Intended for healthcare professionals

Feature Postgraduate Education

Rural postings: controversy in Indian specialists’ training

BMJ 2014; 348 doi: (Published 10 January 2014) Cite this as: BMJ 2014;348:g54
  1. Jaimon Joseph, freelance journalist, New Delhi
  1. jaithemon{at}

Many medical school graduates are furious about new government rules that say they must spend a year in a rural post before they can start postgraduate training, but is working in the villages really so bad? Jaimon Joseph reports

It was after Navneet Motreja got his undergraduate medicine and surgery degree in 2012 that the epiphany hit. It had been a five and a half year slog to become a medical doctor. Yet it would take at least as much study again to become the sort of superspecialist that hospitals want.

Motreja did not mind the grind. But the problem was that there was no guarantee he would make it. About 50 000 students enter India’s undergraduate medical programme every year. Only 40 000 graduate. Most apply for higher studies. But only 22 000 postgraduate seats are on offer each year. Some 12 000 of those are the most coveted—in specialties such as surgery, gynaecology and obstetrics, and paediatrics.

In the unified postgraduate entrance examination held throughout India in 2012, roughly 100 000 doctors fought for those 12 000 seats. Many had sat the examination several times before, in the hope that one day they would enter the big league.

There are 10 000 other seats, of course, in subjects such as biochemistry, pathology, microbiology, and pharmacology. But because they are more laboratory oriented and do not involve direct interaction with patients, many aspiring doctors give them a miss.

Motreja realised that he would probably waste his youth just waiting in the wings. Why couldn’t the government even the odds a bit and increase the number of postgraduate seats in medical colleges?

“Increasing the number of PG [postgraduate] seats need not take years of planning. Right now, one professor teaches only one PG student per year in India. Allow two or three students to train under a …

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