PG Medical students suffer due to disparity in stipends

PG Medical Students Suffer Due To Disparity In Stipends

While the stipends issue is a state subject and tends to be nonuniform across states, the NMC can have a grievance redressal system for students to voice their complaints

Rajlakshmi Ghosh | 

Posted September 12, 2023 09:47 AM

The National Medical Commission (NMC) has issued an advisory recently, warning private medical colleges against withholding the stipends of their postgraduate medical students, following its survey that revealed over 26% of students have not been paid. The medical regulator has warned of strict action if provisions of the PG Medical Education Regulations (PGMER) 2000, are violated by the self-financed/private medical colleges.  

The PGMER 2000 states, “The postgraduate students of the institutions which are located in various States/Union Territories shall be paid remuneration on a par with the remuneration being paid to the postgraduate students of State government medical institutions/Central government medical Institutions in the State/Union Territory in which the institution is located.” 

Experts are of the opinion that the NMC must not take a soft stand on the issue, and while its advisory may have cautioned the institutes, no mention is made about the arrears that need to be paid to the students.   

Balancing act 

Talking to Education Times, a health ministry official on condition of anonymity says, “The anomaly is more prevalent among the private medical colleges and the DNB ( Diplomate National Board) institutes/colleges, and not in the government institutions where budgets are sanctioned, and policies are more streamlined. Often, private entities tend to be exploitative, and they do not pay decent stipends to their interns and PGs as part of their cost-cutting strategy.”  

“Even though the assessors from NMC conduct checks and report discrepancies to the regulatory body for issuing warnings, these institutions have developed mechanisms to outsmart the system. On paper, it may look as if they are paying the requisite stipends, but it is being taken back from the students through fee hike, which is how the issue of ‘returning’ the money arises,” he says.  

Ethics cannot be enforced by law, and an institution which is transparent in its dealings will always attract quality students, the official says, suggesting that the NMC can have a grievance redressal system where students who are otherwise terrified of lodging complaints, can voice their plight. “The NMC, a couple of years back, had issued an advisory that fees of 50% private medical seats should be at par with those paid to government medical colleges, but no institution, it appears, has implemented it,” the official adds.    

State subject 

There is a lack of parity in stipends even among government medical colleges, which is because the stipends issue is a state subject and tends to be nonuniform across states. In Andhra Pradesh, the stipend is around Rs 48, 973 for third-year NEET PG students, in Arunachal Pradesh it is around Rs 29,000 and in Delhi, it goes up to around Rs 1,16,673.  

“As per the central residency scheme, stipends paid to the PGs for all central government institutions such as AIIMS, Safdarjung Hospital, Ram Manoharlal Lohia Hospital, Lady Hardinge Medical College etc, are fixed and at the highest level, though there is no provision for private practice. If junior residents post MBBS earn around Rs 80,000 as stipend, senior residents earn around Rs 1,10,000.  The stipends in the South are somewhat less, as per state regulations, since certain states allow private practice which compensates for the relatively low stipends,” the official says.  However, there should be parity in stipends between the private and government medical colleges within the same states and not interstate, he explains.  

Dignity at stake 

Dr KV Babu, ophthalmologist and RTI activist from Kannur, Kerala, says many of the private medical colleges are commercial establishments, whereas the government medical colleges are teaching and treatment facilities, hence the stipend disparity. “All the PG doctors are fully qualified doctors, hence, not paying the requisite stipend is not only discrimination and injustice but is an assault on the dignity of the profession,” Babu says, drawing from his own experience as a PG medical student at Maulana Azad Medical College (MAMC), New Delhi, in 1989 when he was paid over Rs 3,500, whereas it was just around Rs 1300 in Kerala during that period. 

In the current situation, the PGMEB of the NMC, he adds, just warned the medical colleges about not following the regulations in future but did not address the issue of derecognising them/payment of arrears. 

Since many of the private institutions are disregarding the NMC advisories, the government should regulate their fees, says Dr Manish Jangra, chief advisor and founder, FAIMA. “Nonconformity should invite heavy penalty, even derecognition of some percentage of seats so that an increase in the stipend should not lead to a fee hike that students are compelled to pay,” Jangra adds. 

 NMC survey findings  

The survey conducted by the NMC’s PG Medical Education Board (PGMEB), reveals that while 26% of PG medical students received no stipend, 15% of the students had to return the stipends granted to them. It was based on responses from a total of 28,800 medicos, out of which 10,178 were postgraduate medical students.  From this category, 7,901 were postgraduate students from 213 private medical colleges across 19 states and two Union Territories. The balance of responses were either from students of government medical colleges or DNB hospitals or duplicate responses. The survey uncovered that while 2,110 students had not received any stipend, 1,228 students had to return the money given to them by institution management. Around 4,200 PG doctors who participated in the survey claimed they received fewer stipends than the ones paid in government institutions in their states. 

The survey was conducted after the National Human Rights Commission (NHRC) wrote to the NMC in March, urging it to derecognise private medical institutions that do not follow the regulations. The directive came in the wake of a complaint filed by a student of Malabar Medical College, Kozhikode, where it was alleged that the house surgeons are paid inadequate stipend, in violation of the government order. As per the complaint, the house surgeons are paid Rs 8500 as stipend per month out of which Rs 2500 is deducted towards mess charges```