Doctors, give back what you got

The union health ministry’s latest move to keep young doctors from migrating permanently to greener pastures is welcome. The ministry will now suspend the issuance of the ‘no obligation to return’ certificates had allowed these young medical practitioners settle abroad in the past, though they had gone, ostensibly, for purposes of continuing their medical education. Steps like this are necessary because of the colossal loss of trained manpower in the medical field, much of it due to migration. There is a chronic shortage of doctors in the country, which is exacerbated by this migration. The union health and family welfare minister, Ghulam Nabi Azad, had stated recently that there were only seven lakh doctors in the country against a requirement of 17 lakh, leaving a deficit of 10 lakh doctors, which gap largely affects the healthcare delivery system, particularly in rural areas. The minister had also informed Parliament this year that in the past three years, at least, 3,000 doctors had left the country, showing that this sort of migration, once called the braindrain, still continues. Many of these end up in the United States, which has one doctor for 469 people against one for 2,000 in India, which is a staggering contrast. It hardly needs to be said that most of the doctors who migrate are products of a subsidised education system. Thus, for example, the cost to the All India Institute of Medical Sciences (AIIMS) of training a doctor works out to about Rs 1.7 crore but with the student paying only a part of this sum. Yet, at least 53 per cent of the doctors trained in AIIMS leave to work abroad. Other than the subsidy offered to the student, this essentially means that India is subsidising the medical services of the more advanced countries, which, as a developing country, it cannot afford.

It is rather sad that young doctors, trained at great cost by the country, largely at the taxpayer’s expense, feel no obligation to serve the country in return, even though, they could, very probably, have challenging careers in India, curing difficult and rare diseases and doing research in them. There is no doubt that doctors in India deserve better conditions and facilities to practice. The government should also work at improving these so that it becomes more attractive for doctors to stay on in India. However, there is also an obligation on those who have received a highly subsidised education to pay back to the society that has enabled them to practice a highly skilled profession. They must not turn their backs on it.