January 19, 2020

Is medical education expensive ?

I have often pondered over this dilemma faced with a barrage of high profile persons including political leaders, social scientists, administrators and even doctors like Dr Devi Shetty endorsing the view that it is. Figure of 1 crore being spent by the Government on every MBBS doctor produced has been bandied about for a long time. This is the excuse used to introduce a compulsory rural service for MBBS students from time to time in different states in different forms. Even the idea of No Objection certificate from MCI needed by MBBS doctors to go abroad stems to some extent from this hoax. Yes I call it a hoax or a propaganda and I will try to prove the same.

Where did this figure come from ? My idea is that it was picked up from what private medical colleges charge as fee and ancillary charges from its victims. Total of about 67000 MBBS doctors are produced in India every year. If it costs 1 crore per doctor as input cost then we are spending 67000 crores on this venture as a nation. With approximately 32000 Government seats we can whittle down the Governments expenditure to 32000 crores which is 65 % of the nation’s budget for healthcare. Even taking into account the states’ contribution the Government then is spending about 40% of its annual budget for health only on medical education. If we take example of UT Chandigarh which has budget of about 475 crore for health which it has to cover expenditure of all 4 major hospitals multiple dispensaries and other facilities at its command obviously it is not spending 100 crore out of this only on education of MBBS doctors.

Fact is Medical education provides cheap labor to healthcare and if anything subsidizes the healthcare provided to the citizens as part of its constitutional responsibility by the Government. If undergraduate and postgraduate students were not to participate in providing healthcare, the entire system would collapse and Government would need to hire three time more doctors and nurses to do the same inadequate job it currently does. In fact medical education saves expenditure which government would otherwise have to do as part of its duty.

Why then is this oft repeated propaganda heard that Government spends “crores” to make one doctor. The reason is that the Government is loathe to let go of the cheap labour which it has used and abused for 10 years or so it takes to prepare a doctor and wishes to extend the period of bonded labour by another 2-3 years by hook or crook if possible. Unfortunately since this figure has been loosely and frequently stated in public , press and even in court judgments and it has never really been countered, hence it has become entrenched in public psyche.

Medical education is extremely profitable which is why so many powerful people ventured into it. 80 Member parliamentarians were reportedly owning Medical Colleges at one time. Students who could not afford the 60 lac to 1 crore cost in private college in India go abroad where the MBBS education is obtained in 15-30 lac cost from different countries. Obviously those managing the colleges in China, Philipines, Russia, and so many other countries make a profit from this amount.

What is needed is a white paper from the Government as well as the medical associations on the factual cost of medical education after a detailed study of the matter.

Dr Neeraj Nagpal
Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,
Ex President IMA Chandigarh
Director Hope Gastrointestinal Diagnostic Clinic,
1184, Sector 21 B Chandigarh
09316517176 , 9814013735

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