MCI to NMC: Change of Medical Education Regulator


Some drastic regulation is need of the hour, of the  chaotic and non-uniform medical education system of India. Besides an urgent need for  better standards, uniformity in  standards of medical education and  fee structure is desirable. National Medical Commission Act 2019  has been passed. NMC has replaced MCI. But attainment of desired goals will still  depend upon, how well the future plans are implemented. The  mammoth system needs an herculean overall and honest policy changes from the roots.

The National Medical Commission (NMC), a new body, will function as the country’s top regulator of medical education from Friday, a day after the Centre dissolved the Board of Governors—Medical Council of India (BoG-MCI) through a gazette notification.

The setting up of NMC was a government move to bring reforms in the medical education sector, especially aimed at replacing the MCI, which was tainted by corruption.

The government had dissolved the MCI in 2018 following the corruption charges and replaced it with a BoG, which was chaired by Dr VK Paul, member (health), Niti Aayog.

The body was functioning under the Indian Medical Council (IMC) Act, 1956.

“The BoG-MCI has been dissolved and the NMC replaced it with effect from Friday,” said Dr Paul.

The IMC Act stands repealed, and has been replaced by The NMC Act that came into existence on August 8, 2019.

“Indian Medical Council Act, 1956 (102 of 1956) is hereby repealed with effect from September 25. The BoG appointed under section 3A of the Indian Medical Council Act, 1956 (102 of 1956) in supersession of the MCI constituted under sub-section (1) of section 3 of the said Act shall stand dissolved,” stated the gazette notification issued by the Union Ministry of Health and Family Welfare (MoH&FW).

Professor Suresh Chandra Sharma, former head of the ear nose throat (ENT) department at All India Institute of Medical Sciences (AIIMS), New Delhi, has been appointed as the chairman of the NMC.

Dr Sharma had retired from AIIMS in January and was selected by a seven-member search committee for the post from 300-odd applications received from across the country. He was also one of the five short-listed candidates for the post of director, AIIMS, New Delhi, after the then director, Dr MC Misra, had retired in 2017.

Dr Rakesh Kumar Vats, secretary general, BoG-MCI, has been appointed as the secretary of the NMC by the Appointments Committee of Cabinet (ACC).

The NMC will have four separate autonomous boards: under-graduate medical education, post-graduate medical education, medical assessment and rating and ethics and medical registration.

The common final year Bachelor of Medicine and Bachelor of Surgery (MBBS) examination will now be known as the National Exit Test (NEXT), according to the new medical education structure under the NMC.

NEXT will act as licentiate examination to practice medicine, the criteria for admission to post-graduate (PG) medical courses, and also for screening of foreign medical graduates.

Besides, the National Eligibility and Entrance Test (NEET), NEXT will also be applicable to institutes of national importance such as all the AIIMS in a bid to ensure a common standard in the medical education sector in the country.

Expensive medical college seat: is it worth?

What fuels a doctor?


You have to live a doctor’s life or to very closely watch one’s to understand it.

As a young overburdened doctor, still undergoing the rigours of academics, I used to commit certain silly mistakes of commission and omission which my watchful patients and their attendants would easily catch. And they would gladly discount it or let me know not grudgingly. From a twenty year old boy to a fifty plus oldie – that has kept me going.

It is hard getting into medicine. Equally hard studying it and even harder practising it. The litmus test was declaring a patient dead. Even harder , declaring a neonate dead with its face beautified by the large dead pupils. As if it is going to cry just ! It takes quite some heart to do the ultimate job of declaring the undeclarable. And then you come across patients and people your age who tell you they get all sorts of symptoms upon hearing someone die !!

Doctors live fast, age fast and studies have confirmed, they die faster than the general population. Their youth is almost completely absorbed by the vast study material and rigours of one of the most difficult courses.

