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CONTROVERSIES IN MEDICINE
Year : 2021  |  Volume : 2  |  Issue : 3  |  Page : 256-261

Reservations in medical colleges were justified and should continue: Against


Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

Date of Submission15-Nov-2021
Date of Decision08-Dec-2021
Date of Acceptance11-Dec-2021
Date of Web Publication28-Dec-2021

Correspondence Address:
Dr. Sunil K Pandya
Jaslok Hospital and Research Centre, Dr. G. V. Deshmukh Marg, Mumbai - 400 026, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JME.JME_100_21

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How to cite this article:
Pandya SK. Reservations in medical colleges were justified and should continue: Against. J Med Evid 2021;2:256-61

How to cite this URL:
Pandya SK. Reservations in medical colleges were justified and should continue: Against. J Med Evid [serial online] 2021 [cited 2022 Jan 24];2:256-61. Available from: http://www.journaljme.org/text.asp?2021/2/3/256/333946




  Synopsis Top


Our Constitution prohibits distinctions on the basis of caste and creed. This step was taken to ensure that all castes and creeds were treated as equals in democratic India.

Help was provided to hitherto downtrodden sections of society by enabling preferential treatment to them for a limited duration. Corrective steps by government and other agencies over this period were to ensure socio-economic justice to these vulnerable groups so as to bring them on par with the rest of the population.

Instead of ensuring that every possible facility was provided to all members of the segments of the population who had, thus far, been denied them, successive governments have followed the easier options of perpetuating reservations not only in primary and secondary education but also in institutions catering to tertiary education.

Admission of students to public sector medical colleges has been blighted by reservation of progressively increasing number of seats for the underprivileged members of society. Selection for such admissions is made on the basis of their castes, subcastes and tribes. Many of these seats are awarded to students of low academic merit. Non-availability of seats in these old, prestigious medical colleges has pushed meritorious students of 'higher castes' into the private colleges. A significant number travel abroad for their medical studies.

An especially deplorable consequence in medical education has been appointment of administrators and teachers ranging from lecturers to professors, heads of departments and of institutions on the basis of reservations, candidates of proven greater merit being rejected in the process.

Reservations in medical colleges have lowered standards and perpetuated mediocrity.


  The Fundamental Problem Top


The Oxford English Dictionary tells us that the word caste is derived from the Spanish and Portuguese casta (race, lineage, breed); used by them to distinguish pure from mixed stock.

The belief that Brahmans were created from the navel of Brahma and Sudras from his feet led to discrimination over the ages and appears to be the credo of those who justify their ill-treatment of everyone ranking below them in this hierarchy.

Codification of castes by British administrators in the 196 century and preferential allocation of 'respectable' and remunerative jobs and appointments to those from the higher castes cemented prevalent attitudes in society. Historic prohibitions imposed on members of lower castes– education, sharing meals, walking on streets, owning land and property, occupations to which they may aspire, the use of wells and places of worship and inter-marriage continue in 2021.Cruel and inhuman enforcements are reported frequently in our newspapers and on television. These have ensured that these benighted communities remained suppressed, denied human rights and in poverty.

The depths of degradation are reached when those from the 'higher castes' consider it their right to rape 'lower caste' girls and women and enslave them, their menfolk and children; condemn them to lives of misery and servitude; punish, mutilate and murder them for imagined crimes without any recourse to the process of law. When exposed, criminal cases against the wrong-doing 'upper caste' are filed in such a manner that convictions are the exception.

Since division into castes is made in Indian society at birth, stigma is life-long and unchangeable.

Palliative measures such as reservations are not the answer. If we remain on this path, we shall continue to lower standards of medical education and the care of patients, drive away some of our finest young physicians and fail to engender pride and the spirit of competition in the very youngsters we seek to help. Over time, we shall see that nothing has changed as far as the ill-treatment of the deprived is concerned.


  The Constitution of India Top


The grey eminences that drafted this document paid special attention to discrimination.

