LUCKNOW: Terming the Union health ministry proposal to start a bachelor’s degree course in rural medicine and surgery (BRMS) as a “senseless
step” to save villagers from quacks, students from ayurvedic, Unani and homeopathy colleges of UP took out a protest march on Thursday. The march started from the Government Ayurvedic College and Hospital in Tudiaganj. Raising anti-government slogans, they demanded immediate withdrawal of the proposal. The march culminated into a congregation at the Shaheed Smarak.
“Compromising quality to meet a crisis is not a solution to any problem. The decision is ridiculous, especially when the government has qualified doctors,” said Jeetendra Kumar, president, Prantiye Ayush Chhatra Sangarsh Samiti - the banner under which the students are protesting.
The association cited various facts to prove its point:
First, the country has more than 7.25 lakh Ayush doctors, most of whom are passouts of government ayurvedic, Unani and homeopathy colleges. But of these, only 41,000 are in government doctors. “Why not use this human resource to do the needful?” questioned a student.
Second, agitating students said , Ayush doctors study basic aspects of medicine and survey and dynamics of health for five-and-a-half years which includes one year of internship. Many pursue postgraduation and even research which means that Ayush doctors are more qualified than BRMS doctors.
“It takes three years or more to become a nurse or a pharmacist.... won’t this degree mean compromising the level of doctors,” asked another student. His friend added that the syllabus of medical science through any stream cannot be completed in three years. “The burden is so much that even five-and-a-half years fall short,” said a student.
Third, students make it to the Ayush colleges after clearing the medical entrance test. The exam is a proof of the competence and subject intellect. For instance, over 70,000 candidates appeared in the Combined Pre-Medical Test (CPMT) 2009. But only 1700-odd were selected in the medical or Ayush colleges.
“An Ayush doctor is not able to get a medical seat due to a difference of some 20-30 marks. We are a part of the cream selected through a recognised process. Our contention for the same posts is stronger than a BRMS graduate,” asserted a student.
New Delhi, Jan 29 (PTI) Plans for launching a short-term bachelor of medicine course today drew flak from NHRC and Indian Medical Association who feared that the move might produce quacks.
"By doing so (launching the course), government will itself be producing quacks. We already have half-baked medical professionals in rural areas and if government also starts producing such half-baked doctors what will happen to the country?" NHRC member PC Sharma posed at a meeting of state health secretaries here.
The Union Health Ministry is contemplating to launch a three and half year duration's 'Bachelor of Rural Medicine and Surgery' (BRMS) course for students of rural areas to raise a a dedicated corps of medical practitioners who would serve in the villages.
PUNE: Lack of doctors and proper health care in rural areas cannot be corrected by compromised health workers churned out by the proposed
Bachelor of Rural Medicine and Surgery (BRMS) course feel experts, who add that such degree holders will in no way substitute MBBS doctors, thus denying the rural population a right to good health.
"On one hand the health care in metros and big cities is quite advanced. On the other, rural areas where 60 per cent of the Indian population resides does not even have basic health care (primary care). This gap, however, cannot be filled by compromised health workers in the name of BRMS. It is against the fundamental right of a citizen of India where every one should be provided with quality health care of similar standards at affordable cost," said S Arulrhaj, president of the Commonwealth Medical Association a conglomeration of national medical associations of commonwealth countries.
Ashok Adhav, national president of the Indian Medical Association, said, "Factors like paucity of doctors, low doctor-population ratio (1.62 per 10,000 only), absence of doctors, lack of infrastructure facilities contribute to the absence of proper health care in rural areas. But this situation cannot be corrected by compromised health workers in the name of BRMS. The IMA strongly opposes this proposal."
Former state president of the IMA Devendra Shirole said, "If the service of qualified doctors is denied to the rural population, early detection of complicated disease conditions and appropriate treatment will be hit."