Once as a house physician, I encountered a school girl with fever admitted in my ward. As a routine I used to check the vitals of around 30 patients morning and evening before the rounds. She used to laugh at me saying that I had nothing better to do than a nurses’ job. It took us almost a week to diagnose her with a blood cancer. She happened to be a cousin of one of my friends. She lost her hair to chemo drugs. Tired of the disease and confines of the hospital, one evening she insisted to go out.  She was so insistent that her mother requested me if I could take her from the hospital to my room. I refused to oblige her under a veil of principles and legality. After the whole night of  confusion, whether to accede to what may be one wish in her last days, I decided to take her out of ward. I prepared  myself  for a reprimand, I would face in the department. Next morning when I reported for duty , her bed was empty. She had massive bleed at night. I cried. That was about 25 years back. I still cry though very sparingly now, on losing a patient.

Only a doctor would understand this.

Looking back , it is not money , it is not anything but a glint of gratefulness in the eyes of my patients and it is the tolerance of my patients to my mistakes that has kept me going all these years. But that desired emotions are lacking somewhere and myself, at times do not feel the zeal  to continue anymore.

  A sense of gratitude in the  eyes of patients that fueled the doctor inside me,  is no more visible now.

Dr Sandeep Chaudhri

Consultant Internal medicine, Karnal (Haryana)

Doctor & nurses at risk from unknown or mutated germs@ Mystery virus in China


 

First pneumonia death from mystery virus in China, world on high alert

          The  viruses, bacteria are germs  had been discovered only in last one century and many more are still not known. Patients carrying specially unknown germs are  handled by doctor and nurses, who have no clue, what they are dealing with.   Time gap in such  patients coming to the  hospital  and  the exact diagnosis of finding a dreaded disease, may be  quite dangerous to doctors and nurses. To add to the problem, In  large number of patients, exact viruses cannot be diagnosed or even suspected. In many cases of ARDS, the causative organism cannot be  isolated or identified.  It is important for  doctors and nurses  to take universal precautions from the beginning. There can be many more viruses or germs which are yet to be discovered or mutated ones that  are unknown.

21 occupational risk to doctor and nurses

H1N1, Zika,  Ebola,  SARS  are few examples,  just to imagine that they existed and handled by health workers as unknown germs, till they were discovered.

The death of a 61-year-old man  due to pneumonia from a mystery virus in the central Chinese city of Wuhan on Saturday has put the world on high alert against another new life-threatening illness. Seven of the 43 others diagnosed with the disease are in a critical condition, but no new cases have been reported since January 3.

To protect the world still smarting from the lightning spread of devastating viral diseases such as H1N1, Zika and Ebola, the World Health Organisation (WHO) issued this year’s first  international travel and trade alert on  on January 10 that advised all international travellers to report symptoms of fever with breathlessness and difficulty breathing, especially if they have travelled from China.

On January 9, China announced that the cluster of pneumonia cases reported in December in Wuhan in the Hubei Province of China was caused by a new coronavirus.

Only six viruses from the coronavirus family infect humans, which would make the new one the seventh to cause human disease. The coronavirus viruses cause diseases ranging from the common cold to very severe and life-threatening illness from Middle-East Respiratory Syndrome that caused 851 deaths since it was identified in 2012, and the Severe Acute Respiratory Syndrome (SARS), which killed 774 of the 8,098 people infected in an outbreak that started in China in 2002.

“Though currently there is no evidence of human-to-human transmission, we need to remain vigilant. WHO has shared with all Member States technical guidelines on surveillance, testing as well as infection prevention and control practices for suspected cases. WHO is in close contact with national authorities in the region and will extend all possible support to ensure core capacities are geared up for addressing potential cases that may come to countries,” said Dr Poonam Khetrapal Singh, WHO regional director, South East Asia Region.

Unknown threat

Some countries in the region, including Indonesia, Myanmar and Thailand, have started screening passengers travelling from China for pneumonia symptoms at airports. The health ministry reviewed the situation with WHO experts on Wednesday and plans to start providing travellers with risk-reduction information at airports and other ports of entry, travel agencies and conveyance operators.

“We are waiting and watching as entry screening at ports of entry like airports, seaports, train stations and border check-posts are not cost-effective. It is resource-intensive but offer little benefit,” said a health ministry official, who did not want to be named.

Though no pneumonia have been reported outside Wuhan, which has a population of 11 million, WHO said there is need for caution as the city is a major domestic and international transport hub with heavy population movement. Travel in the region is expected to significantly increase during the Chinese New Year in the last week of January, which increases the potential of infected travellers carrying to other parts of China and the world.

