Will MBBS be passé soon?

Will MBBS be passé soon?

A cursory google search reveals that 84,000 plus MBBS seats are up for grabs every year. If government figures are to be believed, we’re on course to break past the minimum doctor-patient ratio of 1:1000 stipulated by WHO within the next 5 years . Here’s where things stand - In 2017, the minister of state for health informed parliament that the country had 10,22,859 registered MBBS doctors. That’s a doctor-patient ratio of 0.77:1000 for a population of 1.33 billion people. There were 67,000+ MBBS seats up for grabs then and 12,000+ of these seats had been added in just the last three years. And the trend seems to have continued apace since 16,000+ seats have been added in four years between 2017 and 2021. On average, 4000 seats are added every year. If the population grows by 1% every year, we would approximately need 14,000 doctors (at least in the foreseeable future) to maintain the doc-patient ratio. Assume that 8000 doctors retire every year (number of MBBS seats 50 years before). Assume an attrition rate of 10% (doctors who graduate but don’t practice medicine). Some back of the envelope calculation (67000-8000-6700) and we see that 50,000+ doctors are getting added to the ranks every year and this number only keeps growing (by roughly 4000 every year). The gap between the present doc-patient ratio and the desirable ratio of 1:1000 is just a little over 300,000 doctors. Given the current pace of growth, we’d reach the WHO stipulated ratio in 7 years from 2017, that is, in 2024 .

Even today, MBBS doctors are treated like chattel and assigned dreary shift-based jobs that don’t exactly pay well and require one to work long hours. What’s worse, some even work in clinics run by quacks. In urban and semi-urban areas, it feels like there is an oversupply of doctors already (thanks to the skewed urban-rural doc divide) and specialist clinics can be seen these days in almost every street corner. Most people don’t prefer consulting MBBS doctors anyway. And if one wants to do PG, the competition seems to be intensifying and getting harsher by the day (going by the accounts of fellow doctors).

But, this is not the only threat we’d face in the upcoming years. As a doctor and now an MBA student, it’s been quite the revelation for me to see a whole lot of tech businesses, startups, venture funds, and the likes eyeing the health care sector . From a profusion of teleconsultation apps to MI/AL solutions that promise to automate the fields of radiology/dermatology/pathology (pattern detection) and intelligent clinical reference apps that seek to at least partially replace physicians, tech firms are on a mission to stake out the healthcare market for themselves and ringfence profits. And, doctors are woefully unprepared to tackle this threat . As tech firms try to leverage our expert knowledge to their gain, physicians that are competent enough to deal with technological developments would fare much better compared to those that obstinately resist progress .

MBBS is very outmoded in terms of the education we receive to confront these new developments . We don’t learn stuff as preliminary as statistics, stuff like confidence intervals, statistical significance, hypothesis testing, etc. (essential knowledge one requires to make sense of clinical trials that inform practice and very critical in an era of big data where the volume of data from studies is fast becoming unwieldy) leave alone more advanced concepts like medical AI/ML. Perhaps, there should be a greater thrust in this direction while we also focus on adding more PG seats (comes with its own set of challenges, but that’s for another day).

In my opinion, it’s an uphill task for doctors to upskill, committed and driven as we are, after devoting so much time to the medical profession. However, I deem it all the more necessary, given the threats confronting us. What do you think?