Abolish seat leaving, compulsory rural service bonds instead give positive incentives: NMC task force on mental health

New Delhi: The 'National Task Force on Mental Health and Well-being of Medical Students', set up by the National Medical Commission (NMC) has opined in its report that seat-leaving bonds and compulsory rural service bonds should be abolished.

As an alternative to the seat-leaving bond, the Task Force has suggested prohibiting such students from applying to medical colleges for twenty-four months from the date of leaving.

For the compulsory rural service bonds, the NMC Task Force has recommended transitioning it from compulsory service to a system of positive incentives such as paying higher fees for service in rural areas, granting grace marks, providing reservations in PG or super-specialization seats for completing rural service etc.

"Abolishing seat leaving fees/bonds and a compulsory rural service bond is imperative. The government should offer positive incentives that can reduce financial pressure and encourage public health services," the National Task Force on Mental Health and Well-being of Medical Students mentioned in its report.

NMC Anti-Ragging Committee had set up the National Task Force to study existing literature and data on the mental health of medical students and propose evidence-based strategies for improving the same.

This Task Force had initiated an online survey, collecting data from medical students, faculties, and administrators regarding mental health history, workload, overall stress level, etc. More than 37,000 medical students had submitted their responses to the government authorities, indicating that they were suffering from mental stress.

Analyzing the data received in the online survey, the NMC Task Force mentioned in its report that about half of the PG students i.e. 2747 (51.5%) report stress due to the PG seat leaving bond, indicating a potential area for policy adjustments and less than half 1998 (37.4%) of the PG students reported stress due to the rural service bond.

Policy Adjustments Regarding Bonds: 

"Abolishing seat leaving fees/bonds and a compulsory rural service bond is imperative. Medical students who abandon their seats after admission should be prohibited from applying to medical colleges for twenty-four months from the date of leaving. Additionally, medical colleges can fill the vacated seat (UG/PG) in the same category (Government/Management Seat) as the student belonged to in the next upcoming calendar year," the Task Force mentioned in its report.

Seat leaving bond: 

The Task Force noted that the policy requiring students to pay a bond if they vacate their medical college seats (both UG and PG) was implemented when the medical seats and doctors were scarce. However, the report mentioned that with the current availability of medical seats and doctors for hiring, "it is high time to reconsider this policy".

"The financial pressure imposed by the seat-leaving bond creates a punitive environment that detracts from the overall educational experience," it opined.

Compulsory Rural Service Bond: 

The Task Force noted that the compulsory rural service bond was initially established to address the shortage of doctors by mandating service in underserved areas. However, with the current adequacy of medical professionals and improved availability of healthcare resources, it is appropriate to reevaluate this policy, it noted.

"States continue to rely on this compulsory method to compensate for inadequate investment in health resources, playing with the lives of medical students, and public health safety at large. This approach should be avoided as a perpetual solution, as it places undue strain on public health and fails to address the root issue of resource allocation in the healthcare system. States must invest adequately in health infrastructure to sustainably meet public health needs without relying on compulsory service bonds. To alleviate the financial burden on students and foster a more nurturing educational setting, it is proposed to abolish both the seat leaving and compulsory rural service bond," the Task Force mentioned in its report.

Positive Incentives Instead of Rural Service Bond: 

As an alternative to the compulsory rural service bond, the NMC Task Force has recommended initiating positive incentives by paying higher salary for rural service, granting grace marks etc.

"Transitioning from compulsory service to a system of positive incentives is recommended. Alternatives include higher pay for service in rural areas, granting grace marks, providing reservations in postgraduate or super-specialization seats for those who complete their rural service, offering adequate incentives, income tax rebates, and excellent facilities," the report mentioned.

As per the Task Force, this approach aims to create a more encouraging and supportive environment for fulfilling public health service requirements, moving away from the current compulsory methods that may not effectively motivate medical professionals.

"Both the compulsory rural service bond and Seat leaving bonds should be reconsidered and removed at the earliest opportunity. Furthermore, any unethical practices, such as withholding documents or refusing to declare student results due to non-payment of bonds, are not supported by the NMC. Appropriate actions will be taken against entities engaging in such practices," the Task Force mentioned in its report.

Earlier this year, the Apex Medical Regulator NMC had already directed the State/UT governments to reconsider the seat leaving bond conditions for the PG medical students.

The Anti-Ragging Committee of NMC had recommended the State/UT to review the seat-leaving policy in medical colleges in an attempt to address the mental health concerns of PG medical students. Medical Dialogues had earlier reported that as an alternative, NMC had recommended that the States may consider debarring the students for admission in their States for the next one year.

Also Read: NMC considering to relax bond policies: Report