Wednesday, June 10, 2015

Medical Education - Craze for specialisation, few takers for general medicine

ENT specialist for a sniffle; a cardiologist for a minor breathing problem; a neurologist for a throbbing headache. With doctors being judged by the panoply of degrees suffixed to their names, general practitioners with MBBS degrees have been pushed to work as subordinates till they earn an extra acronym on their name plates.

While more than 5,000 MBBS students in the state of Tamil Nadu fought for 1,200 post-graduate seats, senior doctors say the rat race has taken a toll on the health sector since fewer people are opting to become general practitioners attending to minor ailments.

"Over a decade ago, many MBBS students would go back to their native place to practice medicine and would apply for post-graduation after two to three years," said J Mohanasundaram, former director of medical education. But, now, pursuing a specialization immediately after under graduation has become an obvious choice for students. "Now, a general practitioner with an MBBS is seen unfit to write out prescriptions. Even for a minor ailment, people head to a specialist," he said, adding that in most countries, patients first approach a general practitioner, who would then refer them to a specialist.

Students who complete their MBBS can practice as physicians and start their own clinics or nursing homes. However, with many struggling to pay off hefty student loans, they choose to work as duty medical officers in the government sector or in private hospitals. "However, most of them eye post-graduate seats and prefer to join government sector so they can secure a seat through the state quota," said Dr V Kanagasabai, former dean of Madras Medical College (MMC). 


Senior doctors say that students often begin preparing for their specialization during their one-year compulsory house surgency period. "The one year is to train them as physicians and they learn to treat all sorts of ailments. But most of them use this time to prepare for their PG admission. They focus only on the specialization they are interested in," said Mohanasundaram.

Although age is no bar for applying for postgraduation, MBBS graduates are reluctant to wait for more than a year or two. "I feel I won't be competent enough to crack the entrance compared to those who are fresh out of college," said Pavithra E, a medical officer in a private hospital who plans to appear for the entrance exam next year.

Experts say increasing the number of PG seats would help in a big way. "The thrust on postgraduation is so much that many of them pay hefty capitation fees and join private medical colleges. They don't realize that having an MBBS doesn't make you half a doctor. It is the hands-on experience and the learning that you get that really matter," said Dr K Raghavan, former head of the department of general medicine at the government general hospital.

Source: The Times of India, June 10, 2015
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