White coat loses its charm

Students nowadays are increasingly opting for careers in business and engineering instead of medicine.

The classroom for XI standard boys and girls in Delhi's Springdales School is built and fitted to accommodate 40 life science students. There are 40 students in the class, but only 16 have opted to study life sciences in the hope that they will one day become doctors "" the others study fine arts etc. Last year, their number stretched a little longer to 19.

In contrast, in the adjacent two choc-a-bloc classrooms, students study mathematics and chase the dream of becoming engineers soon. Some of them may even opt for business schools after that.

Ameeta Mulla Wattal, the principal of the school, says that the students have a wide spectrum of careers to choose from and the number of those who settle for medicine is on the decline.

The message is clear. The white coat and stethoscope have lost their charm for Gen Next. Once the first career choice of the brightest students in schools and colleges, the profession of doctors is now in the dumps. Life science teachers that Business Standard spoke to disclosed that only those students whose parents own nursing homes or hospitals now opt for the subject.

The dire condition is reflected in the number of students who take the All India Pre-Medical Test organised by the Central Board of Secondary Education "" while 200,000 wrote the exams last year, the number was just 160,000 this year.

In the capital, the number has fallen from 40,000 to 26,000 between 2007 and 2008. A CBSE official familiar with the situation says that though the decline has been in evidence for the last four years, it was particularly steep this year.

The growing disinterest in the profession also gets reflected in another set of numbers. Since 2004, some 300 engineering colleges and 400 business schools have opened in the country; in contrast, only 38 new medical colleges have come up. The 270 medical colleges have 30,433 seats, less than ten per cent of the 350,000 engineering seats in comparison. 
 

New medical colleges since 2004	38
New engineering colleges since 2004	300 Approximately
New business schools since 2004	400 Approximately
Entry-level salaries (per month)
MBBS doctor	Rs 10,000-20,000
Engineering graduate	Rs 15,000-40,000
B-school graduate	Rs 10,000-40,000
Technical diploma-holder	Rs 8,000-25,000
Call centre executive	Rs 10,000-20,000

Doctors, teachers as well as human resources experts say this is because of the higher salaries offered by other professions. While a doctor starts out with a salary of around Rs 15,000 per month after putting in seven years of studies, an engineer can hope to get double of that and a call centre executive the same amount.

Not that salaries at the senior level are any better. Rishi Das, CEO, CareerNet Consulting, says that his firm recently found out during recruitments for the National Health Service UK that even senior doctors who head medical specialities in several private hospitals in India were not earning more than Rs 100,000 a month.

It is also a fact that it is tough to get a respectable position in a hospital. Young doctors with basic medical degrees have no hope for growth unless they go for postgraduation. These courses are not only extremely competitive but also cost a bomb (Rs 30-40 lakh). And, if you go through these courses, you have no hope of earning a salary before you turn 30.

Curiously, the salaries doctors get are low, though they are in very short supply. According to a recent report of the Planning Commission, there is a shortage of about 600,000 doctors, one million nurses, about 200,000 dental surgeons and a large number of paramedical staff in the country. To meet the shortage, the 11th Five Year Plan talks of no less than 60 new medical colleges and 225 nursing schools.

Against that, the Medical Council of India has sent de-recognition notices to a dozen medical colleges because they do not have adequate faculty. Some of them are amongst the oldest in the land.

Therein lies the cue "" there is an acute shortage of teachers and training staff. The Planning Commission report also points out that the number of postgraduate degrees and diplomas awarded is only about 4,500 "" way short of what is required.

"It is an obvious and a huge problem which needs to be urgently addressed by the government of India and the Planning Commission," says Medical Council of India President Keshavan Kutty, adding: "The Sixth Pay Commission may have helped people in the top rung in the administrative services but doctors in this country are getting a raw deal."

Giving his own example, he says: "I was getting just Rs 24,000 per month as the principal of Trivandrum Medical College till the other day. My colleagues in the IT sector were earning between Rs 200,000 and Rs 300,000. Who would want this?''

GP Dwivedi, the principal of Shyam Shah Medical College at Rewa in Madhya Pradesh, who received a notice for de-recognition this February, expresses his helplessness on the matter.

"The college just doesn't have enough people to teach. We are short of teachers by more than 50 per cent," he says, adding: "Our biochemistry department has been closed down for the lack of teachers. For radiology, I have just one assistant professor. We need two more, besides one professor and an associate professor." The college, he mentions, is short of no less than 1,000 nurses.

The portents are ominous.