Are doctors soft targets for government?

Every medical graduate is aware of the fact that getting a post-graduate seat in a good medical college in India is not child’s play. The numbers of post-graduate seats, especially in medical colleges run by state governments, are dwindling every year. One has to spend a good 10 years up to post-graduation in intense study and get out of medical college as aged, unmarried, balding doctors. To add to our woes, a few states in the country have made compulsory a bond service period of three years after post-graduation.

Recently, the state of Maharashtra, in an unprecedented move, had decided to execute the said bond services for medical graduates from colleges run by the state government or by municipal corporations. The Director of Medical Education and Major Hospitals, Municipal Corporation of Greater Mumbai, issued a notification regarding the execution of the said bond services for candidates passing out from three corporation medical colleges viz. Seth GS Medical College, Lokmanya Tilak Medical College and Topiwala National Medical College located in the region of urban Mumbai. To our utter surprise, candidates with a super speciality degree i.e. Doctorate of Medicine (DM) and Master of Chirurgical (MCh) qualifications were, after 13 years of toil, allotted posts of assistant medical officers which could have been allotted to an MBBS graduate, rather than posts of Assistant Professors in the respective specialty, with unrealistic duty schedules and work hours. These 66 candidates decided not to accept their postings and filed a writ petition in the Honourable High Court of Bombay demanding posts at par with their qualification.

On the directives of the Honorable High Court of Bombay, in a writ petition 1440 of 2011 (Dr Maqsood Khan & others vs. State of Maharashtra), the Directorate of Medical Education and Research was given the responsibility of allotting such bond services (1). In a shocking and incomprehensible move, the Director of Medical Education and Research undertook a massive drive to allot the so-called bond services to around 900 candidates (PG Diploma – 235, MS – 189, MD – 420, DM – 30, MCh – 33) who passed out from government and corporation-run medical colleges in an overnight procedure from the morning of September 6, 2011, to the next morning. The allotment procedure was chaotic, with the authorities being oblivious to the candidates’ queries regarding the nature of duty, work profile, and duty hours.

Many of the DM and MCh candidates were allotted the post of medical officer in a speciality (a post created on paper), but in reality these doctors were assigned the duties of an MBBS doctor. Thus, the expertise and talent of well-qualified doctors was under utilised by the state authorities (2). The government machinery grossly misinterpreted the health needs of society by pushing over-qualified doctors into the rural sector which lacks basic infrastructure. Even more shocking was the government action of removing ad-hoc medical officers (already serving for a period of five to seven years) to accommodate the bonded candidates. When the Honorable High Court was apprised of the tactics employed by government machinery, the state received a sharp rap on the knuckles for making super-speciality and broad speciality doctors serve as general duty medical officers. Some of the MD/MS doctors were allotted posts that had either been discontinued or were already occupied. One of my dermatology colleagues got an allotment as a medical officer in a leprosy unit of Pune district. To her utter surprise, the said post had been discontinued much earlier, and she was asked to serve under the tuberculosis control programme, taking instructions from the medical superintendent, attending polio vaccination camps and doing work which was in no way related to her speciality. If such misapplication of mind continues, our medical colleges will be lacking in full-time teachers and none would get timely promotion.

Since 2006, the Maharashtra Public Service Commission has not filled the regular posts of Assistant Professor, and Associate Professor and government is trying to fill those vacancies with such bonded candidates who cannot be permanently commissioned. Thus there is an acute shortage of medical teachers, to the extent that some medical colleges are on the verge of losing the mandatory Medical Council of India recognition of their post-graduate courses.

It is high time that the government applied its mind to tackling this issue with common sense and sincerity. If the government does not have enough vacancies to accommodate bonded doctors, shouldn’t one question the validity of such bonds?