70 percent MBBS doctors skipped Bond Service in past 3 years in Gujarat
Ahmedabad: In a shocking revelation, the Gujarat Government recently informed the State legislative assembly that around 70% of MBBS students who graduated since the academic year 2020-2021 have skipped their bond duty.
As per the Government data, a total number of 2,653 MBBS students passed out from the government-run medical colleges since 2020-2021. In exchange for getting subsidized medical education, these students sign a bond at the time of admission with a promise to serve for one year in government-run health facilities located mainly in rural or remote areas.
However, in the recent State legislative assembly, the State informed that 70% of these MBBS graduates i.e. 1,856 students have not joined government-run facilities.
The State Health Department shared this data while responding to the questions raised by Kirit Kumar Patel, MLA from Patan, and Dinesh Thakor, MLA from Chanasma.
The Health Department further revealed that out of these 1,856 doctors who did not join service in government health facilities, 70% i.e. 1,310 doctors have not yet paid the bond amount. Currently, this due amount is rs 65.4 crore.
As per the latest media report by the Times of India, experts have opined that a shortage of medical officers (MO), who are generally MBBS graduates, may affect the availability of human resources especially when the State is planning to increase the healthcare infrastructure at district levels.
Senior officials at the health department told the Daily that the supply of health professionals at government-run health facilities is ensured through the bond service system.
The Daily adds that out of the 872 MBBS graduates 57% i.e. 872 students did not join the service in 2022-2023. The ratio was higher at 75% and 84% in the academic years 2020-2021 and 2021-2022 respectively.
Commenting on this, a senior health department official told TOI, “One of the reasons for not joining duty and paying bond amount could be students opting for medical PG course. A procedure is already in place to recover the pending amount from the students who have not served the period.”
However, some of the districts attract relatively fewer number of doctors compared to the others. For instance, 34 out of 57 doctors, who were assigned duties at Chhota Udepur with a predominant tribal population, skipped their duties in 2022-2023. In the case of the arid Kutch region, 43 out of 61 doctors skipped their bond duties.
According to experts, the trend forces the population in several such pockets to travel far to get access to basic medical procedures. This ultimately increases the burden of the city-based hospitals such as the facilities in Ahmedabad and Surat.
Commenting on the issue, a former Junior Doctors Association-Gujarat president told TOI that one of the major reasons is unclear policy and the appointment being perceived as "punishment posting".
“I was assigned to a CHC in Jamnagar district where there was only three bus services daily. If you miss the last bus to Jamnagar, you have to stay at the facility. Right from human resources to medicines, the junior doctors face issues, and some consider it a waste of time due to lack of learning curve,” said the student leader.
“Many also start preparing for the NEET PG exam and decide not to take appointments. If you get PG admission, the period is waived,” added the student leader.
Previously, the MBBS graduates were required to sign a bond of Rs 1.5 lakh for the three-year bond service. Changes were introduced during the COVID pandemic and currently, the students have to serve for one year at a government health facility chosen by the Health Department or pay Rs 10 lakh as penalty. Often, these bond postings are given in remote locations or rural areas at Public Health Centres (PHCs) and Community Health Centres (CHCs).
Medical Dialogues had previously reported that earlier this year, the State Government of Gujarat formulated a new bond policy for doctors who fail to adhere to their service bonds after completing both MBBS and Postgraduate medical courses.
The state had proposed to allow such doctors to serve for only one-and-a-half years instead of the mandatory service of two years. The State Health Minister Rushikesh Patel had mentioned during the Question Hour at the State Assembly, "We are going to make a new policy wherein we will allow a student who has completed both MBBS and PG to serve (in the rural areas) for 1.5 years instead of the two years. Or else, the student has to pay Rs 20 lakh bond fee for MBBS and Rs 40 lakh for the PG course for freeing from the bond."
Last year, the Gujarat State Government had informed the assembly that around 67% of MBBS doctors skipped bond service duty in the last two years. Providing exact figures, the government had informed that only 608 out of 1,879 MBBS doctors reported for duty in 2020 and 2021 and the Government had to recover an amount of Rs 38.15 crore from those absent doctors as bond payment.
