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Vijay Mehta
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xx Sorry state of Medical Education in India
« Thread started on: Nov 6th, 2015, 1:54pm »

The status of getting in the medical college - getting thru five and half years of grueling studying - getting a post graduate specialisation - and practising medicine in India has deteriorated to the level that I never imagined was possible.

Add to this the public (patients and relatives) who do not hesitate to use physical violence against the physician when they are not satisfied with the care.

In this blog we shall address the issues facing medical profession. Many of my friends have confided in me that if they had to do all over again they definitely would seek some other way of making a living.

Please post any relevant information that may be helpful to others who are thinking of becoming a physician or are already in the process of medical career.

« Last Edit: Nov 6th, 2015, 2:35pm by Vijay Mehta » User IP Logged

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« Reply #1 on: Nov 6th, 2015, 1:59pm »

The first thing you notice is that while everyone would agree that smart physicians are vital to the health of the nation, no one seems to think that current system of large number of quota allocated to Reserved seats based on Backward and other classes is changeable. So if you are admitting a backward students with far lower grades because of his/her status, how does it factor when he/she is making life saving decisions on you?

Next big chunk of seats goes to those who can buy medical college seats (Rich and Prosperous)! Some of them manage to buy the seats on so called NRI Quota! Of course the middle men get in the act and many a times swindle lacks of rupees claiming to secure seat and then disappear or put their large premium for basically acting as a go between the prospective student and the college.

There are many articles highlighting the issue

Article (October 2013) cautions about the scam going on in the name of touts?

http://www.dnaindia.com/pune/report-admission-racket-touts-on-the-prowl-dupe-professor-of-rs23l-1898480

2. List of approved medical schools and provisionally approved medical schools in India by Medical Council of India

http://www.mciindia.org/InformationDesk/ForStudents/ListofCollegesTeachingMBBS.aspx

3. Information about all Medical schools in Maharashtra and the donation and tuition fees for 2013 (have sent a request for 2015 numbers)

https://mail.google.com/mail/u/0/#inbox/14c33259f1ce1f63?projector=1

4.Scam going on in Comedk Karnataka
http://timesofindia.indiatimes.com/city/bengaluru/9-medical-colleges-slapped-notices-in-ComedK-seat-scam/articleshow/37634245.cms

5.Gang involved in medical college seat scam busted in Madhya Pradesh
http://zeenews.india.com/news/madhya-pradesh/gang-involved-in-medical-college-seat-scam-busted-in-mp_891947.html

6. 9 medical colleges slapped notices in ComedK seat scam July 2, 2014 (100 Crore seat blocking scandal)
http://timesofindia.indiatimes.com/city/bengaluru/9-medical-colleges-slapped-notices-in-ComedK-seat-scam/articleshow/37634245.cms

8. Gang involved in Medical College Seat Scam busted in MP Nov 23, 2013 http://zeenews.india.com/news/madhya-pradesh/gang-involved-in-medical-college-seat-scam-busted-in-mp_891947.html


9. 19 doctors from Andhra Pradesh were scammed 15 Crore rupees on false promise to get medical school seats (July 11, 2014)
http://www.thehindu.com/news/national/karnataka/19-doctors-fall-prey-to-medical-seat-scam/article6201715.ece

10. Medical exam fraud is ‘biggest education scam’ 29 Aug 2014 (Former education Minister of MP Lakshmikant Sharma arrested)
hundreds of student’s suspended, Paid proxies appeared in entrance exam.

http://www.universityworldnews.com/article.php?story=20140828171239580

11. Parents allege medical admission racket April 14, 2014

http://indianexpress.com/article/india/india-others/parents-allege-medical-admission-racket/

12. India: Long-term medical school entrance exam fraud involves highest officials Nov 5, 2014 *****
The fraud ring involves students, parents, mediators, and even police, government, university and examination board officials.

http://www.aacrao.org/resources/resources-detail-view/india--long-term-medical-school-entrance-exam-fraud-involves-highest-officials


13. CBI slaps FIRs on 9 medical colleges. July 5, 2010
(CBI has put more than a dozen medical colleges in the dock for gross irregularities in the wake of the arrest of Medical Council of India (MCI) chairman Ketan Desai.)

http://indiatoday.intoday.in/story/cbi-slaps-firs-on-9-medical-colleges/1/104200.html

