Recently the Union Cabinet approved a proposal for increasing nearly 10,000 MBBS seats at government medical colleges across the country. The financial allocation required for the additional MBBS seats was also cleared. The proposal is aimed at increasing the number of doctors to help bring down the doctor-patient ratio from the current 1:2000 to 1:1000.

From theoretical perspective this should be considered as a welcome move. But just increasing MBBS seats without increasing PG seats (Medical Specialty) is definitely gonna have big implications on the future of doctors who will be occupying these seats. 

A fresh MBBS graduate typically has limited skills and even if they are skillful they are usually not confident enough to practice independently. They usually have to work in hospitals to practice these skills and gain confidence. 

Low salaries are a big blocking factor to even think of settling down just after MBBS. And these fresh graduates find very limited usage in today’s modern hospital where their work is mostly limited to patient monitoring, ward rounds and night duties. Almost all of the decision making lies in the consultants’ hand. Owing to these factors, majority of fresh MBBS doctors actually do not start practicing after completing MBBS but they take a drop, join a coaching and prepare for PG entrance examinations. 

The system of PG entrance exam in itself is a immensely broken system with uncountable number of exams with each having its own pattern. Owing to the high number of graduates and less number of PG seats the competition is intense with approximately 10-15 MBBS graduates fighting for 1 PG seat! 

The preparation for PG entrance for most doctors lasts for 1-2 years (usually without practicing) which breaks the continuum and dilutes the clinical skills of our budding physicians.

Most of the Indian MBBS doctors can be seen in hospitals cramming, more interested in MCQ guides than taking care of patient on the bed side. And why is that?? Because none of the Indian PG entrance exam puts any stress on clinical skills, patient interactions or professional aspects of the practice.   

So in this mess, what do we need to do in the coming future?

-PG seats to be increased in the same proportion

-Pattern of entrance examination should be changed such that it favors practicing MBBS graduates who are actually doing the real clinical practice. As William Osler said – “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all”

-There should be knowledge and technical support initiatives from MCI, State Governments and the Central Government  to help the MBBS graduates to establish their own clinics. This will have lasting impacts on both equitable distribution and easy access to healthcare