The recent Covid pandemic has proved one thing that we have shortage of Hospitals, Doctors, Nurses, paramedical staff etc etc. As there were less number of beds available in govt hospitals, the covid affected people who entered the private hospitals were presented with hefty bill, and no hospital followed the guidelines set by govt regarding upper limit for various billable heads. So where for normal disease like heart attack you were charged x amount for 15 days stay, in covid situation the bill came to any where between to 4x to 5x amount.
Now what was the basic reason for these shortages- let us talk about Mumbai city. You will be surprised to know that there have been no new medical colleges added to the existing one in Mumbai, either govt or private in last 2/3 decades. Why ? The reason is the govt rules and Medical Council of India’s guidelines for opening new medical colleges in India. The biggest hurdle in this is requirement of land- other than metro cities if one has to open a medical college then land requirement is 20 acres, and for metro city like Mumbai the land requirement is 10 acres. Now first thing who can arrange and pay for 10 acres of land in Mumbai city and suppose you get the land, do you know how many students you can enrol per year, it will shock you, max 120 students. So considering the course is of 4 years that means for max 480 students you will need a land of 10 acres (ie 40,000 sq meters, which is equivalent to roughly 5 lakh sq feet). What you need in medical college is few lecture halls, seminar halls, 5 to 6 types of laboratories and let us say 50 bed hospital, and these facilities can be very well accommodated in 50,000 to 100,000 sq feet area. Why this is not being done is because of the politicians who are involved in framing the rules, because they do not want new medical colleges to set up in big cities , and in this racket politician from all the party are involved, the prime reason being that most of the private medical colleges which were set up earlier all belonged to the trusts formed by these politicians, and they do not want to loosen their hold on this business.
The seats for graduation (MBBS) in these colleges is sold for nothing less than Rs 10 lakhs to Rs 50 lakhs, and for post graduate (MD) the value is in crores. So only rich can afford these seats, and the children of these filthy rich people have no aspirations to do something for the betterment of society and mankind.
Second most important thing happening now a days is that even parents are discouraging their children from opting for medical education, because medical graduation has no value, and by the you complete post graduation you are in 30+ age bracket, and then you set up your practice and by the time you settle in practice you are 40 years old.
Country is facing heavy shortage of doctors , specially in rural areas. The reason being no one wants to go to rural area because there is hardly any medical infrastructure present. Now if there are enough medical colleges in the rural and urban areas, then there will be additional doctors, and definitely then new hospitals will have to be opened, which will give to the development of medical infrastructure. So more hospitals means competition, and with completion the amount in the bills will start reducing. But will these politician allow this thing to happen?
Some political party or govt has to take the lead in changing the rules so that one medical college can be opened within area of 2500 to 4000 sq meter. If this happens then in city like Mumbai, you may find many more medical colleges being set up, and in the every district centre there will be medical college. One has to be very practical in modern times when space is major crunch in all big cities, and in reality you do not that big space to start medical college.
Some other requirement as per present rules
Accommodation shall be provided for – Principal/Dean’s office (36 Sq meter) staff room (54 sq meter) college council room (80 Sq.meter) office superintendent‟s room (10 Sq.meter), Office (150 Sq.meter), record room (100 Sq.meter), separate common room for Male and Female students with attached toilets (100 Sq.meter each), cafeteria (200 Sq.m).
Now can you imagine, that this type of space can be provided in city like Mumbai for the facilities mentioned above . Who can provide cafeteria of 200 sq meter in Mumbai, common rooms of 100 sq meter. Deans office of about 400 sq feet, when a top company MD in Mumbai may not have this luxury.
Central library There shall be an air-conditioned Central Library (1600 Sq.m) with seating arrangement for at least 200 students for reading and having good lighting and ventilation and space for stocking and display of books and journals. There shall be one room for 100 students inside and one room for 100 students outside. It should have not less than 7000 text and reference books. In a new medical college the total number of books should be proportionately divided on yearly basis in five years. The number of journals shall be 100 out of which one-third shall be foreign journals and subscribed on continuous basis.
In today’s digital world when every reference book is available on the internet, why 1600 sq meter (approx 17,500 sq feet) library is required, and that too air conditioned. In today’s time when each student is carrying laptop. The main requirement in library should be availability of wifi network, sitting place and librarian job should be to provide various links for the reference books This can be easily done in 100 to 150 sq meter.
TEACHING HOSPITAL A functional teaching hospital with 300 beds having a minimum of 60% indoor bed occupancy shall be available at the time of submission of application to Medical Council of India, at the time of inception of the hospital by Medical Council of India and upto 2nd renewal of the medical college. The bed strength shall be 500 with minimum of 75% bed occupancy at the time of inspection for third inspection and thereafter for subsequent renewals and recognition. This is the criteria with 100/120 admission every year. The number of beds for general medicine, TB, Dermatology, TB , Respiratory and other diseases, ICUs etc are divided among 500 beds
My contention is why can not 50 beds to start with and 100 beds at the time of 3rd inspection serve the purpose, and for anything special they can tie up with nearby big hospital. It is time to become practical.
In the present scenario the students from the rich community, reserved category students are the main entrant to medical colleges. A student of middle class family who is not among the top ranker in entrance test, can not aspire to become doctor. Actually the dice is heavily loaded in the favour of rich and reserved category students. Now if there are many medical colleges with reasonable fees then there are chances that India’s shortfall doctors can be met.
But everything depends upon who will bell the cat, I mean who will change the criteria for setting up medical colleges.
Friends, I hope this article will be an eye opener for all of you.
Anil Malik
Mumbai, India
30th June 2020
R. N. Mungale.
Medical facilities are inadequate. The present rules should be changed.