Privatization of medical education in India: A health system dilemma

Davey, Sanjeev; Davey, Anuradha; Srivastava, Ankur; Sharma, Parul

doi:10.4103/2230-8598.127116

Cited by 13 publications

(10 citation statements)

References 8 publications

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“…Such research methodologies may further our understanding of the political economy of India's medical institutions and the social framework within which the construction of professional identity takes place. Through an in-depth analysis of the day-to-day life of India's medical schools and students, such methodologies may also potentially address some of the concerns raised in recent literature regarding the role of ethics, corruption, the influence of pharmaceutical companies, and the “effect of continuing privatization of health education”[ 117 118 119 ] on the training of psychiatrists. Moreover, it may help identify the social agents that play an important role in socializing Indian psychiatry trainees, which may reasonably be assumed to differ from their Western counterparts.…”

Section: Discussionmentioning

confidence: 99%

How do psychiatrists in India construct their professional identity? A critical literature review

Bayetti

Jadhav

Deshpande

2017

Indian J Psychiatry

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Psychiatric practice in India is marked by an increasing gulf between largely urban-based mental health professionals and a majority rural population. Based on the premise that any engagement is a mutually constructed humane process, an understanding of the culture of psychiatry including social process of local knowledge acquisition by trainee psychiatrists is critical. This paper reviews existing literature on training of psychiatrists in India, the cultural construction of their professional identities and autobiographical reflections. The results reveal a scarcity of research on how identities, knowledge, and values are constructed, contested, resisted, sustained, and operationalized through practice. This paper hypothesizes that psychiatric training and practice in India continues to operate chiefly in an instrumental fashion and bears a circular relationship between cultural, hierarchical training structures and patient–carer concerns. The absence of interpretative social science training generates a professional identity that predominantly focuses on the patient and his/her social world as the site of pathology. Infrequent and often superfluous critical cultural reflexivity gained through routine clinical practice further alienates professionals from patients, caregivers, and their own social landscapes. This results in a peculiar brand of theory and practice that is skewed toward a narrow understanding of what constitutes suffering. The authors argue that such omissions could be addressed through nuanced ethnographies on the professional development of psychiatrists during postgraduate training, including the political economies of their social institutions and local cultural landscapes. Further research will also help enhance culturally sensitive epistemology and shape locally responsive mental health training programs. This is critical for majority rural Indians who place their trust in State biomedical care.

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Section: Discussionmentioning

confidence: 99%

How do psychiatrists in India construct their professional identity? A critical literature review

Bayetti

Jadhav

Deshpande

2017

Indian J Psychiatry

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“…Many states and UTs (Uttarakhand, Sikkim, Karnataka, Andhra Pradesh, Telangana, and Pondicherry) had more private institutes, which is alarming because privatization of medical education increases not only the cost of medical education but also that of medical care. 25 Privatization can also affect provision of mental health services in semiurban, rural, and remote areas and to people with a middle-to low-socioeconomic status. The ministry of health and family welfare's reply to a right to information query revealed that more psychiatrists work in the private sector in Uttarakhand, Karnataka, Andhra Pradesh, and Telagana.…”

Section: Table 4 Trainee Seats and Requirement Of Staff/psychiatristsmentioning

confidence: 99%

Inequity in Distribution of Psychiatry Trainee Seats and Institutes Across Indian States: A Critical Analysis

Ransing¹,

Agrawal

Bagul

et al. 2020

JNRP

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Background The delivery of mental health services largely depends on the adequacy of human resources. In India, the deficit of psychiatrists is more than 90% and is one of the major challenges that needs to be tackled to address the huge burden of mental illness. Psychiatry trainee institutes play a vital role in reducing human resource deficit and inequality in delivering mental health care. However, the distribution pattern of psychiatry trainee seats and institutes across Indian states is unknown. Therefore, we estimated the number of psychiatry trainee seats and institutes in each Indian state and union territory (UT). Materials and Methods In this cross-sectional study, psychiatry trainee seats and institutes were searched on the official web sites of Medical Council of India and National Board of Examinations. The data available on these web sites until December 2019 were included. State-wise data were compared using proportion and percentages. The psychiatry trainee index (PTI) was calculated and compared across Indian states and UTs. Results Among 221 Indian psychiatry trainee institutes considered in the present study, 116 (52.48%) were private institutes and 105 (47.51%) were government institutes. Overall, more psychiatry trainee seats were reported in government institutes (n = 565, 65.89%) than in private institutes. National PTI was considered fair (0.06), and based on their PTIs, Indian states and UTs were classified as follows: worst (n = 9), poor (n = 8), fair (n = 9), average (n = 7), good (n = 1), and excellent (n = 2). Conclusion A huge deficit of psychiatry trainees and institutes exists in more than two-thirds of Indian states and UTs, along with a huge maldistribution of seats. PTI and its distribution across the states and UTs are a crucial indicator of the need to improve the access and equity of mental health care.

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“…In countries where universities have historically been state-run, the entry or possible entry of private institutions, often triggers debates and concerns about the quality of graduates, cost of tuition fees and fears that such institutions would recruit scarce academic faculty from public medical schools. In India, where 194 out of the 356 medical schools are privately owned and where 72% of the new intake slots created since 2000 have been in the private sector (Davey et al, 2014), serious concerns have been raised about staffing norms, availability of infrastructure, tuition fees and quality of students produced (Chen et al, 2012).…”

Section: Figure 47: New Medical Schools By Decade Of Being Establishmentioning

confidence: 99%

“…To prevent poaching, India has introduced restrictions that prevent private medical schools from employing public-sector academics prior to them retiring (Davey et al, 2014).…”

Section: Consensus Study Reportmentioning

confidence: 99%

Reconceptualising Health Professions Education in South Africa

2018

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Reproduction is permitted, provided the source and publisher are appropriately acknowledged. The Academy of Science of South Africa (ASSAf) was inaugurated in May 1996. It was formed in response to the need for an Academy of Science consonant with the dawn of democracy in South Africa: activist in its mission of using science and scholarship for the benefit of society, with a mandate encompassing all scholarly disciplines that use an open-minded and evidence-based approach to build knowledge. ASSAf thus adopted in its name the term 'science' in the singular as reflecting a common way of enquiring rather than an aggregation of different disciplines. Its Members are elected on the basis of a combination of two principal criteria, academic excellence and significant contributions to society.

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Privatization of medical education in India: A health system dilemma

Cited by 13 publications

References 8 publications

How do psychiatrists in India construct their professional identity? A critical literature review

How do psychiatrists in India construct their professional identity? A critical literature review

Inequity in Distribution of Psychiatry Trainee Seats and Institutes Across Indian States: A Critical Analysis

Reconceptualising Health Professions Education in South Africa

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