New viruses are formed when mutate to jump species and cause infection in humans. SARS jumped from the civet cat into humans, MERS from dromedary camel, H1N1 from pigs, and Ebola from bats, just to name a few.

The Wuhan City cases have been linked to the South China Seafood Wholesale Market, where some of the patients worked as dealers or vendors. The Huanan Seafood Wholesale Market deals with fish and other seafood, including sea mammals, along with chicken, bats, rabbits and snakes.

Signs of trouble; The clinical signs of the new lung infection are mainly fever, with a few persons reporting difficulty in breathing. Clinical signs include chest x-rays showing bilateral lung infiltrates (markings) associated with pneumonia and tuberculosis.

With no infection among health care workers treating the patients, preliminary information suggests there is no significant human-to-human transmission, but till the mode of transmission is clearly established, it’s best to take precautions to stay safe.

The WHO advises people travelling in or from affected areas (currently Wuhan) to avoid close contact with people with acute respiratory infections; wash hands frequently, especially after direct contact with ill people or their environment; and avoid close contact with live or dead animals. In case of respiratory symptoms before, during or after travel, travellers must seek medical attention and share their travel history with the doctor.

“The WHO advises against travel or trade restrictions on China based on the information currently available on this event,” said Dr Singh.

 

 

How to implement bridge course, if necessary: A suggestion #NMC


Crosspathy is dangerous to human race and potential global catastrophe because of antibiotic resistance.  All  allopathic medicines are hazardous chemicals in inexperienced hands. Incorrect and massive use of antibiotics will  cause antibiotic resistance, which has global ramifications. From this angle, it is a retrograde step. When all over the world, need is being felt that there has to be better control of antibiotic prescription.  We are entering an era, where antibiotics are getting useless and more so because of rampant misuse of antibiotics.  Rather than exercising a better control, it will be a catastrophic to human race world over by causing antibiotic resistance.

Will  thousands or lac   of alternate medicine graduate will dispense all antibiotics,  anticancer , anti diabetic , cardiac medications? It is hard to think about hundreds of potentially dangerous medicines being given without structured training and  proper exams in this system of crosspathy.

   Although it appears to be an avoidable decision, but still if required can be done by creating “doctors for area of need.

Following steps should be taken before implementation:

 Main Aim; to create doctors  for area of need. (AON doctor)

  1. To identify areas of need; most basic step is to identify the areas of need, where doctors are not available. Government should identify area of need and implement the scheme in selected areas, and with  selected simple drugs. Such areas should be such that which do not have medical facilities or lack doctors. Areas which already have doctors will not accept the diluted  or sub-optimal care, for example urban population.
  2. Limited seats-To identify the number required; let us say start with pilot project of  selecting 500 to1000 such doctors. All the lakhs of alternate doctors  can not be allowed to prescribe allopathic medicines. It will put the community at risk.

Each and every seat of AON and its doctor needs to be identified , earmarked and  trained for the particular seat.

  1. To identify the skills required for the area; for example emergency, for paediatrics or obstretics and gynaecology, trauma.
  2. Willingness to work in area of need- to identify the doctors: have a written competition from all candidates who apply for bridge course. To identify doctors who have given willingness to work in these areas of need. People who perform well should be taken for bridge course  only on limited seats. Bridge course should not  free for all.
  3. To develop a structured bridge course, which should be around one year after comparing the course of MBBS and the course done by the candidate.
  4. Admission and exit in the bridge course should be through exam and limited seats.
  5. Bridge course and allopathic medicines should not be made free for all, that any body can dispense it. We can get benefit only if is specific to needs of people. If everyone is allowed to practice allopathy in all locality, it will be a global hazard besides our community .
  6. These trained doctors will have an undertaking to serve in area of need only. For a period at least 10 to 20 years.
  7. Number should be limited but training should be good.
  8. A special course needs to be designed separately for one year, so that people in area of need do not get substandard care

Without proper planning and implementation and identification of area of need, this bridge course will not benefit anyone, rather it can be disastrous.

