In a surprising turn of events, Health Service has become the hottest and most pursued employment option for young doctors in Kerala.
Till about five years ago, less than 30% of the medical graduates cared to opt for a career in Health Services (HS). Even those who opted to join service at the entry cadre would later disappear seeking extension in joining time, purportedly to complete their postgraduate (PG) studies. But none would return and would go in search of greener pastures in private sector.
The scenario has changed totally now and the reverse flow of doctors to Health Services, which began to be discernible two years ago, is now a reality. Gone are the days when HS used to have vacancies in thousands.
Today, there are just about 100 vacancies in HS at the entry cadre level, most of it being remote area postings in Kasaragod, Idukki and Wayanad.
With the government enhancing the retirement age of doctors from 56 to 60 years in 2017, next promotion vacancies will open up only in 2021.
Surplus
HS, which used to have a serious dearth of specialists (PG doctors) in General Medicine, General Surgery, Anaesthesia and Gynaecology, today have a surplus of specialists.
Hundreds of PG doctors who had entered HS and had given the option of going into speciality cadre are continuing to work as casualty medical officers or in PHCs because there are not enough specialists’ vacancies in HS to accommodate everyone.
“The situation is only going to take a turn for the worse because employment opportunities for doctors in private sector has reached saturation and already, there are thousands of MBBS graduates who are remaining jobless. We have already surpassed a doctor-patient ratio of 1:300, way past the WHO-recommended 1:1000,” says P.K. Jameela, former Director of Health Services.
In 2013-14, because of the shortage of doctors in service, HS had to request PSC for conducting direct recruitment.
At a recent interview at National Health Mission, for a single contract post of doctor, there were 65 applicants. Under NHM in Ernakulam, two Cardiologists (super specialists) are working on contract appointment at a salary of ₹65,000.
“The HS will continue to remain a “hot’” service in the years to come not just because of supply exceeding demand but also because, unlike before, we are paying them a decent salary. Compared to what private sector is paying, HS has emerged as an attractive employer. The morale is certainly up in HS now,” says Rajeev Sadanandan, Additional Chief Secretary (Health).
The problem of plenty and the dire situation in private sector has in fact been to the advantage of HS. Mission Aardram aimed at revamping primary care health delivery, a slew of new public health initiatives and the government’s increased investment in improving the infrastructure and facilities in public sector health institutions have been attracting many young doctors into HS.
“With increasing rate of unemployment, the HS has indeed become a more attractive option now for doctors. But with the patient load going up, the government too will have to create more posts in order to deliver the kind of care it has promised through its secondary and tertiary care institutions,” says G.S. Vijayakrishnan, general secretary of the Kerala Government Medical Officers’ Association.