BDS+MBBS Trained Doctors for Rural India: Second Class Care or Disruptive Innovation?

Just saw this news piece on The Hindu:

Screen Shot 2014-11-29 at 9.38.45 pm

Frankly, I am not sure whether I should be outraged or applaud the Dental Council of India.

On one hand this would mean more trained doctors for providing proper care to the rural Indian population, but on the other it would be morally repugnant to both the Dentists and the rural patients. It would mean that the DCI is, by default, admitting that their students are better off trained to practice as General Practitioners than as Dentists. It would also mean that the rural Indian people are not good enough to receive care from those MBBS doctors who were trained to be MBBS in the first place. The DCI, instead of working on value addition to the course and making it lucrative for the students, is catering to the “short cut” to Medicine route instead. While it is true that there are multiple subjects that are common to the MBBS and the BDS curricula, it does not mean that the BDS should be reduced to a stepping stone for getting a “proxy” MBBS degree. Many of the dentistry students would actually be happy to see this deal, because, let us face it, their first choice would have been to study Medicine in the first place. By catering to that undercurrent, the DCI is taking a short route to popularity, and in exchange, further undermining the value of the BDS course. In my opinion, this move basically would translate into the fact that the BDS is a stepping stone to becoming an MBBS doctor.

The flip side of the story is that the Ministry, the MCI and all other health associations have failed miserably when it has come to catering to the healthcare needs of the rural Indian people. While it is true that instead of taking the long-winded, planning-intensive, exchequer-draining process of developing infrastructure, these bodies have solely concentrated on coercing junior doctors to spend time in ramshackle rural rubble passed off as healthcare centres, doctors themselves have been loathe to take the initiative to balance the issue of equity of care. If the DCI can actually pull it off, and ensure that the transition course is planned well enough to provide oral-general physicians, it would not be an entirely bad thing.

However, the crux of the case remains that even then, the rural healthcare conundrum shall remain unsolved. The biggest and most damning logic against this move is the current picture. How many BDS doctors themselves are willing to go and work in a rural setting where they shall hardly have access to any operating or diagnostic instruments? Very few. What is the guarantee that once they have been given the license to practice as MBBS doctors, they shall go down and fulfil the dual roles that they have been groomed for? And if they do, should they not, then, receive the pay of two professionals rather than one, since they are providing services equivalent to two caregivers? What about the expensive set up needed for providing dental diagnostic and therapeutic care? Will our governments handle those expenses and set them up, or will they, by default, relapse into MBBS doctoring, eventually sliding right back into the urban set up for more lucrative offers?

The MCI seems to be quite resistant against this idea, and I doubt even if they relent, the IMA or other medical professional bodies will look on this too kindly. This is unlikely to pass on and become a reality. However, as far as out of the box ideas go, this one, this one does not even know where the box is!

This post does not intend to denigrate either the MBBS or BDS physicians. This is an idea that should spark debate, and more importantly, should open up channels of communication that lead to solutions for the rural healthcare crisis in India. Do feel free to leave your comments and opinion on this matter, and if you do, please be civil. 

48 thoughts on “BDS+MBBS Trained Doctors for Rural India: Second Class Care or Disruptive Innovation?

  1. So, it ultimately becomes an eight (5 + 3) year process to become an mbbs who has to work in rural settings. Several dental practitioners already serve as general practitioners in small districts where there is increased need for health care rather than specific dental care. So many professors of mine have worked as general physicians early in their career prior to being posted as a professor/ in the city with proper dental equipments.

    Such a move would only undermine the already frail outlook everyone has towards dentistry. Ptch. Why would DCI think of this? (I agree with the one or two reasons you’ve stated but surely there are better ways)
    Next up, We’ll see a bridge course from Nursing to MBBS!


    1. Just trying to play points from both sides. It does not make sense to me, personally. It just makes the Dentistry course look bad. Really bad. If the big bosses cannot spur you to practise what they are teaching you, then there is something amiss…


    2. Personally, everyone I know is supremely happy with dentistry and wouldn’t trade it for mbbs, especially after roughing it out for five years. Even the first years are happy. The trend must be changing.
      : )


    3. I do admit that bit is slightly in tune with my perception, which is bound to be tinged with bias. That is how it should be: people should be proud and happy about their professions. Someone who always thinks negatively about their profession will never strive to bring positive change. It is good that the trend is changing: that is a much needed change!