 

Reasons of having excessive thirst:


If some ones  feels  the need to   drink lots of water, most of time  reason is usually  known . For example,   not  drinking enough of it. But some times there can be more sinister mechanisms and need evaluation. There can be number of diseases,  which can  present  by  excessive thirst.   This derangement is  more  other than merely being dehydrated.

If drinking more fluids for several days hasn’t helped, there can be reasons other than dehydration.

Dehydration:

If some ones  feels  the need to   drink lots of water, most of time  reason is usually  known . For example,   not  drinking enough of it. Dehydration occurs if some one  does really hard work  in the ground or  sweating in the sun. The loss of fluids need to be replenished .

Dehydration commonly happens, in cases of food poisoning ,  diarrhoea, vomiting, inability to eat or drink  and loose motions.

Diabetes

One of the most important symptom of diabetes is thirst.  All types of  diabetes will present as increased intake of water and being thirsty.  Frequent urination, another common symptom of diabetes, will bring on thirst.   Therefore  excessive thirst and urination, along with unexplained weight loss, fatigue, or irritability, can be indications of diabetes.

Dry mouth

The abnormal dryness of the mucous membranes in the mouth, due to decreased  flow or change in the composition of saliva.  It is  also known as xerostomia, is often mistaken for excessive thirst.  Causes of dry mouth include smoking tobacco, use of  marijuana, stress, anxiety, or  aging.  But certain drugs (antidepressants) and autoimmune diseases can also cause dry mouth.

One  may think  being thirsty, whereas  actual reason is  having a dry mouth.

Dry mouth can present as :

  • a burning sensation or soreness in your mouth
  • changes in your sense of taste
  • difficulty speaking, eating or swallowing.

Menstrual blood loss

Estrogen and progesterone levels can both affect fluid volume.  If blood flow is more, it can  also cause  more  blood loss.   The blood loss will cause increase in thirst.

 

Thyroid problems

When the thyroid function is deranged , hormone  production is erratic can,  produce increased  or less e hormone. Thyroid dysfunction can   spur a variety of nonspecific symptoms, including abnormally heavy periods, anxiety, feeling hot, and dry mouth. These all can lead to increased thirst.

 Stress

Stress or specially chronic  stress is a cause for  adrenal gland dysfunction specially if  stress is severe.  This can cause dizziness,  depression, anxiety, and  severe  thirst.

 

Diuretic  and food containing diuretics:

    Drugs that produce lot of urine  are diuretics. They  can cause feeling of thirst.

Foods that have a diuretic effect can make you thirsty because they cause you to urinate more. Foods like melons,  ginger, celery, asparagus, beets, lemons.

 

Low-carbohydrate  diets:

        One of  side effect of Keto- diet  is thirst. The eating plan  significantly cuts down on  carbohydrate intake.   Carbohydrates s absorb  more water than protein and fat.

 

Pregnancy:

excessive thirst can happen in pregnancy due to many reasons for example  Increased urination,  nausea and morning sickness

Excessive bleeding:

Ongoing or sudden blood loss,   can  cause  thirst levels  in order to  make up for the fluid loss.

 

Diabetes insipidus:

Diabetes insipidus is a rare disorder that affects water absorption.   It can cause loss of huge  amounts of water  by production of litres of urine.   Cause can be brain or kidney called as central and nephrogenic respectively.

Psychogenic  polydipsia:  this is an urge to drink more water and  patients are unable to control the urge.  Patients may have intake of many litres per day.

 

 

“EDG scale of doctor’s comfort: guide for medical students” – How to choose medical specialty


Choosing a medical specialty is possibly one of the most important variable factor in doctor’s life. This one factor will decide the rest of the  life of the doctor. General rough guide to the factors involved, which persist forever and throughout the life, after a doctor chooses a specialty is given below. There can be individual variation depending upon the individual attitudes, compromises and way to do practice. Therefore there will be some variation in all the fields for individuals, places, systems and countries.

