LETTER TO EDITOR
Year : 2014 | Volume
: 39 | Issue : 2 | Page : 120--121
Recruitment of young rural doctors: Are we adopting the qualitative and ethical approach?
Sukhminder Jit Singh Bajwa
Department of Anaesthesiology and Intensive Care Medicine, Gian Sagar Medical College, Banur, Patiala, Punjab, India
Sukhminder Jit Singh Bajwa
Department of Anaesthesiology and Intensive Care Medicine, Gian Sagar Medical College, Banur, Patiala, Punjab
|How to cite this article:|
Bajwa SJ. Recruitment of young rural doctors: Are we adopting the qualitative and ethical approach?.Indian J Community Med 2014;39:120-121
|How to cite this URL:|
Bajwa SJ. Recruitment of young rural doctors: Are we adopting the qualitative and ethical approach?. Indian J Community Med [serial online] 2014 [cited 2020 Jan 27 ];39:120-121
Available from: http://www.ijcm.org.in/text.asp?2014/39/2/120/132740
The published work of Shroff et al., "Attracting doctors to rural areas: A case study of the post-graduate (PG) seat reservation scheme in Andhra Pradesh" in the current issue of Indian Journal of Community Medicine is a good initiative in highlighting the present health scenario of rural areas in Andhra Pradesh.  The authors have supported the aims of this study in a very meticulous manner and have arrived at statistically significant conclusions both qualitatively and quantitatively. Acute shortage of medical specialists in our nation in general and rural areas in particular has been a serious concern. Numerous efforts are being made by government and policy makers to attract medical specialists to rural areas throughout the nation, but have tasted only sporadic success.
The study has emphasized basically on one important area that is incentive of possibly getting PG degree in lieu of minimal fixed years in a rural area service while few other important concerns have been described only in brief. However, there are many other potential areas, which need serious introspection before we can conclusively establish this isolated methodology as the right approach in tiding over acute deficiencies in rural health set-ups. In fact, we need more descriptive and larger studies, which should cover the important aspects of inadequate rural health services. These important areas of concerns include, but are not limited to simultaneous up-gradation of rural health infrastructure, provision of adequate medical, surgical and diagnostic facilities, similar incentive based recruitment of paramedical staff, provision of better means of transportation and communication, recreational facilities for the medical staff and so on. Moreover, the academic and schooling needs for the children as well as the formulation of policies for adjusting the spouses of medical staff are other important aspects before posting the doctors in rural areas. Recruitment of specialists in rural areas without appropriate facilities as mentioned above is just like sending a soldier to the warfront with an old rusty gun.
A major concern as mentioned by authors is the quality of health service delivered by these specialists.  These specialists are generally inexperienced as they are posted immediately after obtaining PG degree and handling of clinical complications can sometimes prove to be a daunting and impossible task thus increasing the morbidity and mortality. Moreover, the age of majority of specialists is also not on their side when they eventually finish their PG courses. It has been generally observed that reflexes and enthusiasm is on the lower side as compared with young fresh candidates. Few of the brilliant physicians who are academically oriented suffer the worst as the academic and research activities comes to a big halt during rural services, which otherwise could have helped in uplifting the medical education in our country. This can instill a sense of frustration and disinterest among these specialists. The attitude, interest, caliber and experience of these specialists can be highly decisive in delivering the quality health services. Few states like Punjab also recruit the faculty for medical colleges from the in-service candidates who have lost track of regular academics for a long time. Though Medical council of India has directed every physician to complete minimum 10 academic hours per year through conferences and continuing medical educations, such measures are not foolproof.
It seems strange that the majority of health needs of 70% of the Indian population, which resides in rural areas, are being taken care of by young specialists. Though the recruitment of young doctors may improve the services already being provided by the unqualified staff, but the health set-up requires and deserves much better services.  The policy of recruiting doctors in rural areas in lieu of PG degree should be accompanied by suggested measures otherwise it will amount to a some form of socio-economic exploitation of young medical fraternity. The better possible alternative to such measures may include compulsory posting of in-service senior doctors in rural areas for a year during their service tenure so as to avoid compromising the quality of health services. Within the economic limits, more stress should be laid on the above mentioned suggestions so as to make rural areas really attractive for any age and not just by pushing the young physicians to rural areas in exchange of PG degree. The approach to improve the rural health services is multidimensional and policy makers should ensure to adapt all the suggested measures in totality so as to ensure quality within ethical norms.
|1||Shroff ZC, Murthy S, Rao KD. Attracting doctors to rural areas: A case study of the post-graduate seat reservation scheme in Andhra Pradesh. Indian J Community Med 2013;38:27-32.|
|2||Rao K, Bhatnagar A, Berman P. India's health workforce: Size, composition and distribution. In: La Forgia J, Rao K, editors. India Health Beat. New Delhi: World Bank, New Delhi and Public Health Foundation of India; 2009.|