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| LETTER TO THE EDITOR |
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| Year : 2021 | Volume
: 34
| Issue : 3 | Page : 126-127 |
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Factors influencing the social obligation of doctors
P Ravi Shankar
IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
| Date of Submission | 21-Dec-2021 |
| Date of Decision | 10-Feb-2022 |
| Date of Acceptance | 11-Feb-2022 |
| Date of Web Publication | 26-Apr-2022 |
Correspondence Address:
P Ravi Shankar
International Medical University, Bukit Jalil, Poskod 57000, Kuala Lumpur
Malaysia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/efh.efh_447_21
How to cite this article:
Shankar P R. Factors influencing the social obligation of doctors. Educ Health 2021;34:126-7 |
Dear Editor,
I read with great interest the article by Dandekar et al. on the perception of faculty toward social obligation at an Indian medical school.[1] The authors conducted interviews among seventeen faculty members at a government-run medical college in Mumbai, India. Although the exact time when the study was done is not mentioned, from the date of manuscript submission, I assume that it may have been in 2018 or earlier. It is also not mentioned who was the interviewer though, I assume, it may have been the first author. This, as mentioned in the manuscript, may have led to desirability bias among respondents. I am also not sure about the background of the faculty included. I assume most of them may have been educated at the institution where the study was conducted.
I postulate that privatization of medical education can impact the degree of social obligation and social commitment of graduating doctors. Medical education in colleges run by the government and certain organizations is subsidized. I believe that these students may feel a greater social obligation as their education and training were supported by society. I am not sure about the degree of social obligation perceived by students who finance their own education and hail from well-off families. A recent news article mentions that India has 276 private medical colleges with Karnataka and Maharashtra topping the list and 37 applications have been received to start new private medical colleges during 2021-2022.[2]
Another factor that can affect the commitment of doctors both to the profession and to society is monetary compensation. Salaries for doctors with an undergraduate medical degree are low in India and varies from 0.4 to 1 million Indian rupees (5300-13000 USD) per annum.[3] Violence against doctors is another major problem and this is an issue that doctors are not trained to avoid or deal with.[4] A recent review concludes that COVID-19 has been associated with an increased mortality in doctors and health-care workers globally.[5] Male doctors, those from minority backgrounds, elderly professionals and those with co-morbid conditions may be at greater risk. In my opinion, high tuition fees, low pay, fear of violence, and the risk of death due to the ongoing pandemic and other diseases can influence the morale of doctors and their perception toward both the profession and society.
In my opinion, most medical students and faculty are likelier to participate in social and outreach activities held by their institutions if this contributes to their grades and performance reviews. Factors that can influence doctor's commitment to serve long term in an underserved area should be investigated. The current practice of sending just graduated doctors to these areas under contractual obligations may only be a stop-gap arrangement. Doctor's social commitment must be supported by a nurturing environment both during their course of study and during their career.
A large-scale study among both faculty and student at state run and private medical colleges in different Indian states may be required. Similar studies in other South Asian countries will be help ful. The factors that can influence doctors' perceptions regarding social obligation should continue to be explored.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Dandekar SP, Mhatre R, Mohanna K. Perceptions of faculty toward “social obligation” at an Indian medical school. Educ Health (Abingdon) 2021;34:48-54.  |
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| 3. | |
| 4. | Reddy IR, Ukrani J, Indla V, Ukrani V. Violence against doctors: A viral epidemic? Indian J Psychiatry 2019;61:S782-5. |
| 5. | Iyengar KP, Ish P, Upadhyaya GK, Malhotra N, Vaishya R, Jain VK. COVID-19 and mortality in doctors. Diabetes Metab Syndr 2020;14:1743-6. |
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