Government quandary over using medical students in crisis

India has not yet taken a decision about whether to fast-track final-year medical students through their exams, although some experts have suggested that India should take a hint from the United Kingdom and Italy and engage final-year students in the anti-COVID-19 fight.

Medical and nursing students could join the battle against the deadly virus, as the authorities are mulling different alternatives to provide strategic protection to senior doctors since they are at high risk if they contract the infection.

But the students may have to appear in the final-year exams afterwards and the authorities have to take a call on this matter.

The health ministry said in a recent guideline that dentists could be recruited to boost the healthcare system amid the coronavirus outbreak. Experts suggest final-year medical students should be permitted to skip exams to provide a much-needed workforce as every year nearly 38,000 postgraduate and 70,000 MBBS students graduate from colleges in India.

Noted cardiac surgeon Devi Prasad Shetty said a person who is above the age of 50 is very vulnerable. “This is a very contagious disease and the battle against coronavirus can be won by young doctors and nurses,” said Shetty, who is the chairman and founder of the Bengaluru-based Narayana Health.

Shetty told the news agency Press Trust of India that the nation requires about 150,000 extra doctors to manage all the government and private hospitals to fight COVID-19.

He said just by changing Medical Council of India regulations, India can produce doctors and specialists. Those waiting to appear for final exams should be allowed to work as doctors with immediate effect.

He pointed out: “Nearly half of the total 40,000 anaesthetists in the country, who are specially trained to handle ventilators, are above the age of 50 and so the nation is likely to face an acute shortage of people trained in handling ventilators in case of a more all-out outbreak of COVID-19.”

Dr Srinath Reddy, president of Public Health Foundation of India and a member of the national task force on COVID-19, said the MBBS students who are doing their final internship could be allowed to look after less critical patients and the foreign medical graduates awaiting certification could also be roped in to increase the young manpower.

But while medical and nursing students could join the fight against COVID-19, no decision has yet been taken by the authorities on whether to conduct the exams online or to provide degrees to final-year medical students without their having to appear in the examination in view of the virus outbreak.

According to the health ministry, students of senior classes could be allowed to treat COVID-19 cases for the time being. Thus final-year medical students would be joining the workforce as soon as possible, although their graduation would inevitably be delayed under the present circumstances as the government’s focus right now is to contain the pandemic and all exams and academic activities will be delayed.

Gautam Nigam, a final-year medical student in New Delhi, said according to the government there are just over a million doctors registered with state medical councils, of which only 80% are believed to be in active service. This means the country has one doctor for approximately every 1,500 persons, while the World Health Organization norms recommend that there should be one doctor for every 1,000 persons.

“In such a scenario, the government must take an early decision to allow final-year medical graduates to start working as fully qualified doctors. Unless the government takes such a decision, the graduation will be delayed in the current environment. We’ll have to wait for this crisis to be over,” he said.

Dheeraj Agrawal, another final-year medical student, based in Jaipur, said: “Amid the outbreak, we have been allowed to treat COVID-19 patients without waiting for examinations and it is a good step, I believe. We gain the much-needed experience of working in hospitals and treating patients and the satisfaction of serving people in this time of crisis. It is imperative that medical colleges do not delay qualification and allow new doctors to join the workforce.”

Meanwhile, the government in the eastern state of Orrisa (Odisha) has decided to train seventh-, eighth- and ninth-semester MBBS students of all medical colleges to engage them in the management of COVID-19 if required.

In the first phase, the training of students of government medical colleges has been taken up. The private medical colleges will also be required to train the doctors and students simultaneously, according to the need.

So far, around 1,500 MBBS students have already been trained to handle COVID-19 cases. The Orrisa government has provided online training to the students and trainees are helping existing medical staff.

India had recorded 149 deaths linked to coronavirus up to the evening of 8 April. The latest data from the union health ministry took the total number of COVID-19 cases in the country to 5,194 cases.