Meeting Specialists Shortage, Dr VK Paul Calls for Support for DNB Programmes

New Delhi: Addressing the shortage of specialists in the country, Dr V K Paul, a NITI Aayog member, recently stressed the importance of DNB programmes to create a speciality workforce in India and deal with the shortage.

"DNB programmes are so important for our nation's journey to create a workforce, the speciality workforce that we all should put our weight and time behind if possible," Dr. Paul said.

"The reason is very simple. Postgraduate seats have been more than doubled from about 32,000 seats to 70,000 seats. And this momentum is being made, maintained because there has been a severe deficit for speciality workforce," he added while addressing the 64th Annual Day celebration programme of the National Academy of Medical Sciences (NAMS).

Shortage of Specialists: 

Dr Paul pointed to the World Health Organisation's norm of having 1 doctor per 1000 population and mentioned that India is trying to secure a place where the country will have 3 doctors catering to the needs of 1000 patients. Despite this, there is still a severe shortage of specialist doctors, he explained.

Describing this issue in detail, he mentioned, "If the overall (healthcare) workforce is 1 per 1000 (WHO norm), and we are pitching to move to 3 per 1000, we already were at about 1 and with AYUSH workforce we are 1.4. But when you look at the gradient for specialities, for most specialities, the gradient is where we need 3 to 4, we have 1 specialist."

"That gradient difference is much more acute for several specialities even to reach the level of not a developed nation, but one level below that, it would take 25 years, 23 years, 79 years for some specialities," he added.

Full View

Also Read: Shortage of faculty in India is twofold- Lack of inclination to teach at college level and Genuine shortage: Parliamentary Panel

"Each bed potentially is a teaching bed": 

While discussing the possible solutions to deal with the deficit of specialists in the country, Dr. Paul stressed on the contribution of the private sector towards medical education and the importance of utilising the available beds in the private sector and converting them into teaching beds.

He mentioned, "We need to bridge this (gap) because this nation expects speciality care. Now, in the NMC-driven medical College system, huge improvements have been taken place, infrastructure has been built. This takes time. You build up medical colleges, then a few seats are created, some more specialities are created and so on. That journey will go on. But, at the same time, we have 7 lakh beds in the private sector and all are teaching beds potentially."

Dr. Paul explained that each private hospital bed has the potential to serve as a teaching bed with the availability of faculties. "From these 7 lakh we only have 12 to 13,000 seats. Each bed potentially is a teaching bed. What you need is one person eight years PG after MD and another five years MD and you can start teaching them formally and lead them up to degree and two seats are given," he said.

Urging the medical fraternity to support the DNB programmes, Dr. Paul added, "Make it the best way of doing it. PG training is apprenticeship. This is how it happens in UK, for example, which we often draw example of."

"So I urge that formally make it a part of DNB system so that the postgraduate DNB students across a territory and more, and there could be many cells doing this, are embraced into this. They all come, they study and it's more about practical training. It's not about theoretical training. That's possible because it's hands-on that makes a difference and wonderful teachers can contribute," he further mentioned.

Medical Dialogues had last year reported that the Rural Health Statistics Report 2021-2022 had revealed that the rural healthcare services in India were affected by an acute shortage of specialist doctors, with around 80% shortfall of specialists at Community Health Centres (CHCs).

While CHCS must be manned by four medical specialists i.e. Surgeon, Physician, Obstetrician/Gynaecologist, and Pediatrician, the report revealed that there was a shortfall of 83.2% of Surgeons, 74.2% of Obstetricians & Gynecologists, 79.1% of Physicians and 81.6% of Pediatricians. The report mentioned that overall there was a shortfall of 79.5% of specialists at the CHCs as compared to the requirement for existing CHCs.