« Last Edit: Nov 6th, 2015, 2:17pm by Vijay Mehta » User IP Logged

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« Reply #2 on: Nov 6th, 2015, 2:16pm »

What amazes me is that when I was trying to figure out how much would it cost to get a bright young student who could score high on AIPMT but was not in top 10 percentile. So only way to medical college was to pay 50 Lac rupees donation on top of fees etc. I figured that if we added interest at (10% which is available on keeping your funds in bank in fixed deposit) by the time one graduated the amount of investment would be 80 Lakh Rupees. That means if one puts all that money in the bank and does nothing still can be getting 8 Lakh rupees per year! or Rupees 66,666 per month and that too without moving a muscle! so if one adds modest income of 2.5 to 3 Lakh rupees per year you can have comfortable living with 10-11 Lakh per month.

If you become a doctor and not lucky to have your parent who owns a well established clinic you start at the lower end of totem pole. And you might be better off not going to Medical College at all!

If this is the case what is the incentive for young men and women to waste prime years of their life memorising "ligaments of knee joint'!!!
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« Reply #3 on: Nov 6th, 2015, 2:31pm »

Gone are the days when a Doctor was well respected and trusted as someone who devoted his/her life for the betterment of the society. Growing up I felt so proud that my mother and father both were physicians.

Now it is not uncommon for GP to get commission for referring a patient to specialist. Now do you think he is going to refer to the best specialist who is more likely to manage the patient or the one who pays him the most commission? Would he refer a patient to a great specialist who does not give commission at all?

Unnecessary procedures or charging for the procedure that was never performed etc., are not uncommon.

How do you know if the angioplasty was even indicated? Heard a horror story of a man who thought he had open heart surgery and he had a scar to prove it, however few years later he was told they only cut the skin and not the bone!

Now, if you had borrowed 80 Lakh plus to get your medical degree how can you afford to be ethical physician? You got the loan to pay the family to raise and may be save the donation for your children's medical college fund.

When someone brings up the topic of "let us look in the mirror" it is not uncommon for us to blame the messenger. Amir Khan took a lot of flap for highlighting the fraud, corruption and incompetence in our profession and reaction was predictable.

I am not saying that all of us are cheaters or incompetent but we do know so many around us who definitely are.

It is considered unethical and calls in for disciplinary action in USA if a physician who knows about incompetence of the other physician but fails to report it to medical board.

In India it seems that medical fraternity has lived with this all their life so it does not get as strong a reaction as it would be from an outsider like me who visited the country after a long time.
« Last Edit: Nov 6th, 2015, 2:37pm by Vijay Mehta » User IP Logged

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xx Violence against physician
« Reply #4 on: Nov 6th, 2015, 2:43pm »

We all know that Medicine is not a perfect science and inspite of our best efforts there are times when the patient does not get well or dies. The lay public at such a time automatically assumes that the Doctor is guilty and instead of going to the law to press charges or seek the answers many feel it is ok to beat first and ask questions later.

Being a physician is becoming a risky profession. How would you know that one of your patient is not going to do well and may end up dining? While you are performing CPR to save his/her life you might be worried about your own safety.

This is happening more and more as the society see the physicians as people who will do anything to make money - are incompetent or neglectful - or they have defrauded the patient and family. Not uncommon for physician to LIE to the patient and family if he or she had made a mistake. Telling the truth may cost them life.
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« Reply #5 on: Nov 6th, 2015, 2:50pm »

KOTA: Another medical aspirant allegedly committed suicide today at her accommodation in Rajiv Gandhi Nagar here due to "study pressure".

This is the fourth such suicide in one month by an aspirant in Kota, one of the hubs for coaching centres of the country.

18-year-old Anjali Anand of Muradabad in Uttar Pradesh, who was taking classes for AIPMT in a premier coaching institute in Kota, took the extreme step in the morning at her hostel room by hanging self from the ceiling fan, police said.

A suicide note was found written in her diary, which stated that she ended her life due to "stress about studies" and her "inability" to fulfil her parents' dream, police said.

According to the Ms Anand's parents, she took the extreme step due to tension about studies, police said.

The body has been kept in the mortuary of Maharao Bhim Singh (MBS) hospital for a post-mortem.

The caretaker of the hostel noticed the girl hanging from the ceiling in the morning and informed the police, he said. Anjali had failed in her fist attempt in AIPMT exam last year and was preparing for the second attempt this year for the same entrance, SI Meghwanshi said.

