NEW DELHI: Rural positing for six months will soon become compulsory for undergraduate medical students before they get their MBBS degree with the Medical Council of India (MCI) recently presenting the proposal to the health ministry.

At present, an MBBS course of 5.5 years includes one year of internship. However, most of these medical students end up practising in urban settings, refusing to serve the country’s rural population.

The MCI has suggested that a six-month rural posting (serving in a primary or a community health centre) should be made a compulsory part of the curriculum of the country’s undergraduate medical education. The students can spend the other half of the year interning in an urban setting.

MCI chairman Dr K K Talwar told TOI that the proposal was presented to the health secretary recently. "We are presently fine tuning the proposal which will ultimately be notified by the health ministry. A six-month rural posting will become mandatory," Dr Talwar said.

An official said the health ministry and the MCI were close to reaching a consensus on the issue of rural posting. Calling it "a meeting of minds", the official said, "Getting a medical student to practise for one whole year in a rural setting was difficult. So we are breaking it into six months each of urban and rural internship."

The official added, "MCI is working out what change is required in regulation to make a six-month rural posting mandatory for all MBBS students. At present, medical education is urban and big town-centric. So, when doctors pass out, they aren’t confident in dealing with public health needs. By serving rural areas for just six months, they will get an experience on dealing with rare and difficult diseases."

India’s rural health services are presently in a dismal state. The latest rural health statistics 2011 say there is a 76% shortage of doctors in rural India, there are 53% fewer nurses , specialist doctors are short by 88%, radiographers are short by 85% and laboratory technicians are short by 80%.

As against the need to have 1,78,267 sub-centres, there are only 1,48,124 — about 17% short. A quarter of them don’t have water and electricity.

Earlier, a National Rural Health Mission report said out of the sanctioned posts, about 59.4% of surgeons, 45% of obstetricians and gynecologists, 61.1% of physicians and 53.8% of pediatricians were vacant. In effect, 67% of doctors enrolled for rural posting remain absent from duty.

The report said, "Clearly, there is a huge challenge to meet the shortfall for rural health infrastructure, specially the manpower."

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.

