Medicine that doesn’t work: Higher quotas mean lower chances of India being a medical power

However, the timing is also extremely important, given the assembly elections in six states, including Uttar Pradesh, next year. Bear in mind, OBCs constitute a significant proportion of UP’s population.

Last week, the Centre announced that 27% and 10% of the “all India quota (AIQ)” seats in state-government medical colleges will be reserved for OBC and economically weaker section (EWS) candidates, respectively. The decision likely follows from a Madras High Court order last year directing the Union government to implement OBC quota for AIQ seats under the National Entrance cum Eligibility Test (NEET). However, the timing is also extremely important, given the assembly elections in six states, including Uttar Pradesh, next year. Bear in mind, OBCs constitute a significant proportion of UP’s population.

So far, reservation was only accorded to scheduled caste and scheduled tribe candidates in the AIQ seats, following from the 2007 judgement of the Supreme Court in Abhay Nath. For the domicile seats—85% at the undergraduate (UG) level and 50% at the postgraduate (PG) level—the states provide OBC quota. The Centre’s latest decision will earmark some 2,050 (1,500 + 550) UG seats and 3,500 seats (2,500 + 1,000) seats for OBC and EWS candidates.

The actual numbers may seem small, but given there are just 85,000 UG and 55,000 PG medical seats in the entire country, the pool for merit shrinks significantly. States implementing reservation means the cause of representation and affirmative action is already being served. Reservation, as the newspaper has argued earlier, dilutes India’s intellectual capital. While other countries, such as China, are investing heavily on research and talent cultivation in cutting-edge fields of medicine, focusing on representation instead of nurturing the best talent caste/class notwithstanding hobbles India’s future. With so few medical seats, the country already has a chronic shortage of doctors.

Slashing the space for merit further means many deserving candidates are forced to either drop medical education as academic pursuit or seek admission in other countries, including China, and often join research/medical practice abroad. Against the 85,000 MBBS seats in 66 medical universities in India, the now-defunct Medical Council of India recognised degrees from 45 medical universities in China alone, with 21,000 Indians pursuing medical degrees in these universities in 2019.

It is an own-goal to push deserving students to medical colleges and, later, professional engagement abroad instead of creating more medical seats by relaxing rules, something which many experts have recommended time and again. The creeping advance of reservation, from education to jobs to promotion shows how flawed the existing system is—the span envisioned for the policy at the time of its creation has lapsed several times over.

Besides, as pointed out before in these columns, PRICE data shows reserved category households with a higher level of educational attainment for the primary earner post higher incomes than general category households where the primary income earner has a lower level of educational attainment. This shows there is likely very little systemic backwardness that needs addressing in the manner the Centre has just announced.