London: A prestigious British medical journal has raised an alarm over "capitation fees" paid by students to get admission in India's private medical colleges, saying it "raises concerns" about the quality of one of the world's largest medical educational systems. The so-called "capitation fees" are effectively compulsory one-off donations which could exceed Rs 10,000,000, the report in the 'British Medical Journal' compiled by Mumbai-based author Jeetha D'Silva said. "Except for a few who get into premier institutions of their choice purely on merit, many students face Hobson's choice -- either pay capitation to secure admission at a college or give up on the dream of a medical degree," writes D'Silva in the weekly peer-reviewed journal. The journal quotes a global report, 'Education For Health Professionals for the 21st Century' that also highlighted concerns recently, saying, "In India, the growth of private medical schools raises concerns about the quality and transparency of one of the world's largest medical educational systems."

The situation seems to have deteriorated recently as the regulator of medical education, the Medical Council of India, did not renew permits for at least 10 medical colleges, with 6,390 seats lost, explains D'Silva. This decrease coupled with an increase in the number of students applying to medical colleges has reportedly resulted in a sharp rise in the so-called capitation fees, the report said. Despite the Supreme Court declaring the practice illegal, capitation continues because of high demand for medical degrees in the country. It is estimated that capitation fees paid to professional colleges last year added up to around Rs 60 billion, it said. Although officials at private medical colleges that the 'BMJ' contacted stated that they follow all norms and regulations that govern admissions, many colleges are alleged to have developed covert methods to collect capitation. With huge investments in their education, students are understandably keen to start earning as soon as possible. "As a result, we see a growing inequity in healthcare standards between the rural and urban areas. Few private colleges have mandatory rural postings," the report said.