Reservation in postgraduate education for government in-service doctors: a case study from Andhra Pradesh

Introduction In order to achieve health for all, it is essential to attract and retain health workers in rural India, a need recognised by the National Rural Health Mission (NRHM), a flagship programme of government of India. Since the majority of allopathic doctors aspire to do specialisation, making it easier for doctors serving in rural areas to get admission to specialist medical postgraduate courses is a logical step towards attracting fresh medical graduates to serve in rural health services. In this study, we explore one such strategy used by the state of Andhra Pradesh. The state has reserved 50% of seats in postgraduate preand para-clinical disciplines, and 30% of seats in postgraduate clinical disciplines for candidates who have served in government health services. Students using this scheme have to sign a bond of INR 20,00,000 (USD 42946.1) and are required to serve in state government health services for the period of five years after completing their postgraduate education. If they leave the government health services before a minimum of five years period, they are obliged to pay the bond amount and refund the salary amount received after their postgraduate course. Doctors having served for two years in tribal areas, or three years in rural areas, or five years in urban areas become eligible for these reserved seats.