AIIMS grads -- two angles by Dr. Leo Rebello

January 9, 2009

ALT Health Members would do well to read the following

report from the Times of India and then read my comments

at the end.

Dr. Leo Rebello

www.healthwisdom.org

AIIMS spends Rs 1.7 crore on producing one doctor8 Jan 2009, Kounteya Sinha, TNN

NEW DELHI: It takes Rs 1.7 crore to produce a single MBBS doctor at AIIMS.

This is the finding of a first-of-its-kind study submitted by AIIMS' department of hospital administration to the dean recently. The figure includes both direct (services of the faculty and stipend) and indirect (services of non-teaching personnel and furniture) costs incurred by the country's premier teaching hospital over the five-and-a-half year period. According to the study `Determination of the cost of training of MBBS student at AIIMS' conducted under the supervision of Dr Shakti Gupta, (HoD), department of hospital administration at AIIMS, if computed using a traditional costing method, AIIMS spends Rs 31.31 lakh on every undergraduate student per year per course.

When calculated using the Time Driven Activity Based Costing method (TD-ABC), the study says that total costs incurred on one MBBS student is Rs 98 lakh per course. "As against this, the annual fee of an MBBS student at AIIMS is Rs 850 per year that includes hostel and tuition fee," Dr Gupta told TOI.

What's worse, an earlier study by the Media Study Group found that over 53% of students who pass out as doctors from AIIMS leave India to work abroad.

Of the 2,129 students who passed out in the first 42 batches of the MBBS programme at AIIMS -- from its inception in 1956 to 1997 -- the study team tracked down 1,477 doctors. Of them, 780 or 52.81% were found to be working abroad.

These stark figures made health minister A Ramadoss plead to students on Wednesday to stay back and work in the country. Addressing the annual AIIMS convocation that saw 376 degrees of which 50 were MBBS degrees being given out, Ramadoss said, "Please stay put in India. This country needs you very badly. You are the best in the world. Your country faces an acute shortage of quality doctors."

Even convocation chief guest Dr R K Pachauri echoed the same view. "If you (students) are looking at spiritual or professional satisfaction, then serving your own people in your own country, where you are needed the most, is the greatest gift you can get. The challenge is here and you will not regret the decision," Dr Pachauri said.

Dr Gupta has a solution to curb such brain drain. "Medical students who graduate from the Armed Forces Medical College in Pune have to serve in the Army for a minimum of five years or else they pay Rs 15 lakh to be allowed to practice in the private sector. Similarly, AIIMS too should think of imposing such a clause where students have to sign a bond agreeing to work in India for a certain period of time after graduating from AIIMS," Dr Gupta said.

A recent Planning Commission report said India is short of six lakh doctors, 10 lakh nurses and two lakh dental surgeons. Indian doctors, however, form 5% of the medical workforce in developed countries. Almost 60,000 Indian physicians are working in countries like US, UK, Canada and Australia alone.

India has a dismal patient-doctor ratio. For every 10,000 Indians, there is one doctor. In contrast, Australia has 249 doctors for every 10,000 people, Canada has 209, UK has 166 and US has 548.

Dr. Leo Rebello commentsIt is good that most of our Indian doctors / nurses are serving abroad. Hence, our people are enjoying relatively better health. MBBS doctors are 'one organ, one disease'specialists and besides antibiotics, steroids, painkillers,anti-this, anti-that, chemotherapeutic substances and somechemical vitamins they know nothing about health.Their diagnostic methods are useless, costly and timeconsuming, their treatment is full of side effects.You go to them to treat one disease, and you return withmore diseases. If you have got to live with insulin for lifetime,if you have to live with a pump for asthma for lifetime,if there is no known cure for several diseases, then such a pseudo science should be dumped.Mr. Anbumani Ramadoss (I deliberately do not address him as doctor, because he is only MBBS -- a bachelor degree) is well intentioned. But he knows hardly anythingabout traditional and natural medicine.

We have in India six recognised systemps of medicines,namely, Ayurveda, Nature Cure and Yoga, Homeopathy,Siddha, Unani and Allopathy. To that can be added Acupuncture,Hypnotism etc. But we know only one pathy -- allopathy, andthat is really pathetic.

With the useless medicine graduates that our system churnsout spending crores, we can train millions of Naturopaths,Yoga experts, Homeopaths, Vaidyas, Siddhars, acupressurists,etc. It is about time, therefore, that we demanded that thehealth budget should be divided into 6 parts, since we havesix recognised systems of medicines in India and every hospitalshould have a six systems department, so that the patients canavail of the health care of their choice. But we spend more moneyon useful. The Bajrang Dal, and other Hindutvawadis and theso-called vegetarians raise so much hoo-haa on religion, conversions,language issues, but do not mind eating western junk called sludge medicine.

Right to Health is akin to Right to Life and Health Care is Self Care.Dump the deleterious Modern Medicine.