The News Minute| November 29, 2014| 11.33 am IST
Close to 85 percent of medical graduates in Karnataka do not opt for a year of mandatory government service in rural areas, choosing instead, to pay the penalty and go their separate ways.
Taking into consideration the fact that the intake of colleges has also increased, yet the number of candidates opting out seems only to increase incrementally every year. Rs 6.68 crores was the amount paid by the 2013/14 batch of MBBS graduates who just passed out of college, who each paid Rs 1 lakh.
Rs 5.88 crores was the amount paid by the 2012/13 batch according to the Department of Health and Family Welfare’s Bond Enforcement Cell.
In 2012, the Karnataka Legislative Assembly approved the Karnataka Compulsory Service Training by Candidates Completed Medical Courses Bill, 2012, which makes one-year rural service compulsory for doctors in the State.
It awaits a union nod after which it becomes a law and people who opt out of rural service will not get a medical degree. The fines for MBBS students will be hiked to Rs 10 lakh, MBBS students with a diploma get a Rs 15 lakh fine, up from Rs 3 lakh earlier. Post-graduates students will be affected the most, shelling out Rs 25 lakh instead of the Rs 5 lakh earlier.
Many other states have similar rules – Maharashtra, Tamil Nadu, Assam, Madhya Pradesh, Gujarat to name a few. Students who obtain their medical degrees from government colleges must serve in the public health system for a stipulated period and if they wish to opt out, they must pay a financial penalty running to lakhs of rupees to get out of it. The rules vary in each state.
Union Health Minister Anbumani Ramadoss had proposed a law which would make it mandatory for students of government medical colleges across the country to serve in the public health system for a stipulated period.
But the basic question has always been the chicken-and-egg puzzle. Did the egg come first, or was it the chicken? Some argue that doctors will sign up if the government provides good facilities / and the government argues that nobody wants to join and that’s why you need a law.
Mangalore-based physician Dr Srinivas Kakkilaya told The News Minute that he was not aware of what students thought of the law, but said that the students who go to government medical colleges are the top rank holders of the CET. The ones who go to private medical colleges pay a hefty fee and are generally come from the lower ranks of the merit list.
“These are the brightest minds of Karnataka. Encourage them, don’t force them,” he says, by creating a law. He was also of the view that if the government improved three basic things – accommodation, working conditions and incentives – young people would be willing to serve in rural areas.
“If you ensure doctors good facilities for their work, stay and safety so that even women are comfortable working in rural areas, then I’m sure that people will be willing to go,” he says.
However, while the demographics of medical graduates and post-graduates for any state are unavailable, there is a level of resentment among them towards the compulsory government service. Since it takes them far more years than their counterparts from other professions to qualify, many of medical graduates are of the view that they have been dependent on their parents for too long and feel the need to begin earning money. Government service, they say, is neither financially feasible for them, nor are the working conditions, besides the fact that they have to work in far flung areas.
Even in states like Tamil Nadu, where health infrastructure is fairly good, the government claims that not many are willing to come forward even though working conditions are fairly better than in most states.