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Journalism of Courage
The National Board of Examinations in Medical Sciences (NBEMS) will conduct the National Eligibility cum Entrance Test, Postgraduate (NEET PG) on August 11 in two shifts. The board postponed the PG exam scheduled for June 23 as a ‘precautionary measure’ amid allegations of irregularities in the recent competitive examinations.
However, confusion prevails on NEET PG shifts, and the doctors find it difficult to plan their preparation and leave. Moreover, they are raising questions about maintaining the difficulty level of both shifts.
“If the exam will be conducted twice in a day and the question paper would stand out differently. This again puts a question mark over how the overall merit list will be prepared. I hope NBE clarifies these details soon,” said Dr Prashant Kumar Singh, a medical officer under the Government of Odisha.
When asked if the Board should plan the NEET PG schedule ahead of time like how the Union Public Service Commission (UPSC) does, the Federation of All India Medical Association (FAIMA), Dr Rohan Krishnan chairman, said, “The condition of NEET PG is pretty sad for students. If UPSC can issue the exam calendar ahead and can take the exams of so many students in a single day without problems, and all by charging a minimum fee, why can’t NBE do the same? They take hefty amounts for NEET PG with poor conditions of the exam centres and numerous complaints about the lack of facilities. These things are unfortunate and they must think about it.”
For any MBBS student, completing their PG is a must or otherwise, it gets difficult to secure a well-paying job. “There is a lot of difference in how the society treats an MBBS and an MD or MS. Medical field is updating itself rapidly, and due to that getting a higher degree gets more important; especially when you consider its future impact,” said Dr Farah Mumtaz, who is currently pursuing her PG in MS (Obstetrics and Genecology) at Tagore Medical College and Hospital.
This change in society’s perspective has also translated in an increased demand for specialists. Dr Utkarsh Gupta, who works in a Uttar Pradesh-based hospital, believes the value of MBBS doctors has reduced as patients now prefer specialised doctors. “Once a student comes to the second year of MBBS, they focus more on preparing for NEET PG, rather than completing MBBS, and this is simply because now being an MBBS graduate is not enough. Also, there aren’t enough government vacancies for MBBS graduates, and the pay structure in private hospitals is not ideal, so students have to upskill themselves by getting a postgraduate degree,” he said.
Additionally, since there are limited PG and Super Specialty (SS) seats available, students spend more time preparing for NEET PG during their MBBS years. The June 2022 data of the Ministry of Health and Family Welfare shows that the number of PG seats have increased by 93 per cent from 31,185 seats in 2014 to 60,202 seats. However, this does not match the demand as over two lakh students appear for the NEET PG. About 247 postgraduate (PG) medical seats under the all-India quota were vacant last year, and the Health Ministry reduced the cut-off to zero to fill these seats — a move that was criticised by the medical fraternity.
Sharing his views on the work-life balance, Dr Shubham Anand from Lady Hardinge Medical College said many medical graduates find it hard to support their family financially. “In Delhi, there are no permanent jobs in the government sector, and we simply keep getting extensions of six months. Due to this, students move to higher education, while continuing to work. Those who work in private hospitals complain that they are underpaid and overworked,” he said.
Many complaint that while there are fixed work hours on papers, these are rarely followed. “Usually junior residents prepare for NEET PG while working, and it can get very hectic. Some aspirants tend to resign from their jobs to focus on NEET PG preparation and thus it feels disheartening when such postponements happen. Another issue is that hospitals struggle to find replacements for the people who resign for NEET PG, which leads to extra workload for the remaining resident doctors,” Anand added.
Twenty-seven-year-old Dr Farah Mumtaz, said, that the situation gets more chaotic for women as they struggle to balance their domestic life with hospital and NEET preparation. “I was 8 weeks pregnant when I was appearing for my final year MBBS exam, and was doing my internship when my son was born. Two months after my delivery, I returned to complete my internship. I had to wake up at 3 am, pump my breast milk for my son, and reach hospital by 7:30 am. I had a nanny to babysit my baby at the duty doctor’s room in my hospital. This was my routine for four straight months, and I quit only when Covid hit and I couldn’t risk my son’s health. After Covid intensity reduced, I had to rejoin to complete my extension posting.”
The issue is same in private hospitals where doctors’ working hours get extended as per the department’s demand. “Your working hours depend on your department, for instance, a junior resident in a non-academic department will work for 8 to 10 hours every day, but people in clinical-based departments work for 8-9 hours. In the Surgery department, you will be called on case-basis, and the shifts are never just eight hours long,” said Dr Raghunandan, who is a private practitioner based in Tamil Nadu.
According to the latest data from the Ministry of Health and Family Welfare, there are 13,08,009 allopathic doctors registered with the state medical councils and the National Medical Commission (NMC), as on June 2022. Additionally, the doctor-population ratio in the country is 1:834 which is better than the World Health Organisation (WHO) standard of 1:1000. As per data presented by the Centre in Rajya Sabha in July 2022, there are 34.33 lakh registered nursing personnel and 13 lakh allied and healthcare professionals in the country.
However, the data provided by the government is contrary to the 2021 report of the WHO which mentions that India was below the 44.5:10,000 ratio till the year 2018. “The study results suggested that to meet the density threshold of 34.5 skilled health worker per 10 000 population, there will be a shortfall of 0.16 million doctors and 0.65 nurses/midwives in the total stock by the year 2030. The shortages at the same threshold would be much higher (0.57 million doctors and 2 million nurses/midwives) by the year 2030, in case an active health workforce is considered. The shortages will be even higher when compared with a higher threshold of 44.5 health workers per 10 000 population,” the report stated.
Most students are struggling with mental health issues, especially after the Covid. While other central and state universities (such as IITs) are taking steps towards helping students out of this world-wide issue, medical students complaint about lack of health from the government and other stakeholders.
Dr Raghunandan added that mental health services are provided to the doctors with the support of state government and some doctors forums. “In the state, medical health insurances are not implemented properly. Governments have their own policies like Provident Funds (PF) but private hospitals fail to implement these,” he added.