    4. so you compare nurses with. BDS graduates !, tell me if nurses have to crack aipmt /neet exams for this !
      it already a drawback that we dentists will have to stydy for 3mire years..and we will work in the rural areas , and we are okay with that.
      i suppose uou are a post grad in dentistry . that makes you feel your post grad degree useless after all een you wanted to be a physician in the first choice. you envy us?!


    5. Nurses do have to crack an all india exam. Each profession has their defined requirements in the health care sector and has an importance in the society.
      It is not mandatory to study for three more years for dental surgeons. The post grad degree is completely voluntary for dental surgeons just just as it is for MBBS students.

      I am sorry that you feel I am not a physician. Just to clear the air, I don’t envy my doctor counterparts from MBBS and I, contrary to what you think, am also a physician.
      Such a superiority complex is hilarious. God bless.


  2. This is a very fertile topic for debate. Yet, if the DCI makes it mandatory that the BDS+MBBS(bridge) must practice in rural areas only, then the move is jusitified. That will trigger much more resistance. And I guess that not all BDS graduates would prefer to leave their dental profession… Well, the situation for BDS graduates is tough as they need a huge amount to euther establish their clinic or pursue a postgraduate course. Those tired and frustrated *may* opt for the bridge course, but hey! Dentists too have patriotism for their profession(just like MBBS folks do!)…

    Let’s hope the DCI, MCI and IMA take a proper decision in this regard…

    On the other front(I know I’m deviating to a significant level here), some practitioners have a feeling that MBBS doctors need training in ISM(Ayurveda, Homeopath et al) as the converse is true(ISM folks have a basic idea of Allopath).
    This is not just debatable, it may spark off some controversial topics too!

    Good post. Kudos!


  3. I think its great decision by DCI. There should be some conditions. Actually rural people are having many more dental problems but they are just neglecting. So a dentist is unable to practice there. But if any physician tells those people to report dentist then only they do so. If dentist is having medical professional degree & practice over the rural area, it will be more beneficial to people for oral health rather. People use to call doctor to other professional but not to dentist. It’s situation of rural area, since i am from a village i know their mentality & as a dentist it’s very difficult to convince those people regarding need of dental care for them. So the bridge course will help in changing people attitude towards dentist & need of oral health care also.
    I just tried to tell the attitudes of rural people about dentist & other health professional. People listen to doctors but not dentist……….


  4. Sir, Its a good idea of having a Bridge course for BDS students so that they can even practice as mbbs doctor.Today the average life of a person is 60 years, and in 08 years if one student is practising both as bds and mbbs doctor as well, than on an average he is saving 03 years and one person. Otherwise for mbbs 06 years and for bds 05 years, it takes total 11 years and two persons. SO I FEEL THE DCI SHOULD MOVE FORWARD AND MAKE IT A REALITY. tHE MCI SHOULD AS WELL GIVE COOPERATION IN THIS MATTER. ….oH COME ON, THINK HIGH. INDIA KO AAGE BADANA HAI. CHOTI CHOTE BATON ME NAHI ULAJNA CHAHIHE. YOU KNOW I AM AN ENGINEER.


  5. if they are really intrested in MBBS they are most welcome by coming through PMT and earning a seat rather than demanding for a parallel course in modern medicine. Please sir go through DCI act and it does not gives power DCI to propose this course .BHMS , BAMS and ISM students will too demand for a bridge as they too study the basics of MBBS if BDS students are given this parallel education . The real motto of DCI is to extract money from BDS graduates as these courses will be conducted in substandard private medical colleges ,
    DCI cannot register an MBBS student and such a course shall undermine the graduate medical EDUCATION REGULATIONS of MCI . I myself an officer in kgmoa Having substantial contacts in IMA and TCMC do not think there professional bodies will approve such courses

    Even if this becomes a reality the orthodox institutions will formulate screening examinations just like FMGE exams so to make sure that a vast majority gets no license even after completing the coures
    The MCI has raised the MBBS seats from 2009 now every year 8000 new seats are created and by 2020 the doctor patient ratio will improve . New AIIMS in all states would churn up nearly 20000 doctors an year from 2020 (already 7 aiims set up in 2 years time ) . This makes parallel course in modren medicine a futile exercise . Dental council need not worry about doctor patient ratio .

