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Should Doctors Leave India - Honest Thoughts & A Broken System | Dr. Anuj Pachhel

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Dr. Anuj Pachhel, an MD medicine resident, argues that many conditions in India are pushing doctors—especially young doctors—to consider leaving. While he is personally conflicted (due to family ties and affection for his community), he frames his case as a combination of personal observations and broader system-level criticisms.

1) Daily-Life Breakdown: Worsening Commute Reflects Wider Urban Dysfunction

He opens with a personal anecdote: his commute to the hospital has increased from roughly 20–25 minutes to 30–35 minutes over recent years. He attributes this to:

  • Roads being frequently dug up (construction/impeded traffic)
  • Construction near town areas creating bottlenecks and causing vehicles to enter/block traffic from “wrong sides”
  • A nearby railway station where autos/rickshaws stop abruptly, increasing delays behind them
  • More visibly risky driving behavior

He uses this as evidence that even “nearby” travel has become unnecessarily punishing—particularly for people who live and work locally.

2) Perceived Tax Burden and Low Initial Earning Power

He claims India is among the most taxed countries and argues that the tax load feels heavy relative to what people—especially doctors early in their careers—earn. He highlights a sense of “multiple layers” of cost, including:

  • Income-related deductions
  • Road tax
  • Insurance
  • Fuel taxes
  • GST

He also argues that doctors often begin earning relatively late, meaning early income may be too low compared to years of training and taxes paid.

3) Quality-of-Life Gaps (Water/Air) and Preventive-Health Impact

He argues that limitations in daily life force people to solve basic problems privately:

  • Installing water purifiers because safe drinking water may not be reliably available from taps
  • Installing air purifiers due to air-quality concerns

He contrasts this with his experience in Europe, where he says people can drink from taps and where he cites Paris having very low AQI, along with a perceived sense of civic responsibility. He connects these gaps to health outcomes, arguing that better water/air quality could prevent disease.

4) Safety and Social Treatment of Doctors: Fear and Abuse

He says doctors face constant anxiety driven by:

  • Media/social media reports of doctors being thrashed
  • Public blame in situations where wrongdoing is alleged or outcomes disappoint

He contrasts India with systems he describes abroad, where appointments, investigations, and costs differ—often involving delays and fees—which he suggests reduces immediate public confrontation. He argues that in India, where healthcare is described as comparatively free and accessible quickly, doctors become the easy target when outcomes are unfavorable—leading to doctors being taken for granted.

5) Education and Training Quality: Too Many Colleges, Too Little Practical Skill

He argues medical training has weakened because medical colleges expanded rapidly without a proportional increase in:

  • Clinical exposure (patients/hospitals)
  • Practical competence

He emphasizes that books cannot replace internship/residency experience. He claims MBBS graduates are often less skilled than previous generations due to reduced training depth, and he worries about clinical errors and unsafe prescribing.

He also describes examples he claims to have seen:

  • A referral involving organophosphorus poisoning, where he felt treatment at a PHC was inappropriate
  • A case of sulfonylurea-related hypoglycemia, where he says a patient was prescribed a higher dose of glimepiride than he would typically prescribe; he reports the patient developed hypoglycemia, syncope, and injury—suggesting preventable harm from inadequate knowledge or oversight

6) Exam and Residency Structure: Competitiveness and International Recognition

He argues the specialization/residency pathway in India differs from systems like the US:

  • India: fewer gatekeeping steps described as “one exam,” with college choice based on rank
  • Abroad: multiple exams/interviews, with selection being mutual between applicant and program

He also claims Indian PG degrees are less portable globally and may require additional country-specific examinations, while he suggests US training provides broader practice opportunities across many countries.

7) Balanced Conclusion: Pro-Leave Conditions, but Personal Reasons to Stay

He concludes that his video presents both reasons to leave and reasons to stay. He says that if he had the “courage” and “guts,” he might leave due to the system issues discussed—but he personally cannot because of:

  • Family commitments
  • Strong attachment to his home and local people

Ultimately, he frames leaving as individual rather than a universal choice.


Presenters or Contributors

  • Dr. Anuj Pachhel (Dr. Anoj)

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