Resident doctors in Karnataka have been on strike for five days, asking for a long overdue hike in their stipends. This is the third such strike in the country in the last three months. Junior doctors in Delhi went on strike in late June and those in Maharashtra did the same in July. But unlike the previous two instances the Karnataka doctors have a single agenda – get stipends raised by a maximum of Rs 20,000 for interns, post-graduates and super-specialty residents to bring them in line with other states in India.

“We have been approaching the medical authorities for the past one and a half years but we haven’t got any positive response form them,” said Anudeep TC, surgical resident at Mysore Medical College and general secretary of the Karnataka Association of Resident Doctors. “We submitted a memorandum asking for our demands to be met by 10th of August. Our demands weren’t met so we started the strike from the 31st.”

Medical residents in Karnataka are among the worst paid in the country. An intern gets Rs 15,000 per month, a post-graduate gets Rs 25,000 and a resident in super-specialty training gets Rs 30,000. By comparison a post-graduate in Delhi gets close a stipend to Rs 70,000 and one in Maharashtra earns more than Rs 40,000.

The 2,500 protesting Karnataka doctors are asking that interns get a pay hike of Rs 5,000 taking their monthly stipends to Rs 20,000. Post-graduate residents, they say, must get at least Rs 40,000 and super-specialty residents must get Rs 50,000

The disparity isn’t only among the different stipend rates from different states but within Karnataka itself, according to Sudhindra P Kanavehalli who is also a secretary of the resident doctors’ association. He said that MBBS graduates who join government hospitals as medical officers get paid far more than equally qualified residents who specialize with a further degree. An MBBS doctor who joined government service in 2011 got Rs 26,000. In four years’ time he is getting Rs 60,000 now, which is a hike of 105%,” claimed Kanavehalli. “The government has responded to the medical officers and raised their stipends according to price of living and inflation. But what about the doctors working here in medical colleges?”

Even the low stipend condition is not always met. Although the Medical Council of India say that private institutions must offer the same amount as the state government regulations allow, a few medical colleges hand out more per month and many are caught giving much less. A council report from January this year noted some private medical institutions paid as little as Rs 5,000 to their post-graduate residents.

Linked with the demand to hike stipends in Karnataka is the appeal for a system of periodic pay review. What has forced Karnataka’s resident doctors to rally and protest is the fact that their last pay hike was in 2011 and there hasn’t been any assessment of increments since then.

Do strikes pay off for doctors?

The striking doctors recognise the bind that their protest has put their hospitals in. Many have been forced to cut back on patient admissions the last few days and take on only emergency cases. But they feel an unresponsive government has left them no choice. “The moment we get something in writing from the government we are ready to work,” Anudeep assured.

The Karnataka strike has been on for almost a week, much longer than those in Maharashtra and Delhi, which lasted only two days each. “We have to call off strikes whether we get assurances or not because these are essential services,” said Sagar Mudanda, president, of the Maharashtra Association of Resident Doctors.

Maharashtra’s junior doctors who protested two months ago are still waiting for their demands to be met in full. They had a 10-point charter of demands and topping that list was increased security for residents.

In Maharashtra, it has been all too common for relatives of patients to assualt junior doctors. To address this, the doctors demanded that security be upgraded in government hospitals. “The government had said that by July 25 they would ask all Maharashtra colleges to submit the security audit report after which the needful would be done. That did not happen till late August and that too only when we personally went to the minister,” Mudanda said.

The Maharashtra government has also delayed a stipend raise, another of the doctors’ demands, citing budgetary problems.

The Delhi doctors had put forward a charter of 19 demands, most if which the government said it would fulfill within three months. Pankaj Solanki, president of the Federation of Resident Doctors Association in Delhi, said that there has hardly been any movement on the promises. "We are still fighting for clean water. It has already been two and a half months and they have only some 15 days left [to fulfill that condition] and I don;t think that will happen."

While promises remain unfulfilled, the only way to get their  demands heard, Mudanda said, is to hit the streets.