Increase in the number of MBBS seats through the scheme of one medical college per district: The debate on quality versus quantity and opportunity to strengthen family physician system In India

Raman K Kumar
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Abstract

India currently hosts the largest medical education system in the world with 650 medical colleges and 98613 MBBS (undergraduate) training seats. The reasons for Indian Medical Graduate's international migration and internal distribution within India have been multifactorial. There are push factors (with India) as well as pull factors (international host countries). Almost the same reasons are implied to the distribution and availability of the medical workforce geographically within India. To address the regional disparities in medical education and the availability of human resources in health, the policy of establishing one medical college in each district in India was initiated. Impressive progress has been achieved so far. However, the policymakers must look at it critically to be able to steer this project towards meeting the public health objectives of the country in the coming century. The discussion must include arguments on the type of doctor India needs. Indian can no longer afford the policy of having many cardiologists as compared to miniscule number of trained family physicians. All specialist system is being perused at the cost of a generalist health system. This paper critically looks at the district medical college scheme and exponential growth in the number of medical seats in India. Statistical success alone cannot address the public health needs and medical care of the Indian population. The creation of the National Medical Commission (NMC) has eased the criteria for recognition of new medical colleges; however, several limitations of the Medical Council of India are being carried forward within the functioning of NMC. Unless, there is a focus on creating employment and retaining medical graduates within the health system, it is worthless producing millions of them.
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通过每个地区一所医学院的计划增加MBBS席位的数量:关于质量与数量的辩论以及加强印度家庭医生制度的机会
印度目前拥有世界上最大的医学教育体系,拥有650所医学院和98613个MBBS(本科)培训名额。印度医学毕业生国际移民和国内分布的原因是多方面的。有推动因素(印度),也有拉动因素(国际东道国)。印度境内医疗人员的地理分布和可用性也隐含着几乎相同的原因。为了解决医学教育方面的地区差异和卫生人力资源的可得性问题,印度启动了在每个地区建立一所医学院的政策。到目前为止已经取得了令人印象深刻的进展。然而,决策者必须批判性地看待这一问题,以便能够引导这一项目朝着实现国家在下一个世纪的公共卫生目标的方向发展。讨论必须包括关于印度需要哪种医生的争论。印度再也无法承受拥有众多心脏病专家,而训练有素的家庭医生却寥寥无几的政策。所有专科医疗系统都在以全科医疗系统的成本为代价。本文批判性地审视了地区医学院计划和印度医疗席位数量的指数增长。仅靠统计上的成功无法解决印度人口的公共卫生需求和医疗保健问题。国家医学委员会(NMC)的成立放宽了新医学院的认可标准;然而,印度医学委员会的几项限制正在全国医学委员会的职能范围内得到执行。除非把重点放在创造就业和在卫生系统内留住医学毕业生上,否则培养数百万名医学毕业生是毫无价值的。
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