In an effort to get medicines and health care to remote regions, India plans to create an army of rural doctors to serve exclusively in villages. Some 300 medical schools to be specially set up for this purpose will provide high school graduates a three-and-a-half year crash course in medicine (against the usual five-and-a-half years), awarding them Bachelor of Rural Medicine and Surgery (BRMS) degrees.

After a short training in district hospitals, they will be deployed in any of the 145,000 government-run health centers in villages. They cannot practice in urban areas.

The plan, introduced by the Medical Council of India in consultation with the health ministry, aims to address a shortage of doctors in villages, where 60% of Indians live. As Nature Medicine went to press, the cabinet had yet to clear it, but a parliamentary committee on health, after a meeting on 18 February, has given its nod of approval.

Under pressure: India pushes for more pastoral physicians. Credit: Newscom

Health Minister Ghulam Nabi Azad says individuals who hold a BRMS degree will be an “additional workforce,” and the shortened training will not compromise health care quality.

However, his predecessor, Anbumani Ramadoss, says that in addition to creating “a brigade of qualified quacks,” the scheme is discriminatory. Dharam Prakash, secretary general of the Indian Medical Association, agrees. “We are opposed to creation of two classes of doctors—one for cities and one for villages,” he told Nature Medicine.

Prakash says that instituting a one-year compulsory rural posting for all new doctors after they complete their internships and earn their degrees, increasing the number of seats in existing medical colleges and additional short-term obligatory rural service for all doctors wishing to serve within government institutes would be a better alternative. “But,” he adds, “the government did not ask our opinion.”