The decision to go in for the steep fee hike will mean that PG medical education in Andhra and Telangana will become unaffordable for the middle and lower middle income groups, with the possibility that students who qualify may even have to drop out.

Dr M Srikkanth, an MBBS doctor in Anantapur in Andhra Pradesh who aspires to do his PG, is at his wits end on how to fund his education for the next three years. That's because the Chandrababu Naidu government has hiked the fee in private medical colleges under the merit quota from Rs 3.2 lakh to Rs 6.9 lakh per year, an increase of more than 100 percent. Under the management quota, the hike is nearly five times — from Rs 5.25 lakh to Rs 24.2 lakh. The Telangana government will follow suit as common counselling will be held for applicants from both states.

Students are understandably upset. "You can increase the fee by say 10 percent, and increase it from Rs 3.2 lakh to Rs 3.5 lakh,'' says Dr M Srikkanth. Another doctor Latha Rao says, "It is tough for my parents to get such a huge educational loan. I do not know how we are going to manage."

For the past three weeks, hundreds of MBBS doctors under the banner of AP Junior Doctors Association and Padmarao Nagar PG Aspirants have been protesting in Hyderabad and in different towns in Andhra Pradesh. They are upset that despite representations to the governments, the fee has been hiked.

They call this hike the side effect of demonetisation. To understand how, one needs to understand the fee structure.

Till last year, PG medical seats were allotted in two categories — merit or convenor quota and the management quota. Both categories were allotted 50 percent of the seats. The former was allotted by the university on merit and the latter by the power of money. While the fee per year in merit quota was Rs 3.20 lakh, the management quota seat fee per year, officially, was Rs 5.25 lakh. However, depending on the demand for the seat and reputation of the college, the real fee could go up to Rs 50 to 60 lakh per year. Needless to say, the remaining amount was paid in cash (read black money) and this is what practically funded the college besides lining up the pockets of the politically influential.

This year, the Medical Council of India (MCI) decided that even the management seats will be filled up according to merit. Which means that those students who do not bag the top ranks, will get the first preference to get a seat under the more expensive management quota, should they desire to opt for it. This means the management seat will not go to anyone walking in with loads of unaccounted for cash.

Besides under more stringent rules, all fees can now be taken only by cheque or DD. This is part of the MCI's attempt to streamline the admission process so that the PG medical courses do not become a market.

That is when the private colleges lobbied with the governments in the two Telugu states. The colleges lobby obviously want to be compensated for the black money they will no longer get to tap. And the governments have been more accommodating even if it puts the doctors and their parents in more than a spot of bother.

"This means that an MBBS doctor to complete his PG in three years, will have to spend close to Rs 21 lakh for the course. It will only mean that his or her first focus will be to earn back that amount at the earliest. Are these the kind of specialised doctors you want to create?'' asks Dr B Kaushik.

To rake in more money, the private colleges have also started an NRI quota (out of the management quota) at Rs 70 lakh per year. However, there is no guarantee that only genuine NRIs will get admission under this quota and whether this is a way to circumvent the MCI rules.

The Andhra government justifies the steep increase. "The private colleges also need to have good facilities in the colleges, don't they? For that they will need the funds," says K Srinivas, health minister of Andhra Pradesh. His counterpart in Telangana, Laxma Reddy says, "Since Andhra has hiked the fees, we will be forced to do the same.''

Experts point to a nexus between the governments and the private managements for the hike. They point out that it is unethical to take a decision that affects the students, without consulting them.

In fact, the dual fee structure — the merit and the management quotas — itself is discriminatory. "Why should X student pay more to subsidise the education of Y student?" asks N Ramesh, chairman of Consortium of Engineering College Management Association. "This is why we went to court demanding a uniform fee structure for engineering colleges and since 2009, we have had only one fee structure for every student."

The decision to go in for the steep hike will mean that PG medical education in Andhra and Telangana will become unaffordable for the middle and lower middle income groups, with the possibility that students who qualify may even have to drop out. While 'Operation Fee Hike' for the colleges has been a success, the 'patient' as in the aspirations of poor students, is dead.