Friday, June 28, 2013





Rural service for doctors set to be a reality soon

Rural service for doctors set to be a reality soon

Bengaluru: The Medical Council of India (MCI) and ministry of health and family welfare want to make one year of rural service compulsory for all MBBS graduates if they want to be eligible to pursue higher studies.
The rule, if it gets approval, will be applicable to all students irrespective of the category under which they have joined the course/college. Presently, the rural service condition is applicable only to those studying in government medical colleges and government quota seats in private colleges.
The proposal was first mooted by the ministry of health and family welfare in April 2013. Now the MCI has forwarded the proposal with its consent. The main thrust of the proposal is that before the post-graduate course, all MBBS graduates in the country must undergo a mandatory posting in a rural area for one year. An officer from the ministry said the proposal is at a very early stage.
He justified it on the grounds that "it is the only solution available to provide better health care facilities to the rural people who are deprived of all the facilities. If the proposal is not changed at a later stage, this mandatory rural service will also be applicable to NRI students and those who study under the management quota."
Such a step, however, is a double-edged sword. The official admitted that meritorious students are avoiding medicine and going in more for engineering. "If we increase the duration of the course in the name of one year compulsory rural service, the course may lose its sheen. The challenge is in balancing the course duration, PG admission process and health care facilities for rural people," he added.

Rural docs threaten strike over delay in PG quota counselling

Rural docs threaten strike over delay in PG quota counselling

Rural medical officers (RMOs) of Punjab have threatened to go on strike in protest against the state health and family welfare department's decision to put off counselling for the post-graduation (PG) quota. 
Dr Aslam Parvez, president of the Rural Medical Services Association (RMSA), 

Punjab, said if the department did not announce the counselling date at the earliest, RMOs would be forced to proceed on strike.
"The strike by RMOs will have an adverse effect on rural health services, which have already been hit due to the strike by pharmacists and Class-4 workers in subsidiary health centres of the state," said Dr Deepika Puri, who is posted in a rural dispensary in Ludhiana district.

She alleged that principal secretary, health, Vini Mahajan was frequently changing rules to prevent doctors working in the rural development department from getting benefit of PG courses.

In a demi-official (DO) letter (HT has a copy) dated June 18, sent to Dr SS Gill, vice-chancellor of Baba Farid University of Health Sciences (BFUHS), Faridkot, Mahajan asked the V-C to postpone the date of counselling for government in-service 60% PG quota seats. The health secretary cited relaxation of conditions for Punjab Civil medical Service (PCMS) doctors so that more PCMS doctors can get admissions.

Last week, the V-C had stated that counselling had been postponed only for categorisation of subsidiary health centres and getting service records of RMOs who had been permitted by the Punjab and Haryana high court for availing benefit for higher qualification in government medical colleges of the state.

"Earlier, no relaxation was given to PCMS doctors even after opposition from various quarters, but now when the high court has given orders in favour of RMOs on eligibility for PG quota counselling, the government has changed the criteria at the last moment to harm interests of RMOs working under zila parishads," said Dr Vikas Sood, Fatehgarh Sahib district unit head of the RMSA, Punjab.

When contacted, Mahajan stated that as per the mandate of doctors employed in the department of rural development and panchayats, they could only provide primary health services. "There is no infrastructure in rural dispensaries to provide secondary and tertiary health services. It's not about the health department versus the rural development and panchayat department; it's about logical functioning. The health department has infrastructure for secondary and tertiary healthcare. That is why doctors working under this department are eligible for the PG quota in medical colleges," Mahajan added.

Thursday, June 27, 2013



second round allotment details are now available in site 



Medicos protest against rural stint for PG course

Medicos protest against rural stint for PG course

Chennai: More than 100 students of MMC on Wednesday staged a demonstration near collector’s office demanding the central government not to make rural posting for MBBS doctors mandatory. The students also demanded the government to scrap the three-year rural medical course on community medicine.

Tamil Nadu Medical Students’ Asso­ciati­on(TNMSA) organised the demonstration, whose member Harinivas said, “The Union government has announced students who wish to pursue PG should compulsorily undergo one-year rural service.

We are ready to do rural service, not just for one or two years, we could do it permanently. Will they make us permanent doctors in primary health centres?” Students also felt that three-year rural medicine course would divide urban and rural students. “What if rural students were asked to pursue only rural medicine course in future?” students questioned.

The medical students’ association is planning to stage more such demonstrations.

State flouts MCI guidelines in PG admissions

State flouts MCI guidelines in PG admissions

Gives 25% seats to in-service doctors.
The state government is flouting Medical Council of India (MCI), the apex body for medical education in the country, rules by reserving 25% of seats for “in-service” doctors in post-graduation courses.

The medical education department keeps aside 25% seats in post graduate courses under the “in-service quota” for its medical officers. The quota snatches 60 seats annually from fresh MBBS graduates.

As per the 2009 amendment of MCI –Post-Graduate Medical Education Regulations 2000, 50% of seats in diploma courses can be reserved for doctors in service for three years.

However, the rule doesn’t say anything about PG courses. The rule came into effect on 21 July, 2009 but Maharashtra continued to allocate “quota” to its medical officers due to “unknown reasons”. The quota was incorporated in 1996.

