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The medical community finds itself embroiled in yet another heated debate, this time centered around the significance of academic ranks in determining the quality of doctors. Sparked by a post on social media platform X (formerly Twitter) by Dr. S.P. Kalantri, Director Professor of Medicine at the Mahatma Gandhi Institute of Health Sciences, the issue has stirred controversy among students, medicos, and professionals alike.
In his post, Dr. Kalantri raised concerns about graduates from the “lower tertile” of MBBS (Bachelor of Medicine, Bachelor of Surgery) ranks opting for critical and demanding specializations like cardiology, neurosurgery, oncology, and gastrointestinal medicine. His remarks prompted widespread reactions, with many arguing that academic ranks should not dictate perceptions of medical competence or the ability to excel in a chosen field.
Diverging Opinions on Ranks and Competence
Dr. Rohan Krishnan, Orthopedic Surgeon and former Chairman of the Federation of All India Medical Associations (FAIMA), was among the voices challenging Dr. Kalantri’s perspective. “There is no correlation between ranks and quality when it comes to medicine,” he asserted.
Dr. Krishnan emphasized that small differences in marks—sometimes as little as 5–10 points—can lead to disproportionately large rank discrepancies, making ranks an unreliable measure of competence. According to him, the choice of specialization is rarely dictated by ranks alone and is influenced by a host of other factors, including the demanding nature of certain fields.
“Specializations like cardiology, orthopedics, and surgery come with steep learning curves and grueling work hours of 12–16 hours a day. Interns and junior residents often rely heavily on senior guidance,” he said, adding that this labor-intensive aspect of certain specializations can deter many young graduates.
External Factors Impacting Specialization Choices
Dr. Krishnan also pointed to external pressures, such as rising instances of violence against doctors, particularly surgeons, as a significant deterrent for those considering intense specializations. He noted that these factors, combined with the evolving demands of medical practice, often lead graduates to reconsider their career paths. However, he believes aspirants’ preferences are fluid and likely to shift with changing market dynamics.
Academic Performance vs. Clinical Excellence
Contrasting this viewpoint, Dr. Arvind Pandey, Professor of Anatomy at Kasturba Medical College, Manipal, argued that academic performance, especially during MBBS, does have a bearing on clinical aptitude. “MBBS is a practical course that blends theoretical learning with hands-on skills. It’s reasonable to assume that someone excelling in both aspects could become a competent doctor,” he said.
However, Dr. Pandey acknowledged that academic performance should not be viewed as the sole predictor of clinical excellence. “There are always exceptions. Someone with lower scores might excel later through practice and experience,” he remarked. He also highlighted the importance of continuous learning in medicine, noting that the rapidly evolving nature of the field renders past academic performance less relevant over time.
The Broader Implications
The debate underscores deeper concerns within the medical community regarding how competence and success are measured. While some insist on the importance of ranks and academic rigor, others highlight the role of resilience, adaptability, and experience in shaping a doctor’s career.
With societal and systemic challenges also influencing career trajectories, experts agree on one point: a holistic approach is essential to understanding and evaluating medical competence, beyond the constraints of marks and ranks.
As the discussion unfolds, it raises important questions about the future of medical education and practice, and whether traditional metrics should continue to define the boundaries of aspiration in such a critical field.
