Abstract
BackgroundIndia has witnessed rapid growth in its number of medical schools over the last few decades, particularly in recent years. One dominant feature of this growth has been expansion in the private medical education sector. At this point it is relevant to trace historically and geographically the changing role of public and private sectors in Indian medical education system.MethodsThe information on medical schools and sociodemographic indicators at provincial, district and sub-district (taluks) level were retrieved from available online databases. A digital map of medical schools was plotted on a geo-referenced map of India. The growth of medical schools in public and private sectors was tracked over last seven decades using line diagrams and thematic maps. The growth of medical schools in context of geographic distribution and access across the poorer and relatively richer provinces as well as the country’s districts and taluks was explored using geographic information system. Finally candidate geographic areas, identified for intervention from equity perspective were plotted on the map of India.ResultsThe study presents findings of 355 medical schools in India that enrolled 44250 students in 2012. Private sector owned 195 (54.9%) schools and enrolled 24205 (54.7%) students in the same year. The 18 poorly performing provinces (population 620 million, 51.3%) had only 94 (26.5%) medical schools. The presence of the private sector was significantly lower in poorly performing provinces where it owned 38 (40.4%) medical schools as compared to 157 (60.2%) schools in better performing provinces. The distances to medical schools from taluks in poorly performing provinces were longer [median 65.1 kilometres (km)] than from taluks in better performing provinces (median 41.2 km). Taluks farthest from a medical school were, situated in economically poorer districts with poor health indicators, a lower standard of living index and low levels of urbanization.ConclusionsThe distribution of medical schools in India is skewed in the favour of areas (provinces, districts and taluks) with better indicators of health, urbanization, standards of living and economic prosperity. This particular distribution was most evident in the case of private sector schools set up in recent decades.
Highlights
India has witnessed rapid growth in its number of medical schools over the last few decades, in recent years
Medical schools in India are teaching institutions offering a five-and-a-half year medical education leading to a university qualification: a medical bachelor and bachelor of surgery (MBBS) in allopathic medicine
The 18 poorly performing provinces with a population of 620 million (51.3%) had only 94 (26.5%) medical schools
Summary
India has witnessed rapid growth in its number of medical schools over the last few decades, in recent years. One dominant feature of this growth has been expansion in the private medical education sector. At this point it is relevant to trace historically and geographically the changing role of public and private sectors in Indian medical education system. Medical schools in India are teaching institutions offering a five-and-a-half year medical education leading to a university qualification: a medical bachelor and bachelor of surgery (MBBS) in allopathic (modern western) medicine. Each of these institutions is attached to a large tertiary care hospital. India stands at the top of a list of countries with the largest numbers of privately-owned medical schools, followed by the United States [4,6,7]
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