I reproduce selected segments:

Article 14. Equality before law. - The State shall not deny to any person equality before the law or the equal protection of the laws within the territory of India.

Article 15. Prohibition of discrimination on grounds of religion, race, caste, sex or place of birth.

Article 16. Equality of opportunity in matters of public employment.

Article 17. Abolition of untouchability. The practice of untouchability in any form is forbidden. The enforcement of any disability arising out of untouchability shall be an offence punishable in accordance with law.

As is obvious, we have failed miserably in enforcing any of these provisions. The blame must be placed squarely on successive governments and law-enforcing agencies.

Article 243D. Reservation of seats:

  1. Seats shall be reserved for


  1. The scheduled castes; and
  2. The scheduled tribes.


Article 334. Reservation of seats and special representation to cease after 10 years.


  Why Was the Limitation of 10 Years Specified? Top


Overcoming his initial objection to reservations, Dr. B. R. Ambedkar provided a guideline on them:

'…Supposing, for instance, we were to concede in full the demand of those communities who have not been so far employed in the public services to the fullest extent, what would really happen is, we shall be completely destroying the first proposition upon which we are all agreed, namely, that there shall be an equality of opportunity'.

'Let me give an illustration. Supposing, for instance, reservations were made for a community or a collection of communities, the total of which came to something like 70% of the total posts under the State and only 30% are retained as the unreserved. Could anybody say that the reservation of 30% as open to general competition would be satisfactory from the point of view of giving effect to the first principle, namely, that there shall be equality of opportunity?'

'In my judgment therefore the seats to be reserved, if the reservation is to be consistent with sub-clause (1) of Article 10, must be confined to a minority of seats…'.

He also specified the duration over which such reservations should prevail.[1]


  Extensions of the Duration of Reservations Top


Sudarshan et al.[1] made this observation: 'Reservation in the Parliament and State Legislatures provided for the Scheduled Castes and Scheduled Tribes through Articles 330 and 332 of the Constitution was initially to remain operative for 10 years'. This 10-year duration has been extended four times since 1960 when it first expired. The very fact that this term for political reservation for the Scheduled Castes and Tribes had to be extended four times shows that there is something basically wrong with this system of reservation which has failed to achieve its objective even after four decades. The plight of these sections of society has further worsened and their problems have remained largely unsolved. What is worse, most of the representatives of the Scheduled Castes and Tribes who got elected on reserved seats have seldom raised their voices in Parliament and the State Legislatures against the daily increasing atrocities on these weaker sections of society….

'Efforts should be made to impart high quality education to the children belonging to the Scheduled Castes and Scheduled Tribes. Adequate financial subsidies and loans must be made available to enable them to free themselves from the clutches of poverty, hunger, disease and ignorance. Keeping them as supplicants forever and luring them into an illusory world of promised prosperity through reservation is neither good for them nor for the nation'.

Sudarshan et al.[1] defined the problem and suggested the solution. Those at the helm of affairs have failed to pay heed to him over the past 30 years.


  Disadvantages of Reservations Top


Escalating demand for increase in quotas of seats and posts for reserved categories

Demands for inclusion in categories that benefit those able to enlist in them continue to intensify. The number of categories and subcategories continue to increase. As far as I can tell, not a single community has been taken off the lists thus far.

Official categories for reservations include scheduled castes, scheduled tribes, other backward classes (OBCs) and, since 2019, economically weaker sections.

One survey on 03 March 2019 (https://www.clearias.com/reservation-economically-weaker-sections-ews-quota/) showed the percentage of reserved categories as follows:

The central list of OBCs up to 2017 includes separate lists for each of 31 states.[2] The list for Maharashtra under 'Caste/Community' has 281 categories of classes starting with 'Alitkar' and ending with 'Lazard'. If you combine all classes in all states, your mind will boggle.

There is a persistent demand for more and more seats (for admission to educational institutes) and posts (in employment cadres) for these categories.

