The document discusses issues with the medical education system in India and the proposal for an exit test for medical graduates. It notes that while the government wants to increase the number of doctors, many new medical colleges lack adequate faculty, which leads to ineffective education. Students often have to teach themselves, without proper clinical supervision. This results in graduates who are inexperienced in patient management. The document argues that an exit test is counterproductive without first strengthening the existing flawed system, which is compromised by inefficiency, corruption, and a lack of merit-based selection. Overall faculty numbers must increase before medical education can improve.

1. WHO CREATES THE BAD DOCTORS – DO WE NEED AN EXIT TEST?
Dr.T.V.Rao MD
Everybody wishes to have best possible treatments, irrespective economic status, as every
constitution guarantees a best possible approach to available treatment, Today we have no policy to
control the system, at one way government wants make any professional by giving little training and
can handle the patients with modern Medicine , which many IMA associations are protesting it
means the government itself is degrading the MBBS degrees and Medical education, however it is
true we are creating substandard Doctors in view of many compulsions in world of commercialized
profession, Improving the health of a common man is a Universal priority, every elected Government
should fall in line to show the citizens that health is a concern for them, they promise to find ways to
improve it. India continues to spend less on basic health care when compared with many of our
neighbouring Nations. India with mass population base of more than 1.3 billion can do little to date;
the existing Governmental system is compromised with politics, lethargy, and corruption. The vision
to start many Medical colleges in India in private sector has greatly changed the face of National
health in the last three decades. Many Institutes are recognized as centres of excellence and
produced many competent Doctors who are no less than Doctors created by the reputed
Government Institutions Recently there is sudden surge of several Medical colleges in private sector
Today Government is planning to initiate an EXIT TEST even for Indian Medical Graduated as
happening to Doctors qualified in China and Russia and Many other countries. Before taking a
decision on the EXIT TEST why they still creating new medical colleges without proper staff when
they know the facts, Most Medical colleges are functioning with 40-50% of the staff needed to
provide instruction at the most basic levels. So how do you provide medical education without
faculty? Not very well it turns out. Basic science and introductory clinical medicine modules can be
covered by traditional lectures. Today in many Medical colleges in the final year the students
become their own teacher’s Clinical work on the wards is largely unsupervised except for occasional
case presentations to instructors and unstructured work with registrars and house staff. Faculty only
appear on the wards twice weekly to participate in teaching rounds. This pattern continues into the
post-graduate years, where its effects are catastrophic. The predictable result is a graduate trained
in theory but inexperienced and uncomfortable with the intricacies of daily patient management. - It
is tempting to be critical of these practices, but once you’ve lived it for a while you realize that with
so few faculty there are not many other options. Improvement of medical education in resource-
limited environments does not lend itself to narrowly targeted, disease-specific interventions which
can be planned to fit budget cycles or development goals defined only by numbers of graduating
students. Until the number of faculty can be increased to adequate levels, the current pattern of
ineffective medical education will continue. Innovative programs have correctly analyzed the core
issues and are exactly on target. Theory students can even learn from Internet but who will develop
the MEDICAL CONSCIENCE and attitude of SERVICE and SACRIFICE, which are totally lost in our
education a Clinical professor has least time to spend few hours with the students to impart skills to
the future doctors - .But I think the world is sitting on a volcano of fraudulent teaching with skeletal
and unsatisfactory grossly deficient retired, tired and frustrated "TEACHERS”. Many of them are
hooted by students and they surrender and tell that they do not know teaching. I will be happy with
renowned faculty taking guest lectures and volunteers available sometimes globally who may opt for
helping the ailing resource crunched educational centres. - Improvement of medical education in
resource-limited environments does not lend itself to narrowly targeted, disease-specific
interventions which can be planned to fit budget cycles or development goals defined only by
numbers of graduating students. Until the number of faculty can be increased to adequate levels,

2. the current pattern of ineffective medical education will continue – The greatest down fall of our
degrees lies without poor practical assessment of our students. Many private management's asses
the teacher's capabilities to produce good percentage of results, every sincere teacher is a loser in
the present commercial system of education where managements market results as source of their
strength. There are several medical colleges started in the last 5 -10 years, waiting for social
judgments, and people are watching how they perform, and many substandard students awarded
degrees will spoil the reputation of their parent Institutions. We are certain to see many Medical
graduates produced in the substandard Institutes are harmful, non-competitive and bring in
dangerous trends in Medical Profession Several medical institutions which do not comply with ethics
and integrity will certainly face Darwin's law waiting to set right things. It is time Medical Council of
India should monitor the events and start Academic grading and continued performance based
support in need of crisis in upcoming Medical colleges, otherwise vision of elders making ours as
healthy Nation will be an unachievable dream. In my strong opinion I cannot blame the fault lies
with just Medical college managements the Unethical, greedy, substandard teachers too contributed
to down fall of the system of Medical education in India, Hope my voice is heard in good light, we all
elders wish to be treated by a competent Doctors. The Idea of EXIT Test to Medical Graduates is
counterproductive we are trying to question the system we have created, as MONEY MATTERS TO
RUN THE MATTERS? Many qualified Doctors from many Government colleges may demand the
definition of Merit and eligibility to be a Doctor? A TIME WATCH TO THE REPERCUSSION OF EXIT
TEST WITHOUT STRENGTHENING THE EXISTING SYSTEM WHICH IS LOADED WITH INEFFICIENCY,
CORRUPTION AND NO RESPECT FOR MERIT?
Ref Medical Education in Crisis: Training Doctors without Faculty - Stephen H. Humphrey
Dr.T.V.Rao MD Professor of Microbiology Freelance writer