The Indian education system's obsession with ranks and percentages has permeated into most professional and academic tracks. Medicine, which is a highly sought-after career in India,perhaps bears the biggest brunt.
Medicine has a higher barrier to entry because of the abnormally long time commitment one is required to make. Further, it leaves little room students to experiment or explore different subjects apart from the foundational education, or what is called the MBBS. For the most part, it even demands specialization. But specialization should not translate to an accumulation of degrees, because simply accumulating degrees does not guarantee a better doctor. This is where the root of the problem lies.
Much like India's education system at large, the medical fraternity places undue focus on ones 'qualifications' and marks. Those who set their minds on the medical profession participate in one rat race after another. After completing an MBBS, one begins the race to grab a seat for a post-graduate degree. Unlike other professions, such as law or engineering, a graduate degree is necessary. The entrance exam for those seeking to pursue an MD in India consists of 20 subjects including Anatomy, Pharmacology, Ophthalmology and Surgery. One's rank in the exam determines whether they will land a seat in one of the medical institutions or not. If you don't make it -- which is likely given the competitive nature of the exam -- the options involve diversifying one's skill set by pursuing a Masters in Public Health (MPH) or business administration (MBA), exploring the world of medical business, or even social work in the field of healthcare. Some may find their calling in these career paths, but for others this is still alternative to their original intended path of pursuing an MD.
The idea that one's career is determined on the basis of a single exam is not an uncommon feature in the Indian education system. But for a profession as vital as medicine, the cutthroat competition naturally creates a strain on the number of good doctors in India. It is no surprise that the brain drain of medical students is one of the highest. Of course, going overseas may not be an option for all, and so many attempt the exam numerous times before settling for another career. Those who come from families of doctors may still have their family's practice to fall back on, while others may pay exorbitant fees to reserve a seat in a good institution. This phenomenon has adverse implications for a system that is intended to filter students on the basis of aptitude.
Judging whether somebody will make a good doctor and is actually qualified to handle the lives of other people on the basis of their marks in a single exam not only places immense pressure on a student, but completely disregards one's genuine passion for the field of healthcare. While most are quick to point out the difference in terms of medical facilities between India and the U.S., a more striking distinction is that between the medical fraternities of both countries. Abhishek, who had the privilege of gaining practical exposure in the U.S. whilst completing his MBBS in India, an increasingly common phenomenon, was struck by the warmth and compassion that doctors exude at the hospitals where he worked. The cutthroat competition in India creates a sense of entitlement among the few who do succeed. This prevents a strong sense of camaraderie within the medical fraternity, which is a distinctive feature of the U.S. medical environment.
The process of applying for a residency program in the U.S., while perhaps as competitive is more holistic. It involves the United States Medical Licensing Exams -Step 1, Step 2 Clinical Skills, Step 2 Clinical Knowledge and the Step 3 exams -- which places less pressure on a student to perform one a single day. Further, it involves a personal statement where one is able to clearly express his/her thoughts, insights and experiences. It is not just a cumulative assessment of one's marks and qualifications, but one's character. The Indian education system does not force students to think about why they want to pursue medicine, or what motivates them to specialize in their chosen field. India's health system faces several challenges today, and to resolve them we don't just need students who are 'qualified' to practice medicine, but those who are passionate about the field. We need enthusiastic individuals who deeply care about addressing the lacunae in our public health system. The admission process needs to evolve in order to be able to provide India with more passionate doctors.