The 2013-14 admission notification issued by the department has reserved 61 seats in PG and 21 seats in diploma courses for doctors working in government hospitals employed by the Directorate of Health Services.

Over 623 seats in post-graduation and 175 seats in diploma courses are available in Maharashtra under the state quota this year. Equal number of seats has been set aside for all-India quota as per the NEET-PG framework.

Dr Santosh Wakchure, president of Maharashtra Association of Resident
Doctors (MARD), expressed shock over the issue. “How can the state flout MCI norms? We were not aware that this quota is illegal. By giving PG seats to in-service doctors the government is deliberately creating shortage of medical teachers and helping in-service doctors to boost their illegal private practice.”

Interestingly, in-service doctors have appealed in the Bombay high court to get more seats citing “injustice”. In the June 20 writ petition, the petitioners have said they are entitled to get 25% of seats, including all-India quota.

The HC, in a previous case, had asked the government in 2012 to clarify its stand but the government failed to do so until the doctors dragged the state in the High court again early this month. Now, the department has issued a GR on June 21 clarifying that it would be 25% of the state quota only.

Students in soup
As per the schedule declared by the Directorate of Medical Education, the first list of PG admission should have been out by June 20. But the Bombay High Court has stopped the DMER to declare the first list till further orders. This has delayed the admission in PG courses. “As the PG courses are of three years, we currently have shortage of 1/3 resident doctors,” said a JJ Hospital professor.


Wednesday, June 26, 2013

Doctors by merit, not privilege-THE HINDU

Doctors by merit, not privilege-THE HINDU

Cleaning the mess in India’s medical education first needs a strengthening of the Medical Council of India through the appointment of members by an independent and rigorous selection process

India is the only country that authorises, as official policy, the sale of medical seats by private medical colleges, implicitly accepting the principle that the ability to pay, and not merit, is what counts. Further, in the absence of any system of third party certification by way of an entry or, more importantly, an exit exam — which could guarantee the qualities and competencies a doctor must possess before starting to practice — many medical colleges are producing quacks. The tragedy is that we all know about it.
The issue is not just about illegal capitation fees that range from Rs.50 lakh to Rs.1 crore for a MBBS seat. The process of admission is itself flawed with a walk-in system for those with money but for the others, it is a harrowing tale of expensive tuitions and writing 15 to 20 examinations across the country — a process that once again excludes and deters several.
Entrance test
In order to reduce the stress of multiple examinations, make it more equitable and ensure minimum levels of competence, having the National Eligibility-cum-Entrance Test (NEET) as a qualifying requirement for admission has been a long-standing recommendation of experts. It was reiterated in 2010 by the Medical Council of India (MCI), inspired by rapidly deteriorating standards of school education.
The delay in implementing NEET was because of a lack of political will and the growing clout of private medical colleges in a neo-liberal environment that has encouraged a deadly cocktail of money power and political muscle. It is creditable that despite pressures, the MCI conducted NEET in 2012, for 90,000 aspirants.
Defying the MCI mandate on regulating entry into medical colleges, about 90 private colleges held their own examination and, on specious grounds, successfully obtained a stay from the Supreme Court. On May 13, the Supreme Court issued an interim order, making NEET voluntary and permitting the private colleges to go ahead with admissions based on their own examinations. For the harried students, it was Black Monday.
As business
Archaic and outmoded rules, regulations and eligibility conditions requiring a capital base of more than Rs.150 crore have made the establishment of medical colleges a business proposition. Combined with no incentives for quality education, there has been a twofold impact: 1. commercialising the medical profession, where “recouping” the investment is the prime concern for the investor and graduating doctor alike; and 2. an aggravated shortage of doctors in three ways: 15 per cent of those in the Non-Resident Indian quota within the 50 per cent management quota do not practice in India; of the remaining 35 per cent, many do not practice, migrate abroad or establish themselves in cities for better incomes; and, poor training makes many “unemployable” as amplified in a provider survey by Jishnu Das in Madhya Pradesh which found a marginal difference in the practices of “qualified” doctors and quacks. Clearly, the commercialisation of medical education is one of independent India’s biggest mistakes.
Therefore, the solution of “flooding the market with doctors by opening more medical colleges” to contain the menace of capitation fees without in the first instance, overhauling the regulatory framework related to quality of instruction, faculty development, better salary structures and banning private practice, etc has little merit.
Issue of quality
There are no short cuts or easy solutions to what has become a highly political issue. If people’s health really matters for this government and if India is to stay competitive globally, it can no longer look the other way. It has to exercise its constitutional authority to bring in much needed institutional reform to clean up the mess, just as it did in 2010 by replacing a corruption-ridden MCI with a board of governors by way of an ordnance.
In the same year, the ministry also drafted a bill to establish a National Commission for Human Resources for Health (NCHRH) to address the issue of quality by balancing the three critical functions of the profession: a) curriculum — what is to be taught and for how long; b) accreditation — who is to teach and in what manner; and c) ethical practice — adhering to the best interests of patients.
While the first two aspects were placed within the domain of a nominated body of experts, ethical medical practice was to be ensured by an elected body of the MCI. A distinction between nomination and election was made keeping in view the professional expertise needed to address complex issues related to content, standards, quality, competencies and skills as required by the country. Such expertise has to be sought and is not thrown up through electoral processes. It is for this reason that in most countries such as the United Kingdom, regulators are selected by the Public Service Commission based on merit and suitability. In addition, the U.K. Medical Council also has patient groups, student representatives and civil society activists as members of the Medical Council. Such openness and transparency is the only effective antidote to an indiscriminate abuse of power.
Focus on the regulator
In October 2012, the Parliamentary Standing Committee returned the NCHRH Bill to the government to re-examine three major concerns: 1. States’ autonomy and potential violation of federal principles;2. excessive bureaucratisation and centralisation, and 3. faulty selection procedure of regulators, providing scope for abuse. Rather than seizing the opportunity to come up with a better draft, the ministry has, for the third time, reconstituted the board of governors with a retired Directorate General of Health Services as chair.
It is believed that the main purpose of the reconstituted body is to oversee the elections to the Board of the MCI. If true, this is disheartening. The MCI is the regulator for medical education and practice just as the Reserve Bank of India is for financial institutions or the Election Commission of India for elections. Regulators cannot be elected on popular mandate — they have to be invited by the government for their professional eminence and moral authority. The MCI has to discipline and police the profession, more so on account of the extensive market failures that characterise it. Elected persons are compromised individuals and cannot do the task effectively. We have seen how disastrous our experience has been with an elected body; within the decade 2000-2010, it was set aside twice, once by the Supreme Court and the second time by the government by way of an ordnance. No other regulatory body has suffered such humiliation.
Since medical education is in the concurrent list of the Constitution, the Central government needs to leverage that power to bring in some discipline before permitting any more colleges to be established. The time has come to strengthen the regulator first by having the MCI Board freed from the clutches of doctors to include all stakeholders and have the members appointed through a rigorous selection process by an autonomous body like the Union Public Service Commission. This will end the nomination process of the ministry and the consequent conflict of interest. Once appointed, the regulator can be allowed to enforce its own rules and regulations.
The government needs to attend to a range of reforms from: appointing a tariff committee, indicating the right quantum of fees to be charged and legally enforcing the same; providing autonomy to medical colleges to stimulate excellence and innovation; constituting a committee of experts under the chairpersonship of a senior politician to examine some of the contentious issues, including the frequently made suggestion to nationalise private colleges, and appointing an advisory committee to undertake some of the critical functions of curriculum change and accreditation pending the establishment of a body like the NCHRH, which in today’s circumstances may take not less than three years. What is required is a non-negotiable, high priority concern for patient welfare and safety by focusing on the quality of doctors being produced, in sufficient quantity of the skill mix.
In conclusion, sorting out the mess in medical education requires a consensus across the political spectrum. Any shifts in the status quo will be bitterly opposed, so deeply entrenched are the vested interests. But the time has come for the government to act as the acute shortage in human resources is the main barrier to achieving universal health coverage. The more the delay in addressing the critical challenges facing human resources for health on grounds of political expediency, the greater the social, political and financial costs this country will have to bear in the years ahead. Prudence lies in stemming the rot by decisive action and before it is too late.
(Sujatha Rao is a former Secretary, Ministry of Health & Family Welfare.






