Teaching for lucre

Since time immemorial man has loved to teach – be it hunting, the use of the plough or the alphabet. A price-tag was then placed on this pleasurable activity. It was not long ere the profit motive superseded the joy of teaching. In the continuing process corrupting this natural tendency of man to teach, ugly forms like the Sabnis episode now surface with increasing frequency. These days, many consider such actions ‘normal’ and few give a second thought to ‘corruption’ since, in the words of a late, unlamented Prime Minister, it is an universal phenomenon.

During my last year as a resident surgeon at the K. E. M. Hospital, in 1987, a second MBBS student informed me that some senior members of the faculty were taking private tuition for a fee. This came as a shock as I had always felt that the teacher and student, alike, delighted in the process of education. Corruption of this endeavor, especially in medicine, was unimaginable.

Learning medicine :without patients

I later heard of private coaching classes run by eminent teachers from the four public medical college hospitals in Bombay. Initially I thought that these classes were intended to cater to students from the sub-standard private medical colleges. I reacted to them with anger and pity. Anger followed the realisation that a dual appointment to the medical college and to private tuition classes would, inevitably, result in injustice to students at the former institute. The pity was for the students at the private classes who had to learn the art of medicine without patients. Osler’s aphorism continues to ring in my ears: “To study the phenomen of disease without books is to sail on an uncharted sea To attempt to do so without patients is not to go to sea at all.”

Corrupting examiners

Corruption then invaded the medical examination examined using the system. We were witness to ‘chits’ (bearing names and roll numbers of candidates to be unduly favored) being sent to examiners. We then started receiving phone calls from ‘influential’ persons a day prior to the practical examinations, asking us to favor select candidates. It remained somewhat surprising that even those who do not indulge in unethical private practice succumb to such malpractice.

When the phone calls are from respected, retired teachers, the gloom deepens.

The Sabnis episode

Dr. Sabnis was Professor of Surgery at the Grant Medical College and the Sir J. J. Group of Hospitals (J. J.). Fees for his private tuition included not only the cost of passing a candidate in the examination but, on suitable additional gratification, the award of a distinction in the subject as well.

The fact that the student was guaranteed that Sabnis would be appointed an examiner indicates the extent of depravity in the University of Bombay. He could prevail, unchallenged, even though his misdeeds were common knowledge on the J. J. campus for years. He was secure in the knowledge that there was none willing to risk his career in order to expose corruption.

Sabnis met his downfall only when he started victimizing candidates. A poverty-stricken student appearing at the final MBBS examination was failed because he had not coughed up the fee demanded by Sabnis. Since he had nothing to lose, the student approached officials in charge of the anti-corruption bureau at the Crime Branch. Using marked notes, they nabbed Sabnis red-handed.

The only punishment awarded by the authorities to Sabnis was transfer to another medical college and hospital, where, presumably, he is free to continue his nefarious activities.

The tip of the iceberg

The Sabnis episode indicates only the tip of the iceberg. The prevailing atmosphere encourages selfishness and favors cut-throat competition over co-operation as a means to progress.

Most teachers, administrators at medical colleges and those at the University are well aware of these malpractices. A few have tried to effect changes but have been overwhelmed by the system. Most bury their heads in the sand. There is a callous disregard of such issues.

Unusually we see a spark that suggests that all is not lost. Some years back a student at the Seth G. S. Medical College exposed, at considerable risk to himself, the undue favors done at the M. D. examination to the daughter of the then Chief Minister of Maharashta by the then head of the department of obstetrics and gynecology. This resulted in the transfer of the teacher concerned and the fall of the government headed by Mr. Nilangekar-Patil.

Unfortunately, such instances of young Davids fighting successfully against Goliaths are all-too-few!

Is there no cure?

We learnt some important lessons.

1. The University of Bombay is riddled with corruption. Those appointing examiners are either scandalously inefficient or totally perfidious.
2. Even when it is common knowledge that an examiner is crooked, not a single colleague or senior is willing to stand erect and denounce him. Almost everyone prefers to look the other way.
3. For the unscrupulous, getting caught red-handed is not the end of the world. At worst, it means a temporary dislocation and some inconvenience. In time, his misdeeds will be forgotten and he will, once again, be free to indulge in his favorite malpractice with abandon.

There is little hope for improvement. There is no will for changing the status quo in those wielding power in the University or in the state government. The medical councils – in Delhi and in Bombay – do not consider this evil a matter of concern. The few who worry about the baneful consequences of such fraudulent certification of competence in the medical sciences are impotent.