Government to establish more medical colleges I am a little worried that it may not be easy for it to find good and capable medical teachers to run them.
This is too real a problem in our country since the scarcity of doctors with Post-Graduate qualifications far exceeds the scarcity of doctors with basic under-graduate qualifications. Even those doctors who have adequate PG qualifications to serve as teachers in Medical Colleges hesitate to join the teaching profession as it does not pay them as much as private practice pays. This can be mitigated to a great extent if the Government makes medical teaching more lucrative with increased salaries and other perks. A second measure that can help greatly would be to increase the retirement age for medical teachers.
I believe that all good teachers, of all classes and all courses, can do without retirement as the ability to teach has an immortality inseparably enshrined in it! Here, a system of assessment by students through secret ballot to decide who should get this extension and who should not can be of immense help because even among teachers we have both cabbages and kings! Let me warn you that while some may be retired but not tired, a few others are already dead much before they are shed !
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