A Pakistani doctor may treat you in the near future!

In 2029, Kavitha dials a corporate hospital in Bangalore to schedule an appointment for her father for treatment for his heart issues. The scheduling manager apologises and states that the appointment cannot be scheduled, as a flight from Karachi to Delhi has been cancelled due to bad weather conditions. When Kavitha insists and asks more questions, she is told that the treating surgeon had gone to her home town and is stranded in Karachi.This might happen to any of us in India in the next 10 years. The reason is that due to the shortage of doctors in India, medical professionals may be recruited from neighbouring countries and a few African countries.

In the recent past, in India, it was a trend among kids and teenagers to dream of becoming doctors. Similarly, medicos aimed to study further and become specialists such as cardiologists, cardiac surgeons, and neurosurgeons.However, even in 2019, hundreds of seats remain vacant in super speciality courses including cardiac surgery, paediatric surgery, brain surgery, and cardiology.I have been noticing this trend for the past 5 years. Another alarming trend is that every year, the number of seats and the areas of medicine with diminishing interest from students have increased. This is the trend even in popular MD and MS courses across all branches, and surgical specialties including obstetrics-gynaecology and orthopaedics are the most affected.

What is the reason for this negative trend?

So far, no randomised control study has investigated the cause. Thus, I take the opportunity to discuss a few possible causes, including conventional demand and supply scenarios.Youngsters have realised that this is the best time to be an entrepreneur, an investment banker, an entertainer, or a corporate lawyer. The press has speculated that physically demanding branches of medicine have lost their sheen. I also would like to state that it takes nearly 15 years of relentless hard work to learn the basic tenets of neurosurgery/cardiology or to gain expertise in similar fields. Moreover, when one has devoted a large amount of resources to becoming super specialists over the years, diminishing returns add misery.The large amount of resources required, high risks, and low rewards prevent doctors from opting for these courses.It is indisputable that our large population requires a large number of qualified specialists.It is also a common practice to refer to WHO recommendations on health indicators. Numerous other parameters are also measured in the healthcare system, and only increasing the absolute number of specialists cannot solve the problems in the healthcare system.

Lack of infrastructure in general and medical infrastructure in particular has led to the nonuniform distribution of healthcare, with healthcare resources skewed toward urban and semi-urban areas.In addition, on entering these courses, one may not receive optimal training during the course period.Favouritism and nepotism are still prevalent in medicine, and surgical trainees are heavily dependent on seniors to acquire the necessary skills.

The professional lives of specialists are associated with challenges such as a litigious society and the dangling sword of consumer court. Long and stressful working hours and night calls are other challenges faced. The widely prevailing and increasing potential risk of verbal and physical abuse by patients and families as well as by attendants add to mental stress among specialists.In general, the best candidates prefer to receive training in government institutes due to the variety and intensity of exposure. However, the downside is that one has to serve a 3-year tenure in rural areas on completion of the training, where there is a lack of optimal infrastructure. To break the bond (an unlikely event now), one has to pay 30 lakhs to the government.

To ensure a work–life balance, most medical students choose other lifestyle branches. Because the healthcare system is neither patient-centric nor doctor-driven, students seek practical options. Insufficient recognition, low autonomy, and low satisfaction have led to the perception of exploitation among doctors.

A few of them also realise later that they do not even get the recognition they have longed for. After all, doctors are not called doctors anymore but healthcare professionals!!