“I am fed up of fighting and struggling in the worse situations. This is time for me to rest. I quit,” wrote Dr Smriti Laharpure, a first-year, post-graduate resident at privately-run Index Medical College in Indore (Madhya Pradesh) in her suicide note.

On June 11, the 32-year-old doctor overdosed herself with anaesthesia at the college quarters and died. Her final hand-written suicide note outlines exorbitant fees hiked arbitrarily, non-payment of full stipend and a resulting debt trap, as reasons that forced her decision.

Smriti’s father Kishore speaks of his bright young daughter who had completed her MBBS from government-run Gandhi Medical College (Bhopal) and secured a merit-based seat in Index Medical College through the common NEET exam.

The college demanded annual fees of ₹8,55,000 plus ₹2,00,000 for hostel, he says, adding that he managed a loan of ₹35 lakh for Smriti’s education.

“However, when we were paying the fees, an additional ₹2,00,000 was demanded,” alleges Kishore (60), a retired bank employee.

Mid-session, the college hiked the tuition fee from ₹8,55,000 to ₹9,90,000 and told the students to pay the difference of ₹1,35,000 per year for three years, he alleges. “Students, including Smriti, moved the court and despite repeated High Court orders to not hike fees, the college kept demanding enhanced fees, an additional ₹4,05,000 over the course of three years,” says Kishore.

Close to a month later, the police registered a first information report against Suresh Bhadoriya, Chairman of the Index group which owns the medical college and Dr KK Khan, Head of Department, Anesthesiology, both of whom Smriti had held responsible for abetting her suicide.

Efforts to contact college authorities did not elicit a response.

Exorbitant fees

The incident is a murky reminder of the massively unregulated business of private medical education across the country.

The last decade has seen medical schools in India increase from 256 in 2006 to 479 in 2017, of which 259 are privately owned and managed.

Recently, the Union Health Ministry barred 82 medical colleges from taking admissions in 2018-19, on the ground of inadequacies in infrastructure and faculty. Twelve of these were government-run, the remaining 70 being privately-owned.

Far from being a social mission, medical education is seen as a lucrative business linked to large profits and run by powerful political and business interests, says Dr Avinash Supe, Dean of civic-run King Edward Memorial (KEM) Hospital, Mumbai.

Private trusts that run new colleges have permission to charge huge fees and the regulatory bodies have turned a blind eye to these deficiencies and subversion of minimum standards, “passively caving in or actively succumbing to pecuniary temptations,” he alleges.

The Medical Council of India (MCI) has been criticised for its failure in regulating these colleges. But the Central government too is unable to get involved in regulating exorbitant fees.

“We have no power to regulate at the Central level. There is a Supreme Court ruling that instructs appointing a state-level committee led by a retired High Court judge to fix fee structures. Any deviation from such a ruling should be checked by state authorities,” says the Health Ministry’s Arun Singhal, Additional Secretary, Medical Education.

The National Medical Commission (NMC), which is proposed to replace MCI, has a provision for Government to decide the fees for 50 per cent of the seats in private and deemed medical colleges. “We hope to be able to make a difference with the NMC, but that is when it comes into force…. Until then our hands are tied,” Singhal says, while hoping that the current monsoon session of Parliament takes it up.

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