PG medical students file petition in HC

PG medical students file petition in HC

MUMBAI: A few PG medical candidates, who have done their MBBS abroad but live in Maharashtra, have filed a plea against the state in the HC on Monday, after being denied eligibility under the state quota despite being allowed to practice. They said students from other states are allowed to apply under the quota but not them. Admissions have been stayed till Tuesday.

Tuesday, June 25, 2013



For candidates whose PG seat has been up-graded in second round PG All India Quota 2013 Candidates who have taken relieving letter from the college allotted through first round of counseling, on 25.06.2013 are requested to report back immediately to the authority of college in which
PG seat was allotted through first round of counseling and hand over the relieving letter to college
authority, immediately. Due to technical reason the result of Second round has been withdrawn for re- evaluation and correction, if any. The inconvenience caused is regretted. Please wait for revised result of second round, which is expected shortly.
Notice posted on 25.6.2013.

Monday, June 24, 2013



For candidates whose PG seats has been up-graded during 2nd/3rd Round
1. In case the seat has been up-graded during 2nd round of allotment, the candidate must report to the college allotted during first round of counseling, get the MCC website software
generated relieving letter duly signed by college authorities and the candidate and then
report to college where the candidate has been allotted seat through second round of counseling, as early as possible. Candidates are advised not to wait for last day. 2. The candidate and all participating college to please note that in case the seat has been
upgraded (or allotted seat during third round) in same subject/course by change of category, in this case also the candidate is required to get relieving from earlier allotted seat and join the up-graded seat by completing admission formalities on MCC software. 3. In case the candidate is allotted seat during third round of allotment, the candidate must report to the college allotted during earlier round (where candidate is admitted at the time of allotment through third round) of counseling, get the MCC website software generated
relieving letter duly signed by college authorities and the candidate and then report to
college where the candidate has been allotted seat through third round of counseling, as early as possible. Candidates are advised not to wait for last day.. 4. In case candidate’s seat is up-graded (or seat allotted to a candidate who is already admitted through All India Quota, during third round), the candidate must, get the MCC website software generated relieving letter duly signed by college authorities and the
candidate. The candidate once upgraded during the second round or third round, she/he
cannot change her/his option, in case she/he does not report for getting relieving letter
then also, her/his seat will be automatically cancelled.

