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An open letter to PMO: Trainee Doctors in India have become bonded labourers with no choice of their own (NEET SS Bonds)



The Prime Minister's Office,
New Delhi

Respected Sir,

Subject : Resident Doctor Protection Act for NEET SS counselling 2017.

A general misconception amongst people is that the government is spending whole lot of money in training of postgraduate specialty MS/MD and  super-specialty MCh/DM doctors. But the reality is that a Post graduate or a superspeciality MCH, DM resident doctor (JR/SR) is the backbone for carrying out all the work in any department in a government or a private hospital. Without resident doctors which constitute a cheap labour, it is impossible to run a hospital 24 hours for 7 days a week.

The main purpose of government medical colleges is not only training of doctors but they are mainly tertiary institutes for medical and surgical treatment of poor public. Only a minute fraction of public funds goes towards training of resident doctors which is all taken back as yearly fees, hostel fees, exam fees, library fees etc.

There are actually no training and simulation facilities provided to trainee resident doctors in government medical colleges and they are asked to straight away start on patients from first day of their residency.

Majority of funds put in government hospitals are for patient welfare. There are actually no training and simulation facilities provided to trainee resident doctors in government medical colleges and they are asked to straight away start on patients from first day. So the premise that a lot of money is invested for training postgraduate specialty MS/MD and  super-specialty MCh/DM doctors is not true.

It is the duty of the government to provide a fair opportunity, basic necessities for safe working environment and security of these doctors. At present the following problems are being faced

1. Working hours

There is no prescribed working hours for a resident doctor and hence many doctors are forced to work more than 100 hours in a week. The decision making capacity would begin to decline after long working hours and can have dangerous implications on the health of the patient.

2. Financial insecurity

There has to be a uniform pay for a resident doctor working in any hospital throughout the country. The medical course is long (12 to 15 years) and most resident doctors need to take care of their families and children also. Some colleges are paying a salary of 25000 for a 30 year Senior Resident.

3. Safe working environment

The number of attacks on doctors at hospitals is increasing every day. Many a times it is the lack of infrastructural facilities that is causing problems.

4. Bonds

It takes 16 years to establish as a consultant in medicine. (6 yrs- mbbs + 3 yrs MD/ MS + 3 yrs for DM /Mch + Individual Work Experience ). Some states are imposing a work bond of 5 to 10 years after pursuing a seat in a particular speciality (DM/MCH). By the time a doctor finishes such a course and bond completion of 10 years  he would be 45 years. There is a high possibility that a doctor might die with a heart disease while still pursuing the courses and bonds of the government which are now adding up to 25 to 30 years in total with a fixed meagre pay. They will never get to pursue their own interest in life. These days with so many restrictions on doctors, it is even getting difficult to find a spouse for marriage, as people don't want to spoil the life of their children by getting them married to a doctor.

Following is the latest status of bonds for superspecialization (DM/MCh) in various states:

  • Delhi - No
  • Punjab- No
  • Haryana- No
  • UP- No
  • Maharashtra- 2 crores/ 1 Year
  • Raj- 25 lakhs/ 5 years
  • MP - No
  • Kerela - 2 crores/ 2 years
  • Karnataka- 50 lakhs/ 3 years
  • TN - 2 crores/ 10 years
  • Gujarat - 50 Laks/ 3 years
  • West Bengal for 3 years, 10 lakhs for each year

5. Hostel facilities

Some colleges do not provide accommodation when joining the course. The conditions of some of these hostels are worst and are poorly maintained. There is no good quality food provided in the mess of some hostels.

Suggested Solutions

Hence I request you to pass a Resident Doctor Protection Act which will uphold the interests of  resident doctors in colleges with following provisions

1. Working Hours. With frame work on maximum permitted working hours per week. Highest permitted straight shifts.( https://en.wikipedia.org/wiki/Medical_resident_work_hours). Guidelines can be based on this article. Working hours should be monitored with biometric system and if doctors are overworked corresponding department and institute should be penalized.

2. One Designation One Pay. The doctor pursuing  Dm/Mch should be given same salary irrespective of college or institute he is working in which should be uniform throughout the country

3. Regulations for Safe working environment and security in the hospitals .

4. In the name of bonds resident doctors are being abused and made to work for 5 to 10 years with a fixed meager pay. Hence de-linking of medical education with bonds has to be done. Any sort of bonds should be abolished. And all existing bonds should be cut down to maximum of 1 year.

5. Provision of hostel facilities, mess with nutritious food and hygenic drinking water at working areas and hostels should be part of mci inspection before giving nod for recognition of courses at all institutes.

Sir in the present scenario many doctors are pledging that they will not let their children take up medicine profession because of the above mentioned difficulties. With NEET superspeciality 2017 admissions happening in the next week if the above mentioned act is passed it will provide security to thousands of doctors to safely pursue their course and provide service to all people in this country. It will inspire the future generation to take medicine as a profession with reassurance.

Thank you

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