A case under section 174 would be lodged in this connection after the investigation into the matter is over, SI Meghwanshi said.

Two AIPMT aspirants - Tarachand from Rajasthan's Pali district and Siddharth Choudhary from Bihar - committed suicide in Kota on October 2 and October 13 respectively, while another coaching student Amitesh Sahu (19) from Chhattisgarh was found dead under suspicious condition at his rented room in Mahaveernagar area on October 21.

On the night of October 27, an AIPMT aspirant Vikas Meena (17) ended his life by hanging himself with a plastic pipe to the ceiling of his rented hostel room in Talwandi area.

Meanwhile, amid rising alarm of suicide deaths due to study pressure, Allen Career Institute today has issued helpline number for the counseling of the students, who are undergoing stress, depression or pressure.

Any coaching student who feels stressed, depressed and pressured may call round the clock helpline number 0744-5156161 and seek counseling and other required facilities, Allen Career Institute director, Naveen Maheshwari, said.

Another 16-year-old Harshdeep Kaur, a student of class XI, committed suicide yesterday by using "crape bandage" in neck at Jaishree Vihar area, police said, adding that it was not confirmed if she was a coaching student.

The body was handed over to her parents after post-mortem. She left a suicide note in which she mentioned study tension as a major reason, they added.
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« Reply #6 on: Nov 6th, 2015, 2:54pm »

AIPMT and other Entrance Exams are supposed to help decide between likely to succeed students to likely to fail students.

However, as everything else the cheating is rampant and people with resources to manage to get high scores even with less of a brain.

The original AIPMT exam for 2015 was over turned by the Supreme Court of India due to widespread fraud and cheating.
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« Reply #7 on: Nov 6th, 2015, 2:58pm »

According to the Indian Consulate General who visited Temple TX in many of Medical Colleges large number of faculty position remain vacant (30 -40%) This is due to the fact that compensation for teaching faculty is to low that not many highly successful doctors afford to teach.

So you start out with the prospective students who are not chosen due to their merit but either due to caste or the bank balance of their parents now you add the teachers who are short staffed and create a physician who is likely to take care of thousands of patients.
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« Reply #8 on: Nov 6th, 2015, 3:19pm »


Here is Times of India Article where 7500 Medical graduates are not able to register or pursue post graduation due to confusion by government about rural practice - high court - Health commission!! This is going on for more than a MONTH - Does anyone care?

MBBS over, but no degree for medicos in Karnataka
TNN | Oct 30, 2015, 06.26 PM IST

BENGALURU: Almost a month after their courses ended, around 6,000 MBBS graduates in Karnataka — the whole batch of 2015 — are not able to either apply for higher studies or get registered with the Karnataka Medical Council to practise even though they have completed internships in the hospitals to which their colleges are affiliated to. All thanks to the confusion created by the government with its compulsory one-year rural service rule.

Even though the high court has stayed the compulsory rural service Act and asked colleges to give students degree certificates — the condition being that students will have to come back and do the service if the final order goes against them — colleges are not doing so.

This has also affected students who joined the courses through All India Pre Medical Test (AIPMT) — 15% of gover nment seats are reserved for AIPMT. The state produces around 6,000 MBBS, 1,100 post graduate medical students and over 200 super specialists every year.

Dr H Veerabhadrappa, president of the Karnataka Medical Council, said not a single candidate has registered this year, though there have been many enquiries. "This is sad. We get calls from students but we explain them that we need an affidavit signed by himher before the court to register himher as a doctor. The affidavit should mention that the candidate would come back to Karnataka for rural intern ship if the Act is implemented. No one has reached out to us yet with affidavit. Any No law should be retrospective. The government should ideally chalked out a proper plan before implementing it," said Dr H Veerabhadrappa.

An MBBS graduate from Hassan medical college said he has not received the course completion certificate as the director of medical education has reportedly told medical colleges not to issue the certificates until further orders. "We got seats through All India selection test and not through Karnataka CET. Only those who got seats through KCET will have to do rural internship, not us. Delay in issuing certificate and registration is affecting my chances of pursuing higher education or joining a job," the graduate said.

The only option they seem to be having is to approach the court. "There is a stay on the implementation the rural internship by the high court. The option left for us is to petition before the court and declare through an affidavit that we would come back to serve in Karnataka for rural internship for one year if the Act gets implemented and plead for registration and issuance of certificate," said an MCh candidate working in Victoria hospital as a plastic surgeon.