Meanwhile, the 84th Central Council of the IMA said it is committed to the health of rural Indians and also unanimously and strongly objects to the proposal to introduce the BRMS course, which is a compromised MBBS course, to take care of the rural population of India. "As per article 14 of the Indian constitution, all citizens of India are equal, whether rural or urban. The IMA demands that rural Indians be offered the same standard of health care which is offered to urban Indians. We appeal to the Ministry of Health, Government of India, not to dilute the standards of health care for the rural people. The IMA is of the opinion that only an MBBS degree should be the basic allopathic medical qualification in the country," said Adhav.
Arulrhaj suggested, "At least 25 seats need to be reserved in district medical colleges for candidates who will have to work in rural areas of their choice for the first five years, with annual recertifications. After the five years, they would be free to pursue a post-graduation degree, since, by that time, a second lot of rural doctors' will come in."
Adequate allowances, facilities like rural service allowances, proper free accommodation, education allowances for children, vehicle or vehicle allowances, appropriate reservation for education and employment for children, updation of knowledge, facility for interest-free personal loans etc. should be extended to doctors working in rural areas. Implementation of the Bhore committee recommendations of three-tier system of health delivery should also be done, said Arulrhaj.
By Rupsa Das/ANI New Delhi: The NationalHuman Rights Commission (NHRC) has opposed the launch of short-term bachelor medicine courses by the union ministry and has called for a meeting on Friday to discuss the issue.
The Union Health Ministry is thinking to introduce ‘Bachelor of Rural Medicine and Surgery’ (BRMS) course of three and half year duration for the students of rural areas to serve in the villages.
Talking about the issue NHRC member PC Sharma said, “By doing so (launching the course), government will itself be producing quacks.”
“We already have half-baked medical professionals in rural areas and if government also starts producing such half-baked doctors what will happen to the country?” he continued.
TAKING strong exception to the Union Health Ministry's proposal for a rural MBBS course to provide treatment in far-flung areas, the National Human Rights Commission (NHRC) on Friday termed it discriminatory.
At a day-long meeting of State Health secretaries, NHRC member PC Sharma said people in rural areas were entitled to treatment from fully-qualified doctors just as in urban areas.
Referring to a suggestion of having three and half years of short-term training for deployment in rural areas, Sharma said, "This step would be discriminatory to both the people who get treatment from such half-baked professionals and also to medical students who take eight to ten years to become a specialist."
In a bid to combat acute shortage of doctors in rural areas, the gover nment proposed a unique three-and-ahalf-year bachelor course for students from villages. Once the rural doctors get their degrees, they will be allowed to practice only in notified rural areas. NHRC acting chairperson Justice Mathur said that in the absence of recognised medical practitioners, rural and tribal population were dependent on unqualified doctors.
Justice Mathur said that one of the big challenges facing quality medical care was untrained and unqualified people or quacks practicing medicine even in a city like Delhi.
The medical profession of the country has been challenged .There is only one way out of this quagmire: to fight. Be prepared for a prolonged struggle for we are arraigned against formidable foes. People are sovereign, not rulers. We will use everything in our power to stop BRMS. BRMS is embodiment of injustice and discrimination on villagers and an affront on medical profession. The need of the hour is to unite and rise as one to protect the fraternity and the country .We will fight in the parliament and legislatures; we will fight in the courts; we will fight in the press and media; we will fight in the streets.We will never surrender. The world is yet to see a Government that can ignore concerted action by the medical profession.
MCI has called for a workshop of vice chancellors of medical universities, Deans and Principals and MCI members on 4th and 5th of February 2010 in New Delhi to finalize the curriculum and syllabus of BRMS. On behalf of the Joint Action Council I give a call to all to send representatives to show solidarity with JAC at Delhi on 04/02/10 to show our concern to the delegates. Let us meet in Delhi.
We are happy to inform you that a Joint Action Council of concerned doctors of modern medicine has been formed to fight BRMS. BRMS is a threat to the health of the nation and amounts to legalizing quackery. IMA central council has resolved unanimously to stop BRMS in its tracks. The aim of this Joint Action Council is to coordinate the opposition to BRMS at national level.