As shown in [Table 1], only 40.5% seats and posts were available in the 'open' category on merit in 2019. This would have been unacceptable to Dr. Ambedkar as it completely destroys 'the first proposition upon which we are all agreed, namely, that there shall be an equality of opportunity'.
Table 1: Reservations based on schedule of castes, tribes etc

Click here to view


Misuse of reservations by those who do not need them

There should be just one class of citizens for whom special help in learning from government and society is justified – individuals of promise among those are have been deprived of opportunities.

Financially well-to-do and politically powerful entities claim benefits that should, rationally, go to the many who are truly deprived. Sections of the 'higher castes' are manoeuvring to get themselves included in the reserved categories. This runs counter to the criterion identified in the preceding paragraph.

Professor Andre Beteille phrased it well: 'The prospects of material advancement through reservations have led to a kind of competitiveness for backwardness… This kind of competitiveness creates a vested interest in backwardness… It stifles individual initiative without creating equality between individuals and it obstructs the natural processes through which the barriers between castes and communities can be effaced…'.[3]

Merit is spurned

At times, the difference in merit when seats are awarded and appointment to posts are made is almost unbelievable. A person from the reserved category with a very low grades gains a seat or post in preference to a candidate from the open category with much greater proven merit.

Poor preparedness, lack of confidence in using the English language pose great difficulties

Many students admitted to the first M.B. and B.S. class in medical colleges on reserved seats often find themselves at a loss. They have not benefited from education in English and thus find it very difficult to understand what is taught. At a premier medical college in Mumbai, I was asked to deliver a scheduled lecture in Marathi. The teacher who had organised the talk pointed out that many of the medical students in the audience did not understand English.

These hitherto deprived students are unable to participate meaningfully in seminars, discussions, tests and examinations. A percentage of these students will fail and have to repeat classes, suffering demoralisation.

They are forced to depend on published 'guides', tuition classes and other substandard sources of current knowledge rather than on advanced texts, journals, conference proceedings and the treasures available in libraries and on the world-wide-web.

Erroneous methods of education are being proposed

Solutions posited to help such students, like the system of reservations itself, are counterproductive and do not address the root cause of the malady. Education in vernacular languages is being advocated in medical and engineering colleges (to use but two examples).

The lessons from the 1830s and 1840s when such experiments by experts in the East India Company failed have obviously been forgotten. Let me quote just one instance. When the first medical school was set up in Bombay in 1826, Dr. John McLennan, the sole teacher, was asked to translate books on anatomy, physiology, materia medica, medicine and surgery obtained from England into Marathi. The task was arduous even then. It did not strike the administrators of the day that it is impracticable to teach advanced sciences in native languages. Eventually the school was deemed a failure and was disbanded. Learning from the experience at this school, Dr. Charles Morehead, first Principal of the Grant Medical College and the Board of Education in Bombay specified in 1845 that '…the course of medical instruction in the College will be carried on through the medium of the English language…'.[4]

The numbers of books, journals, learned treatises and works that stimulate the intellect have multiplied many times since 1845. These are essential to maintain scientific rigor and propel medical advances. How is anyone to translate these at the rate at which they are being produced? And into how many languages shall we translate them? English is the universal language of communication in medicine, engineering and other forms of higher education and common-sense dictates that we should exert every sinew in capitalising on the heritage of excellence in this language we are fortunate to possess.

If education in Maharashtra is to be only in Marathi, students and professionals will, perforce, be cut off from advances in their fields. Besides, they will be unable to serve their functions in any state other than their own. Exchanges of scientific data, hypotheses, techniques and plans for the future between states will almost come to a standstill. And what of students in Maharashtra whose mother tongue is Gujarati or Kannada or Tamil or Malayalam or Bengali?

