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We need to discuss India’s reliance on private medical colleges

BMJ 2015; 350 doi: (Published 22 January 2015) Cite this as: BMJ 2015;350:h237
  1. Sanjay Nagral, consultant surgeon, Department of Surgical Gastroenterology, Jaslok Hospital and Research Centre, Mumbai 400026, India
  1. sanjaynagral{at}

Indian citizens need reminding that growing commercialisation in healthcare and medical education is linked to the corruption they experience in their healthcare encounters, writes Sanjay Nagral

In 1983, as a young intern, I helped lead a strike by junior doctors in Maharashtra to oppose a government proposal that would permit private medical colleges to charge “capitation” fees. These high one-off fees for admission were 100 times those of government colleges.

The strike brought the healthcare system to a crawl for three weeks and drew huge media and public support. Political leaders, student organisations, prominent citizens, trade unions, and senior doctors—including those from the Indian Medical Association—marched in solidarity on the streets of Mumbai. When the government agreed to re-assess the proposal we ended our strike.

Today Maharashtra has 21 private medical colleges. Of the 398 colleges offering the bachelor of medicine, bachelor of surgery (MBBS) degree throughout India, 215 are private and churn out about 27 000 graduates a year, outnumbering those from government colleges (25 000).1 Teachers trained in government colleges often move to private colleges for higher pay. Many private colleges are not affiliated with hospitals and rely on public hospitals for …

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