Rs 600 a day keeps the doctor away

The stipend we get is Rs 600 per day Labourers earn more than usrdquoFor Dr Rohit Sidhamwar medical intern at JJ Hospital and joint secretary of the Association of State Medical Interns ASMI the arithmetic of becoming a doctor in Maharashtra is increasingly difficult to reconcile After years of studying medicine the intern from Nanded district finds himself asking his family for money even as he works shifts stretching up to 30 hours His monthly stipend of Rs 18000 he says barely lasts 15 daysldquoAn Rs 18000stipend only works for 15 days and that too after a lot of planning If I want to go out that becomes even more difficultrdquo he says ldquoWhen you have an internship after studying and paying tuition and hostel fees for four years you would like to be financially independent to some extentrdquoThe struggle is not just about making ends meet It is about the gap between the responsibility interns shoulder inside hospitals and the value attached to their work From handling outpatient departments OPDs emergency wards collecting samples and checking patientsrsquo vitals interns are part of the machinery that keeps hospitals runningProtests at Jammu and Kashmir led to a R30000 stipend for medical interns PICINSTAGRAMgamcsanganiDr Sidhamwarrsquos emergency duty begins at 9 am with OPD work until 1 pm before he moves to the emergency ward There he handles patient formalities and investigations through the night often continuing until the next morningAdmission cards sample collection and checking vitals can stretch his duty until 2 pm on the second day mdash 30 hours in all On nonemergency days ward rounds tests and other hospital work keep him occupied until 5 pm There are no guaranteed weekends or weekly offs ldquoWe also have postings at Palghar where nothing is reimbursed for transport or foodrdquo he saysrdquoThe frustration is building across Maharashtra More than 8000 medical interns have threatened to strike post Diwali demanding that their monthly stipend be raised from Rs 18000 to Rs 30000The proposed stir could affect services in 42 government hospitals and 28 major private hospitals attached to medical colleges with OPDs emergency services and procedures potentially taking a hit The strike was going to start this Sunday but a meeting with the President of Indian Medical Association Maharashtra IMA led to the strike being postponed until Diwali seasonThe demand comes amid a wave of stipend protests across India Interns in Jammu and Kashmir Madhya Pradesh Uttar Pradesh and Uttarakhand have taken to the streets over inadequate remuneration and long working hours with several states announcing increases following protests For Dr Sidhamwar Maharashtrarsquos economic standing makes the payworkload disparity harder to acceptThe statersquos Economic Survey 202526 estimates its nominal Gross State Domestic Product at Rs 51 lakh crore retaining its position as Indiarsquos largest state economy ldquoMaharashtra is one of the richest states Then why are they paying Rs 18000 to interns That is our questionrdquo he arguesThe financial strain also follows interns home Those from financially weaker families may be expected to send money back home even as they struggle to cover their own expenses ldquoWe have to ask for money from our families insteadrdquo Dr Sidhamwar says ldquoWe also have to study for our PG degree and there are no savings at all from thisrdquoAfter three months of representations and a meeting with the medical education minister interns say they are yet to receive a response Their strike will initially leave emergency services running But if the government does not respond within five days even those services could stop ldquoWe at least deserve R1000 per dayrdquo Dr Sidhamwar saysDr Raman Pawar an MBBS intern and general secretary of ASMI believes that the fight for a higher stipend is also about being valued for the work he does Originally from Latur he says even access to hostel accommodation at JJ Hospital has been a struggle with interns having to demand rooms after being denied them for years He draws comparison to interns in other medical degrees getting paid the same amount for much less workload and fewer hoursldquoA BAMS Bachelor of Ayurvedic Medicine and Surgery intern also gets paid Rs 18000 but we work longer hours and have a much bigger workloadrdquo he says While BAMS interns typically work six to seven hours medical interns put in 10ndash12 hours with emergency duties stretching to 24ndash30 hours ldquoWe remain accountable to junior residents and may be called back at midnight to complete a patientrsquos workup Thatrsquos not the case with the BAMS interns They can walk off as soon as the clock hits 4 pmrdquoldquoRs 18000 is inadequate in terms of the work we do We need to get paid more to just maintain some dignity