Re-blog

There can be extremes and variations  on either side of spectrum, but are exceptions. Following article does not include satisfaction and earning gained from   other businesses done by doctors, running nursing home or hospitals, commercial gains  from pharmaceuticals etc. this is on basis of income purely from professional work of treating patients.  These  factors and units can be used as a scale for guidance of medical students and hence named as EDG scale of doctor’s comfort (Extinct doctor good)

Factors

  1.      Earning
  2.      Prolonged tough training
  3.      Satisfaction of treating patients
  4.      Satisfaction of making diagnosis
  5.      Emergency & odd hour duty
  6.       Stress of life and death
  7.       Legal complexity and stress

The Unit—-Single * or (I) is  one unit. With experience and years of work , this unit  (for same doctor) will also multiply with age.

UNIT

India ( * or 1) is  1  million  rupees/annum

Advanced countries- (* or 1)== one lac or 100,000 dollars/ annum

 

General practice

 

 
       1.  Earning **to ***      2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**
Internal medicine

 

 
       1.  Earning **to****        2-4
       2..   Prolonged tough training

 

**to***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***

 

cardiology

 

 
       1.  Earning **to*******  2-7
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****

 

gastroenterology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

**

 

Neurology

 

 
       1.  Earning **to******  2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                  3

 

Nephrology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***           3

 

Pulmonary medicine

 

 
       1.  Earning **to*****     2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***                    3

 

 

Emergency  Medicine

 

 
       1.  Earning **to****     2-4
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****                4

 

Anaesthesia

 

 
       1.    Earning **to*****     2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

**
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****                 4
Endocrinology

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**                2
Psychiatry

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                  2

 

 

 

 

paediatrics

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

****                  4

 

Critical care

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****           4

 

Paediatric critical care

 

 
       1.  Earning **to*****     2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

General Surgery

 

 
       1.  Earning **to*****      2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

Minimal access surgery

 

 
1.          Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***                3

 

 

Cardiac surgery- CTVS

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

Urology

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                 3

 

Gastro-surgery

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****            4

 

Neurosurgery

 

 
       1.  Earning   **to******   2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****            4

 

Head and Neck surgery

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***               3

 

Orthopaedics

 

 
       1.  Earning **to******                2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                             3

 

Ophthalmology

 

 
       1.  Earning **to*****             2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                           2

 

Radiology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

*
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                  2
ENT

 

 
       1.  Earning **to*****    2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                 2

 

Dermatology

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

*                1

 

Gynaecology/obstetrics

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****

 

Plastic Surgery

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

*
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**              2

 

 

Oncology

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**               2

 

Onco-surgery

 

 
       1.  Earning **to******     2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**                    2

 

Anatomy

 

 
       1.  Earning **to***     2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Physiology

 

 
       1.  Earning **to***
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Biochemistry

 

 
       1.  Earning **to***    2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Microbiology

 

 
       1.  Earning **to****    2-4
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

0 to*
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

 

Pathology

 

 
       1.  Earning **to ****    2-4
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

NIl
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

Medical administrator/Manager

 

 
       1.  Earning **to********  2-8

sometimes multiple

       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

. There can be extremes and variations  on either side of spectrum, but are exceptions.

If the reader have some different view, or want to add something, they are welcome to  write in comments. This table just  highlights a trend of factors and may not be perfect. But it gives the factors which need to be taken into account,  before choosing specialty.

How to choose medical specialty? Variation of doctor salary, earning & important factors


Choosing a medical specialty is possibly one of the most important variable factor in doctor’s life. This one factor will decide the rest of the  life of the doctor. General rough guide to the factors involved, which persist forever and throughout the life, after a doctor chooses a specialty is given below. There can be individual variation depending upon the individual attitudes, compromises and way to do practice. Therefore there will be some variation in all the fields for individuals, places, systems and countries.

There can be extremes and variations  on either side of spectrum, but are exceptions. Following article does not include satisfaction and earning gained from   other businesses done by doctors, running nursing home or hospitals, commercial gains  from pharmaceuticals etc. this is on basis of income purely from professional work of treating patients.

Factors

  1.      Earning
  2.      Prolonged tough training
  3.      Satisfaction of treating patients
  4.      Satisfaction of making diagnosis
  5.      Emergency & odd hour duty
  6.      Stress of life and death
  7.      Legal complexity and stress

The Unit—-Single * or (I) is  one unit. With experience and years of work , this unit  (for same doctor) will also multiply with age.