Demoralisation of the truly meritorious

There is another drawback to the present system. The resultant demoralisation in the truly merited is evident. Some of these students gain admission into capitation fee medical colleges. The evils of this practice are well known. Others prefer education abroad. Britain, U.S.A., Canada and Australia were preferred earlier. With increasing numbers travelling along this route, we now have Indian students in Russia, China, Malaysia, Ukraine, Philippines – and this list is increasing each year. Several students remain in these countries after completing their education with consequent loss of talent in our own country.

When individuals who are not of the highest calibre are appointed to academic and administrative positions in institutions of higher learning, they lower the standards of education, fail to inspire students and set course for a downward spiral. The results are already evident in many public sector medical colleges.

When advertisements of academic professorial and other posts reserved for specific castes or backward classes elicit no applications meeting requirements, the posts are often not filled in by applicants from the open category or are filled in only for a year when the posts are re-advertised. There are also occasions when after three or more years, candidates meeting the requirements of the reserved posts do apply, they are selected for appointment despite being found to lack expertise and being generally substandard. Such steps downgrade the quality of teaching, care of patients and research.


  Two Legal Opinions Top


Legal luminaries have provided clear opinions which, alas, have been consigned to the waste bin by our 'leaders'. Let me quote just two examples.

In 1994, Nani Palkhivala was very clear in his observations on reservations when he commented on the judgement in Indra Sawhney. '…The basic structure of the Constitution envisages a cohesive, unified, casteless society. By breathing new life into casteism the judgement fractures the nation and disregards the basic structure of the Constitution. The decision would revitalise casteism, cleave the nation into two – forward and backward – and open up new vistas for internecine conflicts and fissiparous forces and make backwardness a vested interest'.[5]

Ten years ago, Justice J. B. Pardiwala included the following paragraph in his judgment: 'If I am asked by anyone to name two things which have destroyed this country or rather have not allowed the country to progress in the right direction, then these are (i) Reservation and (ii) Corruption. It is very shameful for any citizen of this country to ask for reservation after 65 years of independence. When our Constitution was framed, it was understood that the reservation would remain for a period of 10 years. Unfortunately, it has continued even after 65 years of independence'.[6]


  What Are the Logical Means for Fostering Merit in the Hitherto Deprived? Top


Do not merely treat symptoms, eradicate the disease.

Empower the underprivileged in every way starting from infancy.

If these deprived communities are enabled to live well, are well-educated and able to seek and obtain occupations of their choice, they will rise to become respected and productive citizens on their own merit.

Gandhiji advocated this approach in the 1930s, well before we gained independence. He had lived amongst Harijans in different parts of the country. As Tushar Gandhi pointed out, 'Gandhi's idea for poverty alleviation was beginning at the bottom of society instead of the top'. His stated mission included wiping the tears from every eye.[7]

Houses for the deprived

Let us take the example of houses for the deprived. Laurie Baker– who won international fame with his work – described the source of his architectural philosophy: 'It was also through the influence of Mahatma Gandhi that I learnt that the real people you should be building for, and who are in need, are the ordinary people-those living in villages and in the congested areas of our cities… One of the things he said has influenced my thinking-that the ideal house in the ideal village will be built using material that is found within a five-mile radius of the house'. In following this guideline, Baker revolutionised the concept of housing.[8]

Gandhi's description of an ideal village is all-embracing. 'An ideal Indian village will be so constructed as to lend itself to perfect sanitation. It will have cottages with sufficient light and ventilation built of a material obtainable within a radius of five miles of it. The cottages will have courtyards enabling householders to plant vegetables for domestic use and to house their cattle. The village lanes and streets will be free of all avoidable dust. It will have wells according to its needs and accessible to all. It will have houses of worship for all, also a common meeting place, a village common for grazing its cattle, a co-operative dairy, primary and secondary schools in which industrial education will be the central fact, and it will have Panchayats for settling disputes. It will produce its own grains, vegetables and fruit, and its own Khadi. This is roughly my idea of a model village…. My ideal village will contain intelligent human beings. They will not live in dirt and darkness as animals. Men and women will be free and able to hold their own against anyone in the world '[9] (Emphasis added).

