The junior doctors' strike has brought to fore the great apprehension among post-graduate degree and diploma students of medicine over the rule of compulsory rural posting.
Though students are not averse to to working in rural and tribal areas, the fuzzy guidelines have been a major deterrent and have led to concerns regarding pursuit of higher education, recruitment as government doctors and seniority.
“While enrolling for the course of MD I had to sign a bond to serve for a year in a rural area, a rule which applied to all our batchmates.
But there is no clarity whether our service in the rural or tribal area will be considered during recruitment by the government.
Will it be treated as a year of service or part of studentship,” asks Dr I.
Abhilash, a student of firstyear MD and president of the Junior Doctors Association (JUDA).
In case of PG Diploma students appearing for the DNB examination, if the government does not issue a No Objection Certificate, they will not be considered for admission.
“This year 319 diploma candidates were given rural postings, of which five were selected for the DNB admissions.
Since they did not have an NOC for not having served in their rural postings, they had to fight a court case where the High Court ruled that the students should be allowed to pursue higher education.
A similar situation faces students who are enrolled in MD/MS/Diploma /DNB/DM/Mc h courses.
There should be clear guidelines stating that candidates can do a year’s rural stint at any point in their career without delay in their education,” he says.
Citing the example of Kerala and Karnataka which have clear guidelines on the emoluments and service conditions for rural posting, Abhilash indicates that the orders issued by the Andhra Pradesh government were high on language and low on substance.
“The director of medical education (DME) made no mention of honorarium paid for rural service.
Other states, which have this system in place, extend the same benefits to the candidates which are given to government doctors serving in rural areas.
The order passed by the DME focuses on the ‘healing touch’ of a doctor rather than clarifying the conditions we will be working in.
Also, the request for accommodation has fallen on deaf ears and the DME suggests that a bathroom and a room be provided to students at the Community Health Centres (CHC).
But the order is silent on security for female doctors and who will take the responsibility for their safety,” he asks.
Abhilash also points out that the rural service stipulation also applies to students of private medical colleges, including those admitted under the management quota.
But, strangely, they are not given rural postings As a matter of fact, there is no mention of compulsory rural service in the Medical Council of India's PG Guidelines 2000.
“No one can force students to serve under a bond.
A similar issue was debated in 2002 and the GO was rescinded saying that one cannot force students to follow bonded education system.
This is going to be a longdrawn debate this time,” says the junior doctor