Interview with Dr. K. Srinath Reddy – President, Public Health Foundation of India

1. How do you view the medical education in India?
I believe medical education needs substantial reform to align curriculum, training methods and professional competencies to health system needs of India. Presently there is a major disconnect between how medical education is configured and delivered with health care priorities of primary and secondary care. Even in its present form, there are widely varying standards across the different medical colleges across the country. These standards need to be better defined, monitored and enforced.

2. How should a student plan his career during his studies?
Students should first orient themselves to the overall health system functions in their state and then the country. That will help them to define the role they wish to play as a trained health professional. Each student should then match personal aptitude for a general practitioner or a specialist role with potential career opportunities to identify a desirable and attainable career track. The questions the students should ask themselves are: what can I do as a doctor that will be socially useful, personally satisfying and win the respect of my professional colleagues - and not how much can I earn. They should also assess whether they would like to be only practicing doctors or if they also have an interest in research or teaching so that they can choose an academic career track later.

3. What qualities, attitude and skills should a medical student develop during his/her course of study as he/ she needs to interact with the public?
Communication skills are absolutely essential for becoming a good doctor. They are needed for making a proper diagnosis by eliciting a detailed and accurate history of the illness and associated conditions. They are also part of the treatment, to inspire hope and confidence that can help the recovery process. As the model of health care is no longer doctor-centred but is becoming patient-centred, informed participation of patients in decision making is needed on many occasions. Patients and their families too are seeking more information from doctors. Hence, a doctor must be able to communicate with clarity and exhibit care, concern, compassion and courtesy.

4. Do you think that the infrastructure and lab facilities in colleges need to be improved?
Medical colleges must improve their infrastructure to modernize their laboratories and use information technology to make teaching more effective. Skill labs and Simulation labs are useful for imparting practical skills without endangering patient safety.

5. There is a severe shortage of doctors, nurses and pharmacists in India. Despite that, why the Government is not encouraging new medical colleges?
Government of India has proposed more such colleges during the 12th plan. The new colleges should be started in the states that have very few colleges and they shall be attached to district hospitals. It is important that central and state governments should together set up more colleges with adequate standards rather than depending on more private colleges.

6. The medical education has lost its charm which it previously had. What are the reasons for this situation?
Medical profession no longer has the same attraction for young persons because of long years of study, uncertainty about admission to highly competitive postgraduate courses, heavy workload that lasts throughout career, with little leisure time, and low salaries in government service.

7. Though the medical profession has been held as Godly one, students are still afraid of the profession because of its long period of study. What is your opinion?
Young people now have a wide range of career options including some options where they can settle down early with fairly high salaries. They prefer those options to a medical career where people are frequently trying to find a professional identity at 30 years of age.

8. The doctors are not getting the salaries that they seek despite their hard work. What measures should be taken to improve this situation?
Attracting young persons to the medical profession will require restoration of the social respect of that profession, satisfactory working conditions, and a well-defined career track with assured opportunity for professional advancement and reasonable salaries in government service.

9. The interest shown by the students for opting medical education has been reduced when compared to other professions like engineering because of their shorter period of study and high packages. What measures should be taken?
It is not correct to compare these two professions. Each has its own training needs which are linked to the expected work profile. Some years ago medicine was the higher paid profession. Why complain if engineering now has its turn? Even now, most doctors have a much longer active career time than engineers - they virtually never retire. If career choices are dictated only by starting salaries and bonuses, every student will dream only of becoming an investment banker. What will happen to society then? Let people choose professions based on their aptitude and ability, not by greed and temptation.

10. There is no proper management / NRI quota admission process in terms of fee structure? What measures should the Government take to streamline management quota admissions?
Medical admissions should be based on a merit list prepared from a common standardized examination. Even the management quota should be based on that. Fee structure should be openly stated and approved by the government. Under the table payments should be stopped by mandating the merit list and imposing strict penalties on violators.

11. The AP government has planned to raise the medical education fee to around Rs. 2.5 lakh. Don’t you think this decision would impede the aspirations of financially weak and rural aspirants?
Medical education has recently become more expensive everywhere because it has been highly subsidized by governments previously and that policy is undergoing change. It is very important however, that fee should not become a barrier for deserving students especially those from disadvantaged groups. Governments must provide scholarships to such students.

12. It is easier to get a medical seat but difficult to complete the course in foreign countries like USA. In India, it is difficult to get a seat but it is easier for most of the students to complete the course in time. Does the curriculum need to be changed?
There is a need to change our curriculum and training methods to meet the health needs of India and not to imitate what US does. We have to reform medical education radically and not merely make a few cosmetic changes. We have to make our undergraduate training much more primary care oriented and impart problem solving practical skills to students.

13. When there is ambiguity in getting a seat in Medical College, what alternatives the students should resort to?
There are many other career options. Public health education offers a career in the health sector through which one can help to protect health of the people and shape health policy. Dentistry, pharmacy, biotechnology, nursing, physiotherapy and health communication are other potential career tracks. There are also several other allied health professional tracks from radiography to optometry. Even if government jobs are limited, the private health sector is rapidly expanding and self-employment is possible.

14. What are the options for students after MBBS/ BDS?
Options are to take up a job straight away, start practice on one's own or go for postgraduation. Further training can vary from clinical disciplines to basic sciences and can also be in disciplines such as public health or hospital management.

15. Nowadays, students are opting for MBBS in foreign countries - How do you rate medical education in other countries?
The standards of medical education in other countries vary widely from excellent to very poor quality, depending on the country. Even in countries rated high, the training may not sufficiently cover health problems relevant to India such as malaria, rheumatic heart disease or cervical cancer since such conditions are far less frequently seen in developed countries.

16. Many students are planning to study PG in USA through USMLE - Your suggestions to them.
Students who wish to go for postgraduate medical education in US have to take the USMLE exam. It is entirely a personal decision. I would personally like to see Indians staying back and working and studying in India.
Interview with Dr. K. Srinath Reddy – President Public Health Foundation of India
Published on 6/17/2013 3:56:00 PM

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