Medical Graduates Should Be Offered Diploma Courses To Make Them Specialists

To tide over the acute shortage of medical specialists in India, the country needs medical educational institutions on the line of the College of Physicians and Surgeons (CPS) in Maharashtra which would offer diploma courses in fields like anaesthesia, gynaecology, and paediatrics to medical graduates, according to experts.

Talking about the acute shortage of medical specialists in the country, Dr Devi Shetty, founder and chairman, Narayana Health, recently pointed out that while the US has 19,000 undergraduate medical seats and 32,000 postgraduate seats, in India it is the opposite – the country has close to 50,000 undergraduate medical seats but only 14,000 PG seats.

“The low number of PG seats results in a shortage of specialists. This can have terrible consequences on the ground. For example, India has one of the highest maternal mortality rates in the world and this is unrelated to the amount of money we spend on healthcare. The reason is that we have created a regulatory structure where only a specialist can perform certain tasks, and the country simply doesn’t produce enough of these specialists,” he said.

Dr Shetty suggested that to tide over the problem, the country needs medical educational institutions on the line of the College of Physicians and Surgeons (CPS) in Maharashtra which would offer diploma courses in fields like anaesthesia, gynaecology, and paediatrics to medical graduates.

“This can convert the entire 50,000 medical graduates produced in India every year into specialists who can then help reduce maternal mortality in India,” Dr Shetty said, adding, “If we want to deliver better healthcare outcomes, India doesn’t require money. We only require policy changes. This will not happen till the Government looks at medical education as integral part of the country’s development.”

Dr Shetty was speaking at ‘The Future of Healthcare: A Collective Vision’, a global healthcare conference that was held here on March 3-4. The event, hosted by The Healthcare Alliance, witnessed the participation of thought leaders, policy makers, senior government officials, and business and health leaders from over 15 countries.

Calling for major changes in the existing health system, Dr Naresh Trehan, chairman and managing director, Global Health (Medanta-The Medicity), said, “Healthcare is basically disease management. We should build our system from the ground up to create a new blueprint of India’s healthcare.”

“We have over 800,000 ASHAs (Accredited Social Healthcare Activists) in India but they are ill trained and don’t have any medical skills. Their costs are a huge burden on the exchequer and nothing gets accomplished in return. All we have to do is to upscale their skills so that they can be the eyes and ears of the healthcare system on the ground. They need to monitor hygiene and find out who in the community needs medical assistance. This will be a big help in ensuring quick diagnosis of diseases and reducing the incidence of NCDs (non-communicable diseases),” Dr Trehan said.

Outlining his views on the role of technology in ensuring greater access to quality healthcare, Shivinder Mohan Singh, executive vice chairman, Fortis Healthcare, said, “Technology has played a vital role in healthcare in the last 30 to 40 years, whether it is diagnosis or treatment. Going forward it is going to trigger more changes in healthcare than any other factor.”

Singh said, “Healthcare access will get radically transformed with technology whether it is in terms of proximity through devices planted in our bodies or by low-cost healthcare using innovative technological solutions or the speed with which information is shared.”

“A healthcare ecosystem would be created in future where different silos begin to talk to each other about patients and exchange information. Healthcare delivery is going to become more personalized in terms of tailor-made treatments for an individual,” he added.

Talking about the need for better integration of different systems of medicine, Singh said: “Allopathy has taken a predominant share of the existing market in healthcare, but I think we can’t avoid for too long the benefits that other health sciences bring to the table. Some kind of integration of different health disciplines is bound to happen in future.”

He also emphasized that the onus of taking charge of one’s health has to rest on the individual. “We need to be more concerned for what we do to our health rather than what healthcare would do to us. We need to take ownership of our own bodies and mind and not outsource these to healthcare providers. People need to focus more on preventive care rather than just landing in sick care – this is going to the mantra of healthcare in future,” he said.

Dr Shetty expressed concern about the nursing profession in India, which he said would die down in a few years if urgent measures were not taken.

“There is zero career progression for nurses. Nursing is now considered a dead-end career. Admissions to nursery colleges in India have come down by 50 per cent. Half of the nursing colleges in Karnataka have shut shop. In the years ahead, there will be an acute shortage of nurses in the country,” he said.

Dr Shetty further said, “There is a critical need to empower nurses by offering them a path to upgrade their skills and become specialists. About 67 per cent of anaesthesia in the US is given by nurse anaesthetists. In India, we don’t allow a nurse who has worked in critical care for 20 years to even prescribe a Paracetamol tablet!”

Dr Shetty also highlighted the need to look for alternative ways of funding healthcare, such as by a surcharge on mobile phone bills, to bring down the cost of building hospitals, develop patient management software, and establish one or two health cities with 3,000 to 5,000 beds in each metro where cutting-edge work can be done.

Source: India medical times

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