The state government has proposed to reserve 10% of MBBS and 20% of medical post-graduation seats for in-service doctors who are ready to work in interior areas for five and seven years, respectively in a proposal to bridge the doctor-patient gap in rural areas.

The quota seats, however, has a stringent condition: Those failing to work in state-run hospitals after completion of the course could face imprisonment of five years and even cancellation of their degrees.

On Monday, the state cabinet approved the decision and will introduce a bill called Maharashtra Designation of Certain Seats in Government and Municipal Corporations Medical Colleges in the legislature to make it a law. The reserved seats will be available in state and civic-run medical colleges as well for candidates who want to work for a long period in government centres. As per the preliminary estimates, 450-500 MBBS seats could be reserved under this quota while the count of PG seats for in-service MBBS graduates could be around 300.

Dr T P Lahane, head of the Directorate of Medical Education and Research (DMER) said that the decision has been taken to ensure that there are enough doctors to lead the primary health centres and other rural health facilities in rural, hilly or remote areas. Students getting a seat under this quota will have to sign a bond. Any breach would invite imprisonment of five years as well as cancellation of degrees. Only those with the state’s domicile certificate can decide for the quota. A senior medical education department said that a similar concept too exists in the Armed Forces Medical Colleges, Pune.

As per the latest economic survey of Maharashtra 2018-19, the doctor population ratio in the state is 1:1,330 against the WHO recommended 1:1,000. In isolated parts of the state such as Gadchiroli, the ratio is dreadfully low with one doctor for a population of 5,000 or more. Officially, the state has over 1.5 lakh allopathy doctors and around 66,081 are PG degree holders.

The decision has aroused a mixed response from experts, mostly because of the state’s failure in executing the existing bond services effectively. All MBBS and PG students studying in the public medical colleges are supposed to serve a compulsory one-year bond after the completion of each degree failing which MBBS students have to pay a penalty of Rs 10 lakh, PG doctors Rs 50 lakh and Rs 2 crore by super-speciality candidates. But, data has shown that less than 10% candidates continue to finish the bond or even pay the penalty.

Dr Abhay Shukla of Jan Arogya Abhayan said that it is a unique approach but wondered that the state could have got 5,000 doctors by implementing the bond concept. He further said that penalty doesn’t work here. Vast countries like Canada and Australia manage to get doctors to work in rural areas by providing them good facilities.

Former dean of KEM Hospital Dr Avinash Supe said the decision was a bold one but should be supplemented by up-gradating rural infrastructure. The state has to ensure that the centres have updated facilities and infrastructure is well-maintained.