UNIT

India ( * or 1) is  1  million  rupees/annum

Advanced countries- (* or 1)== one lac or 100,000 dollars/ annum

 

General practice

 

 
       1.  Earning **to ***      2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**
Internal medicine

 

 
       1.  Earning **to****        2-4
       2..   Prolonged tough training

 

**to***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***

 

cardiology

 

 
       1.  Earning **to*******  2-7
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****

 

gastroenterology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

**

 

Neurology

 

 
       1.  Earning **to******  2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                  3

 

Nephrology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***           3

 

Pulmonary medicine

 

 
       1.  Earning **to*****     2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***                    3

 

 

Emergency  Medicine

 

 
       1.  Earning **to****     2-4
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****                4

 

Anaesthesia

 

 
       1.    Earning **to*****     2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

**
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****                 4
Endocrinology

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**                2
Psychiatry

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                  2

 

paediatrics

 

 
       1.  Earning **to*****       2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

****                  4

 

Critical care

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****           4

 

Paediatric critical care

 

 
       1.  Earning **to*****     2-5
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

General Surgery

 

 
       1.  Earning **to*****      2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

Minimal access surgery

 

 
1.          Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

***
      7. Legal complexity and stress

 

***                3

 

 

Cardiac surgery- CTVS

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****               4

 

Urology

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                 3

 

Gastro-surgery

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****            4

 

Neurosurgery

 

 
       1.  Earning   **to******   2-6
       2..   Prolonged tough training

 

****
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****            4

 

Head and Neck surgery

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***               3

 

Orthopaedics

 

 
       1.  Earning **to******                2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

***
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

***                             3

 

Ophthalmology

 

 
       1.  Earning **to*****             2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                           2

 

Radiology

 

 
       1.  Earning **to******   2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

*
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                  2
ENT

 

 
       1.  Earning **to*****    2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**                 2

 

Dermatology

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

*                1

 

Gynaecology/obstetrics

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

****
       6. Stress of life and death

 

****
      7. Legal complexity and stress

 

****

 

Plastic Surgery

 

 
       1.  Earning **to******    2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

*
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

*
      7. Legal complexity and stress

 

**              2

 

 

Oncology

 

 
       1.  Earning **to*****   2-5
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

***
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**               2

 

Onco-surgery

 

 
       1.  Earning **to******     2-6
       2..   Prolonged tough training

 

***
       3..   Satisfaction of treating patients

 

***
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

**
       6. Stress of life and death

 

**
      7. Legal complexity and stress

 

**                    2

 

Anatomy

 

 
       1.  Earning **to***     2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Physiology

 

 
       1.  Earning **to***
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Biochemistry

 

 
       1.  Earning **to***    2-3
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

Nil
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

Nil

 

Microbiology

 

 
       1.  Earning **to****    2-4
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

0 to*
       4.  Satisfaction of making diagnosis

 

**
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

 

Pathology

 

 
       1.  Earning **to ****    2-4
       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

NIl
       4.  Satisfaction of making diagnosis

 

****
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

Medical administrator/Manager

 

 
       1.  Earning **to********  2-8

sometimes multiple

       2..   Prolonged tough training

 

**
       3..   Satisfaction of treating patients

 

Nil
       4.  Satisfaction of making diagnosis

 

Nil
       5. Emergency & odd hour duty

 

*
       6. Stress of life and death

 

Nil
      7. Legal complexity and stress

 

*

 

. There can be extremes and variations  on either side of spectrum, but are exceptions.

If the reader have some different view, or want to add something, they are welcome to  write in comments. This table just  highlights a trend of factors and may not be perfect. But it gives the factors which need to be taken into account,  before choosing specialty.

Expensive medical education ? Future may be “free medical education”: NYU offers free education for all its medical students


     At a time when students, parents and even doctors are uncertain whether opting for medical college along with the vulnerability and risk associated with   becoming a doctor is worth it or not, some are naive enough to pay millions as fee for medical education and for securing a seat of MBBS.

Truth  cannot remain hidden for long.  It has  to be realized that getting into medical college is a minuscule component of the process of becoming a good doctor.  Once they opt for this profession, the real tough and prolonged battle begins. Quite a few successful candidates may eventually feel that the money spent and the hard work may not be worth it, especially those who may have invested in heavy fees and in debt.

