A student of post-graduation in general surgery at a government medical college in Madhya Pradesh was not granted leave when his father was hospitalised after a road accident. His seniors said he should either provide a substitute or resign. The student resigned in distress. The untimely resignation, however, came with a hefty bill. He had to pay Rs 30 lakh “seat leaving bond” from his father’s retirement funds.
Another first-year PG student of obstetrics and gynaecology at a private medical college in Maharashtra had to pay a “hefty amount as a seat leaving bond” when she wanted to leave the course because of low patient load in her department. She had worked at a government medical college during her internship and knew that the number of patients at her private college were not enough for a well-rounded education. According to norms, medical colleges have to ensure a minimum patient load in every department for proper training of students.
Seven such case studies of students pursuing their post-graduate medical education were highlighted by the country’s apex medical education regulator, National Medical Commission (NMC), to urge states to relook at their bond policy and do away with it.
Five of the seven students whose cases were highlighted by the NMC complained of toxic work environment, ill-treatment by seniors, or no leaves granted to go home. PG medical students work in hospitals associated with their medical colleges as junior residents as part of their training. Resident doctors are the backbone of medical college hospitals and take on most of the clinical workload.
“On behalf of the National Medical Commission’s Anti-Ragging committee I am requesting you to kindly review the seat leaving bond policy in medical colleges in your state at your level and do away with the seat leaving bond policy… An action taken report by your government on this issue will be highly appreciated,” says a letter to the principal health and medical education secretaries of all states from Dr Aruna Vanikar of NMC. The letter states that it will create a supportive and nurturing environment for the students and enhance their mental health.
The seat leaving bonds were meant to discourage abrupt resignations, seat blocking, and wastage of PG seats.
Chairman of Federation of All India Medical Associations (Faima) Dr Rohan Krishnan said: “There are very different bond policies across states, but most demand lakhs of rupees to ensure that students do not leave their seats or they provide services in the rural areas after their training. For example: Kerala charges around Rs 50 lakh. This can be very challenging for students who may want to quit for genuine reasons.”
He said: “We are not against mandatory rural service after one completes their training, but students should not be forced to pay the hefty sums if they need to quit because they cannot keep up with the course work, the college does not provide adequate facility, they are not comfortable with the subject, or they are being harassed.”
Dr Krishnan said that the dropout rate in post-graduate training for technical subjects stands at 20 percent to 30 percent, but for medical training it is very low because many are forced to stick with the course for the lack of resources to pay the bond.
The letter from Dr Vanikar states: “The case studies given … are of those lucky ones whose parents could support their wards by bearing the financial constraints but the unlucky ones may commit suicide in such mental health condition.”