Heart of Bengal’s Healthcare: Inside the Dilemma of Disillusioned Doctors

Kolkata: Three batchmates from Calcutta Medical College passed their MBBS in 2013. Eleven years later, only one of them is working in Bengal’s health department. The other doctors are now employed with central institutions — one in an autonomous medical institution in North India, and the other is working in Kolkata but under the Government of India.

While the RG Kar rape and murder incident brought attention to institutional safety concerns for junior doctors, as well as corruption within these institutions, larger issues affecting resident doctors in Bengal, still persist. eNewsroom interviewed several resident doctors and uncovered two significant problems: salary disparity and deteriorating work culture. These issues are prompting doctors to either leave the state for opportunities elsewhere or avoid returning to ‘Sonar Bangla,’ resulting in a major brain drain of medical professionals from the state.

Batchmate 1: Opts for Central Government Job

“Shortly after completing my MBBS, I took the Union Public Service Commission Examination in 2015. Since July 2016, I’ve been working with the Central Government Health Scheme (Ministry of Health and Family Welfare). From the beginning, I have received a Seventh Pay Commission salary. Although private practice is not allowed, I haven’t felt much need for it. I chose a central government job because I need a basic work structure that the state government doctors, especially in rural areas, are not provided with. Most of the time, you’re initially posted in rural areas or on the outskirts,” said

He added, “I would have worked outside the state anyway, but when I was offered a central government job with a better pay scale (almost double) with a Kolkata posting, I was content. I’m now a Senior Medical Officer.”

This medical officer draws a monthly salary of Rs 1,50,000.

“It’s not that I don’t want to work in rural areas or for the state government. Apart from the salary difference, there’s also a lack of proper medical facilities needed to work effectively for the state,” he explained.

Batchmate 2: An Endocrinologist Working at an Autonomous Institution

“I was admitted in one of India’s best centres for my MD, so I completed my Master’s in Medicine (MD, Internal Medicine) in 2016 and my Doctorate in Medicine (DM, Endocrinology) in 2019. In 2021, I joined as an Assistant Professor at the same institution. I may be promoted next month,” said the doctor over the phone.

The endocrinologist earns Rs 1,70,000 and receives Rs 1.4 lakh in hand along with other perks, including full treatment coverage and medicine costs borne by the institution.

“Under me are a few students from Bengal doing their DM. These students are sponsored by the Bengal government. They have no choice but to return to Bengal after three years, but they’re not happy about it because they have no alternative,” the Assistant Professor remarked.

When asked if he feels an obligation to serve Bengal, as he completed his MBBS there, he responded: “I’m grateful for my education at Calcutta Medical College—it was very good. My schooling and medical education in Kolkata laid the foundation for everything I am today. While pursuing my MD and DM studies, I wanted to return to Kolkata because my ageing parents live alone in South Kolkata. But my friends advised me against it, saying it’s very difficult for someone like me, who is dedicated to their work, to thrive in Bengal. For me, salary is not the main issue; I need a dedicated work environment, which my friends say is severely lacking in Bengal.”

Batchmate 3: A Senior Resident at RIO, Calcutta Medical College

“I’m the one who joined most recently in 2020. After completing my graduation, I did a one-year fellowship and later began my service obligation,” said a senior resident at the Regional Institute of Ophthalmology (RIO), Calcutta Medical College. The ophthalmologist earns a fixed Rs 70000, without any additional perks, housing allowance, or health insurance.

The ophthalmologist, whose father is a renowned paediatrician, plans to open a clinic soon, so he is not seeking other jobs, either in government or the private medical sector. His sister, a microbiologist working in a government hospital, has done her MD and, after seven years of service, earns Rs 1,04,000.

“For the lower salary, the state government justifies it by allowing private practice for doctors. But like central jobs, if the state offered a better pay, 30 to 40 per cent of doctors would leave private practice because it carries huge risks. There’s a luck factor involved, along with the expenses of setting up an office. Clinics are not ideal places to treat patients,” noted the state government doctor.

Comparative Salary in Jharkhand and Bengal’s DA Case

In neighbouring Jharkhand, doctors receive higher salaries than their Bengal counterparts and are allowed to engage in private practice.

“The West Bengal doctors’ DA case is pending in the Supreme Court. We won the case in the High Court, but the state government appealed to the Apex Court. You can imagine that when the DA case is still unresolved, how we can fight for the implementation of the seventh pay commission in the state?” he reasoned.

State government doctors do benefit from the Old Pension Scheme (OPS), while central employees are required to opt for the New Pension Scheme (NPS).

Stories of Two Colleagues Working in Bengal’s Health Department

A cardiovascular and thoracic surgeon, performing complicated surgeries in private setups, expressed frustration at not being allowed to conduct surgeries in medical colleges. “I’m from North Bengal Medical College, currently on deputation at a medical college in Kolkata. When I ask to perform surgeries, I’m threatened of being sent back to North Bengal,” said the surgeon.

One of the demands of the 43-day-long protest by junior doctors was to address the work culture in North Bengal medical colleges, but this went unheard.

“A colleague of mine, who completed MCH from AIIMS is having to work in Bengal because of his parents. He is also facing difficulties in the current scenario,” the doctor lamented, adding that both of them are reconsidering their service in government hospitals.

Health of the Bengal Health Department

West Bengal has 23 government medical colleges and 8 private colleges. Every year, 3,900 doctors (3,600 from government institutions and 1,300 from private colleges) graduate.

Most of the doctors taking up government jobs are opting for Health Services over academic roles due to shorter duty hours in the former.

One of the best steps taken in the last decade in Bengal’s health sector was the development of Super Specialty Hospitals in every block. At least 43such units have been built. However, these facilities lack critical resources and are not serving their intended purpose.

There has been no recruitment of resident doctors since 2020, with lateral entries taking place in 2023. Additionally, there has been no recruitment in dental colleges since 2016.

Since TMC came to power, Mamata Banerjee has held the health portfolio. Previously, Dr Surja Kanta Mishra served as the health minister during the Left Front era.

Protest Leader and Medical Officer Prescribes Remedies for Bengal’s Ailing Medical Sector 

Accepting that there is a brain drain of doctors from Bengal, Dr Sourav Bhakat, Ex student of RG Kar Medical College and Hospital, who also led the 43-day protest of junior doctors after the rape and murder of a trainee doctor in RG Kar told eNewsroom, “In my batch of 2022, almost thirty percent went outside. And now, more students are opting for DNB courses instead of MD.”

The Diplomate of National Board (DNB) is a postgraduate degree in medicine awarded by the National Board of Examinations in Medical Sciences (NBEMS) under the Ministry of Health and Family Welfare, Government of India.

Dr Sourav, who is also a medical officer with GoB further said, “Not only the salary is less in Bengal in comparison to Delhi and Mumbai, but here it is also mandatory, which is not there in many states.”

The young doctor also reasoned why issues of salary and long work hours were not among their demands in the recently ended protest. “We did not ask for the raise in salary, as the people will say the protest is going on for salary enhancement. And as we have the habit of working continuously for 36 hours, we have added other important issues.”

But then how do you feel, things will improve in Bengal?

The young doctor has prescribed a remedy too to repair the broken system, “To change the system, senior doctors, who are in official positions need to correct themselves. They should be neutral. If a professor or senior doctor does not obey the wrong orders in fear of transfers, the threat culture will be weakened. The officials should not be nominated but elected. Today all are saying we need justice, but it will go in vain if the system within our colleges and hospitals does not change.”