By Dr Arun Mitra
The report that the health ministry has asked the MCI to review the tuition fees in medical colleges is a welcome step. Better late than never, it has become so essential because the fee structure in private medical colleges has gone sky high and is out of reach of not only poor people but even the middle classes are now feeling the pinch. They have to shelve their savings and even borrow to send their wards to the medical colleges. This is not only for MBBS courses, but even for the admissions to the Ayurvedic colleges. Tuition fess even in some of the Ayurvedic colleges, especially those which are deemed universities, are quite high. As a result several meritorious students are left out of the medical colleges due to exorbitant charges which they are unable to pay. Such situation leads to feeling of helplessness causing serious stress in the minds of the students and the whole family. The students have worked hard to fulfill their aspirations to become doctor; now at the stage when they have achieved merit, they are denied admission because of financial reasons, is a very sorry state of affairs.
The WHO recommends one doctor per one thousand of population. Replying to a question, Minister of State for Health. Krishna Patel had told in the Lok Sabha that on 31st March this year 10,22,859 doctors of modern medicine are registered with various state medical councils. She further said that around 8 lakh doctors are actively available at one time. This means that the doctor population ratio in India is 0.62 doctors per one thousand population. While nearly 70% of India’s population lives in rural areas, the rural India has 1/4th the doctors as compared to urban areas. This is a huge gap to be fulfilled. Thus we need more doctors for our population. For this the government plans to open more colleges. To fulfill the health requirements of our people we have to have medical colleges which impart relevant training to the students and orient them to the needs of our society and encourage them to work in areas so far neglected.
A review of the medical education scenario tells that admission to the medical colleges has been a contentious issue for quite some time. Initially most of the medical colleges were in state sector. Going by the information from the website of Medical Council of India, at the time of independence, there were 20 colleges out which only one was in private sector. Most of new additions were in the state sector till late eighties. But after the shift in economic policies and neo liberal model of development the whole scenario changed. Between the periods 1990 to 2017 number of colleges opened in private sector was 238 while only 115 were opened in state sector. Many of these were made as deemed universities which could have their own examinations, admission system and fee structure.
Many of these were charging under hand money as capitation fee. Merit was completely ignored and money became supreme. Seats are reserved under the management quota where they can charge at their will. For example in the state of Punjab the tuition fee in the government colleges is Rs.13.4 lakh for the full course of MBBS for 4.5 years, in the seats under the management and the NRI quota it varies from Rs.35 lakh for the full course to Rs.63.9 lakhs. Astonishingly telephonic enquiry from the Era’s Medical College Lucknow revealed the tuition to be 17 lakh per annum which with 10% increase every year comes out to be nearly Rs.91.34 Lakh for MBBS course. The PG seats tuition fee in this college is up to Rs.49 lakhs per year. That means for MBBS and MS/MD both from this college, one will have to pay nearly 2.5 crore rupees and an additional charges for books, travel etc. This means the student has to spend nearly 3 lakh rupees per month or Rs.10,000 per day.
This is a cruel joke. In our country where vast majority of population is devoid of even basic needs, it is literally impossible for them to imagine to send their wards to the medical college even when they are on merit. There was hope that after introduction of NEET, capitation fee will end. But what has happened is to the contrary. The private colleges increased their tuition fee and are now earning legally in white money. This will simply undermine the quality of medical education and not fulfill the needs of society we are striving to achieve. Going by the track record it appears that this advice to the MCI to regulate the fee structure may not turn out to be an eye wash. State must recognize its responsibility to health and education if it really wants to serve the people. Health and medical education cannot be left to market economy mechanism, they should be taken as social responsibility.