Medical Seats Saga

 Why is there such a huge mismatch between the number of medical seats and the number of kids applying for them? Going by instinct alone, and from what we hear from parents of kids, well, that approach doesn’t get us to all the right reasons, I realized as I read Pranay Kotasthane’s post.

 

Few, he says, talk of the topic dispassionately:

“Ask anyone about MBBS education in India, and they will launch into a tirade about how the “commercialisation” of medical education has turned it unaffordable.”

 

But let us be more analytical than emotional. Prices are high because the demand is far greater than the supply. Usually, when such a condition exists, more producers enter the market, i.e., more medical colleges should have opened up. So why didn’t that happen?

 

Because nobody wants us every Tom, Dick and Harry to open medical schools, do we? What kind of doctors would we end up with? Obviously then, regulations are needed on the criteria to open medical schools. The Medical Council of India (MCI) was asked to do that job. It made sense, since the MCI is run by doctors. Unfortunately, it created a conflict of interest since the MCI also regulates the medical profession (practice). Doctors wouldn’t exactly want to increase the supply of doctors – scarcity is good for them, professionally speaking. So quite often, the regulations are excessive. While nobody can argue with the regulation calling for the college to be attached to a hospital, why should auditorium size be a regulatory constraint? Or campus size?

 

Next, the regulations become even more stringent the larger the number of seats in the college. So everyone prefers setting up smaller colleges whose intake is fewer students. And then they settle at that level. Or if they can increase the size, they don’t (too much regulations, remember). Instead, it’s easier to set up a new college! A new, small one, of course. Which is why India, unlike other countries, has so many medical colleges with such small seat intakes.

 

Another option, as you might have guessed, is to have the power to bypass regulations. Which explains why so many politicians open medical colleges. Who has more power than them to stare down regulators? A bad system sets off second order consequences, which we then mistake as the root cause.

 

With so few seats, a multitude of coaching institutes explodes, which further increases the effective cost of medicine for students. The amounts involved in the entire system (coaching, tuition) is so high that, inevitably, those hacking the tests, leaking them becomes lucrative…

 

While there is no easy solution to this, at least I can conclude that the knee-jerk to blame one actor alone is hardly the right response.