Several complaints have been raised against the administrators of Gandhi Hospital and Osmania Hospital in Hyderabad, regarding ‘illegal’ transfers of interns to these hospitals. One doctor recently approached the Telangana Junior Doctors’ Association (TJUDA) saying that he had filed an RTI addressed to the Directorate of Medical Education, asking for the guidelines and circumstances under which such transfers are granted to students. He wanted to know on what basis the Directorate of Medical Education (DME) is granting permission for these transfers.

What is a medical internship and why are some transfers so controversial?

The typical medical school course lasts five-and-a-half years. The last year of this period is devoted entirely to clinical rotations, where the students (now referred to as house surgeons or CRRIs, short for Compulsory Residential Rotation Internship) are exposed to the major clinical practices. This is the time when students receive a critical amount of their practical, hands-on training. Upon completion of the internship period, students receive their medical degrees and are eligible to work in a hospital or clinic.

It has recently come to light that a number of students, in order to bypass this one year period, are allegedly paying off administrators in the two hospitals. Once permission is granted for these students to transfer from their respective medical education institutes to pursue their house surgeon period at these hospitals, they allegedly do not attend their clinical rotations, but bribe off officials to sign off on any paperwork. As a result, they are allowed to obtain their medical degrees, without having actually completed their required training. This results in many students who pass out each year with a degree, but are not qualified to see patients.

So there are essentially unqualified doctors who are seeing patients.

A doctor known to the TJUDA recently filed an RTI aiming to find out exactly how students are granted transfers to these hospitals. “Some people might be doing this for health reasons,” a TJUDA source said, adding, “Maybe they need to be closer to family for any personal reasons. But the number of people who opt to take up transfers for a genuine reason is definitely very less!”

Dr Aparna Rao,* a native of Hyderabad was studying MBBS in a college outside her home state of Telangana. Weeks before she was to start her internship, a family emergency called for her immediate return to the city. “It was when I went home that the discussion on what options were available for me to complete my education took place. An older cousin of mine was the first one to tell me that I could look into transferring the CRRI year to one of the colleges in Hyderabad. I was able to move back home and be closer to my family, which came as a blessing to me,” she says to TNM.

But Aparna is one of the few doctors who required a transfer for legitimate reasons. Several students actually opt to take up internships in such a method in order to avoid doing their duties during the CRRI period.

“Many students opt to utilise this time to study for their postgraduate exams, which they would otherwise end up taking time off after the completion of their MBBS,” adds Aparna. This often results in overcrowded outpatient departments and understaffed hospitals.

While Aparna had opted to pursue her CRRI year in Hyderabad to be closer to her family during a crisis, some students do so knowing that they will be able to obtain the required signatures and get their medical degrees, without going through the training and acquiring the practical skills they are supposed to, during the internship year.

TNM reached out to Dr Ramesh Reddy, the DME, who said that this was an issue which was brought to their attention and had been dealt with accordingly. “We set up a committee of doctors to ensure that such things don’t take place. We also changed from the older attendance system to biometrics. Students can only receive their certificates and degrees if their biometric attendance and log book are maintained regularly.”

TJUDA representatives, however, feel that a better set of guidelines need to be issued to prevent the misuse of the system and to ensure that all healthcaregivers receive proper training.