‘Rural posting is not solution to vacancies’

‘Rural posting is not solution to vacancies’

One-year rural posting is mandatory for MBBS graduates who wish to apply for postgraduation

The Centre’s move to make a one-year rural posting mandatory for MBBS doctors who wish to pursue postgraduate studies has evoked a mixed response from students and doctors in the city.
In the past, proposals for compulsory rural practice have faced stiff opposition from medical students across the State. Nearly five years ago, the Union health ministry had proposed to extend the duration of the five-and-a-half-year MBBS course by an additional year to make rural posting mandatory. This was withdrawn after protests.
A government medical college student said the latest proposal was just in a different form. “The Centre has said we can begin practice after receiving our degree but are eligible for the PG entrance exam only on completion of a year’s rural posting. This will definitely discourage many students from taking up medicine. This will also pose a difficulty to first-generation learners who look to start earning at the earliest to support their families,” he said.
Kavin Kumar, coordinator of Tamil Nadu Medical Students Association, said the move was aimed as a cost- and job-cutting measure.
“At least 40,000 doctors pass out every year in the country. Most of these doctors will aspire for a PG degree. By posting us to rural areas, the government need not worry about filling the existing vacancies and can simply manage with MBBS pass-outs year. The State government should issue a statement opposing the Centre’s move,” he said.
Doctors in Tamil Nadu do not shy away from working in rural areas, however, he said. Recently, the Directorate of Medical Services recruited more than 2,100 MBBS doctors through the medical services recruitment board.
“At least 75 per cent of these postings are in rural areas. We give one mark for one year of rural service in the PG entrance exam,” an official said.
Working in rural areas would provide increased exposure, said another medical student. “I am familiar with diseases in the urban population. We see more cardiac problems and cancer here, while villagers face problems of infectious diseases. It will definitely give me a better exposure,” he said.

Stay on PG medical admissions in Maharashtra quota till tomorrow

Stay on PG medical admissions in Maharashtra quota till tomorrow

MUMBAI: The Bombay high court has stayed the declaration of the first selection list for postgraduate medical admissions in the state quota till Tuesday.

The enrolment process, which started earlier this month, has already been delayed by several months due to a Supreme Court battle between private medical colleges and the Medical Council of India (MCI)
over a single national entrance test. The selection list was to be released on June 20. Medical officers (MOs) in Maharashtra had moved the high court seeking an increase in the quota already available to them. The next hearing for the same is on June 25. Until then, the directorate of medical education and research (DMER), which conducts the PG medical admissions, will not be able to declare its first list in the 50% state quota.

Currently, MOs have around 60-70 seats reserved for them out of 600 PG seats. "Although medical officers have 25% of seats reserved, they do not opt for courses such as anatomy and microbiology. After eliminating these courses, they are left with 60-70 seats. However, they prefer seats in gynaecology, paediatrics and clinical practice. They have moved court seeking an increase in their quota," said DMER director Pravin Shingare. Meanwhile, a separate group of students-who formed the Association of Maharashtrian Foreign Medical Graduates (AMFMG)-are planning to move court on Monday since they have been denied eligibility in the state quota. They are candidates from the state who have completed their MBBS abroad.

After the completion of their course, the MCI permits such graduates to practise in the country after clearing the a screening test, Foreign Medical Graduates' Examination. The candidates also have to do a year's internship in MCI-approved hospitals, after which they get a permanent registration. "If our children are allowed to practise in the state, why cannot they be allowed a chance to be eligible in the state quota? After appearing for the NEET-PG, they also got a separate state rank and an all India rank. Despite getting a state merit rank, the state has denied admission to us as we did not complete the MBBS course from the state," said a parent. All these candidates from the AMFMG are residents of Maharashtra.

Shingare, however, said that admissions in the state quota are only open to those candidates who have completed their MBBS course from here.

The great medical education bazaar

The great medical education bazaar

The massive fraud being played on medical students who prepare for the entrance exam of private colleges, thinking them to be genuine, should be stopped

