'Forced to take up bonded labour

There's massive resistance to a state policy in Karnataka that requires even private medical college graduates to do one year's mandatory rural service

- Atul Krishna

Karnataka's effort to make rural service mandatory for all medical students, including those in private colleges, has always found its way to the courts with medical students seeing it as a "lost year" and private students questioning its legality.

In January 2024, the Karnataka government amended the compulsory rural service Act to partially relax it. With the new amendment certain meritorious students are given an exception from rural service with the government citing lack of posts to accommodate all students graduating in a year.

While the latest amendment gives leeway to at least some students from taking up the mandatory rural service, private medical students have again approached the court arguing that their seats are not subsidised and hence they should not be forced to take up "bonded labour". Meanwhile, authorities are denying students permanent registration with the state medical council and students are blaming the authorities for not communicating the rules in advance.

Few vacancies 

As per the Karnataka Compulsory Service Training by Candidates Completed Medical Courses Act, 2012, "every candidate after successful completion of MBBS degree" has to practice medicine in rural Karnataka for one year.

The reasoning behind the mandatory rural service is to fix the doctor-to patient ratio in the region. The doctor to-patient ratio in India is 1:834, that is one doctor per 834 patients, according to the National Medical Commission. However, this figure hides the lopsided distribution of doctors and their shortage in rural areas as most prefer working in the cities. Karnataka is not the only state to do this. States such as Kerala have also applied this rule to both government and private colleges.