India of today is facing a huge challenge in the public healthcare sector. The past few months have been seemingly harsh for the Indians. The legislation, executive, and judicial bodies are working vigorously to support the health infrastructure of the country.
Today, there is a huge number of people dying on the streets as they are unable to reach the hospital on time and a few who had managed to reach were not provided with the required medical attention and resources. The common cause is concluded to be the lack of resources in the present-day ‘modern’ hospitals.
Death is an omnipresent reality of the human race. But people dying without getting the required medical attention due to the lack of resources, especially when there is a huge chance that they can be saved is heartbreaking. Today, many hospitals are facing a shortage of beds, medicines, oxygen, machines, etc at a grand scale. These materialistic requirements, though can be taken care of by some monetary input by the Government of India and other non-governmental organizations there is an overwhelming requirement of the technically skilled human resources, i.e, doctors, nurses, technical and medical assistance, etc in the hospitals which requires immediate attention.
The handful number of medical staff is concerning and forces us to reflect on what went wrong. Is it because we don’t have enough people to aid our crumbling healthcare system? Certainly not. India is home to more than 136.64 crores of people. If we draw out the age pyramid, we find that it is of the constructive type, of a strong base, with more youngsters and a well-balanced population density of various age groups. Almost 65% of the population is below the age of 35. That means that there are enough human resources available in the country.
One might wonder that with such grand numerals why there are such a limited number of doctors in the country?
The possible answer probably lies in the working mechanism of the country itself. Sure enough, medicine is a profession of quality so under no circumstances it should be compromised. Probably that is the reason why the Government of India has made specific eligibility criteria for studying and practicing the profession in the country. With a limited number of seats available in the government medical universities, most of the students who qualify NTA NEET(UG) Exam prefer to study medicine abroad. When these students complete their studies are referred to as the Foreign Medical Graduates (FMGs).
These students are required to qualify for the Foreign Medical Graduate Exam (FMGE) which is a screening as well as a licensing exam in order to practice in India. At present, there are lakhs of FMGs currently available as an immediate help to the country for combating the pandemic.
A webinar was held discussing the “Role of FMGs in Corona Crisis and the NMC Draft 2021” on 30th April 2021, which witnessed the remarkable presence of Dr. Girdhar Gyani (Director General, Association of Healthcare Providers), Dr. Alexander Thomas (Founder member and President of AHPI, ANBAI, CAHO), Dr. (Mrs.) Reena Nayyar (Former Secretary, Medical Council of India) and Air Marshal Dr. Pawan Kapoor (Retd) (Vice-Chairman of Rus Education and Former Director of General Medical Service (IAF)).
All these virtuosos of the educational leadership and medical experts, unanimously agreed that the government of India should use this potential workforce at this time of crisis.
The panelist also reviewed the National Medical Council Draft (NMC) draft pertaining to FMGs.
Evaluating NMC Draft 2021 for FMGs
The experts as well as the students feel that many clauses of the NMC Draft 2021 for the FMGs fall into the contradiction of the NMC Act itself which states that NMC is the successor in interest for the Medical Council of India (MCI). Many students also raised their opinion that if the FMGs are eligible to practice in other countries why are they not being considered to serve their own nation.
The entire discussion highlighted four major points of improvement which can drastically help in strengthening our health infrastructure and skill requirements.
- During the question and answer session in the webinar, many FMGs volunteered to assist the nation in defeating the coronavirus without anything in exchange. The government should employ the FMGs to fight- off the Covid virus. They could facilitate the routine like triaging of patients, providing additional support in the emergency departments, assisting the medical professionals in Intensive Care Units, etc. In exchange, the government can provide them with some form of weightage in the coming FMGE. The government of India, however, can set up appropriate incentives, rewards or advantages for them. It could be in terms of advantage for qualifying marks, a letter of recommendation to facilitate their entry in the main steam health industry.
- The draft not only restricts the entry of Indian citizens into the mainstream but is also restrictive towards those who wish to come and practice in India as stated in NMC Draft 2021. The draft pinned by the NMC pertaining to FMGs should be revised immediately with the perspective of facilitating the entry of the FMGs into the Indian Healthcare Delivery system rather than restricting them.
- The draft also restricts the FMGs to qualify for the screening test (FMGE/ National Exit Test or NExT) within 2 years of completing MBBS abroad The Draft appears discriminatory towards the FMGs at various points throughout the document. As the entrance exam for the medical study (NTA NEET(UG)) and the exit exam (NExT) would be mandatory for all the medical graduates including those from India as well as overseas, it would not be appropriate to include additional and discriminative clauses exclusively for the FMGs.
- The government of India must ensure the proper facilitation of opportunity to FMGs especially pertaining to the internship and practice requirement for those who wish to serve the country.
From the entire discussion, it can be concluded that the public health care system is in urgent need of reformation from top to bottom at each and every level. This goal could only be achieved in the long run and does nothing to help the current crisis faced by the public. We as a nation have failed our mothers, fathers, daughters, and sons in providing them with the basic human right- the right to survive, the right to live.
It thus is extremely important for us to use every possible resource in the country against the pandemic. Lakhs of FMGs are potentially enriched with the skills required in the present times. Are sitting idle in their homes. Their years of study and skills are wasted. They wish to come and join the fight against the virus, serving their nation. They are willing to be used as assistance for the exhausted doctors, nurses, and health care workers. What they want in exchange is just an opportunity to use their knowledge and skills to serve their country. As far as the NMC Draft, 2021, it requires a thorough revision at many points as it should be more inclusive towards the FMGs.