    There are some 20000 russian and chinese trained doctors without any employment . I myself know a person trying to clear FMGE exams from 2006 on wards . If government want to show humanity please pass all of them and if not giving FMGE 5 years rural service for a registration in case if they fail rather than making BDS students becoming MBBS .
    Dentists too have passion for their profession just as we guys do for medicine . Dci moves are very unfortunate by bringing BDS course in a very very poor light as being an inferior course to MBBS . DCI is insulting dental students by not having value addition course to BDS . If the bada babus of DCI cannot make their students do what they have been trained for this only means the Dentistry was killed due to rampant seat allocations and corruption . The MDS seats are increased by 400 percentage last year .If such a corrupt body is given a free hand to regulate MBBS in 4 or 5 Years it will too face the fate of BDS .

    MBBS seats are increasing year after year by 2025 doctor patient ratio will improve .


    1. hai doc .bds graduate s already studied anatomy. physio .bio.chemical. path.pharma.micro.gen med gen surgery .wats they left has to be taught and gv permission to prat ice .wats wrong in it


  6. i love dentistry n nd love to hlp othts…right now in 3 rd yr we have already learnt a hell lot about drugs of genreal trtmnts along with this we are learning the art of dental trtmnt nd associated drugs nd thats too tough….a bridge couse is a good thing as those doing it will have a more bettr cntrol over both field…bt one thing is not making sense to me why only rural prsns will be trted by them all human body is same every one know that….


  7. it will be a gud news for many dentists like me …i completed bds 4 years back…still i couldnt earn even for my studies bank loan….dentistry looks rich from outside,but in reality it takes many years to become a famous dentist and earn(and luck is also needed)… at present minimum 40,000 dentists clear bds every year… minimum no. of gov. PG seats or PG seats in deemed colleges with bulky capitation,many private clinics per street, limited government seats, minimal payment (12000) for BDS doctors in institutions makes life frustating,….this would be a gud alternative ….it would be grateful if this becomes real…


  8. with rewgards to all those mbbs degree holders here, lets look over the whole matter..firstly india lacks general health practicioners in the rural areas,as no mbbs graduate wants to go and practice there,instead they raised voices against the one year mandatory rural placement..
    then why not the bds graduates do this course and practice there for few years??
    i mean trhey already hav studied the medical subjects for first 2 added 3 years course to trhem means a better health manager,both dental aspect aspect and general!!
    the mbbs fellas be like..we wont practice in there,nor we let others practice…is that some excuse??


    1. I am mbbs, pursuing md. I have no issues with bds being trained further and being awarded mbbs degree. howecer, that will stil, not solve the issue. this is because the reasons for which an mbbs or md doesnt want to go to the rural areas will still not have been addressed and a bds with dual qulification will also faxe the same situation and not want to go to the rural areas.
      it’s not just doctors. Anyone who can manage to, goes out of eural areas. The rural to urban migration is a reality in our country.
      this is because there are abysmal facilities in the rural areas, no matter which aspect you look at.

      i am willing to go, if the govt provides me the following:
      1. A good pay, befitting my 8 and half years of gruelling coursework and residency duties.
      If a freshly passed md working as sr is getting 75k for working in a central govt institution why should i settle for 30k to go to an underserved area? I was earning more than that as mbbs. Now with specialization why should i expect less?
      and i should expect to be paid well. Medical education is not cheap. And the time, effort blood sweat and tears invested, the loneliness, the isolation that we suffer at various stages in our training should not be undervalued.
      if a manager who has spent 5 to 6 years of study can be paid 100k starting package, why should a significantly longer trained health professional who is actually taking care of something most vital to u be paid significantly less?

      2. adequate equipment, drugs and facilities.
      My mere presence iant foing to kmprove the health care situation. I need reliable technology, reliable and adequate drugs and diagnostics to do that.

      3. Provide opportunity for professional and academic growth.
      i am training in a tertiary care centre where i can do challenging and interesting cases. Indo things that challenge the limits of my skill and knowledge. 3 years of md is also jot enough; there is still a lot to learn. I want to be able to expand my knowledge and skills to derive more satisfaction out of my profession. There is more to my profession than just money.

