Solving Societal Problems Requires Collaborative Approach: Sadguru Sri Madhusudan Sai

Sadguru Sri Madhusudan Sai spearheads a global mission of service and spirituality across 33 countries. Since 2011, Sri Madhusudan Sai has established institutes of excellence which brings respite to thousands of underprivileged and needy children, through free healthcare, free education and free nutrition. In an exclusive conversation with BW Education, Sai addressed the major challenges to the medical education and healthcare in India. He also highlights a few solutions to tackle geographical disparity between rural and urban areas and make medical education and healthcare more affordable. Excerpts:

How do you propose resolving the challenges related to the accessibility of medical education in India, including limited seats and high fees in private institutes?

In a country where the number of aspiring doctors far exceeds the available seats, the scarcity of opportunities poses a significant challenge. The NEET exam, taken by approximately 1.8 million individuals, leaves only around 8,00,000 qualifying candidates. Unfortunately, the shortage of MBBS degree seats, with only 100,000 available, exacerbates the issue. Moreover, the number of seats for PG courses is even more limited, resulting in a scarcity of specialists compared to general practitioners.

This growing problem threatens to become one of the most pressing issues in the country in the coming years, potentially hindering people's access to healthcare. Recognising the urgency, a solution has been devised to address the root cause of this disparity: the cost of medical education and its accessibility to rural students who study in vernacular languages.

These students often face difficulties cracking exams conducted in English and struggle to secure seats in reputable medical colleges. Even private colleges demand exorbitant fees. To tackle this challenge, a unique approach has been proposed: the establishment of a fee-free medical school.

Under this innovative model, students who pass the NEET exam can receive free medical education. The only condition is that they commit to serving in rural areas for the same duration as their educational period. By completing their five-year MBBS degree, students contribute to society while gaining valuable education at no cost. This initiative addresses the shortage of healthcare professionals in rural India, providing an opportunity for aspiring students who cannot afford medical education.

In your experience, what are the primary factors contributing to the high cost of medical education in India, making it unaffordable for most students? Furthermore, what measures can be taken to mitigate these costs and ensure greater affordability?

The main issue lies in the significant disparity between the number of available medical seats and the number of aspiring doctors. 

Half of these students secure seats in government institutions based on merit, while the other half opt for private institutions that require payment. Consequently, the high demand drives up the cost of medical education. Despite government regulations on maximum fees, private institutions find ways to impose additional charges.

The primary challenge revolves around the demand-supply gap. Although the government is working towards opening medical colleges in various districts, quality concerns arise. Only a few medical colleges offer high-quality education due to factors such as faculty expertise, infrastructure, patient load and clinical data availability. Most colleges lack these essential elements, creating gaps in medical education.

In summary, the challenges encompass the supply-demand mismatch, limited quality education in specific colleges and the subsequent increase in the cost of education.

How can we address the challenge of geographical disparity in accessing medical education, especially for students from rural areas who often lack opportunities to pursue medical studies due to the concentration of institutions in urban areas?

The primary challenge lies in the disparity between regional languages used in rural education and the English-medium exams required for medical studies. Rural students struggle to adapt and compete with their urban counterparts, hindering their chances of admission.

To address this, coaching classes should be established in rural areas, providing training and support to students. However, the affordability of such classes poses a challenge. Efforts from the government or charitable organisations are necessary to make coaching accessible to rural students, levelling the playing field.

Furthermore, the establishment of more medical colleges in rural areas, where patient load is high, could alleviate the shortage of healthcare professionals. However, the quality of education and availability of faculty become concerns. Converting district hospitals into medical colleges is a positive initiative, but ensuring faculty availability and their willingness to settle in rural areas remains an obstacle.

Our own rural medical college has addressed some of these issues by providing infrastructure, faculty support, and basic amenities for faculty and their families. The patient load and diverse cases also enhance the training experience. The government needs to accelerate efforts to bridge this disparity and provide opportunities for rural students.

Is the burden of limited seats in Indian medical institutions forcing students to pursue education abroad, only to face additional exams upon their return if they wish to practice medicine in India?

Ensuring quality medical education and care in India poses challenges, particularly for doctors who pursue education abroad. While it is reasonable to expect them to meet Indian standards, the licensing process should complement their training rather than burden them with additional exams and topics. Achieving global standards in medical education would facilitate seamless integration and remove unnecessary barriers. Balancing quality assurance and recognition of training received abroad is crucial to address this issue and ensure the provision of high-quality healthcare in the country.

How does your organisation collaborate with government agencies, institutions and stakeholders to improve the accessibility and affordability of medical education in India, particularly in rural areas?

I believe that solving societal problems requires a collaborative approach involving individuals, institutions and the government. As a charitable organisation, we work closely with the government to leverage schemes like ‘Ayushman Bharath’ and employee state insurance to reduce the cost burden on our hospitals and provide affordable healthcare to rural patients. Government provisions, such as the modifications by the National Medical Commission (NMC), have helped us streamline the establishment of our medical college by reducing land and bed requirements. However, there is still scope for further innovation and support for charitable institutions to facilitate the seamless establishment of medical schools in rural areas.

What is your plan to equip your colleges and institutes with state-of-the-art technology and tools, considering that many Indian medical institutions and government hospitals are reported to be using outdated equipment?

When it comes to funding colleges and implementing the latest technology, expenses can be significant. However, our institution has actively sought support from like-minded organisations, foundations, philanthropists and institutions worldwide. We have received contributions from over 30 countries, which have played a crucial role in building our institution. Through voluntary donations, we have raised substantial funds, nearing a quarter billion rupees, to provide the best education to rural children. 

We operate 10 hospitals across India, spanning from Trichy to Karnataka and from Mumbai to Chhattisgarh. These hospitals, with a focus on pediatric and general care, are made possible by the support of monetary donations, volunteers, and philanthropists who share our vision for quality care and education for rural communities. 

Looking ahead, we envision setting up one or two more colleges across the country, ensuring accessible medical education for all. Currently, we have schools, colleges, and a university in Karnataka that offer medical education from undergraduate to post-doctoral programs. Furthermore, we have 27 schools that provide free education from grades six to twelve, acting as a pathway for students to pursue medical studies in our colleges. Expanding this model is part of our plan.

Apart from raising awareness about the challenges in India's medical industry and education, what inspired you to take action and address these issues?

The fundamental principles of our organisation are rooted in religious ethics and the belief that we are all one global family. We consider everyone as our own and embrace the concept of unity in diversity. Our inspiration comes from the teachings of spiritual leaders, who emphasised the importance of translating spirituality into service. We understand that true spirituality cannot exist without compassionate action. It is not limited to rituals or pilgrimages but encompasses charity and healthcare. We are motivated by the understanding that spirituality must be accompanied by tangible support for those in need. As Mahatma Gandhi aptly expressed, "God manifests in the form of richness for the poor, nourishment for the hungry, healthcare for the sick, education for the uneducated and shelter for the homeless." We believe that spirituality today should be redefined as a dedicated service to those who require assistance.