It is admission time and the great medical education bazaar is in full swing. Parents are running around like headless chickens ready to mobilise bundles of cash trying to get their children into the best medical colleges. In a society that has come to accept that paying illegal capitation fees is an effective way to get good education it is little surprise that parents have no compunction in violating the law and in acceding to the demands of the colleges by paying up whatever is asked.
Officially, the collection of capitation fee is banned. However, it is an open secret that many colleges continue to charge this fee with impunity. Many private medical colleges are believed to be charging between Rs.30 lakh and Rs.60 lakh as the capitation fee per candidate for an MBBS seat this year. On top of this, is the official annual fees which is between Rs.5 lakh and Rs.7 lakh a year. Thus a medico joining a private college this year under the management quota is likely to be spending anywhere between Rs.50 lakh and Rs.80 lakh or even more for just the undergraduate degree. The capitation fee for a post-graduate seat in a prized specialty like obstetrics & gynaecology or orthopaedics or radiology is now rumoured to be well over Rs.1.5 crore. The colleges have tightened their security systems to keep away the media who are always on the lookout for their hidden camera scoops.
One step of the farcical admission process is the “entrance or admission test” conducted by many of these private colleges. In most of them, the result/merit list is ready even before the candidates appear for the exam. Thousands of gullible students are spending time preparing for and paying entrance fees to appear for these bogus tests where the candidates who have already “booked” their seats months or even years in advance get the top ranks.
The present system needs urgent reform for several reasons. There is a massive fraud being played on students who are actually preparing for the entrance tests in these colleges thinking them to be genuine. If they knew that these are rigged exams, it will enable them to save their time and money. Private colleges would do their best to try to scuttle the National Entrance-cum-Eligibility Test (NEET) exam administered by the MCI, which would be transparent and where the merit list can be the basis of admission (though this is not the case at present), as there is no guarantee that the selected merit list candidate will be willing to pay anything more than the official fees.
Capitation fee or its equivalent which is widely prevalent needs to be brought above the table. If the governments cannot or will not enforce the law and stop the colleges from collecting this fee then they must consider some method of legalising it. The colleges claim (not without some merit) that with today’s cost structure it is simply not financially viable to run a private medical college without collecting capitation fee. The present system also leaves the colleges open to blackmail by politicians, bureaucrats, Income-tax officials, police, etc., all of whom know very well what’s going on. In fact, the corrupt among these groups are the major beneficiaries of the present system. Many of the more established colleges may actually welcome an opportunity to go legitimate if they are legally allowed to collect the capitation fee component.
All over the world, including the best private universities in the U.S., one is permitted to pay his or her way in once the college is satisfied that the student meets the eligibility criteria. The education fairs being held all over the country by foreign universities are essentially aimed at attracting buyers for the seats. So why can private colleges in India not do the same? If there are more colleges the cost would automatically come down as has happened with the engineering colleges and the courses would become affordable to a larger segment of the population.
Management quota seats can be at a hefty premium but the allotment of these too needs to go through a centralised, state-supervised process to ensure that candidates without the minimum qualifications are not selected and that capitation fee is not charged. Private medical colleges have made huge investments and the system evolved must protect their interests too as the fate of thousands of students is involved.
While the principle that education must not be a commodity that can be purchased without merit is a sound one, burying our heads in the sand without acknowledging the stark reality of the medical education bazaar in India will have dangerous repercussions.
In a situation where the parents and the colleges collude and neither has a problem it becomes difficult for the government to act against the collection of capitation fees as there is no complaint made by anyone. The ones who lose out are often the weakest students (no money/no influence) whose only asset may be merit. In the India of today, that does not count for much.
(The writer is a consultant in internal medicine.)

Saturday, June 22, 2013



One-year rural posting is unfair and impractical-TOI

 One-year rural posting is unfair and impractical

Incentives will work better 

The decision of the Union government to make it mandatory for all MBBS doctors aspiring for postgraduate specialisation to undertake a one-year rural posting is unfair and impractical. Stipulating that the candidates complete their rural stint even before they sit for their postgraduation entrance examination will open the door to all kinds of manipulation to meet the eligibility criterion. For the fact remains that rural healthcare in India is in a shambles. Devoid of basic infrastructure, there is very little that doctors can do in these parts of the country. Hence, forcing doctors to move to the villages will not solve anything. 

It is true that rural healthcare suffers from an acute shortage of medical professionals — around 60% of general doctors and 80% of specialists are missing. But things have come to this pass precisely because of long-running government apathy towards healthcare. At only 0.32% of the country`s estimated GDP, the Union budgetary allocation for healthcare is woefully inadequate. Even these funds are not utilised properly as exemplified by the deplorable condition of primary and secondary healthcare centres. With poor pay and little incentives, doctors cannot be expected to work with such decrepit infrastructure. In such a scenario, it is only natural that they seek greener pastures in the cities. 

The only way to rectify the situation is to boost spending on healthcare and incentivise rural postings. Medical professionals should be offered enhanced compensation, housing benefits, and paid refresher courses and seminars to get them to work in the villages. Besides, rural health centres should be well equipped and made operational so that doctors are motivated to work there. This requires a thorough revamp of our approach towards healthcare, backed by strong political will. Short cuts like forcing doctors to undertake rural postings will only incentivise innovation in circumventing the rules. 


Make doctors serve the poor 

Chandan Nandy 

At a time when state governments have lost the capacity to provide quality healthcare, the Centre`s decision that all MBBS graduates must serve a compulsory one-year stint in rural areas before being eligible for MD or MS programmes will reverse the situation. This is a sound strategy that will benefit India`s villages where people hardly get to see doctors. Public health centres across thousands of backward villages remain unmanned not because there is a dearth of doctors or even paramedics. Soon after graduating from government medical colleges, young doctors refuse to serve in the countryside because these postings prevent them from lucrative private practice. 

Fresh MBBS graduates are often poached by better pay and working conditions offered by the private sector, offering medical facilities which only the middle class and the affluent can afford. The private sector is loathe to setting up hospitals in rural areas, leaving village folks at the mercy of quacks. It is not that government medical colleges do not produce adequate number of MBBS graduates. There is an overall shortage of 60% general and 80% specialist doctors in the rural areas, a testimony to MBBS graduates` apathy to serve the country where infant and maternal mortality rates are still quite high. 

