The real purpose of the medical college
25 Aug 2023 5 mins Download PDF
The real purpose of the medical college
Why in the News?
Recently, a surgical instrument left behind in the patient’s stomach was found after her having suffered with pain for almost a year, a case of medical negligence in one of the leading medical colleges in Kerala.
Growing need to examine contribution of medical colleges in a public health perspective:
- The case of the patient was due to medical negligence even in one of the most advanced health care systems in the country.
- Growing vacancies in seats to Bachelor of Dental Surgery and Master of Dental Surgery courses in dental colleges across the country.
- A policy proposal of 2019 by the GoI to convert district hospitals to medical colleges that is being pursued along with a policy of sanctioning an AIIMS- like institution in every State.
Medical colleges:
- The institution serves two main purposes:
- Educational role: To provide education and training of students to become medical professionals through teaching and apprenticeship (internship).
- Offering medical care: Patients with serious illnesses can avail services from medical colleges anytime when they have a referral from the lower-level facilities.
- Myths about medical colleges:
- A medical college sanctioned for a district would take care of every health-care needs of the people there
- False security and hope that the chances of children living near the vicinity of medical college has increased chance of getting a medical seat.
- Increasing the no. of medical professionals is the solution to the issue of inadequate access to health care.
Tertiary care needs:
- Emphasis on secondary-care facilities is required rather than large state-of-the-art medical colleges, if curative care needs of the people are the priority.
- Only 1% of the total population requires advanced tertiary care, annually.
- District hospitals which have to function and follow referral systems from the lower-level facilities face challenges such as,
- Poor infrastructure
- Lack of specialists
- No referral system, which is partly due to non-functional secondary-level care facilities.
- Overload of all kinds of patients- requiring primary care to the most advanced care waiting for treatment in higher-level facilities, i.e., district hospitals or medical colleges.
- Ideal model for secondary-care facilities:
- Referral system
- Patient care specialities such as
- Cardiac care and surgery
- Regular dialysis services
- Cancer treatment with a network of regional cancer centres
- Best trauma care responses after road traffic accidents.
- Problems faced by medical colleges:
- crowding of patients in need of primary and secondary care
- 80% of the cases that are treated in medical colleges do not require treatment under tertiary specialty care.
- perennial failure of India’s health services to implement a referral system in tertiary-care facilities is because of failure to strengthen secondary-level care.
- Most secondary-care needs do not require hospitalisation and hence are excluded from any health insurance scheme. Therefore, medical colleges are being stormed by the patients for curative care.
- crowding of patients in need of primary and secondary care
Popular versus people-centric policy:
Though popular support rests with establishment and the creation of a medical college as it encompasses an ‘image’ of advanced technology and development, inadequate provisioning of secondary-level health care in the region should be real problem to be addressed.
- If district hospitals are converted to medical colleges, the priority shifts from a treatment centre to that of an education and research centre, where patient priorities become secondary.
- Strengthening secondary-level curative care can be the best policy for governments to strengthen their health-care system.
- It can be a strong regulator for the commercial private sector which survives on the less complex secondary-care needs of people.
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