Residency programmes in emergency medicine passing themselves off as masters courses have become a multi-crore industry. Many private hospitals running such courses charge Rs 11-19 lakh for a three-year course.
Given the huge demand for doctors trained in the discipline, the industry finds no lack of takers.
Ironically, this ensures that the stipend or salary to be paid to these young doctors over these three years comes out of the course fees they pay.
Sources in the private healthcare sector told TOI that this cheap or even free labour to run emergency departments is one of the biggest factors behind the increasing number of private hospitals offering these courses.
The masters in emergency medicine (MEM), administered by the George Washington University (GWU) in conjunction with several private hospitals is termed “a three-year postgraduate program in emergency medicine” on the GWU website.
The MEM being run by the Society for Emergency Medicine in India (SEMI), is promoted as a PG programme by most hospitals on their website, with only the fine print acknowledging it is not MCI recognised.
In the case of GWU-MEM, the affiliation is usually with the “academy” that most corporate hospitals have, to train medical personnel needed for their hospital chain.
Each GWU-affiliated academy or stand-alone hospital pays $60,000 to $90,000 (Rs 39 lakh to over Rs 58 lakh) per year to GWU for course administration and to cover the cost of the GWU faculty’s monthly class visits.
Each student pays Rs 4-6 lakh per year as fees and get paid about Rs 25,000 per month in the first year, going up to Rs 45,000 in the third year. In effect, the students get their stipend from the fees they pay and the hospital gets the free service of a bunch of doctors for three years. GWU-MEM started in 2007 as a two-year fellowship.
In 2010, a year after MCI recognised emergency medicine as a specialty and started the three-year MD course, the fellowship was converted into a three-year “masters” programme. SEMI, whose board is dominated by doctors without an MCI-recognised PG medical degree, started its own MEM in 2011 in the name of Make in India.
SEMI took Rs 20,000 per year per student for course administration, much cheaper than the GWU-MEM. Students also pay Rs 3,000 for SEMI life membership and about Rs 17,000 as examination fees.
Thus SEMI’s revenue from each MEM student is about Rs 80,000. With about 350 MEMs produced each year, that’s about Rs 2.8 crore annually.
The hospital running SEMI-MEM charges from Rs 75,000 to over a lakh per year as fees, again much cheaper than the GWU-MEM. SEMIMEM students are paid the same stipend as Diplomate of National Board (DNB) students (Rs 25,000 to Rs 50,000 depending on the state), claimed former SEMI president Dr T Srinath Kumar.
SEMI-MEMs have mushroomed across India as it is cheaper for hospitals and gives the same benefits in terms of getting a steady flow of cheap labour to run emergency departments.
SEMI earlier ran a one-year diploma course in emergency medicine, which has been wound up. GWU also used to run a one-year PG diploma.
“If the idea was to address the shortage of doctors trained in emergency medicine quickly and to meet the rising demand, why would they extend the training to a threeyear masters programme? Why not start more one-year diplomas or stick to two-year fellowships?” asked a senior faculty of emergency medicine in a medical college.
With a huge mismatch in the number of MBBS graduates and recognised postgraduate seats, doctors who cannot make it through the entrance exam for MD and DNB in emergency medicine opt for these training courses even if they are unrecognised, as they help them get jobs in private hospitals.
Societies like SEMI are glad to keep these lucrative courses running. Since emergency training courses include rotation to other departments including ICUs, hospitals are keen to get EM trainees they can use across departments.
Some hospitals with just 60 emergency patients per day were training 14 one-year diploma students in emergency medicine along with 12 MEM trainees, raising questions about the quality of training.
No one is opposed to training programmes as long as students are not cheated into believing their courses will get them a PG qualification that can be registered, and as long as the organisations running these courses do not claim their courses are equivalent to a recognised PG degree, pointed out Dr Praveen Aggarwal head of the department of emergency medicine at AIIMS.
Training courses in various specialties run by medical societies are common, but those do not claim to be a masters programme or degree. They are typically called certificate courses, fellowships or diplomas.