THIRUVANANTHAPURAM: Battle lines have been drawn for a major show down in the medical education sector with the state government introducing a three-year compulsory bond for post-graduate students in government medical colleges and the junior doctors vehemently opposing the move. The three-year bond period will come into effect in the current academic year. Medical PGs had just one year bond after completion of their course till last year. The Kerala Medical PG Association said the new order amounted to exploitation. “Instead of filling up the existing 545 posts which are mainly in entry cadre of assistant professors, the government is looking up to the bond system to get the work done in medical colleges. This is unacceptable,” said Dr U.R. Rahul, KMPGA state secretary.

The doctors allege that bond will delay their chances of getting regular appointments. “Look at the timeline of a doctor’s professional life once the bond system kicked off,” Dr Rahul said: “It takes six years for MBBS, nearly two years for preparation for post-graduation, three years for PG, three year bonded service as senior residents and another three years for super specialty. A person who joins for MBBS at 18 years would be 34-35 years on the completion of bond period. This means he would not get a permanent job in the medical education sector till he is 34.” It could be more in the case of an average student, Dr Rahul said.

However, the government is firm on the three-year compulsory bond. “The government is going to provide specialty and super specialty services in taluk and district hospitals as part of the Ardram mission,” said additional chief secretary (health) Rajeev Sadanandan. “We need a large number of senior residents to take up these responsibilities. The doctors are availing subsidised education in government medical colleges and they have a responsibility towards society.” He said senior residents were also needed for Idukki medical college which will start functioning from next year. Kasargod and Wayanad medical college are also coming up subsequently. “Efforts are on to fill up the vacant posts in medical colleges through PSC,” he added. Government sources say most post-graduate doctors tend to keep off government services in the name of preparing for super speciality if there is no bond. The special rules demand that one must have a one year senior residency and another one year teaching experience for appointment as assistant professor.

However, doctors refute the claims that senior residents were not available. “Over 400 candidates had applied for the 12 posts of permanent junior residents in Palakkad Medical College recently,” said Dr P.S. Jinesh of Kottayam medical college. “This shows that doctors are waiting for jobs in the government sector.” This rush of candidates also exposes the claim that specialist doctors prefer private sector, he said. Dr Jinesh suggested that the government make senior resident doctor a permanent entry cadre post. ‘This is a win-win situation that ensures the services of qualified doctors for the people, and offers an assured career for the doctors.” Government sources claimed that 40 posts in the entry grade were filled up last month. Efforts are to fill up posts in all clinical departments. But it important to retain a minimum number of senior residents for which bonded services are required, they added.

Doctors in the medical education sector are irked by the rough deal given to the sector in the budget. It has proposed an addition of only 45 posts which is too low when compared to over 1000 posts planned for the health services department. Recently the Kerala Government Medical College Teachers Association (KGMCTA) took up issues related to medical colleges with health minister K.K. Shailaja. “We have requested the government to take into consideration workload and deficiency while finalising the posts in medical colleges,” said KGMCTA state president Dr Kavitha Ravi. “We are preparing a status report on the sanctioned posts, number of vacancies and the posts required considering the work load in each government medical college hospital. The report will be submitted to the minister after Assembly session.”

Even as the government claims to make ground-breaking changes in medical sector, the ground situation in the state remains pathetic. While the existing medical colleges are plagued by acute shortage of doctors seriously hitting patient care activities, the clamour for new medical colleges has only aggravated the situation. Premier institutions such as Government Medical College, Thiruvananthapuram should ideally have only 900 beds considering the existing number of MBBS seats. However the current bed strength is 2750. But what is more alarming is that at a given time there are 4000 in patients availing treatment, many without beds.

Kozhikode medical college has the highest number of medical seats at 250. It should have 1100 beds. But the existing bed strength is 2800. The gap between the sanctioned and existing strengthen of doctors is as high as 100 in many of the medical colleges. The older ones are working with a staff pattern which was approved more than 50 years ago. There has not been any significant change on the ground barring little recruitment here and there. Many hope the KGMCTA exercise to carry out a realistic assessment of existing staff strength, work load and required strength will help the government find a solution to the chronic problem confronting the medical education sector.