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Mapping the rapid expansion of India's medical education sector: planning for the future.

Sabde Y, Diwan V, De Costa A, Mahadik VK - BMC Med Educ (2014)

Bottom Line: 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 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.

View Article: PubMed Central - PubMed

Affiliation: R.D. Gardi Medical College, Ujjain, India. sabdeyogesh@gmail.com.

ABSTRACT

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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Growth in the number of medical schools in India.
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Fig2: Growth in the number of medical schools in India.

Mentions: Figures 2 and 3 show the growth in the number of medical schools and their annual intake capacity in the public and private sectors. The figures show that growth in the public sector reached a plateau following the 1970s. The private sector on the other hand, has grown exponentially since the 1980s, as seen in the figures. In India, the private medical education sector currently trains more students than the public sector (24205, 54.7%). Figures 4 and 5 show the geographic distribution of these schools in each decade from 1950 until 2012. These figures show that foci of private sector schools began in the south in the 1960s and then ‘spread’ to the north in the 1970s. The number of public sector schools also grew during this time. By the 1990s, there were many more private schools concentrated in the southern peninsula and the better performing northern provinces. After the 1990s, the public sector (no longer expanding) remained the major provider of medical education in the poorly performing provinces. However, the last decade has seen the establishment of private schools even in the poorly performing provinces.Figure 2


Mapping the rapid expansion of India's medical education sector: planning for the future.

Sabde Y, Diwan V, De Costa A, Mahadik VK - BMC Med Educ (2014)

Growth in the number of medical schools in India.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4302536&req=5

Fig2: Growth in the number of medical schools in India.
Mentions: Figures 2 and 3 show the growth in the number of medical schools and their annual intake capacity in the public and private sectors. The figures show that growth in the public sector reached a plateau following the 1970s. The private sector on the other hand, has grown exponentially since the 1980s, as seen in the figures. In India, the private medical education sector currently trains more students than the public sector (24205, 54.7%). Figures 4 and 5 show the geographic distribution of these schools in each decade from 1950 until 2012. These figures show that foci of private sector schools began in the south in the 1960s and then ‘spread’ to the north in the 1970s. The number of public sector schools also grew during this time. By the 1990s, there were many more private schools concentrated in the southern peninsula and the better performing northern provinces. After the 1990s, the public sector (no longer expanding) remained the major provider of medical education in the poorly performing provinces. However, the last decade has seen the establishment of private schools even in the poorly performing provinces.Figure 2

Bottom Line: 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 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.

View Article: PubMed Central - PubMed

Affiliation: R.D. Gardi Medical College, Ujjain, India. sabdeyogesh@gmail.com.

ABSTRACT

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.

Show MeSH