Inequality in Access to Medical Education in India: Implications for the Availability of Health Professionals

This study examines the access of students from diverse backgrounds to medical education in India. It shows how inequalities existing in society may entail significant social injustices with regard to access to a career in medicine. The study is based on data from secondary sources. The major part of the analysis is from the Periodic Labour Force Survey, 2019–20; All India Survey on Higher Education, 2019–20; and National Sample Survey data on Social Consumption, Education 2017–18. It is observed that the availability of health professionals is very low overall but it is even lower among underprivileged groups. There are indications of a better share of salaried health professionals among underprivileged caste/ethnic groups probably due to the presence of affirmative action but inequality prevails in self-employment and high quality occupations, thus reflecting the inequality prevalent in society. However, the pattern among Muslims is different from the caste/ethnic groups as the share of regular salaried workers is lower and self-employed is higher among Muslims. The study shows that access to medical courses is linked to family background depicted by caste/ethnicity and religious identities. The availability of medical education in general is very low. The situation is further aggravated for students from underprivileged backgrounds. The high cost of medical courses combined with the dominance of self-financed courses and private unaided institutions may make it inaccessible to students from weaker sections of society. In fact, the probability of attending a medical course is relatively lower for Scheduled Castes/Scheduled Tribes (SCs/STs) and Muslims than Hindu High Castes (HHCs). The low average expenditure of medical courses confirms the low quality of education accessed by the student from underprivileged backgrounds at every level. It is important to note that education of the head of the family emerges as the most important predictor for access to medicine education. Similarly low household size also improves the probability of attendance. It is thus important to improve the access to medical education through establishing new educational institutions with affordable costs. The challenge is to ensure equal access for students from underprivileged groups so that the existing inequality in the availability of health professionals may be addressed. For this, affirmative action for the students from poor families and first generation learners may be worthwhile to address the problem of inequality of access to medical education. Such policies would also improve the availability of health professionals from the underprivileged socio-religious background which in turn would play an instrumental role in ensuring better access to healthcare services for patients from underprivileged communities.