The Association of State Medical Interns (ASMI), Maharashtra, has sent over 10 letters to ministers of the state and union governments since April 2023 about rising fees and the uneven stipend given to medical interns who work in government hospitals in the state.
The Maharashtra government pays a monthly stipend of Rs 11,000 (effectively Rs 10,800) to medical interns — which is the lowest in the country.
Medical interns have said that there has been no increment in their stipend for the last five years and are demanding an increase in their monthly stipend amount from Rs 11,000 to Rs 30,000.
“This is not practical for us in today's times when the price of basic human needs have reached an all time high," Dr Gaurav, an intern at the Government Medical College and Hospital, Nagpur told The Core.
It is also very less if compared to stipends received by interns of other states in India with some states offering as high as Rs 30,000. The average stipend across India is Rs 21,000.
“Interns play a key role in offering health services to patients and their demands should be heard and justice be served,” said Dr Gaurav.
“We have offered many letters to various ministers, MLAs, officers, etc. and if our demands are still not heard we will have no other option but to withdraw our services and go on an indefinite strike for the sake of our demands,” he said.
Further, the letter also stated that on an average there has been a 45% increase in MBBS fees, from Rs 72,000 in 2017 to Rs 1,05,000 currently.
Stipend In Other States
Karnataka and Assam pay Rs 30,000 to their intern doctors — which is the highest in the country. Overall, there are 11 states that pay below Rs 20,000 and four that pay below Rs 15,000 (Telangana, Madhya Pradesh, Uttar Pradesh and Maharashtra).
Notably, not only is Maharashtra the lowest paying state when it comes to monthly stipends, it is also one of the states with the highest MBBS fee. While an intern doctor spends more than Rs 4.72 lakh over 4.5 years, they earn only Rs 1.32 lakhs during the internship duration of one year.
On the other hand, medical interns in Karnataka and Assam are paid Rs 3.6 lakh per annum (36% more than doctors in Maharashtra) for lesser course fees.
Interns in private hospitals receive no pay or are paid far lesser than government hospitals. “We do not get a single rupee as stipend and our batch paid a fee of 8 lakhs per year,” Dr Chirag* from Maharashtra Institute of Medical Education and Research, Pune, told The Core. “But ours is the only hospital that does not pay in Maharashtra,” he added.
Other private colleges in the state pay a monthly stipend between Rs 2,500 to Rs 10,000 during the internship period. On an average an open category student has to spend around Rs 36 to Rs 40 lakhs, he said.
Low wage, long hours
Dr Ketan, 24, a medical intern at JJ Hospital in Mumbai, receives a monthly stipend of Rs 10,800. On an average he has to work for a minimum of eight hours a day but on some days it stretches to 24 to 30 hours due to emergency postings.
Long working hours, patient load, infection exposure, lack of emergency facilities and equipment and managing studies in spite of all this takes a toll on us, he said. “On most days my lunch and dinner timings are altered due to emergency duties,” he added.
Additionally, he said, “We are also assigned for rural posting in Palghar. We don’t get any allowances from the management or the government for travel purposes.”
There is no definite schedule for an intern. The reason they give is that you have to be prepared for future scenarios. Under the name of exposure they’re exploiting us,” said Dr Shinde
Need For Uniformity in Stipend
Dr Atharva Shinde, vice president of ASMI said that government medical colleges come under the rule of the state government because of which the central government cannot impose a standard policy because the budget of every state is different. “Hence it depends entirely on the state governments. But central universities like AIIMS, NIMHANS, etc, receive the same stipend because it falls under the central government,” he said.
“We reached out to every MP and MLA. It has been around five months and the government has not responded to our requests,” Dr Shinde told The Core.
According to Dr Ishwar Gilada, an infectious diseases expert and secretary-general, Organised Medicine Academic Guild, the issue has existed for years.
“Doctors have always protested for a pay raise. Even when I was in medical college in 1979 we had gone on strike for stipend related issues. It was only after that the government listened,” Gilada said.
“The internship is not only a training experience. These doctors are responsible for the lives of people. The state and central government should treat them with honour and dignity. An uniformed stipend for interns should be given across the country otherwise we will be facing a brain drain.” Dr Gilada concluded.