The Economics Of A Medical Degree

This is from the Hyderabad edition of today’s TOI

The reality behind rising number of women medicos in Andhra Pradesh

Bushra Baseerat, TNN | Jul 15, 2012

HYDERABAD: If the price tags of management quota seats in medicine are skyrocketing in Andhra Pradesh today it is not simply because the good old sentiment behind taking the Hippocratic oath to serve society remains a compelling call for the educated. An estimated 70% of management quota seats in medical colleges have been cornered by the fairer sex but this heartening trend masks a disturbing reality – a medical degree is coming in handy these days for those looking to snag a good match in the marriage market.

College managements state that a doctor’s certificate often masks the not-so-palatable truth that an MBBS degree fetches girls a “good match” – a key reason why parents shell out big bucks for a medical seat for their daughters. Also responsible for the prevailing management quota seat rates of Rs 50 lakh to Rs 1 crore is the increasing wealth of the state’s elite over the last couple of decades and the post-liberalisation anthem of ‘have money, will buy’ that applies to education as well.

But first the gender reality check in medical colleges. The percentage of girl students in state medical colleges has shot up by about 20% in the last three years. The state also boasts of a women’s medical college. However, social reality check offers this perspective: girls joining MBBS courses have behind them parents hopeful of getting a good groom for their daughters.

But, at the same time, grooms expect a handsome dowry from the families of their MBBS brides, the belief being that if the parents could spend so much on a medical degree, they would dig deeper into their pockets to offer a good dowry.

Well, the rules of the game are predictably different for men. Doctor grooms fetch a handsome sum in the marriage market with the prevailing dowry they command ironically being the same as what one might be expected to pay for a management quota seat, between Rs 50 lakh to Rs 1 crore.

Explaining the social trend, a senior doctor said: “If a girl wants to study, parents do not think twice about the repercussions such as dowry and marriage expenses. And, when they are prepared to pay Rs 50 lakh for an MBBS seat, they will also be prepared to loosen their purse strings for the marriage.” Furthermore, it is also a status symbol and prestige issue.

Doctors say that while parents usually go by the interests of their children, there are some who also put pressure on their kids to take up the profession. “Till the undergraduate level, girls do very well in studies. However, by the time they finish house surgeonship, a good number of them are already married,” says Dr AY Chary, dean of Dr VRK Women’s Medical College, the only medical college in the state exclusively meant for women.

Management quota seat distribution tilting towards girls is a phenomenon only three years old but the development that ensured it was so is five decades old. In the 1960s, there were only two private medical colleges in the state, Ranga Raya Medical College in Kakinada and Kakatiya Medical College in Warangal which charged a ‘donation’ of Rs 7,000 to Rs 12,000 for admission.

That donation amount started increasing during the late 1980’s and saw an exponential rise in the last two decades. Riding high on the national obsession for a medical career and the limited number of seats, private medical colleges jacked up their ‘donation’ demands, rechristened it as ‘capitation’ fee and started selling ‘management quota’ seats for a hefty price saying it was for investment in infrastructure.

So, over the last two decades, burning the midnight oil to crack a medical entrance was no longer the only route to medical college. By mid-2000, the price of a management quota seat had touched the Rs 10 lakh mark and the girl-boy ratio was 50:50. Seven years later, that figure has multiplied 10 times, with some colleges this year even selling seats for Rs 1 crore. And the latest twist to the MBBS story is the changing gender equation in colleges.

But if parents are willing to spend big bucks on their daughter’s MBBS even if to only obtain a good match for her, college managements still prefer treating prospective girl students with kid gloves, suggesting “lighter” courses for them.

Dr G Bhaskar Rao, treasurer of AP Private Medical and Dental Colleges Managements’ Association says that colleges discourage women from pursuing an MBBS suggesting that they instead opt for BDS as it is the easier course when compared with MBBS.

“But parents insist that their daughter is interested in MBBS. In some cases, in fact, it is the parents who are more interested,” he says.

Also keeping the management quota seat rates high is the demand-supply gap that has only widened over the years. If 5,500 doctors are churned out every year in AP, the demand is for double that number given the sluggish growth in the healthcare sector in the state.

A senior doctor shares that when he joined the profession, in the 1970s, there were 10 government medical colleges in the state with 1,500 seats all put together. But four decades later, despite the colossal rise in population, the number of medical colleges and seats has not seen a commensurate rise.

“A male in the OC category cannot dream of a seat in a government college today unless he gets a good rank. About 80,000 to 90,000 students are vying for approximately 5,500 seats,” he said.

Incidentally, even he had to cough up a hefty sum to get his son admitted into a medical course for the sole reason that he wanted his family’s legacy carried forward.