      4. 24 hours electricity

      5. Clean drinking water.

      6. Reliable security.

      7. Opportunity for my wife to get a professionally satisfying job. She too is educated and a professional.

      8. A good school for my children to study in.
      i have studied in one of the best schools in india. I have not just participated in routine academics but also in extra curticulars. I am a violinist. Don’t i owe my children atleast a basic and reliable standard of education? Or should i after being a post graduate have children who are not even properly educated at a primary school level?

      You have to realize. The problem in rural areas goes beyond just health care. there are many other issues which act as a deterrant for others. The govt should be addressing those issues. But that costs money which they cant spend because then what will go into theie swiss bank accounts? So they are taking the easy route by showing doctors to be ungrateful, money minded wretches and forcing us to work at abysmal pay in pathetic conditions.

      If the govt really cares about health care, they need to stop this eye wash and start addressing these issues. Villages need more money poured there. The health care system needs more money poured in. Our spending on health care is lower than even poorer countries if u look at percentage of gdp. Why doesnt the govt actually spenda greater percentge of money there? On rural electrification? On rural education?

      This problem is more complex than the simple solutions these buffoon politicians are metting out.

      To break the present impasse, my suggestions are the following:

      1. Incentivise rather than force.

      2. Instead of disrupting professional careers and personal lives with permanent postings to rural areas, why not have existing govt hospitals and medical colleges adopt chcs and phcs and send doctors there on short rotations as an outreach program?
      A fifteen day stint every 3 – 6 months would be a good compromise.
      it enables the doctor concerned to continue having a fulfilling professional and academic life without major disruptions to their families with the minor and adjustable inconvenience of having to spend 1 or 2 weeks every few months i a rural area. Even those rural areas benefit by having generalists and specialist doctors.


    2. i agree… with your view paritosh .
      @harshit bavishi… you are not graduated to jus get all d facilities and then to do this business .. doctors need their put their luxury aside work for the needy… if BDS gets a hand in it whts the harm… you cant expect a AC to be working with you everytime .!


  9. I cannot understand why MBBS friends are saying we are modern medicine or allopathy . by MBBS means you not allopath alone’ but you are medicine graduated .BDS too is in modern system of medicine and both MBBS and BDS degrees treated as equivalent. Both degrees are allopathy system of medicine .so one can treat any alignments of human body as per the knowledge and BDS+MBBS or MBBS+ BDS courses are ate needed to formulated by the govt for greater services of this country.the mci dci ida and IMA and lndian Parliament should accept the proposal the BDS+ MBBS bridge course.


    1. I support Dr. I. Wage because in BDS student study more books then mbbs student
      BDS theoretical =MBBS theoretical +many extra books
      Human physiology, Human anatomy, General medicine, biochemistry, general surgery and many more common in BDS and MBBS (even same company books study both)
      So I support bridge for BDS students
      I feel very different when I know that BDS student study overall body, all general medicine, general surgery and even after this didn’t prescribe for all general diseases
      Truth is that our system is weak
      System require modification


  10. BDS and MDS students should also get a chance to practice and operate big diseases like tooth cancer along with MBBS students as they also have the same educational experience(5 years for bachelor and 3 years for master) I think Medical Council India (MCI) should consider also BDS students and take some necessary action about the matter
    They should get parallel studies like MBBS students and should get a chance to give MD exams.


    1. i agreee… oral cancer should b taken under consideration by the dentist we have worked in that field for 5 yrs.. all into the teeths and mmb ppl end up handling the oral cancer thing where is the education system going…. doctors are meant to help people not just to relax in their luxury appartments and clinics come and work for the needy …. if BDS can add on to this service whats the harm…. we neede doctors to help the society progress dude..!!


  11. BDS and MDS students should also get a chance to practice and operate big diseases like tooth cancer along with MBBS students as they also have the same educational experience(5 years for bachelor and 3 years for master) I think Medical Council India (MCI) should consider also BDS students and take some necessary action about the matter
    They should get parallel studies like MBBS students and should get a chance to give MD exams


  12. I am not a doctor. I have noted that, it is Indian students who have to stick to a profession from beginning of their course. But in advanced countries, they can change as they proceed their studies.