No exemption for anyone:

Dr SS Harsoor, director of medical education, said the issue of rural internship is handled by the health commission. "This matter has not come to me off late. If students approach me, I will explain the same. Why should they resist working in rural areas for a year whether they have signed or not? There were plans also to include the students who got seats under management quota to do mandatory rural internship, and not just for those who got government seats. The rules are the same for those who got seats through AIPMT. The matter is currently in court," he said.
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« Reply #9 on: Nov 6th, 2015, 3:57pm »

It is ironic that we have best and the brightest who would do anything to become physicians while 2.5 million who do not have proper training and education are serving the need of population.

Why do so many of our students have to go to far away corners of the world to get the medical education? Why can't we use all these energy to solve the major issue of quality health care for India.

This problem is only going to get worse as with advances in medicine we need physicians who not only know what is the current state of knowledge but who are also adaptable to make changes with any new information and improvement.

Here is a good article in Atlantic about the non educated health care providers who serve rural population.


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« Last Edit: Nov 6th, 2015, 4:03pm by Vijay Mehta » User IP Logged

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xx 18,000 plus doctors not allowed to practice
« Reply #10 on: Apr 8th, 2016, 4:36pm »

More than 18,000 Indians who have studied medicine in foreign countries have not been able to get registered by the Medical Council of India (MCI), which can make them eligible to practice in their homeland. These students have failed to clear the FMGE (Foreign Medical Graduate Test) test conducted by the MCI through NBE (National Board of Examination), an autonomous body under the Union Ministry of Health and Family Welfare.

These foreign educated doctors have questioned the screening test, alleging it is not transparent. According to them, this is being done deliberately by the MCI, which is under the grip of a powerful private medical college lobby, to discourage students from going abroad and to force them to enroll themselves within the country by shelling out a hefty amount to private colleges.

The pass percentage of the FMGE test is abysmally low. It was 10.4% in June 2015, and 11.4% in December 2015. In June 2014, only 4.93% students could clear the FMGE test. According to the data available, an average of 77% Indian students who returned with a foreign medical degree in the last 12 years failed to clear the FMGE test. The data says that since 2005, there have been only two instances when more than 50% of all candidates, who appeared for FMGE, cleared it (in September 2005 and March 2008). On one particular instance, only 4% students passed the test.

In most of the sessions in the last 10 years, the percentage of successful candidates was between 20 and 29. According to Dr Raghuram Nayak, an executive member of the All India Foreign Medical Graduates Association, “The test is conducted online but we are not given the question paper or the mark sheet as done in other tests conducted by UPSC. One gets the score immediately after such an online test. But the NBE takes one month,” said Nayak, who finished his medicine course from a college in Ukraine in 2012, but is yet to get registered with the MCI.

http://www.sundayguardianlive.com/news/4011-doctors-foreign-degrees-not-registered-mci


My response to the above article


I am a retired chief of General Thoracic Vascular surgery from Central Texas Veterans Health Care System from Temple Texas. I have served on the admission committee of Texas A & M Medical Health Science Centre for 19 Years.

I am appalled by the state of medical education in India. Large number of seats are out of reach to intelligent students just because they are born in a non-minority family who are not able to pay 60 + lac rupees. So, they get scammed by some consultancy who pocket the money.

Few of them venture to Russia China etc., and endure hardship of language and weather. Now, Philippines have opened its doors to these students and they go to this faraway places to get the medical education. Granted that it is duty of MCI to assure that anyone practicing in India is properly educated. But that is not the purpose of NBE exam with dismissal pass rate of 10%.

69 years after freedom it is sad to see that our deserving and motivated talented young men and women have to go all over the world to get medical education - this is all because Mafias have taken over our local Medical Education Establishment and turned it into a money making machine.

What we need is uniform exit exam such as USME in USA that is taken by ALL graduates regardless of where they got the degree form. This is the only way to assure quality!

Let us go for Equality - Exit Exam for Everyone. (with the same questions and ranking system for Everyone) As a matter of fact this exam may also help if a particular education institute consistently produce the graduate with low pass rate should be put on 2 year probation and if they fail to improve the quality of their education judged by their graduates passing MCI - they should be removed from approved Medical College list. And the pass rate of all the educational institute should be posted to public domain so prospective student can use that information in his/her decision.

I think best strategy is for all the current and former students from outside India and their family must demand one simple thing... Equality means Exit Exams for Everyone (with the same questions and grading scale, regardless of location of the medical college.

