Soon, students studying medicine in government-run colleges will have to sign a bond promising to work in a government health centre for a year. And if they opt out, they will have to pay the bond money.

“They can pay the bond, which will be the amount private medical colleges charge as fees for an MBBS course,” Health minister Anbumani Ramadoss told Hindustan Times.

Tuition fees in private colleges range between Rs 20 lakh and Rs 25 lakh.

Those who work with health centres will be exempt from paying the annual MBBS tuition fees of Rs 250 a year charged by government colleges.

This proposal will replace the health ministry’s earlier hugely unpopular decision to introduce compulsory rural stint for all doctors before they could apply for a post-graduate course.

“I don’t know why people refer to it as rural posting; most centres are in small and medium-sized towns. They are compared to Delhi, Mumbai and Chennai, but people in big cities should get a taste of India’s social reality,” said Ramadoss. The proposal may be implemented for new entrants from next year.

There are 271 medical colleges in the country of which 138 are run by the government; the remaining 133 are private colleges. Together, these colleges offer 31,172 MBBS seats and 11,005 post-graduate courses.

“I don’t think the bond will deter students from taking up MBBS. The IITs charge students Rs 3.5 lakh a year, but the tuition fee in government medical colleges is just Rs 250 a year,” said Ramadoss.

The idea has been borrowed from the armed forces. Students applying for admission to MBBS at the Armed Forces Medical College have to sign a bond where they agree to serve as commissioned officers for seven years. Students opting out have to pay bond money of Rs 15 lakh.