Medical tuitions – a viewpoint

A recent article lamented the growth of private coaching classes and medical tuitions (1). The world has changed considerably since the years of our fathers and grandfathers. Old paradigms and situations no longer necessarily work or hold true. In this context, the concept of medical tuitions needs to be examined with all its socio-economic ramifications.

Why do students go for tuitions? There are several reasons.

1. The student wants to get a high score or a distinction.
2. The student wants to pass.
3. The student is coerced by the teacher into getting tuitions under threat that she/he will otherwise fail.
4. The parents are apprehensive about the student’s future and force her/him to take tuition.

The competition for postgraduate seats is cut-throat and in this scenario every mark counts. Students believe that special coaching will help them get those extra marks and they are willing to pay for this. To go one step back, if students are willing to pay any amount to get question papers in the XIIth standard, paying for knowledge seems to be a very innocuous act. To go one step forward, students are, in fact, now willing to pay huge sums for those tuitions which guarantee them ‘hot tips’, ‘sure questions’ or the marks they want. Parents, too, are willing to go to any length to ensure that their child does not get left behind. This reflects the general attitude of middleand upper class society where child-child rivalry and competitiveness are marked.

The other factor is that students have got used to tuition classes from the time they were in school and junior college, where tuitions are de rigeur and raise no eyebrows. There are special tuition classes for entrance examinations to medical colleges so why is there any surprise at crash courses before students appear for their MD or MS examinations?

Medical tuitions serve a purpose. The standards of teaching in our medical colleges leaves a lot to be desired. There is no uniformity in what is taught in the various institutions. Private medical colleges are abysmally poor. B y distributing information — albeit theoretical — uniformly, tuition classes give the students a sense of direction. Knowledge, howsoever acquired, is beneficial.

The problem with tuition classes lies not in their-existence but in the manner in which they are conducted. Doctors who are potential examiners have no business taking tuitions as they will obviously favour their students when appointed examiners. They will subvert the examination system to achieve their means. It is here that the authorities (University of Bombay, Municipal Corporation of Greater Bombay, Government of Maharashtra) have to step in. This, however, is an unlikely event, given the manner in which they function.

Medical tuition is a variant of the prevalent theme-private enterprise taking over the function of what should be an efficient public service because of an obvious need. Special coaching of bright students and clinics during the night, after the day’s work has been completed, have been going on for ages. We now have institutionalisation of this extracurricular teaching and the addition of stiff costs.

Where do ethics come in? All we need is regulation and, perhaps, even accreditation of these classes by a regulatory agency such as the University of Bombay or the College of Physicians and Surgeons.