How to vernacularise medical education in India

The measure would entail significant costs given the regulatory and administrative alterations that would be required. This would include translation of educational materials, training of trainers, and the like. The costs will depend on the scale of implementation and need not necessarily be a deterrent. Whatever be the scale, weighing the gains and losses will be imperative.

An argument advanced by critics is that this measure is fuelled by misplaced nationalistic sentiments, which would erode the competitive advantage Indian graduates have in the global scientific arena. In their rejoinder, the advocates state that countries such as Germany and China have long been doing so successfully, and so can India.

It is necessary to recognise one crucial distinction in this respect. Unlike the countries that have traditionally upheld medical education in the local language, for India, this is in essence an innovation in a context where English is firmly entrenched. The implications of this step are likely to be two-fold. First, the measure could face considerable resistance in assimilating into the existing ecosystem which, in turn, could restrict its scope to a few select institutions. Second, it is unlikely to spur enough demand from the masses who may not want to settle for a perceived inferior option. This has already been witnessed in the case of engineering courses.

The extent of systemic rearrangements that would be warranted cannot be underplayed. Medical education doesn’t stop at MBBS alone, and sooner rather than later, postgraduate medical courses would also need to be conceived in regional languages. A considerable segment of medical graduates today are employed in allied sectors straddling research, business and administration, pharmaceuticals and the like. These sectors are firmly entrenched in English and are thus likely to be much less welcoming to regional language medium graduates. The response of the private sector is also unlikely to be brisk. There is a risk of engendering an implicit hierarchy among medical graduates therefore, whereby non-English medium graduates are seen to be lesser than their counterparts.

The diversity and multiplicity of languages across and within states, while otherwise a highly celebrated feature, can comprise a significant impediment to vernacularisation of medical education. Medical doctors are highly mobile professionals and often, English is a mutually-intelligible option in technical as well as routine dealings and interactions. Here, there are two aspects to consider. Envisioning a situation whereby medical education is provided in numerous local languages entails considerable chaos which, even if manageable, would be largely unnecessary. Going for a select few languages with a large following could be an optimum middle-path. However, this is unlikely to obviate the need for incorporating basic English skills in the curriculum.

The present emphasis on expanding the private sector’s scope in medical education also fails to vibe well with this measure. If one of our intentions is to increase access to medical education beyond the English-knowing elite, one cannot be oblivious to the broad correlation between knowledge of English and socioeconomic status. The majority of those who opt for medical education in regional languages would be unable to afford private medical colleges.

An incremental approach should be adopted to gradually make medical education in regional languages more harmonious with the current ecosystem. For example, before offering MBBS in an Indian language, it would be far more prudent to start paramedical courses in that language. Such paramedical workers are often less mobile and function closer to the patients and communities being served than doctors. This magnifies the utility of education in regional languages and thus its potential returns here could be much higher. At the same time, it is worthwhile to remember that vernacularisation is only one of many ingredients in the recipe to demystify medical education. Many other measures, for instance, selection criteria that is based more on aptitude than merit, require political attention today.

The writer is a physician, health policy expert and chief editor of The Indian Practitioner.