Last year, the Karnataka government imposed compulsory rural service (CRS) for all MBBS students, irrespective of whether they were enrolled in government or private medical schools. Failure to abide by the mandatory undertaking, including signing a CRS bond, invited paying a Rs 6 lakh fine. But the Kerala government capitulated to protests by doctors and abolished the CRS for MBBS students. In India, where the healthcare system is starved of resources and in dire need for reforms, the government`s initiative, if seriously implemented, will be a fitting response to villagers` desperate cries for help that often go unheard.

Friday, June 21, 2013

Rural posting must for MBBS doctors pursuing post-graduation

Rural posting must for MBBS doctors pursuing post-graduation

NEW DELHI: The MBBS doctors aspiring to pursue post-graduation will now have to compulsorily undertake a one-year rural posting before becoming eligible for such a course.

In a major decision aimed at improving rural healthcare in India, the Union government has decided to make it mandatory for all MBBS doctors to undergo one year rural posting to sit for post-graduation entrance examination.

According to health ministry sources, a proposal to this effect was cleared by the ministry recently and Medical Council of India (MCI) is in the process of issuing a notification.

"The decision will be applicable from the next academic session (2014-15). All MBBS graduates seeking a post-graduate degree would have to work for one year in a village before they can take the PG entrance examination," said a senior official. He said the MBBS course structure and duration will remain the same.

The decision came after two years of deliberations, as the earlier proposal of increasing the duration of the MBBS course to include a rural posting for doctors was scuttled after stiff opposition.

But now the ministry seems to have decided on it in view of the scarcity of medical professional in medical facilities in the rural areas. Health ministry statistics show there is more than 60% shortage of general doctors and over 80% of specialist doctors in rural India.

"The initiative to make rural posting compulsory is key to addressing the need of more doctors for rural areas. It will be notified soon," said Dr Jagdish Prasad, the Director General of Health Services (DGHS).

A senior MCI official said, "Those candidates who do not want to do a rural posting would be free to practice MBBS after they get their degrees following the internship. The MBBS course structure and duration will remain the same. The only change is one year rural posting will be made the eligibility condition for those wanting to pursue MD and MS."

Earlier, there was a proposal to increase the current duration of the MBBS course by one year and use the additional year for a village posting of MBBS students. The proposal wasn't found feasible as it meant that students would only get provisional MBBS degrees at the completion of their internship and final MBBS degrees only after the completion of a rural posting.

Every year, close to 40,000 students graduate with MBBS and most of them wish to pursue post graduation. The move, skeptics say, may hit students' zeal to go in for higher medical education unless suitably modified to reward them for undertaking a rural posting.

MCI sources said MBBS doctors going for rural posting from the next year may be given financial incentives but that component of the proposal is yet to be finalized.





The Supreme Court has said that admission to the under-graduate and post-graduate medical courses would be subject to the final outcome of the petitions challenging the Medical Council of India's decision requiring that candidates clear the National Eligibility Entrance Test.
This means that the private medical colleges, which were enrolling students on the basis of their own entrance tests can only admit those students who had appeared in the NEET and secured at least 50% marks.
However, since the apex Court interim order of May 13 allowed the declaration of results of MCI's NEET and also of tests by private medical colleges to facilitate the admissions for the current academic year, there is now more confusion sprouting.
While the private medical colleges have started with their admission process not considering the NEET score, the new order to follow NEET score has left students puzzled.
Students now feel that there could be a situation that a student, who had appeared in the NEET but did not secure 50%, gets admitted to a private medical college.



2.9 Review of status of proposal of One-year Rural service as Medical 
Officers as a prerequisite to Post Graduate Admission :
 Chairperson, BOG drew attention of the Members of Board of Governors to 
the background of the proposal on the subject matter which was sent by the former 
Secretary to the MoH&FW on 2.4.2013. He also mentioned that subsequently the 
Secretary, MoH&FW as well as the Health Minister himself happened to discuss the matter 
with him in the recent past when they both had appreciated the Plan as outlined in the 
above proposal. The main thrust of the proposal is that before PG, all the MBBS Graduates 
in the country have to undergo a mandatory rural posting for one year. If anybody serves 
under rural posting for more period, it will be given more preference for admission into PG 
Courses, as per the Regulations. After discussing the matter at length, the Board of 
Governors approved the proposal, in principle. It was also decided that a draft Regulation 
in this regard should be sent to the Ministry. Further it would be advised to the Ministry to 
have the following : (i) Creating the designated “Cell” in the Ministry for the deployment of the 
doctors; and 
(ii) Planning for the timely and equitable deployment of approximately 
40000 Graduates (the number is set to increase annually) every year 
all over the country. It is important to ensure that they join 
immediately after internship and finish one year, before the next 
batch is eligible. 
(iii) While issuing Notification in this regard, the Ministry may also 
consider the point regarding the batch from which on wards the 
above scheme should be implemented


No PG degree for Indian doctors unless they serve a 12-month rural stint


Delhi: Union health minister Ghulam Nabi Azad has finally signed a controversial regulation according to which 12 months of rural stint will now be mandatory for doctors who want to pursue a post graduate (PG) degree.

“The proposal was signed by the minister on Tuesday and will be notified in a day or two,” a senior health ministry official .

According to the reports, rural areas in the country are facing  huge shortage of doctors. The doctor-population ratio in rural areas is 3/10,000, while it is 13/10,000 in urban areas. Besides, just 26% doctors work in rural areas, serving 72% of the population.

