Dr. H. Veerbhadrappa *
Prof. & HOD. Dept. of Pediatrics M.R. Medical College, Gulbarga*
Medical education and health care system in our country are at cross roads. Medical treatment is no longer charity escalation of drug prices, treatment cost, high-tech hospital concept has driven medical care beyond reach of a common man. Now, there is a double standard in the management of patient, those who can afford the cost of treatment get best of treatment. Those who are not having any other means get least possible treatment. As per Karnataka Lokayukta statement, medical treatment in the state has suffered because of many reasons, including political interference and corruption. Govt. Hospitals are blamed for breeding corruption and diseases. These hospitals, which are supposed to be role models and teach hygiene and preventive measures, have become places for genesis of many diseases.

Priority in health sector is ill-conceived people talk of primary health care and gives importance for tertiary health care. Medical practice should be made people friendly, and should reach common man. If a person sneezes and for which if he consults physician, he will have to bear cost of expensive treatment. High-tech oriented medical education through which our graduates are trained are not well equipped to deal with village folk. Judicious use of investigation and treatment are what is needed for common remedy and which can save countries like ours from expensive medicare, economic burden to exchequer and affordable to majority of population.

Quackery is abundantly practiced in our country. Rural man is at the mercy of only quacks. It is because of collapse of our system. Graduates of Indian System of Medicine have become qualified quacks who learn Homeopathy or Ayurveda and practice Allopathy. Rural man has no access to health care since our young graduates are not motivated to serve. Our Medical Education and Health Planners have failed to achieve goals set for rural health services. Quackery can be eradicated if drug production and dispensing is done strictly against registration number of prescribing doctors in that particular system of medicine. Drug quality and pricing should be regulated.

Government should improve rural health services by well equipping primary health centers and mobile clinics. Doctors should be motivated by giving attractive salary for rural services and facilities in the treating centers. Separate cadre, as rural health mission should be created. Instead of spending 250 crores per year to maintain AIIMS-like institution, you can open many health centers at each village and serve needy people.

To improve quality of our medical graduates, new changes should be brought in teaching and learning process in medical colleges. A student learns more from bedside teaching and teacher's mannerism. Today, teachers are not willing to establish rapport with students, teach what is not relevant to the context. Medical universities have become like PUC or SSLC board by subserving function of affiliation and conducting examinations. Research and curriculum development has taken a back seat. Education is supposed to build character and preserve moral and spiritual values of society. According to Dr. A.P.J. Abdul Kalam excellence in mind demands qualities "noble leadership indomitable spirit and universal mind". Our Universities and Colleges seem to contribute for moral decadence and depravity. According to Churchill, first duty of University is "to teach wisdom not trade, character and not technicalities".

In our society which is experiencing abundant corruption in public life, is reflected very well in functioning of Government, Apex bodies, Universities and Medical Colleges. Commercialization of higher education and more so medical education has paved way for many ineligibles in medical education. There is craze to start medical colleges and those who run these institutions, use them to make money as well as a platform for their political career.

Students get admitted in these institutions by paying hefty premium, which is often black money. These graduates want to pass the course by whatever means and want to make quick money by dubious means. They are not compassionate to common people. Most of our graduates are not aware of problems arising out of poverty, they are not exposed to village life.

Today our institutions are producing graduates who are frustrated and in a bid to achieve something they migrate to UK, USA and Gulf countries in search of better amenities, earning and learning opportunities.

Need of the hour is to reorient medical education to produce graduates keeping in mind National health needs, Government should recruit doctors and they should be given handsome salary and covered by health insurance scheme. Referral levels should be strengthened. Tertiary health care should not receive priority. Training DM and MCH should not be given top priority. Government should evolve comprehensive health policy involving both Government and Private partners. Colleges should go out of their way to strive the need and importance of character and virtues of ones life. For this we need teachers of character, wisdom and knowledge.
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