Many doctors hesitate to accept DCHS promotions due to a lack of essential resources, such as dedicated offices and adequate staff, which hampers their ability to perform duties effectively
Published Mar 20, 2025 | 7:00 AM ⚊ Updated Mar 20, 2025 | 7:00 AM
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Synopsis: Andhra Pradesh Health Minister Satya Kumar Yadav revealed that 50 out of 85 eligible doctors declined promotions to District Coordinator of Health Services (DCHS) positions. DCHS vacancies exist in multiple districts, with more expected soon. Additionally, 33 percent of eligible doctors recently declined promotions to professorships, contributing to a 33 percent vacancy rate in government medical colleges
Recently, Andhra Pradesh Health Minister Satya Kumar Yadav stated that out of 85 eligible doctors, 50 declined the promotion to District Coordinator of Health Services (DCHS) positions.
Doctors who have served as Civil Surgeon Specialists (CSS) for three years and have at least two years of service remaining before retirement are eligible for promotion to DCHS.
DCHS positions are currently vacant in Srikakulam, Vizianagaram, East Godavari, Krishna, Guntur, and Prakasam districts, with additional vacancies expected soon in Nellore and Chittoor districts.
At the district level, DCHS officers oversee the functioning of Community Health Centers (CHCs), district hospitals, and area hospitals. These facilities, which operate under the Secondary Health Directorate, total 224 across the state.
It was more concerning that 33 percent of eligible doctors in the state recently declined promotions to professorships.
During the latest round of promotions across 12 clinical and non-clinical departments in government medical colleges, where professor positions were vacant, 28 eligible associate professors were invited for counselling, where 33 percent of the eligible candidates declined the promotion to professor roles, contributing to a 33 percent vacancy rate for professor positions in government medical colleges.
The recent promotions covered vacancies in various departments, including four in General Surgery and Psychiatry, three each in General Medicine, Pediatrics, and Anesthesia, two each in Orthopedics, Pulmonary Medicine, Radiology, and Community Medicine, and one each in ENT, Anatomy, and Pharmacology.
To be eligible for promotion, associate professors must have at least three years of teaching experience and two publications in reputed journals.
“The perception that most doctors are unwilling to take promotions is not entirely true. Promotions are a matter of choice; they are neither compulsory nor mandatory. The vacancies need to align with their career growth and aspirations, and personal factors, such as family circumstances, also play a role in their decision,” said Andhra Pradesh Government Doctors’ Association President Dr D Jayadheer Babu to South First.
He added, “if given the right opportunity, they will certainly accept promotions. However, some may decline them. In any career, if you’re placed in a new position that doesn’t align with your preferences, you might hesitate.”
“The main issue is the irregularity in conducting promotions and transfers. If doctors had confidence that they could return to their preferred location after two or three years through regular transfers, more of them would likely accept promotions. It is that they are not sure when the next transfer will be,” said Dr Babu.
He pointed out these promotions are a routine part of the job. “They typically occur every three to five years, sometimes even two or three times a year. It’s a regular process, and promotions happen annually.”
Doctors also pointed out that senior officials impose undue pressure on doctors by setting patient quotas and treating them with a lack of respect. Seeking medical care is a necessity for patients when they are unwell, and enforcing targets on doctors is both unethical and unreasonable. While doctors are committed to treating those who come to hospitals, penalising them for failing to meet arbitrary quotas is unfair.
Additionally, In case of district authority, higher authorities often bypass District Coordinators of Health Services (DCHSs) and communicate directly with frontline doctors through video conferences, undermining the DCHS role. Despite being a district-level position, DCHSs are deprived of essential administrative powers, a dedicated office, and adequate support staff, making the role significantly less appealing.
Many doctors believe that DCHSs lack essential resources, such as a dedicated office and adequate staff, which hampers their ability to carry out their responsibilities efficiently. This shortage of infrastructure is a key factor in their reluctance to accept promotions.
Meanwhile the health minister instructed senior officials to thoroughly examine the reasons behind government doctors rejecting promotions in secondary and tertiary healthcare and to suggest possible solutions.
Even the health department is aware that many doctors prefer to work in specific locations of their choice. Since they are not receiving postings in their desired locations, they are unwilling to accept promotions.
Dr Babu said that there are always about 20 to 30 percent vacancies at any given time. In fact, across all departments, including the medical field, the usual vacancy ratio ranges between 10 to 20 percent.
“Vacancies arise due to retirements, promotions, and transfers. Because of these factors, a 10 to 20 percent vacancy rate is a normal occurrence. However, if the vacancy rate exceeds 30 to 40 percent, then it becomes a serious concern. Currently, the situation is under control, as the vacancy rate remains below 20 percent,” said Dr Babu.
In some specialties, doctors opt for private practice because they earn significantly more outside the government sector.
“For instance, while government doctors might earn around ₹12-15 lakh per year, specialists like cardiologists, neurologists, neurosurgeons, and pediatric surgeons can earn a starting salary of ₹3-5 lakh per month in private hospitals. Additionally, they often secure jobs in locations of their preference, making private practice a more attractive option,” Dr Babu pointed.
He said that if the government is truly committed to filling these vacancies, it needs to conduct a special recruitment drive.
Meanwhile, he said that the number of doctors opting for non-clinical roles was previously low, but with the increase in PG seats, more candidates are now entering this field. In the next one to two years, this pool is expected to grow further, making more professionals available for such roles.
(Edited by Ananya Rao)
