Plan panel for 3.5-yr rural medical study

Updated on: Tuesday, September 27, 2011

The controversial three-and-a-half year long medical degree-—Bachelor of Rural Medicine and Surgery (BRMS)—has now got the backing of the Planning Commission’s all-powerful high-level expert group on universal health coverage.

The panel has in its report (finalised on Sunday and available with TOI) “endorsed” the all-new BRMS cadre and said as a career progression incentive, they should be promoted to the level of public health officers after 10 years of service.

According to the panel, by 2022, India should actually have BRMS colleges in all districts with a population of over five lakh. The course should focus on “high quality of competence in preventive, promotive and rehabilitative services required for rural populations with focus on primary health care”.

It also recommended that it should be mandated through legislation that a graduate of the BRMS programme is licensed to serve only in specific notified areas in the government health system.

‘BRMS not mini-MBBS degree’

The planning commission has backed the Bachelor of Rural Medicine and Surgery degree but clarified that it was not a mini-MBBS but rather a unique training programme aimed at the basic healthcare needs of its target population.

According to the Union health ministry, vulnerable populations in rural, tribal and hilly areas are extremely underserved. In 2006, only 26% of doctors in India resided in rural areas, serving 72% of India’s population. Another study found the urban density of doctors is nearly four times that in rural areas, and that of nurses also three times higher.

As of March 2010, undue delays in recruitments resulted in high vacancies even in available posts at health centres—over 34% of male health workers are not in position, while 38% of radiographer posts, 16% of laboratory technician posts, 31% of specialist posts, 20% of pharmacist posts, 17% of ANM and 10% of doctor posts are vacant.

Overall, human resources in health shortfalls range from 63% for specialists to 10% for allopathic doctors. The past few decades have also seen the disappearance of certain cadres-—village health guides and traditional birth attendants, first instituted in 1986. “They have now decreased to a point of nonexistence,” the report said.

The panel said, “The BRMS degree should be linked to state health sciences universities. BRMS students should be taught in local settings where they live and work and the faculty should be drawn both from existing teaching institutions and retired teachers. The faculty should include non-physician specialists from the fields of public health and social sciences.”

According to the panel, it is expected that full coverage of BRMS at the sub-centre will be achieved by 2030. In order to support the production of this cadre, the panel recommended the production of 172 BRMS colleges in phase A, 163 in Phase B and 213 colleges in Phase C.

Plan panel for 3.5-yr rural medical study

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