Mapping the rapid expansion of India’s medical education sector: planning for the future
BMC Medical Education 2014, 14:266doi:10.1186/s12909-014-0266-1
Background
India has witnessed rapid growth in its number of
medical schools over the last few decades, particularly in recent years. One
dominant feature of this growth has been expansion in the private medical
education sector. At this point it is relevant to trace historically and geographically
the changing role of public and private sectors in Indian medical education system.
Methods
The information on medical schools and
sociodemographic indicators at provincial, district and sub-district (taluks)
level were retrieved from available online databases. A digital map of medical
schools was plotted on a geo-referenced map of India. The growth of medical schools
in public and private sectors was tracked over last seven decades using line
diagrams and thematic maps. The growth of medical schools in context of
geographic distribution and access across the poorer and relatively richer
provinces as well as the country’s districts and taluks was explored using
geographic information system. Finally candidate geographic areas, identified
for intervention from equity perspective were plotted on the map of India.
Results
The study presents findings of 355 medical schools in
India that enrolled 44250 students in 2012. Private sector owned 195(54.9%)
schools and enrolled 24205(54.7%) students in the same year. The 18 poorly
performing provinces (population 620 million, 51.3%) had only 94 (26.5%) medical
schools. The presence of the private sector was significantly lower in poorly performing
provinces where it owned 38 (40.4%) medical schools as compared to 157 (60.2%)
schools in better performing provinces. The distances to medical schools from
taluks in poorly performing provinces were longer [median 65.1 kilometres (km)]
than from taluks in better performing provinces (median 41.2 km). Taluks
farthest from a medical school were, situated in economically poorer districts
with poor health indicators, a lower standard of living index and low levels of
urbanization.
Conclusions
The distribution of medical schools in India is skewed
in the favour of areas (provinces, districts and taluks) with better indicators of
health, urbanization, standards of living and economic prosperity. This
particular distribution was most evident in the case of private sector schools
set up in recent decades.
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