To address this dismal situation, doctors were thus far given incentives to work in rural areas; those who worked for one year got 10 marks while those who worked for three years got 30 marks for admissions in PG. 

Bachelor of Medicine and Bachelor of Surgery (MBBS) graduates, who want to pursue post-graduate studies in the country, will now have to serve in rural areas for a year. The Medical Council of India will register these students as doctors, following which they will have to work in rural areas. The doctors will be paid as full-time MBBS doctors, and not as trainee doctors.

The move means that MBBS doctors will now be available for government health services, and are likely to be utilised for the National Rural Health Mission.

Earlier, an MBBS course of 5.5 years included one year of internship. However, most of these medical students ended up practising in urban settings, refusing to serve the country's rural population.

The rural health statistics 2011 say there was a 76% shortage of doctors in rural India, there were 53% fewer nurses, specialist doctors short by 88%, radiographers short by 85% and laboratory technicians short by 80%.

India churns out over 45,000 medical graduates annually, but most of them are reluctant to serve in villages and would rather join the private sector for better salaries and an urban posting.


Rural posting made mandatory for MBBS docs wanting PG degree 

New Delhi: MBBS doctors aspiring to pursue post-graduation will now have to compulsorily undertake a one-year rural posting before becoming eligible for such a course. 

In a major decision aimed at improving rural healthcare in India, the Government has decided to make it mandatory for all MBBS doctors to undergo one year rural posting to sit for post-graduation entrance examination. 

Highly placed sources in the Health Ministry told a news agency that Union Health Minister Ghulam Nabi Azad cleared a proposal in this regard and the Medical Council of India (MCI) is in the process of issuing a notification. 

The decision will be applicable from the next academic session (2014-15) and all MBBS graduates seeking a post- graduate degree in medicine or surgery would have to work for one year in a village before they can take the PG entrance examination. 

The decision came after two years of deliberations, as the earlier proposal of increasing the duration of the MBBS course to include a rural posting for doctors was scuttled after stiff opposition. 

Doctors are unwilling to work in rural areas leading to people queuing up in city hospitals. 

The Health Ministry and the country's medical education regulator (MCI) has been toying with the idea of compulsory rural posting for doctors for quite some time to help improve medical facilities in the rural hinterland of the country. 

MCI sources said the posting would have to be located at any primary health centre run by the Government. 

"Those candidates who do not want to do a rural posting would be free to practice MBBS after they get their MBBS degrees following the internship. The MBBS course structure and duration will remain the same. The only change is one year rural posting will be made the eligibility condition for those wanting to pursue MD and MS," MCI sources said. 

Earlier, there was a proposal to increase the current duration of the MBBS course by one year and use the additional year for a village posting of MBBS students. The proposal was not found feasible as it meant that students would only get provisional MBBS degrees at the completion of their internship and final MBBS degrees only after the completion of a rural posting. 

In between, they would not be allowed to practice medicine as they would not get a licence without their degree. 

The old proposal has now been modified considerably to allow the MBBS structure to remain unaltered and add a year of rural posting as a condition only for those candidates who want to take a PG in medicine or surgery. 

Every year, close to 40,000 students graduate with MBBS and most of them wish to pursue post graduation. The move, skeptics say, may hit students' zeal to go in for higher medical education unless suitably modified to reward them for undertaking a rural posting. 

MCI sources said MBBS doctors going for rural posting from the next year may be given financial incentives but that component of the proposal is yet to be finalised. 

Sources said they may be inducted into the National Rural Health Mission (NRHM) and a quantum stipend paid to them for such rural postings.


Thursday, June 20, 2013


Date: 20.06.2013

Sub: Surrender of seats – COMEDK PGET – 2013 reg.
At the time when COMEDK scheduled the counselling, the directive of the Supreme 
Court extending the date of admissions was not there. Subsequently, the last date
of admissions has been extended from 31st May to 31st July 2013.
The above extension of time necessitated the second round of counselling by 
COMEDK. Moreover, the consensual agreement with the State Government has 
also stipulated the second round of counselling where all seats remaining unfilled 
including the seat surrendered be taken to second round. It is only “at the end of 
the second round of counselling, the unfilled seats be made over to the respective 
Accordingly, even though the candidates who have taken the seat during the first 
round of counselling and reported to the colleges are entitled to surrender the seats 
before COMEDK as their tuition fee and the original certificates have been 
deposited in COMEDK.
It is hereby made clear that all such seats surrendered five days before the 
commencement of second round of counselling will be taken to the second round of 
counselling. However, those who have reported and then surrendered are not 
entitled to participate in the second round of counselling to be held shortly.


UPSC conduct Combined Medical Services (CMS) Examination for recruitment to the following services:

 •  Railways

 •  Ordnance Factories Health Service

 •  Central Health Service

 •  Municipal Corporation of Delhi

Exam Date:- 30.06.2013 (SUNDAY)

CMS Exam Pattern:-

The examination shall be conducted according to the following plan:-



The candidates will take the written examination in two Papers, each Paper carrying a maximum of 250 marks. Each Paper will be of two hours duration.


Personality Test : (100 Marks):
Personality test carrying 100 marks of

such of the candidates who qualify on the results of the written examination.