Doctors Association from the Uttar pradesh have staged Dhrana and protest against the Medical Council India's proposal to start BRMS course for the rural Doctors in India. Click here for the You Tube video
— Photo: M.Srinath UPSET: Thanjavur Medical College students protesting in Thanjavur on Thursday against the decision to start Bachelor of Rural Medicine and Surgery course.
THANJAVUR/TIRUCHI: House surgeons and students of the Thanjavur Medical College and K.A.P.Viswanatham Government Medical College in Tiruchi staged demonstrations on Thursday in protest against the Centre’s move to introduce a three-and-a-half-year Bachelor of Rural Medicine and Surgery (BRMS) programme.
The students owing allegiance to the Tamil Nadu Medical Students Association raised slogans against the move and urged the State Government not to allow the introduction of the programme in Tamil Nadu.
The agitating students, wearing black badges, staged the demonstration in front of the Annal Gandhi Memorial Government Hospital attached to the medical college in Tiruchi and in front of the medical college at Thanjavur.
The move, the students contended, would only result in bringing down the quality of rural health services and affect the prospects of the MBBS graduates.
Increase seats
The students were also seeking an increase in the number of seats in the post-graduate medical programmes and recruitment of all doctors registered with the Employment Exchanges to fill up vacant posts in rural government hospitals.
Doctors say it will divide medical education and create two cadres of doctors
Claim concept of a rural doctor will further complicate the treatment scenario
MCI proposal aimed at addressing shortage of doctors in rural areas
Thiruvananthapuram: Doctors, including those from the Health Service, and medical students marched to the Raj Bhavan and staged a dharna on Wednesday to protest against the Medical Council of India’s proposal to start a Bachelor of Rural Medicine and Surgery (BRMS) course.
The protest, organised by the Indian Medical Association, recorded a heavy attendance with over 3,000 doctors and medical students, from both government and self-financing colleges across the State, and doctors’ service organisations like the Kerala Government Medical College Teachers’ Association, Kerala Government Medical Officers’ Association and the Kerala Government Insurance Medical Officers’ Association participating in the three-hour dharna.
Inaugurating the dharna, the past national president of the IMA V.C. Velayudhan Pillai expressed the protest of the entire medical fraternity against the proposed rural medicine course. Dr. Pillai called for the Union Health Ministry to drop the proposal, which he said would create a deep divide in the medical education system by creating two cadres of doctors.
The MCI put forth the proposal to start a three-and-a-half year rural MBBS course, to be called the Bachelor of Rural Medicine and Surgery (BRMS), so that students from rural areas can be enrolled for the same, who can then serve in the district hospitals and the primary health centres in these areas. The MCI came up with this proposal in order to meet the shortage of doctors in rural areas. While some States have welcomed the proposal, the IMA pointed out that it would create a new cadre of doctors who were not as qualified as their urban counterparts.
According to the MCI proposal, the BRMS course will be conducted at district hospitals and community health centres where retired professors will conduct classes. Students from the Plus Two science stream from rural areas will be eligible to join the course. After completing the short-term course, these doctors will be eligible to serve only in district hospitals and PHCs/ CHCs in their States and not urban areas.
Doctors’ organisations point out that apart from creating a divide between doctors as rural and urban, the MCI’s proposal will restrict the geographic area where a doctor may serve. Doctors have also raised concern that when already a lot of quackery is thriving in rural areas, the concept of a rural doctor will further complicate the treatment scenario.
The IMA said that rather than creating half-baked set of doctors, the government should be doing more to improve the health infrastructure in rural areas and give more incentives to doctors to serve in these areas.
Through compulsory rural service, ensuring the participation of private medical colleges in rural health care and liberal health investment policies, the shortage of doctors to serve in rural areas can be tackled, the IMA said.