Even a cursory survey of our villages will show how little has been done towards reaching this goal.

Education

A fundamental requirement is ensuring education of high quality from the primary classes in every school – in village, town and city. Coupled with good nutrition and life in a well-planned home, education from infancy will over a generation or so work wonders. Each student must be helped to continue learning after completing schooling. All necessary help must be provided to proceed on the basis of aptitude and inclination. Some may opt to enter streams leading them to art, culture, mechanics, architecture and service industries. Others will wish to continue in fields such as engineering, medicine, other sciences, philosophy and higher learning.

We also need all schools to conduct classes to sensitise all students to the plight of our poor and the deprived. Members of the 'lower castes' will gain from the ability provided by this step to voice their experiences and present their histories to these impressionable minds. We have a precedent with good results.[10]

Those opting for medicine must be enabled to compete with those from the well-to-do classes of society on equal terms. Such competition will inspire them to outdo others, raise their own standards, and in the process, engender pride.

Education – undergraduate and post-graduate – in our medical colleges needs an almost complete overhaul. If teachers with an aptitude for teaching and showing excellence in clinical and laboratory work carry out their functions satisfactorily, why should there be a need for any student to attend coaching classes?

No more will hitherto deprived individuals need to seek benefits and privileges denied to others. They will hold their heads high as they compete for seats and posts on their own merit.

It goes without saying that any indiscipline in these temples of learning should be dealt with in an exemplary manner. There should never be another tragedy such as that suffered by Dr. PayalTadvi in the B. Y. L. Nair Hospital in Mumbai (See https://en. wikipedia. org/wiki/Suicide_of_Payal_Tadvi),

A level field

Ensuring for the deprived a level field where the rich and 'higher castes' have no biases in their favour will necessitate shedding corruption, nepotism and half-baked and poorly planned measures.

We are well aware of the problems created by the erstwhile Medical Council of India and the current National Entrance and Eligibility Test. These place additional impediments on already handicapped students.

As an aside, I wonder how it is that those able to pay for coaching classes score near 100% marks. The pernicious effects of such incompetent assessment are far-ranging.[11]

Abolition of medical colleges charging capitation fees

These institutions favour only the rich. The quality of education imparted by such colleges set up by politicians and others remains of questionable standards. The only interests of the founders appear to be gaining pelf and power. Such colleges should have no place in our country.

Discipline those ill-treating 'low caste' individuals and groups

Exemplary and punitive action against them must follow. Everyone in the line of action must ensure that no legal loophole is permitted such wrong-doers and no case against them is dismissed by any court on the grounds of shoddy evidence and poor prosecution.

If we can ensure this throughout our land, we shall have uprooted a major factor encouraging ill-treatment, rapes, slavery and murder of 'low-caste' citizens.


  Conclusions Top


Reservations of seats and appointments to staff in medical colleges and hospitals are wrong.

The true solution to the problems faced by those deprived over centuries on the basis of caste and tribe is elevating their living standards, guaranteeing them housing as envisaged by Gandhiji, providing them nutrition, education of high quality from primary school onwards, ideal health care and respectable and ensured occupations.

As regards education, the key is provision of everything needed – well-planned schools, funds, meritorious teachers, books, opportunities for sport and other extracurricular activity… from infancy. As the child progresses, so should the facilities. Merit must be identified and nurtured. The provision of necessities should continue beyond school and into primary college. Students from poor families must be enabled to educate themselves by ensuring that their parents can more than make ends meet. There should never be a need for the student to avoid school to safeguard the family's livelihood.

When it is time to compete for entrance into institutions of higher learning, the student must be well equipped to compete on equal terms with all other candidates.

The need for reservations 75 years after independence and in the face of a clear declaration that reservations were a short-term measure is an indictment on the failure of successive governments in Delhi and in the states to ensure a fair deal to those classed as members of deprived castes and tribes.

