Re: 3-year MBBS to meet rural needs

[Guest guest]

Dear Forum,

Re: /message/10936

The idea to bring the MBBS to a three year basic course does not bode well in

the long term for India.

That we need more healthcare workers in the rural areas of the country is not

debatable. However the lack of trained medical graduates in rural areas is not a

result of absolute shortages but due to distribution biases, with most MBBS

graduates prefering to work in better resourced centres in urban settings than

in poorer, remote rural posts.

Downgrading the MBBS makes the future graduates poorer for their skill sets, and

destroys the entry point to what is now considered a well established medical

education system.

Building capacity by destroying something else isn't the best that we can come

up with. On the contrary, let's think in terms of encouraging the thousands of

our auxiliary nurse midwives to upgrade their skills, and social standing.

Let us think in terms of nurse practitioners who have clinical exposure, and can

manage most clinical situations at the periphery.

Two advantages are quick to emerge from this approach: 1. A shorter gestation

for getting additional training / skills on the ground 2. Aknowledges,

formalises and builds the credibility of the existing channels of healthcare

delivery in the face of quackery and malpractice.

India faces both demographic and epidemiological transitions right now. We

cannot afford to stop building our secondary and tertiary level health systems,

just as we cannot ignore the primary healthcare needs. Who pays for the

secondary / tertiary care system is another debate, but its need is not.

That the State should guarantee primary health is an understanding from a broad

reading of the constitutional right to life. In ensuring primary health but

effecting a zero sum game by robbing the secondary / tertiary care, we do not

expand total capacity, something our current and projected demography and

epidemiology demands.

Hopefully, we can have an expansion of human resources for health care in India

than an unintentional curtailing of it.

Bobby

Conflict of interest: I happen to possess an MBBS degree.

Dr. Bobby

e-mail: <bj@...>

[Guest guest]

Dear Forum,

/message/10936

This is not new. 'Barefoot' doctors in China have done this

since 1949 when Mao took over. That is the basic problem even in USA, where we

have too many specialists and not enough general practioners, and see what a

mess they are in.

Sincerely,

Priyadarshi Datta, Ph.D, PLWA.

e-mail: <pdatta@...>