Our obsession with specialisation is hurting primary healthcare
In a remote health centre, an MBBS doctor stitches a wound, comforts a mother, treats a breathless child, and stays up through the night with no degrees beyond the basic, just deep dedication. Yet, in the eyes of the system and society, he remains “incomplete” not because he lacks skill, but because he lacks a postgraduate degree.
This is the paradox we live in today: where the real measure of a doctor is buried under a pile of entrance exams, and where service often takes a backseat to specialisation. The tale of two systems—one of service, the other of selectionplays out quietly, yet powerfully, every single day.
The pressure to specialise
From the moment an MBBS student steps into medical college, the clock starts ticking, not just to learn medicine, but to “crack” the next big thing: NEET PG. Even before they hold a syringe confidently, they’re expected to hold a high rank.
Interns skip their duties to attend coaching classes. Residents burn out chasing super-specialisations. And young doctors, no matter how competent they may be in primary care, are constantly told they are not enough until they add letters after their names.
The tragedy? Even if you serve thousands in the peripheries, you’re still seen as “waiting” for PG as if your real work hasn’t started yet.
The sacrifice of service
In rural India and especially in places like Ladakh, where terrain, temperature, and timing make every case urgent, MBBS doctors are the backbone of the healthcare system. They don’t have the luxury of asking for CT scans before clinical judgment. They don’t have a backup. They rely on skill, instinct, and heart. And yet, these very doctors, who are available 24/7, are often reminded subtly or directly that their career is “incomplete”. Society celebrates those who clear exams, not those who clear infections in children or fear in mothers.
The MBBS doctor on the frontlines
Let us not forget: the majority of doctors treating India’s population are MBBS graduates. In PHCs, CHCs, and emergency rooms, it’s often the generalists with basic training but rich experience who save the most lives. But rarely do we hear their stories. No newspaper hails the doctor who trekked in the snow to deliver vaccines. No award recognises the one who calmed an anxious family with just his presence, not his degree.
What the system misses
It’s important to have specialists; India needs them. But when the system only values specialisation, it loses sight of grassroots medicine, the art of doing more with less. The public health system thrives on dedication, not just degrees. Yet promotion policies, incentives, and public perception often do not reward this reality. When MBBS doctors are told to “wait till PG” for respect, we discourage a whole generation from staying where they are most needed.
A call for respect and reform
It’s time we change the narrative. Not every doctor must be a cardiologist. Not every MBBS graduate should be judged by what exam they clear next.
Let us start:
By recognising the service of MBBS doctors in rural areas. By making career paths for general practitioners more rewarding.By reshaping societal perceptions so that parents and peers see value in an MBBS doctor, not pity.
Above all, let us remind ourselves that a degree does not define dedication. The one who stays behind to serve is no less than the one who studies.
Conclusion
This tale of two systems doesn’t need a winner. It needs balance. Both specialists and generalists are pillars of healthcare. But for the latter, let us stop asking, “When will you do PG?” and start saying, “Thank you for being here.”
The writer is a Medical Officer at the PHC Shargole
Dr Fazal Ul Haq Wani
wa*******@***il.com