The MCI proposal is slated to be finalised by March after a national-level workshop in February, in which the Deans of all 300 medical colleges in the country, Vice-Chancellors of medical universities and the Directors of Medical Education from all States will take part.
JAC conducted a mammoth rally and dharna infront of Raj Bhavan on 27.01.2010 in protest against implementation of BRMS. Past IMA National President Dr. P.V. George conducted the flag off for the march and Past IMA National President Dr. V.C. Velayudhan Pillai inaugurated the dharna.
More photos follows
Dr. Paul Samuel e-Communication Committee For Joint Action Council
Under the scheme the undergraduate “ Bachelor of Rural Medicine and Surgery ( BRMS)” degree would be acquired in two phases at two different levels – Community Health facility (one and half year duration) and sub divisional hospitals (secondary level hospitals) for a further duration oftwo years.
The BRMS degree would be offered by institutes in rural areas with an annual sanctioned strength of 50 students. “Selection of students should be based on merit in the 10+2 examinations with Physics, Chemistry and Biology as subjects. A student who has had his entire schooling in a rural area with a population not more than 10,000 would be eligible for selection, which would be done by Professional bodies set up by the Directorate of Medical Education of the State Governments”.
In the Democratic Republic of India the citizens are put into two categories of population. People in the Urban areas are offered the best of Health care and Rural Population are given substandard Health care services. This gross discrimination particularly the Health care (Providing Health care has been enshrined as a fundamental right of the citizens in our Constitution of India) is the worst type of discrimination heard in the History of Mankind.
Should the right thinking and responsible citizens of India support this discrimination ?
The supreme decision making body of Indian Medical Association, Central Council of IMA which met on 27thDecember 2009 at Hyderabad has unanimously resolved to oppose this ill conceived , retrograde, reprehensible and undemocratic proposal which totally violates the fundamental right of the citizens of India.
Why Indian Medical Association oppose this Proposal?
1.Two standards of Health care for the citizens of India: This is against the fundamental right of the citizen of India. It is against the Alma Ata declaration which declared that every citizen should be provided with a quality Health care at an affordable cost.
2.The Proposal to start BRMS is a retrograde step: Health and Family welfare Department, Government of India and Medical Council Of India had over a period of time abolished Medical Diplomas like LMP, LIAM , LCPS , MCPS etc to ensure that every citizen is provided with uniform quality of Health care.
3.A Doctor is the Team Leader in any Health care unit. With this concept in view, in 1946 Health Commission recommended 6 years course of MBBS as the basis for the registration of practicing Modern Medicine. The Nursing Council of India is also phasing out
General Nursing and Midwifery Course (3 ½ years course) and is insisting on BSc Nursing Course of5 years duration (4 Year training and 1 year internship). Even the Pharmacy Council of India has made knowledge in computer science and internship compulsory. With the proposed introduction of Rural Doctors (3 ½ years course BRMS Graduates) who is going to be the Team Leader? 2
4.Rural Health care will suffer further: As the Modern Medical science is fast advancing, even the present day Modern Medicine Doctors after undergoing a training of 4 1/2 years plus one year internship find it difficult to cope up with knowledge explosion. It is generally said that if a Doctor don’t read three journals a day and review two Medical Literature, he will become obsolete in five years.
5.Compromising with Competency: Early Detection of Complicated disease conditions and appropriate treatment will suffer if the service of the qualified Doctor is denied to the Rural Population.
6.Encouraging Bonded Labour of Rural Population? Just because a person is born in a Rural area, he should not be bonded to serve in the Rural population alone denying his opportunity to develop his talents.
7.Will Encourage Back door entry to MBBS cadre and promote Quackery: Time and again we have seen that in olden days those who acquire diplomas in Medicine were allowed to undergo condensed courses and were awarded MBBS Degree (Condensed MBBS). This they achieved using their Political clout.
8.Not a remedy to the malady. The shortage of Doctors in the Rural areas cannot be solved by creating Rural BRMS Graduates. Eventually these categories of Health care workers will gravitate to major cities accepting opportunities. Even now the Government has no effective machinery to prevent Quackery. How the Government is going to prevent BRMS holders from practicing in cities.
