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 of two 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
The supreme decision making body of Indian Medical Association, Central Council of IMA which met on 27th December 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
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 of 5 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
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
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, Indian
17.To enhance budgetary allotment for Health care
Courtesy - Secretary, IMA KSB
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.