(A) Written Examination:-

1. The components and syllabus of two Papers and the weightage to different components in the two papers are given below: -

Paper I Maximum (Code No. 1) Marks : 250

(a) General Ability 30 questions
(b) General Medicine 70 questions
(c) Paediatrics 20 questions

Total questions in Paper I = 120 (30 General Ability, 70 General Medicine and 20 Paediatrics).

CMS Exam 2012 Syllabus:-

(a) General Ability

(i) Indian Society, Heritage & Culture, Polity, Economy, Human Development Indices and the Development Programmes;
(ii) Natural Resources, their distribution, exploitation, conservation and related issues;
(iii) Basic concepts of Ecology and Environment and their impact on health and economy;
(iv) Impact of changing demographic trends on health, environment and society;
(v) Indian Agriculture, Industry, Trade, Transportation and Service Sectors;
(vi) Natural and man made disasters and their management;
(vii) Food adulteration, Food processing, food distribution, food storage and their relevance to public health;
(viii)Recent trends in Science and Technology.

(b) General Medicine

(General Medicine including Cardiology, Neurology, Dermatology and Psychiatry)

(i) Cardiology
(ii) Respiratory diseases
(iii) Gastro-intestinal
(iv) Genito-Urinary
(v) Neurology
(vi) Hematology
(vii) Endocrinology
(viii)Metabolic disorders
(ix) Infections/Communicable Diseases

a) Virus
b) Rickets
c) Bacterial
d) Spirochetal
e) Protozoan
f) Metazoan
g) Fungus

(x) Nutrition/Growth
(xi) Diseases of the skin (Dermatology)
(xii) Musculoskelatal System

(c) Paediatrics

Paper II Maximum (Code No. 2) Marks : 250

(a) Surgery 40 questions
(b) Gynaecology & 40 questions Obstetrics
(c) Preventive & Social 40 questions Medicine

Total questions in Paper II = 120 (40 Surgery, 40 Gynaecology & Obstetrics and 40 Preventive & Social Medicine).

Syllabus of Paper - II

(a) Surgery (Surgery including ENT, Opthalmology, Traumatology and Orthopaedics)

I General Surgery

i) Wounds
ii) Infections
iii) Tumours
iv) Lymphatic
v) Blood vessels
vi) Cysts/sinuses
vii) Head and neck
viii) Breast
ix) Alimentary tract

a) Oesophagus
b) Stomach
c) Intestines
d) Anus
e) Developmental

x) Liver, Bile, Pancreas
xi) Spleen
xii) Peritoneum
xiii) Abdominal wall
xiv) Abdominal injuries

II Urological Surgery
III Neuro Surgery
IV Otorhinolaryngology E.N.T.
V Thoracic surgery
VI Orthopedic surgery
VII Ophthalmology
VIII Anesthesiology
IX Traumatology



i) Ante-natal conditions
ii) Intra-natal conditions
iii) Post-natal conditions
iv) Management of normal labours or complicated labour


i) Questions on applied anatomy
ii) Questions on applied physiology of menstruation and fertilization
iii) Questions on infections in genital tract
iv) Questions on neoplasma in the genital tract
v) Questions on displacement of the uterus


i) Conventional contraceptives
ii) U.D. and oral pills
iii) Operative procedure, sterilization and organization of programmes in the urban and rural surroundings
iv) Medical Termination of Pregnancy


I Social and Community Medicine
II Concept of Health, Disease and Preventive Medicine
III Health Administration and Planning
IV General Epidemiology
V Demography and Health Statistics
VI Communicable Diseases
VII Environmental Health
VIII Nutrition and Health
IX Non-communicable diseases
X Occupational Health
XI Genetics and Health
XII International Health
XIII Medical Sociology and Health Education
XIV Maternal and Child Health
XV National Programmes

2. The written examination in both the papers will be completely of objective (Multiple choice answer) type. The question Papers (Test Booklets) will be set in English only.

3. Candidates must write the Papers in their own hand. In no circumstances will they be allowed the help of a scribe to write answers for them.

4. The Commission have discretion to fix qualifying marks in any or both the papers of the examination.

5. Penalty for wrong answers There will be penalty (Negative Marking) for wrong answers marked by a candidate in the objective type question papers.

(i) There are four alternatives for the answers to every question. For each question for which a wrong answer has been given by the candidate, one third (0.33) of the marks assigned to that question will be deducted as penalty.

(ii) If a candidate gives more than one answer, it will be treated as a wrong answer even if one of the given answers happens to be correct and there will be same penalty as above for that question.

(iii) If a question is left blank i.e. no answer is given by the candidate, there will be no penalty for that question.

6. Candidates are not permitted to use calculators for answering objective type papers. They should, therefore not bring the same inside the Examination Hall.

PERSONALITY TEST - (100 marks):

Candidates who qualify in the written examination will be called for Interview/ Personality Test to be conducted by the Union Public Service Commission. The Interview/Personality Test will carry 100 marks.
The interview for Personality Test will be intended to serve as a supplement to the written examination for testing the General Knowledge and ability of the candidates in the fields of their academic study and also in the nature of a personality test to assess the candidate's intellectual curiosity, critical powers of assimilation, balance of judgment and alertness of mind, ability for social cohesion, integrity of character, initiative and capability for leadership.