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The state’s new decision was taken following the failure of the bond system where defaulters were fined anywhere between Rs 10 lakh and Rs 2 crore

Alarmed by the rising number of doctors who do not do their mandatory one–year stint in rural areas after graduating from government colleges, the state has decided to punish such defaulters by revoking their medical licences.

The decision, which is sure to cause a flutter in the medical fraternity, follows the failure of a bond system under which those who did not sign up for the rural service were fined a minimum of Rs 10 lakh. Several fresh graduates, however, would not only skip the village duty, but also not pay the fine.

Of the 222 doctors posted in rural areas last month, 115 did not join duty. The state government had no clue where these doctors disappeared and why they did not join their respective posts. "The doctors have not been honouring the bonds they signed. Initial investigations have revealed that the doctors who skipped the rural stints, started their private practices. We had to find a way to stop this and suspension of registration was thought to be the best method. This will ensure that they cannot practice elsewhere as well," said Director of the Directorate of Health Services Dr Satish Pawar on Wednesday.

The new rule would also apply to doctors who got their degrees from private colleges under government quota.

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The logic of one–year rural stint for medicos was two pronged – one, the medical students this way repaid the state for the subsidized education they received at medical colleges; two, the young doctors filled the gaping shortfall of trained doctors in rural hospitals and primary health centres.

Pawar said the decision was taken last week in a meeting along with Health Minister Suresh Shetty and officer–bearers of the Maharastra Medical Council –– the body that issues licences to doctors.

After the four–and–a–half year MBBS course, a student puts in a year of internship, which should be followed by a year of rural posting. However, if the student plans to pursue a postgraduatediplomaorapost–graduatedegree,the rural posting is pushed forward by two years in the first case and three years in the second.

A doctor wishing to skip time in a rural hospital after acquiring a post–graduate diploma is fined Rs 10 lakh. The cost of shirking village duty after acquiring a post–graduate degree is a steep Rs 50 lakh and the same after acquiring a super–speciality is Rs 2 crore.

Of the 3000 posts for doctors in rural Maharashtra, nearly 1300 posts currently lie vacant. The seposts as spreadacross the general, district, sub–district hospitals and primary health centers.

In September 2013, a group of doctors who had completed the post graduate diplomas approached the High Court asking for their rural positing to be deferred till they apply and get through the post–graduate degree courses. While the court granted them relief, a huge number of doctors started taking advantage and applying to the state for their rural posting to be deferred in the name of higher studies. "In the past four days, we have got 32 applications from doctors who are posted in rural areas stating that they want to study further. If this pattern continues, there will not be a single doctor in rural areas," said Pawar.

Pawar said he hopes that doctors who have not reported for rural duty will return to work now. "Our aim is not to destroy their careers but to make sure they serve in rural areas," he said, adding that the suspension will be revoked as soon as a doctor joins his rural post.

A doctor said that rural setups lacked basic equipment such as anaesthesia tubes, X–ray machines and oxygen cylinder. "A doctor’s stint in such badly maintained hospitals is nothing, but waste of time. There is no scope for us to put our knowledge to use in such places," the doctor, who didn’t want to be named, said.

Times of India
10 October 2013.

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