Although the whole effort and huge expenditure to become doctors in this way may be really worthless in today’s scenario, considering the difficult times and vulnerability of medical profession

Paying the irrational fee of medical colleges may be an unwise idea for the candidates, who are not from strong financial backgrounds. But at the same time unfortunately, it may be a compulsion and entrapment for students, who have entered the profession and there is no way forward or fail to get residency.

The New York University School of Medicine will provide free tuition for all present and future students, the university announced.

Citing the risk of “overwhelming” debt, it says every student will qualify regardless of merit or financial need.  NYU said financial worries were driving graduates to more lucrative specialities, pushing doctors away from more general positions. The scholarship covers annual tuition costs of up to $55,000 (£43,000). A study produced by the Association of American Medical Colleges estimated that in 2017 75% of medical students graduated in debt. The university has reportedly been working for more than a decade to accrue the necessary funds to pay for tuition, and hopes to raise a total of $600 million (£472m) to make the scholarships available permanently. NYU School of Medicine made the surprise announcement at its annual White Coat Ceremony on Thursday – when new students receive a white lab coat as they begin their studies. In their statement, the university said debt is “fundamentally reshaping the medical profession in ways that are adversely affecting healthcare”.Graduates move towards higher-paying areas of medicine over paediatrics, primary care or gynaecology due to their “staggering student loans”. Aspiring physicians and surgeons should not be prevented from pursuing a career in medicine because of the prospect of overwhelming financial debt”. Robert Grossman, dean of the medical school and chief executive officer of NYU Langone Health, said: “This decision recognises a moral imperative that must be addressed, as institutions place an increasing debt burden on young people who aspire to become physicians.”To date, only a handful of institutions have tried to make medical education tuition-free, according to Julie Fresne, senior director of student financial services of the Association of American Medical Colleges, a nonprofit organisation that represents medical schools. At UCLA’s David Geffen School of Medicine, a $100m (£79m) fund announced several years ago pays for the entire cost of medical school for all four years, including tuition, fees, books and living expenses for about 20 per cent of its students. But that program is based on merit, not need.

Meanwhile, a small medical school affiliated with Case Western Reserve University at the Cleveland Clinic covers the tuition and fees for its five-year programme focusing on research. Most of the roughly 20,000 students per year enrolled in US medical schools take out sizeable federal loans to support their studies. According to the Association of American Medical Colleges, in 2017, the median debt for graduating medical students was $192,000 (£151,000).The median cost of medical school attendance, including living expenses, was $60,945 (£47,906) a year for public medical school and $82,278 (£64,675) for private medical school.

This may be a indicator of the future days to come, the need for medical education   to be cheap or made free,  to encourage young generation to become doctors. Society has the choice to encourage and nurture good doctor for itself or discourage them by financial exploitation and subjecting them to debt trap. NYU has wisely decided on its choice.

 

Doctors need genuine Leave – painful barb for others @ Tokyo medical school


Japan medical school admits to altering scores to keep out female applicants

  Usually the kind of work of doctors keep them on toes and it is difficult to have leaves. This may be a global  phenomenon.  Medical systems also are not very comfortable with doctor’s leaves. Scarcity of doctors and difficult replacements makes life of doctors busy and unsocial.  Systematic  denial of genuine leave has been proved by  investigations  at   Tokyo medical school.

 

A Tokyo medical school has confirmed after an internal investigation that it systematically altered entrance exam scores for years to keep out female applicants and ensure more men became doctors. The school wanted fewer female doctors because it anticipated they would become mothers and would shorten or halt their careers. It is extremely important to improve the working environment so that women can pursue their medical professions. School’s purpose in denying women entry was because female doctors often quit working after starting families. Women tend to avoid tough jobs like surgery or work in remote areas. They need to take a break from their careers because of pregnancy and childbirth.

 Tokyo Medical University manipulated all entrance tests results since 2000 or even earlier. The findings released Tuesday by lawyers involved in the internal investigation confirm recent reports in Japanese media.

The manipulation surfaced during an investigation of an alleged wrongful admission of a bureaucrat’s son.

