At a time when chronic shortages of medical staff cause widespread issues across India, the move is unlikely to be well received. Further reducing the number of doctors could place an unnecessary burden on the healthcare system in Maharashtra, even if these doctors were limiting themselves to urban areas.
However, this apparent refusal to work in rural hospitals and clinics violates the doctor’s contracts. Many of those involved graduated from government run medical colleges, a provision of their graduation being mandatory time spent working in rural locations.
Upon graduation, medical students sign a bond which requires a year long service in village communities. This year long service must be performed within five years of graduation.
Failure to serve the mandatory time in rural clinics places a fine on the doctors. A Directorate of Medical Education and Research (DMER) official stated the current figures for the fines as Rs 10 lakh for an MBBS (Bachelor of medicine or surgery), Rs 50 lakh for post-graduates and Rs 2 crore for speciality doctors.
As the doctors have failed to either perform the year in rural communities, or pay the associated fine, their medical registrations have been revoked. If they continue to practice medicine, they will be considered to be equal to quack doctors.
The affected doctors are spread across the state, among those declared to be quacks are: 780 from Seth Gordhandas Sunderdas Medical College, Parel, 761 from Grant Medical College attached to JJ Hospital, 595 from B J Medical College, Pune, 526 from Government Medical College, Nagpur and 485 from Topiwala National Medical College attached to BYL Nair Hospital at Mumbai Central
Doctor’s have been critical of the Maharashtra government’s decision. They say that DMER is sending junior doctors to fringe areas without any improvements to medical infrastructure in the areas. This often leaves recently graduated doctors placed for a year in an area where basic medications are all but unavailable, they claim.
These graduates, some receiving numerous degrees or high level qualifications such as a PhD, will no longer have the opportunity to renew their license. Dr Ajay Chandanwale, Dean, BJ Medical College, Pune has criticised the move as wasting a huge amount of potential for the medical community.
Despite criticism of the move, DMER has treated the matter from a strictly legal standpoint, in which these doctors have both refused the terms of their bond agreement, as well as neglected to pay the fines.
“Most of the students after passing the final exam, choose municipal corporations in cities to work in public health departments rather than serving people in rural areas,” said Dr Sanjay Deshmukh, Deputy Director, Health Services. The dismissal of such a large number of doctors however does little to alleviate the issue, and escalates the problems resulting from a lack of doctors in urban areas.