9.Retard growth of India: The Father of the nation Mahatma Gandhi said that India lives in its villages. Substandard health care in the rural areas will ultimately deteriorate the health of rural population and retard the progress of the nation.
10.The concept is impractical: The District Health authorities responsibility is traditionally preventive and curative health care which even now they are not able to fulfill effectively. Further burdening them with such an important training and teaching programme will only yield to collapse of the existing system. This is a massive training
programme for which the district administration and the institution is ill equipped and hence maintaining of even
the minimum standard envisaged become difficult. Even medical colleges find it difficult to get enough teaching faculties, equipments and facilities. Modern concept of teaching and training is fast changing and the amount and energy going to be spent on implementing this programme if utilised to strengthen the medical education department more and better qualified doctors can be produced to meet our requirements. The government is planning a parallel system which is against any modern concept of management science. The natural inclination should be to improve the quality and quantum of existing system rather than to create a substandard alternative which could have far reaching consequences on the health of the nation.
11.Ill conceived concept: The whole concept rest on the point that if the course is 3 ½ years the BRMS holders will stay in the rural area. If it is 5 ½ years
of training they will migrate to big cities this is against any logic and behavioural science.
Supposed reasons for the proposed BRMS course:
1.Few doctors want to serve in rural areas.
2.Failure to lure doctors to practice in rural areas in spite of incentives.
Solutions suggested by IMA:
1.BRMS Course is not the right solution to this problem.
2.To attract Doctors to serve in Rural areas , 25% reservation for candidates from rural areas (Area with a population less than 10,000) for MBBS admission with a precondition to serve in the rural area for a minimum period of 5 years .
3.Adequate allowances and facilities like Rural service allowances, proper free accommodation, education allowances for children, vehicle or vehicle allowances, appropriate reservation for education and employment for their children, sabbatical leave for academic enhancement of Doctors, allowances for attending academic conferences for updating their knowledge, facility for interest free personal loans.
4.The implementation of Bhore Committee recommendations of three tier system of Health delivery.
5.Re establishing the Family Doctor concept.
6.Mandatory One year Rural service for all MBBS graduates (Govt. & Private) before giving permanent
registration.
7.Reservation for Post Graduate seats for the Doctors who have served in Rural areas for a minimum of 5 years.
8.Full utilisation of the Private Medical sector including out sourcing of investigative/ Diagnostic facilities, part time service in Primary/ Rural Health Centres.
9.Encouraging Private Participation in Rural Health care by offering free land, interest free loan, preference in water, electricity and other support facilities at concessional rates.
10.Increasing the number of seats for MBBS and Post Graduate Courses in the existing Medical Colleges.
11.Encouraging more Government/Private/Self Financing Medical colleges in the Rural areas and relaxing the norms for starting such Medical Colleges without compromising the standard and quality particularly.
12.Preparation of a comprehensive and appropriate Health Policy document.
13.A comprehensive Health care personnel man power assessment.
14.Encourage Indian Medical graduates working overseas to return back home by offering attractive incentives and environment.
15.Any intervention in the Health care delivery sector should be a planned one on the basis of Health Policy and man power requirement and not on an ad-hoc basis
16.For any Health care intervention, IndianMedical Association should be consulted.
17.To enhance budgetary allotment for Health carefrom the present 2.1% to 12% of GDP.
We welcome you to the blog of Joint Action Council(JAC) against implementation of Bachelor of Rural Medicine and Surgery ( BRMS) in India. JAC under the aegis of India Medical Association is protesting against BRMS which is to be implemented in India under the pretext of 'saving rural health'. Since this will damage the rural health and medical profession in a detrimental way, we urge you to join us in this fight.
STOP BRMS !!! SAVE RURAL HEALTH !!! SAVE MEDICAL PROFESSION !!!
