India will meet the World Health
Organization’s (WHO) recommended norm of one doctor per 1,000 people by the
year 2028. This conclusion has been arrived at by the Planning Commission’s
high-level expert group (HLEG) on universal health coverage (UHC), headed by Dr
K Srinath Reddy. However, achieving this target will be contingent upon setting
up 187 medical colleges in 17 high-focus states during the 12th and 13th five-year
plans.

The HLEG estimates that the number of
allopathic doctors registered with the Medical Council of India (MCI) has
increased since 1974 to 6.12 lakhs in 2011, which translates to a ratio of one
doctor for 1,953 people or a density of 0.5 doctors per 1,000 people.

Presently, India has a density of one
medical college per population group of 38.41 lakhs. There are 315 medical
colleges in 188 of 642 districts. The lopsided distribution is accentuated by
the fact that there is only one medical college for a population of 115 lakhs
in Bihar, 95 lakhs in Uttar Pradesh, 73 lakhs in Madhya Pradesh, and 68 lakhs
in Rajasthan. Kerala, Karnataka, and Tamil Nadu each have one medical college
for a population of 15 lakhs, 16 lakhs, and 19 lakhs, respectively.

The HLEG estimates that by 2015, 59 new
medical colleges will come up in 15 states – namely Assam, Bihar, Chhattisgarh,
Gujarat, Haryana, Jammu and Kashmir, Jharkhand, Madhya Pradesh, Maharashtra,
Meghalaya, Orissa, Punjab, Rajasthan, Uttar Pradesh, and West Bengal. By 2017,
13 of these states will have an additional 70 medical colleges. Further, 58
institutes will be built in two phases of 2017–2020 and 2020–2022.

By 2022, India will have one medical
college per 25 lakh population in all states except Bihar, Uttar Pradesh and
West Bengal. This will mean the additional availability of 1.2 lakh doctors by
2017, and another 1.9 lakh doctors between 2017 and 2022. ‘With this rate of
growth, it is expected that the HLEG target of one doctor per 1,000 will be
achieved by 2028,’ the report says.

The report further recommends that along
with establishment of new medical colleges, the admission capacities of
existing colleges in the public sector should be augmented as well.
Partnerships with the private sector should be encouraged, with conditional
reservation of 50 per cent of seats for local candidates, fixed admission fees,
and government reimbursement of fees for local candidates. The revised MBBS
curriculum proposed by the MCI should be revisited if required, in order to put
greater focus on preventive, promotive, and rehabilitative healthcare.

“Measures such as a compulsory posting
of one year for all MBBS graduates immediately after internship, with 10% extra
marks weightage for one year of rural service and 20% extra marks for two years
of rural service in the post-graduate entrance examination should be
included,” the report suggests.

The World Health Statistics Report (2011)
says, the density of doctors in India is six for a population of 10,000. India
is ranked 52 among 57 countries facing human resource crunch in healthcare.

Between 2001 and 2005, India had a doctor:
population ratio of 0.5 per 1,000 population in comparison to 0.3 in Thailand,
Sri Lanka (0.4), China (1.6), the UK (5.4), the US (5.5) and Cuba (5.9).

The nation has the largest number of
medical colleges in the world, with an annual churning rate of over 30,000
doctors and 18,000 specialists. However, the average annual output is 100
graduates per medical college in comparison to 110 in North America, Central
Europe (125), Western Europe (149) and Eastern Europe (220). China, which has
188 colleges, produces 1,75, 000 doctors annually, with an average of 930
graduates per institute.

Picture: Patients queue up for registration at a charitable hospital in Rajasthan