The Doctor is Out

India has less than half the number of doctors it needs.And its the largest exporter of doctors.The cure for both maladies is a massive supply-side response :: Ishani Duttagupta

The reports are in. And things don't look good. India just does not have enough doctors. There are only 6.13 lakh physicians in the country, against a requirement for 13.3 lakh - a staggering shortage of just over 50%, according to the World Health Statistics 2010 report. India has less than on

e doctor for a thousand people (0.6) as compared to China (1.4 doctors per thousand). In absolute numbers, the US - whose population is a fourth of India's - has more doctors than India.

Now analyse another set of numbers. The British Association of Physicians of Indian Origin (BAPIO) estimates that the UK has over 40,000 Indian doctors who are treating about half the population of Britain while the American Association of Physicians of Indian Origin (AAPI) puts the US figures at 50,000. About 20% of doctors working in Australia have received their basic education in India while in Canada, one out of every 10 physician has roots in India.

In a reply in Rajya Sabha, health minister Ghulam Nabi Azad recently said that over 3000 Indian doctors have migrated overseas in the last three years. Quoting figures made available by the Medical Council of India, the minister said that doctors were going abroad to obtain higher qualifications and training or for prestigious assignments.

The diagnosis is clear: the Indian doctor is out. And he is practising his trade in other lands. "The UK and the US are the top two destinations for foreign-trained doctors," read a recent report by Ficci and health-care consultancy Hosmac. Canada and Australia are the other preferred destinations.

India's Headache

With many countries rolling out the red carpet for the best Indian doctors, India's problems of retaining top-notch medical talent is getting worse. Part of India's headache also stems from the growing disinterest of Indian students with the medical profession. "Working as doctors is not glamourous anymore. Young people are turning to more lucrative professions these days," says Charu Sehgal, senior director, Deloitte Touche Tohmatsu India, a consultancy.

Dr YK Gupta, the chief PRO at India's premier medical training institution the All India Institute of Medical Sciences (AIIMS), confirms that the number of students appearing for medical entrance examinations has been decreasing over the past few years. And the shortfall is felt the most in specialisations like nephrology, neurology and endocrinology.

"In India, we need 6-7 lakh more doctors and training them will take between five and 10 years. The huge gap between demand and supply did not happen only because of Indian doctors migrating to Western countries," says Dr Vivek Desai, MD of Hosmac. "The Indian government should think of local solutions to the human resources crunch," he adds.

According to estimates by the Task Force on Medical Education for the National Rural Health Mission, as of 2009-10, India had approximately 300 medical colleges admitting 34,595 students annually. India needs to open 600 medical colleges (100 seats per college) to meet the global average of doctors. Moreover, India produces 30,558 medical graduates every year while there are only 12,346 post-graduate seats available in various courses of all medical colleges, according to the Central Bureau of Health Intelligence. No surprise that the biggest draw for Indian doctors to move overseas is the huge domestic shortage of post-graduate medical seats.