STOP BRMS!!!

stop BRMS!!!

Govt of India in consultation with MCI is planning to introduce a three years course in modern medicine by name BRMS ( Bachelor of Rural Medicine and Surgery ) of 3.5 years duration.For the record, this is a response to a PIL filed in Delhi High Court alleging that Govt of India and MCI have failed in providing health care to villagers .Under this proposal ,BRMS degree would be offered to graduates from medical schools to be established in district hospitals. The annual intake of students has been planned to be between 25 and 50.The admission will be based on merit in the plus two examination. Only students from notified rural areas who have taken science subjects will be eligible .They should have done the entire schooling in rural area
The BRMS graduates should practice only in notified rural areas and are not supposed to call themselves as doctors. They will not be allowed to do surgeries. They will be provided with registration in a separate register in MCI and State Medical Councils. The Government have planned to start 300 medical schools, most of them in 2010.The MCI workshop on 4th and 5th of February 2010 in New Delhi has endorsed the Government view point but has proposed to change the name of the course to BRHC(Bachelor of Rural Health Care).But all other inimical provisions including registration in the state medical council have been retained.The dangers inbuilt in creating two levels of cadres in medical profession and two levels of healthcare for citizens are self evident (www.stopbrms.com)

The policy of leaving rural population to contemplate with a half baked health care system signifies a u turn shift from socialatarian policy which entitled welfare activities to the state.Times have changed to accommodate an angle of thought which expects the masses to look beyond the government as a service provider.A neo liberal thought underlines the exclusiveness of the state and the masses in sustenance of welfare activities.The role of rural sector has been overlooked by the successive governments so much so that rural-urban divide has threatened even the very existence of our social structure.

'the politics of exclusion'
One can only sympathise with a state which looks down the rural population and leaves them with a second grade stethoscope service.The residence of a citizen is no criteria to deny his right to proper health care the constitution has guaranteed.The government by this policy has openly admitted its inability to address the problems of our rural health care.By embracing quake medicine, the state has raped the conscience of our rural junta that has got accustomed to the long queues at the PHC's.Consider an analogy in the education sector if the rural children are taught a lesser syllabus by less qualified teachers.

'a mockery of village students'
BRMS will be some kind of a mirage for a large part of students who would fall into such a under recognised course.These students will fall victims to promises of a life of a doctors esteem and elevation to a new social class.The criteria of admission has been limited only to the rural students on the argument of them staying more committed to the cause.By this,the govt has questioned the self esteem of rural students in assuming and categorising them into a better second grade student community.At the same time what is the disqualification of an urban student if he voluntarily wants to join a course which would easily lead him to rural medicine.

'the future of a BRMS graduate'
It seems to be seen how long the govt: will be able to hold on a educated community to working in rural areas in a politically conscious country like ours.It would not take much time for our judicial system to term it bonded labour and could easily go against the freedom of movement.Going by the 65000 seats projected for the course,votebank politics could give them an easy say in the decisions of health ministry may be more than MBBS doctors. No provisions have been set aside for future studies of such graduates and this could very well contribute to uniqueness of this course.At the end of the day the purpose would be least served and will lead to deliberate wastage of human resources.

'professional equations with MBBS doctors'
In a profession marred with competition and hierarchy,a whole new space of accommodation will have to be created so as to define the roles of BRMS with relation to the regular doctors.In a medical community which has seldom recognised even alternate systems of medicine,this new breed of doctors will always be looked down and will have to starve for recognition.This could be one potential field of conflict where no laws can change age old norms of medical practice.For example even a referral letter from a BRMS doctor would easily be looked down.In such a case a only a new order of work culture can save this profession which seems most unlikely.Leave alone even the nursing staff succumbing to this new order as they themselves undergo 4 years of medical training.

the brand of Indian doctors???
Already reeling under an impeded system of medical education least acceptable to the western world, Indian medical graduates mostly have to face humiliating recognition exams abroad.Add to this a new league of ill qualified medical personnel, the entire medical scenario of the country will be looked down.This will further weaken the efforts of the govt: in their attempts to gain recognition to our education sector.My repeated efforts on the web to find such a system of lesser doctors anywhere in the world has failed.All this in the long run will mar the image of Indian doctors who have proved themselves inspite of all obstacles listed above.

'embracing quackery'
The lancet lately dismissed homeopathy to the level of placebo medicines and ayurveda has come under the scan for the heavy metal ingredients in their medicines.Add to this the numerous fake doctors and quacks still ravishing freely in our country,this new breed of 'little knowledge' doctors will be 'dangerous' assets in legitimising practice of unscientific medicine.The very fact their jurisprudence has not been defined and even if defined will remain unclear for all practical purposes will predispose our health sector to disarray.In such a situation a natural acceptance will embrace their techniques until unfortunate incidents catch public eye.

The establishment of a health cadre can radically improve the administrative efficiency of the health system in the long run.Rather than being pushed into IAS jobs,civil service recruits with a medical background could be designated in the health sector.Put in however milder language,u just cant get doctors to work in rural areas on nominal packages.With the private sector offering sky bound offers as in any other profession only time bound hikes for rural doctors can hold them to work in rural sector.The current monetary allocation for rural health sector is a mere 1% GDP and will have to be raised to at least 3%.The rural infrastructure as often expected is in shambles and only concrete efforts can on this front offer any kind of solace.Another dilemma is the shortage of health care professionals willing to work in rural areas.I seriously don’t believe opening up of new medical colleges or sanctioning more of them in the pvt sector can in any way change a medical student would think.Social commitment on the part of student community can only come with a proper efforts to make them understand the ground realties and inspiration from the part of teachers.The compulsory rural service for new graduates is a welcome step in this regard .

Shame on a country which runs on a well drafted constitution promising its people a welfare state!
Let our conscience rise in revolt of this grave injustice.............