They have also failed to ensure benefits to those truly deserving them – the poor and downtrodden. Beneficial measures such as reservations must not be available to the rich and politically powerful from amongst the castes classified under schedules. The deprived should not remain deprived.

The future appears bleak as political expediency, the urge to hang on to positions of power and the almost overwhelming tendency to view every step only through the prism of how many votes it will engender do not augur well.

Society, at large, has done little to compel governments to serve the poor and deprived.

Reservations have further sapped the will to excel, struggle and overcome handicaps.

Let me conclude with the words of Jawaharlal Nehru, which are as relevant now as they were in 1961: 'The only real way to help a backward group is to give opportunities of good education, this includes technical education... Everything else is provision of some sort of crutches which do not add to the strength or health of the body… If we go in for reservations on communal or caste basis, we swamp the bright and able people and remain second-rate or third-rate. I am grieved to learn of how far the business of reservation has gone on communal considerations. It has amazed me to learn that even promotions are based on communal or caste considerations. This way lies not only folly, but disaster. Let us help the backward groups by all means but never at the cost of efficiency…'.[12]


  Note Top


I have used the term 'deprived' and 'lower castes' to include all those falling under the schedules for reservations.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sudarshan A, Ambedkar BR, editor. The Man and his Message. A Commemorative Volume. New Delhi: Prentice-Hall of India Private Ltd.; 1991.  Back to cited text no. 1
    
2.
National Commission for Backward Classes: Central List of OBCs in 31 States. Available from: http://www.ncbc.nic.in/user_panel/centralliststateview.aspx [last accessed on 2021 Oct 20].  Back to cited text no. 2
    
3.
Andre B. The Backward Classes in Contemporary India. New Delhi: Oxford University Press; 1993.  Back to cited text no. 3
    
4.
Sunil P. Medical Education in Western India: Grant Medical College and Sir Jamsetjee Jejeebhoy's Hospital. Newcastle upon Tyne: Cambridge Scholars Publishing; 2019.  Back to cited text no. 4
    
5.
Nani AP. We, the People. New Delhi: UBS Publishers; 1999.  Back to cited text no. 5
    
6.
Pardiwala JB. Justice: Judgment in the High Court of Gujarat at Ahmedabad. Special Criminal Application (quashing) No. 6330 of; 2015. Available from: https://indiankanoon.org/doc/38630401.[Last accessed on 2021 Jul 08].  Back to cited text no. 6
    
7.
Gitika B. Gandhi Shares his Vision for India. Available from: https://www.chathamhouse.org/publications/the-world-today/2020-04/gandhi-shares-his-vision-india [Last accessed on 2021 Aug 15].  Back to cited text no. 7
    
8.
Ram P, Baker L. The Gandhian Architect. Available from: https://www.mkgandhi.org/articles/laurie-baker-the-Gandhian-architect.html [Last accessed on 2021 Oct 20].  Back to cited text no. 8
    
9.
Garg BS. Community empowerment on health and development based on Gandhian approach an experience of working in few villages of Wardha District, Maharashtra. Indian J Med Res 2019;149:63-7.  Back to cited text no. 9
[PUBMED]  [Full text]  
10.
California Department of Education: State Board of Education approves Historic Ethnic Studies Guidance for High Schools. Available from: https://www.cde.ca.gov/nr/ne/yr21/yr211rel21.asp [Last accessed on 2021 Sep 17].  Back to cited text no. 10
    
11.
Anita R. Marks Boom and Killing Cut-offs: Time to Re-examine Exam System. Mumbai: The Times of India; 2021. p. 18.  Back to cited text no. 11
    
12.
Jawaharlal N. In: Parthasarathi G, Letters to Chief Ministers 1947-1964. Vol. 5. New Delhi: Oxford University Press; 1989.  Back to cited text no. 12
    



 
 
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