The Centre not for the first time is trying to ensure better health services to our rural brethren. This time by a proposal to introduce one year's compulsory rural service for doctors as part of their curriculum. The students have not taken to this suggestion kindly and are agitating. Why? What is the problem? Should they not serve our rural poor who are starved of good quality medical care?

Our medical education planners, since the Independence have been trying to address this problem. In fact, our medical curriculum in the immediate aftermath of the Independence, which followed the British system to a great extent, aimed at producing doctors who would go and serve in villages. But students who were selected for this MBBS course had other ideas. MOST OF THEM, IF NOT ALL OF THEM, WANTED TO BECOME SPECIALISTS OR GO ABROAD. This is the basic dichotomy between intent and result.  Students these days are not taking up medical courses because of any divine calling to serve, but merely to get a degree and a job. And neither parents nor political leaders helping by setting the right example.

There is a history for these compulsory rural service plans. When I joined Bangalore Medical College in 1962, I signed an undertaking on stamped paper that I would serve in a rural area for one year after graduation. I am still to get that appointment.

The present thinking among medical graduates is that “anyone who studies engineering, especially software or information technology study only for four years after PUC and they get between Rs 15,000 and Rs 20,000 as starting salary.

And they get to stay in decent areas. Whereas an MBBS doctor has to do postgraduation and even super specialization before he or she starts seeing money.”   When this is the case, I feel the government should take steps to make the rural service attractive. How?  For one, salaries have to be hiked, with good rural allowances being sanctioned. The doctors should have decent places to stay and good schools nearby where they could, if they choose, send their children. And the Health Centres have to be upgraded and supply of medicines and other material has to be improved. It is a common complaint of Medical Officers in Primary Health Centres that supplies do not even last for three or four months and they are forced to spend money to buy supplies and collect the money from patients.

Another issue is that of PG seats. A PG seat would be a great attraction for a medical graduate to take up rural service. While merit should be rewarded, those who go and serve where the majority refuses to go, have to be rewarded also.

In 1963, after the Indo-China war, the seats were increased in all Government Medical Colleges, with the intention of producing more medical officers to join the Armed Forces. Compared to rural service, doctors have not actually hesitated to join the Armed Forces, precisely because, the salaries are better, decent living conditions are provided, and there is a chance to do postgraduation, if the doctor chooses to continue in the services.

Promise these, and automatically the rural health services also will improve.

The writer is former registrar, Rajiv Gandhi University of Health Sciences