~ Vijay Mehta
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« Reply #11 on: Apr 8th, 2016, 5:05pm »

As we all know the admission to medical seat in India goes to the highest bidder (one who was born in Rich Family or Backward Family) So the next option for vast majority of Middle Class Hard Working students was to go to other countries like Russia - China - Ukraine - Philippines etc.,

You are given a fairy tale by consultancy as to how the admission is guaranteed in Medical College, how the Pass rate for USMLE or MCI etc., is nearly 100% etc., THIS IS PURE BULL CRAP (pardon my expression)

The consultancy is interested in making commission every which way they can so they are not going to tell you the real story.

Here are some shocking facts for the Medical Degree from Philippines:

You have to spend first 16 months of so of your five (they also say 5-5 1/2) in getting AB Psychology. This is a sheer waste of time where they teach you useless information and do a lot of waste of time while sucking your tuition fees and asking you to participate in various projects (every time costing you more money).

Then you have to take National Medical Admission Test. Sounds fair enough. However consultancy guarantees you that you will pass the test even without ever meeting you! How so? May be they have some cheating scheme (we Indians do well in this department) that makes them feel that every candidate of AB Psychology will clear NMAT. Basically they have deal with the medical college to admit everyone to medical school. And of course than the game begins.

After all those years of Medical School the number of Indian Students passing is not published. But the sources tell me that the pass rate for those who complete all the five or five and a half years of training is less than 15% Yes, less than one out of Six get the diploma.

You would think that at least this is a good news for those six! Not so fast. Now, the new doctor returns home to serve the patients in India and guess what? There are complications.

First the issue has to be resolved if the education in Philippines is equal to that of India. If you take out 16 months of AB Psychology form 60 months it leaves you with 44 months of medical school!

Now, we know that Medical College in India is 5 1/2 years - first 4 1/2 years of medical college and one year of Internship. So technically MCI can refuse to recognise your degree for not being equal.

Suppose they were kind and did not raise this issue they have another secret weapon. That is NBE. An exam that all the Foreign students must pass to prove that the education they received is equal to one in India.

The pass rate for this exam is 10 percent. Right now more than 18,000 Indian Doctors with the degree from other countries are sitting home because they can not pass the exam. Why so, you may ask?

All those Medical Mafia in India who are charging 60 -80 lac for each seat do not like the competition from other countries. So they have a simple scheme. Why don't we make the Exam so difficult that very few can pass? So simply they may ask all the question form Post graduate level which not even bright Indian Student can answer. Of course the students from India never have to take the same test.

As more and more students sit home after completing the medical college in far away places the anger is rising.

There is a growing movement asking for Equality meaning same Exit Exam for Everyone. Let us find out how well those students perform with the same exam who bought their seat with 60 lac rupees? I am sure if they can not pass the exam and sit home the Medical Mafia will have far fewer customers giving them such large sum of money.

My appeal is to anyone who wants to consider going to other country for medical degree is as follows:

Please do not waste your time and your parents money unless you are firmly committed to work your butt off.

Be aware that getting in Philippines is no being deal, any one with a fat check book can do it. But the actual probability of you passing the Philippine Medical College is less than 15%. That means five out of six of you are wasting your time - go back home and do something productive.

Even if you were good enough to be that top 15% and got successfully completed Philippines be prepared for the issue of internship (one year required by MCI)

After all the hurdles are cleared now be ready to appear in an exam that is designed to fail you.

So you do the math; out of 100 of current students about 15 will ever get the medical diploma from Philippine Medical College, and of these lucky 15 only 3-4 are likely to pass the exam by MCI! So for 96 of you all this time and money might go to waste. So when a consultancy tell you that you can get a degree for 30 lac INR that is not the real figure. If only 4% succeed than for each successful one out of you practicing in India the cost is 30 x 25 Lac rupees!!! (counting the loss by those who don't make it.

This may explain why so many rather pay 60 Lac donation and another 30 lac for tuition and other expenses. At least they don't have to face MCI and private college paid by them may be more lenient.

Most important study hard the path ahead is very tough. Stay informed about all these rules. Participate in all the protests that is asking for Equality - Exit Exam for Everyone with same questions and grading system in India

Good Luck

Vijay Mehta
« Last Edit: Apr 8th, 2016, 5:41pm by Vijay Mehta » User IP Logged

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