The internal investigation found the school first reduced all applicants’ first-stage scores to 80 percent then added up to 20 points only to male applicants with three or fewer application tries.

The school wanted fewer female doctors because it anticipated they would become mothers and would shorten or halt their careers.

Japan’s government urged a medical university to promptly disclose the results of an investigation into its admissions process Friday after reports alleged it had altered the test scores of female applicants for years to deny them entry and ensure fewer women became doctors.

The school’s public affairs department said it had no knowledge of the reported manipulation but is investigating. The school is already facing a separate scandal involving the inappropriate admission of a top education bureaucrat’s son and was ordered by the education ministry to investigate its admissions records for the past six years. On Thursday, the school said it will combine the examination of the score manipulation allegation with that probe.

The share of female doctors who have passed the national medical exam has stayed at around 30 percent for more than 20 years, prompting speculation that interference in admissions is widespread at Japanese medical schools.

The Japanese medical university’s alleged systematic deduction of entrance exam scores only from female applicants has sparked outrage across Japan. It was reported Thursday that Tokyo Medical University has been slashing female applicants’ entrance exam scores for years to keep female student population low, on grounds they tend to quit as doctors after starting families, causing staffing shortages

Admissions records released to The Associated Press by the school show the percentage of women who passed the entrance exam rose from 24 percent in 2009 to 38 percent in 2010. The figure has since stayed below that level until decreasing to 18 percent this year, when a total of 171 students passed the exam. The ratio of female applicants who were accepted this year was 2.9 percent, compared to 8.8 percent for men.

 

Private Medical College Seat (MBBS)(#Medical #NEET): System of Entrapment or (?)Debt Trap For Many.


MBBS debt trap for many Private Medical College Seat (MBBS)-Debt Trap For Many.

Mirroring the US situation, where medical students come out of the education system with huge loans to repay, India’s medical education is becoming a debt trap for thousands  of medical students with governments doing little to regulate medical college fees.

High fees in most medical colleges means that students who have to take loans to pay it cannot hope to service the loans from what they earn as doctors after completing MBBS. Here’s how the math works. Annual tuition fees in private medical colleges average over Rs 10 lakh. That’s half a crore rupees or more for the entire course when charges for things like hostel, mess, library, internet and examinations are included. The EMI on an education loan of Rs 50 lakh works out to at least Rs 60,000. Government salaries for an MBBS graduate range from Rs 45,000 to Rs 65,000 depending on the state and area. The private sector is even worse.

This raises a question: The government is allowing the opening of more private colleges or allowing existing ones to increase seats citing shortage of doctors, especially in rural areas and in primary health centres, but don’t high fees defeat the purpose? Can such doctors have a living wage after they pay the EMI? In most banks, education loans cannot exceed Rs 7 lakh to Rs 10 lakh without collateral, which typically would mean mortgaging a house or land. With collateral, the loan amount can be . High MBBS fees leaving many doctors in debt trap

Usually, the loan carries an interest of 10% to 12.5% and has to be repaid within 10 to 12 years. If education loans become prohibitive, it could make medical education the preserve of the rich. A TOI analysis of fees charged in 210 private medical colleges in 2017 showed that about 50 charged anything between Rs 10 lakh and Rs 15 lakh and over 30 charged even more. Several government colleges too charge high fees, especially in Gujarat and Rajasthan. After 4.5 years of MBBS, a student has to do a one-year paid internship, during which time his/her salary would be at best Rs 20,000-25,000 per month.

After MBBS, whether a student is doing three-year post-graduation or working as a resident doctor or medical officer, the salary in government service ranges from Rs 40,000 to Rs 55,000 in most states and even less in the private sector. In about three to four years, the salary rises to about Rs 70,000 at best in most places. With EMIs of Rs 45,000- 65,000 for loans ranging from Rs 30 lakh to Rs 50 lakh, doctors are left with barely enough to live on. For those who get married by this stage, the added responsibility of running a household complicates matters further. Even in states with fee regulation, the annual fees in private colleges could range from Rs 2.5 lakh to over Rs 6 lakh+ ,

For those without means, that would entail a loan of Rs 12 lakh to Rs 30 lakh and hence unaffordable EMIs.

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