Demand of Doctors in India
Context:
- In many regions of India, there is a greater demand than there are doctors. In addition, there is a greater demand for medical education than there are available seats.
- It has been difficult to close the demand-supply imbalance in medical education, and this has some bearing on the shortages of doctors.
Actions made by the government to close the shortage of doctors:
- The nation has rapidly expanded medical colleges and seats at the undergraduate (UG) and postgraduate (PG) levels over the past ten years.
- Medical colleges have doubled, UG seats have nearly tripled, and PG seats have nearly quadrupled between 2010 and 2011.
- In spite of this growth, India had 4.1 medical graduates per lakh population in 2021, far lower than the 6.2 in China (2018), 6.9 in Israel (2020), 8.5 in the United States (2021), and 13.1 in the United Kingdom (2021).
Why is there still a shortage of doctors available?
- The quantity and size of medical colleges are two factors contributing to the rise of medical graduates.
- The size of medical colleges continues to be a major obstacle to growing the supply of doctors, despite the fact that the number has grown quickly.
- In India, there are 153 UG seats on average per college, compared to 220 in Eastern Europe and 930 in China.
- The result of budgetary and regulatory limitations is the limited size.
- For example, an increase of seats from 150 to 200 at a public medical college necessitated an increase in library materials from 11,000 to 15,000, a daily increase in OPD foot traffic from 1,200 to 2,000, and
- According to the draught rules for the development of new medical colleges by upgrading district/referral hospitals (2015), the number of nursing personnel required would double.
- It may be more dangerous for private medical universities to expand.
- When seats are left empty and costs are not recouped, investments in physical infrastructure, employing instructors, and hiring other staff members may raise issues about their viability. This can result in price distortions with excessive capitation fees.
- Government colleges are only able to offer medical education at reduced expenses, but their costs are still considerable; subsidies are used to close the gap between the two.
- Lowering expenses will require further integration of innovation and technology into curriculum design and pedagogy, as well as regulatory reform to further rationalise some of the requirements for human and physical infrastructure.
- The new competency-based curriculum implemented by the government follows global standards.
- India is adopting a competency-based curriculum that is comparable to that used in the US. The US has increased the number of doctors produced by innovating in the use of its resources.
- It makes use of several advances in addition to its emphasis on mainstreaming technology and giving teachers stronger financial incentives.
- the employment of medical practitioners in practise who supervise and guide medical students in a clinical environment; curricular integration of interprofessional education (IPE)
- Additionally, collaborative education among physicians, nurses, and chemists enhances quality, lowers the need for teaching staff, and permits the best possible use of available resources.
It is important to uphold equity in addition to quality and scale:
- Although a trade-off is seen to exist between scale and quality, equity is also a problem.
- The case for greater size and productivity must be considered in light of the overall objective of the policy.
- The National Medical Commission has stressed equity even though scale is necessary.
- For new medical colleges starting in 2024–2025, the prior cap of 250 UG seats has been lowered to 150 seats.
- The government’s emphasis on the equitable and localised production of doctors is evident when one considers the mandate of 100 seats for every 10 lakh inhabitants and the limitations placed on the location of new medical institutions within a 15-kilometer radius of an established college. However, because doctors are migrating across states from high-producing states like Karnataka and Andhra Pradesh, this would not result in effective production.
Way Forward:
- Therefore, rather than limiting production, the goal of equity necessitates paying attention to incentives and promoting migration to low-availability areas. Therefore, tackling the hurdles to scaling should be the main emphasis of policy.