Right now it is downright disrespectfulrdquo Dr Pawar continues ldquoI cannot send money home when I am getting paid just R600 a day And that is a mental pressure in itselfrdquoAs Dr Sidhamwar points out interns in Jammu and Kashmir earn Rs 30000 Uttar Pradesh and Uttarakhand Rs 25000 West Bengal Rs 47000 and Karnataka Rs 30000 ldquoIf these states with a lower GDP can give it to the medical interns then why canrsquot our staterdquo he questionsWe view doctors in the country as equivalent to gods Yet when it comes to fair compensation the respect falls short The demands of medical interns in the state are of respect in a thankless job that requires them to dedicate mind body and passion The question is how long can the healthcare system expect its youngest doctors to keep working when they cannot afford to live We reached out to authorities for a response but they did not commentlsquoHospitals can afford to pay internsrsquoA student from a private medical university says that medical internsrsquo work is necessary to keep a hospital runningAt the Pravara Institute of Medical Sciences PIMS a private deemedtobe university in Loni the stipend struggle takes a different shape A finalyear medical student who requested anonymity says interns are paid just Rs 9000 a month despite being responsible for work that keeps hospital departments functioningProtests for an increase in salaries for medical students were held in Lucknow in August PICINSTAGRAMdoc_cooolldquoInterns do all the investigation and lab work paperwork patient files labelling samples and writing discharges mdash all the work residents are too busy to dordquo she says calling it ldquoscut workrdquo With 150ndash200 interns across the hospital at least 10 are assigned to each department Without them the workload shifts to junior residents delaying processes and affecting senior doctors ldquoIt is all important and necessary work in the bigger picturerdquoEvery year interns protest only to receive a Rs 500 hike ldquoI think it is ridiculous for the college to do it this wayrdquo she says Their demand is for a stipend equivalent to one per cent of the collegersquos tuition fee which would amount to Rs 20000rdquo She believes ldquoHospitals can afford to pay more given their funding The pay gap is worse at government hospitals face which face even heavier workloads with little sleep and relentless patient pressurerdquolsquoWe are not demanding special treatmentrsquoAn Instagram campaign page explains how medical interns receive lower stipends at private hospitals despite performing similar dutiesThe demand for a better stipend has also found a digital rallying point in raise_mh_stipend an Instagram campaign that has brought together medical interns across Maharashtra Launched on September 11 the page gained momentum after stipend hikes were announced in states such as Uttar Pradesh and Madhya Pradesh prompting interns to question why Maharashtra was lagging behindProtest held by ASMI in Gondia Maharashtra on Thursday PICINSTAGRAM raise_mh_stipendldquoBeing one of the major states with high living expenses in several cities Maharashtra also needed to address the issue of intern stipendsrdquo says the campaign representative While ASMI had already begun raising awareness the Instagram page intensified efforts through meetings notices and representations to medical college deans the Directorate of Medical Education and Research DMER the Chief Ministerrsquos Office and the medical education minister Dr Hasan MushrifThe campaign has since built a community of approximately 4000 followers including interns and junior medical students Their stories reveal a disparity that extends beyond government hospitals Some interns at private medical colleges reportedly receive different stipends or face deductions despite performing similar dutiesldquoSome interns have shared their financial difficulties Those studying or working in cities such as Mumbai have highlighted the high cost of accommodation food transportation and other essential expensesrdquo the representative says Others are already repaying educational loans while struggling to meet daily expensesFor the campaign the demand is about ensuring that interns are treated fairly regardless of the institution they work in ldquoWe are not demanding special treatment We are demanding fair compensation that reflects their responsibilities the cost of living and the applicable rulesrdquo the representative saysThe campaignrsquos immediate demand is a uniform stipend of at least Rs 30000 for eligible MBBS interns across Maharashtra including those in government and private colleges and eligible foreign medical graduates Beyond the hike it wants greater transparency in payments and effective monitoring of government notifications4000Followers join the campaign page on Instagram for interns