PG med courses: Why stipend disparity remains a pain point for doctors

Reacting to a media report highlighting the massive discrepancy in stipends paid to doctors pursuing specialised (post-graduate) courses in private and government medical colleges based on National Medical Commission data, leading doctors in Delhi confirmed that it is true and highlighted some larger issues plaguing India’s medical education.

The data came from a nationwide survey carried out by the apex medical regulatory authority to determine what kind of amount medical interns and postgraduate students receive as stipends in private medical colleges. It took the decision earlier this year after concerns were raised that many are denied a stipend or receive paltry amounts.

How to ensure parity

Dr Amarinder Singh Malhi of the Department of Radio Diagnosis & Interventional Radiology, AIIMS, Delhi, agreed that the stipend offered to interns who have completed their MBBS courses but haven’t yet enrolled for a PG course and that offered to doctors pursuing specialised (PG) courses varies.

Also read: Equal number of UG and PG medical seats in 3 years: Officials

He added that this variation is quite noticeable within private and government colleges within a state and also between those run by state governments and those by the Centre.

“Since health is a state subject, it is up to the state governments to allocate funds under healthcare. It can ensure parity within state-run and Centre-run colleges. As far as the huge difference in the public-private realm is concerned, the National Medical Commission needs to come up with a strict framework to ensure parity,” said Dr Malhi.

Factors affecting parity

The disparity in stipends can be attributed to areas of specialisation, too, said Lokendra Singh Rathore, a post-graduate student in general medicine at Dr SN Medical College in Jodhpur, Rajasthan.

“I am getting a stipend of Rs 18,000. Although the amount is very little, I am looking at the positives of the course. I am confident that holistic learning during my three-year course will compensate for the low stipend. I keep motivating myself by looking at the bigger picture,” he said.

Dr Shipra Anand, former assistant professor at Baba Saheb Ambedkar Medical College & Hospital, attributed the stipend disparity to the differing payout structures within states too. Within a state, the stipend amount is usually the same, but government colleges in different states pay different amounts as stipend.

“I experienced it during my specialisation days, when I compared my stipend with my sister who was pursuing post-graduation from a different state,” recounted Dr Anand. However, she pointed out that colleges run by the Centre have a uniform payout structure.

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Huge variation

Insisting on confidentiality, a medical officer in Delhi’s Safdarjung Hospital concurred that many private medical colleges offer no stipend at all to their resident doctors pursuing specialised courses.

“The amount of stipend may vary from Rs 15,000 to Rs 1,00,000. Central medical colleges and most state varsities pay their resident doctors a decent amount, although we see a huge variation among the states. Complaints of lower stipends usually come from medical colleges in the southern states. In the north, there have been complaints of Punjab offering the lowest stipend. It goes as low as Rs 10,000 at some state varsities in Punjab,” said the officer.

Commenting on the huge difference between the stipends paid in government and private medical colleges, Dr Tarun Sahni, consultant, Internal Medicine, Indraprastha Apollo Hospital, said most private colleges offering PG seats decide on the stipend amount arbitrarily. The management takes a call on the amount, which is often much less than the average amount paid by government medical colleges.

“It is ironic that, on the one hand, we complain of a severe shortage of doctors and, on the other, there is very little incentive for students to pursue specialised branches of medicine. The larger issue is that private institutions are mostly the second choice for medical students. They seem to be driven more by the aim of getting a PG degree as they shell out a large sum of money,” said Dr Sahni.

As far as setting a basic framework for private medical colleges is concerned, India’s apex medical regulatory authority must look into this disparity. It can be addressed only at that level, stated Dr Sahni.