    Now that in India, BDS students do study all the MBBS syllabus during first three yrs, they should be allowed to treat patients of any category and if not under their knowledge to refer to a higher specialized doctor.

    Its a good idea of having a Bridge course for BDS students so that they can even practice as mbbs doctor, two specialization. As that now BDS degree (4 1/2 years plus one yr internship) holders are larger than MBBS degree holders, this idea to give them a transmission is good idea, but without waiting for more further studies but to do practice for one yr with a minimum salary and then get eligible to do practice as dentist plus MBBS doctor world wide.

    This will solve the problem of shortage of MBBS graduates as well.

    After MDS in each specialization, of course they can do practice in their profession.

    But those who have delay in getting admission for MDS after BDS can get a choice for doing practice. In this way less people will be exploited by donation for MDS studies in private colleges.

    Also the girl BDS students become age of 24 when they complete their degree, a age to get married. Then need to give birth to a child before the age of 26. This bridging can be very comfortable for those who want to continue family life and profession. A reservation for ladies in this will be much appreciated.


    1. female.. we need only those people to join the BDS MBBS bridge course WHO are actually coming up to help the society.. its kind of filtering out business..people ready to work for the society should b in dats all india wants to…not the females who want it as an alternative from their family life… !!!


  13. If u want to do this…nsme the degree as bachelor of medicine B.M better be B.D.S , B.M or M.D.S ,B.M……but please don’t grant them mbbs degrees…..we go thru lot of hrll to get a name and degree and I can also say..these candidates should b allowed to write mds entrance only but not med pg entrance…..line clears now.. We have no objection for B.D.S with a B.M to see general cases but M.B.B.S should b to those who worked fr it with their sweat and hard work…hope u find it useful….


    1. Even BDS people work hard.. its jus not the MBBS students giving their five years into degree to become a doctor.. If BDS people can join to help the society whats the harm..its jus gonna increase the patient to doctor ratio.. and INDIA NEEDS DOCTORS..IT NEEDE PROPER HEALTH CARE. u cant deny the fact dat we are still was behind in providing good health to the public out der.!


  14. I m a dentist. Or being a dentist I think mbbs is the first choice for every student at the time of counselling. Or if r dream come true after bridge course . We will be happy to join this course.
    Dont say that it will be a backdoor entry for us.Because v have done hard work for bds degree for 5 yrs & v r ready to do bridge course for next 3 yrs.




  16. i am still amazed the thought of DR.waseem is that mbbs students alone put their hardwork to finish the course is not BDS we too face a lot of problem and higher difficulty level there is no need for fight with us the only aim is to maintain health of the society
    please think it of your mbbs degree as a way to help the society not to fight among us


  17. hi! guys m dilawer and i know that bds students study medicine as well as dentistry. they should b given right to go for bridge coarse mbbs.we study anatomy they also study anatomy in buchlors.
    they study physiology, histology,even pathology(i have seen them studing robin’s)
    they also study pharmacology even some study Goodman Gillman but i have studied kd tripathi.
    they study medicine and surgery also.(davidson and bailey and love)
    now forensic medicine has been introduced i heard. over all they study six books more in 4th year.
    i think they should b given this right.


  18. AFTER reading the above debates..happy to see people are aware of this..but the fact is bridge courses will be introduced according what actually government wants..i may be quite lat for this arguments..but i want to know what is the point of saying tHAT bams and bhms ism students will come up for a protest for their bridge course to be eligible like MBBS…physio, anat, biochem,, micro,, pharmA, path,, genral med, genral surgery..these are subjects which are exActly the same taught to mbbs students and bds instead of claming dentists for pursuing bridge courses.they should support bczz this authority will only be valuable in rural areas and rules and regulations keeps onn changes with time..actually the point is medicine ppl are scared of their themselves..
    what they mean for modern bds ppl are taught which is something out dated..not aat instead of pulling legs..evryone should come up and work togetherly..
    if bds ppl are facing problems like not getting A bright future..salary pays are not enough…preparing for pg is good,,,but no doubt it is competitive and no doubt everyone knows andar ki baat people bfore exams book their seats with their so called approaches and there is no good scope for hard workers who r roughening their feets for their future and on the other hAND private colleges are charging too high for fees structure and extra expenditures…so everyone cannot deal with private mds.
    so it is better option for bds students to come up with their talents ..clinicl experiences and new ideas.


  19. Guys, first of all, m thankful to have reached this posts and to have gottent o know about the underlying issues in such a vast.

    i am in 2nd yr bds, and theres no less toil. i mean ofc if they had to make it a 5 yr course tht means it needed those 5 yrs fully. the concept of making a bridge course doesnt gets into my head at all.
    truly, by doing this u tell the communities out there that there is a serious problem of recognition for dentists.
    i am pretty much young to comment on this but i really doint find much use in this. instead ve general healthcare to rural population why cnt v jus gve the treatment we have been trained for? i mean we arent boasting of having good orals in rural areas? many people dont visit docs cus dental treatments are costly. why nt provide at to them at reduced costs and ask dentists to improve oral health of rural people? and i read a comment above, i totally agree. expecting a doctor, a dentist or an mbbs, to spend their life in rural area but not giving them the necessary facilities is foolishness. u cnt expect somebody doing a health related job to just be empathetic and sympatyhetic and not think for himself. nope, u cnt. give us all the requisite facilities to carry out our services properly and may be we shall be able to bring a significant change to the healthcare of the real India.

    you bring out jobs in rural settings for dentists and there wont be a need of such courses. bring out more jobs in dentistry in all spheres and dentists wont have to struggle. stop opening colleges like coaching institutes. there r so many dentists out there and no awareness among patients. work on that.

    but truly said, money is might
    you dont wnt to focus on the real work but u want to bring out a way which reduces your workload and presents for you a simple method of transferring your loads.

    mend your ways guys, many dentists wont take this up m sure, but even they do, its nt them doing wrong, they are just solidifying their careers. it is the DCI forcing them to accept that their own breed dint look after them.


  20. I I support Dr. I. Wage because in BDS student study more books then mbbs student
    BDS theoretical =MBBS theoretical +many extra books
    Human physiology, Human anatomy, General medicine, biochemistry, general surgery and many more common in BDS and MBBS (even same company books study both)
    So I support bridge for BDS students
    I feel very different when I know that BDS student study overall body, all general medicine, general surgery and even after this didn’t prescribe for all general diseases
    Truth is that our system is weak
    System require modification


  21. Hi,
    Thanx google to getpass to this post. Nicely discussed.
    thing that should be considered by Govt is 1. Mainly the doctor patients ratio 2. Rural doctor patients ratio, that is far from urban ratio. 3. Infrastructure set-up for new medical colleges to reach nearby to dp ratio. 4. Large amount of dental graduates. 5. Dental graduation is near by and have nearby same syllabus at first three year. 6. New Doctor should be awarded a MBDS bachelor of medicine and dental surgery degree. With bond of work for rural area. 7. Govt struggling for providing medical health and dental health care to rural areas. mbbs doctor not wishes to service in rural and bds doctor can not settle high priced dental setups in rural. After posting a new MBDS doctor rural area will got the both care by one person. 6. Dental degree are always at second prefer option at counselling so dental graduates should be preferred. 7. A regulatory body should be different from dci because dental graduate are migrating to mci.8. Screening test should be offered for degree and some seats should be arranged in govt medical colleges so the no xtra wages will be for new degree.9. For generate new mbbs doctor will be so expensive instead of this type of new entry in indian view.
    So it will be debate question in health ministry but it should be done for getting good rural health and it is not wrong because bds can do mbbs in America also.
    Thanx for reading


  22. BDS or mbbs both are same syllabus but practice is different but why ?? It’s not good for BDS holder full time study, all subject of medical, 3 month posting for higher medical center then after BDS(internship+1year) what is this..??? If u r not doing practice in. Medical so for that only teach by dental subject please do something fro BDS holder


  23. BDS or mbbs both are same syllabus but practice is different but why ?? It’s not good for BDS holder full time study, all subject of medical, 3 month posting for higher medical center then after BDS(internship+1year) what is this..??? If u r not doing practice in. Medical so for that only teach by dental subject please do something for BDS holder the trend must be change..


  24. Instead of this I would like to have dually qualified Maxillofacial surgeons, BDS MBBS MDS. how its in the west. It makes more sense


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