Will dissolving the Medical Council of India help medical education?

Gauri Kohli, Hindustan Times, New Delhi
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Updated: Nov 22, 2016 19:45 IST

Hundreds of doctors across the country have been demanding reforms in medical education such as more seats at the undergraduate and postgraduate levels. (File photo)

Hundreds of doctors across the country are protesting against the proposed National Medical Commission Bill (NMC Bill), which seeks to dissolve the Medical Council of India (MCI), calling it “an undemocratic move.”

One of the primary responsibilities of the MCI is to regulate medical education in the country. The NITI Aayog suggested the creation of NMC in August 2016. The proposed bill has suggested forming an NMC, which will be a policy-making body for medical education. Scrapping MCI might not be the right move in the long term, experts have said.

The proposed NMC Bill 2016 suggests that the Central government will establish autonomous Boards for conducting undergraduate and postgraduate education, assessment and rating of medical institutions and registration of medical practitioners, among other things.

According to Dr KK Aggarwal, national president elect, Indian Medical Association, “Scrapping MCI will cripple the functioning of the medical profession by making it completely answerable to the bureaucracy and non-medical administrators. Instead, the government must consider introducing amendments to the existing MCI Act to make it transparent, accountable, robust and self-sufficient.”

Dr Aggarwal says the autonomy of the regulatory body has to be upheld. Experts also suggest that providing for an accreditation authority for medical education on the lines of the authority vested with the All-India Council for Technical Education in respect of technological institutions through National Accreditation Board can be a solution.

Vesting MCI with the authority to prescribe service conditions and payable scales for full-time teaching faculties in medical colleges on par with the UGC can be another solution.

The government had invited suggestions from stakeholders and public on the proposed NMC Bill. Dr Manish Prabhakar, president, Indian Medical Students’ Association, says an NMC, if formed, will be “undemocratic and highly detrimental to budding doctors, community and medical associations.”

The NMC also aims to prescribe norms for determination of fees for a proportion of seats, not exceeding 40%, in private medical educational institutions. The Commission will also be responsible for conducting the National Eligibility-cum Entrance Test and a National Licentiate Examination for admission into post-graduate courses in medical colleges.

The bill also seeks to establish Undergraduate and Postgraduate Medical Education Boards that will be responsible for determining and prescribing standards and overseeing all aspects of medical education at undergraduate and postgraduate levels, respectively. They will also be given the task to develop a competency-based dynamic curriculum (including assessment) at the two levels and prescribing guidelines for setting up medical institutions, besides developing curricula and conducting examinations.

But will dissolving MCI help achieve these goals? Dr Arun Aggarwal, former president Delhi Medical Council and professor of excellence, Maulana Azad Medical College, Delhi, says, “Replacing MCI with another regulatory body does not guarantee that the current issues in medical education will be resolved. How can we be sure that the new commission will function without any glitches and be corruption-free?”

The new commission also seeks to merge the existing National Board of Examination (NBE), which is responsible for regulating post-graduate medical education in the country, with the Postgraduate Medical Education Board.

“The Supreme Court in its judgment dated April 3, 2016, while placing an oversight committee for MCI, had mandated a period of one year for the government to undertake reforms in regulation of medical education and set up appropriate systems in place. The apex court will review the position in April 2017. The tenure of MCI will also be completed in a year’s time. Thus, achieving high growth in healthcare to meet the growing needs is an area of high priority. Reforms in medical education are necessitated and will have to be undertaken sooner than later. However, the needs of medical profession namely professional autonomy and identity have to be appropriately addressed while holding the professionals accountable,” says Dr Bipin Batra, executive director, NBE.

92% M.Sc nursing seats remain vacant in state

Balwant Garg

Tribune News Service

Faridkot, October 28

There are only 47 eligible candidates for 601 M.Sc nursing seats in 32 nursing colleges of the state. As October 31 is the last date of admission in nursing courses, the “distressed” institutes have asked the state medical education department to scrap many eligibility conditions so that seats could be filled.

In the entrance test conducted by the Baba Farid University of Health Sciences (BFUHS) on September 18, only 47 candidates could qualified.

A B.Sc-pass candidate should have secured minimum 40 per cent (35 per cent for SC/BC) in the entrance test to be eligible to get admission in the M.Sc course.

Eighteen out of these 32 nursing institutes could not get even a single candidate in the M.Sc course this time. The counseling to fill these seats was conducted by the BFUHS on October 24. While eight nursing colleges could fill only one of their seats each, 3 colleges got only 2 candidates each.

Even the highly prestigious State Institute of Nursing & Paramedical Sciences in Badal village could get only 15 candidates against its 25 seats. The second highest number of seats was filled in the DMC Nursing Institute in Ludhiana, which got nine students against its 25 seats.

The nursing colleges have reportedly approached the state government to scrap the eligibility conditions, including qualifying or appearing in the entrance test. As a candidate should have a minimum of 55 per cent aggregate marks in the B.Sc nursing course to be eligible to appear in the entrance test, the colleges want the state government to write off this condition too. Not only in M.Sc Nursing, in B.Sc nursing too, Punjab is facing the problem of filling the seats. While 109 nursing colleges in the state offer 4,405 B.Sc nursing and 2,785 B.Sc (Post-Basic) nursing course seats, 925 B.Sc nursing and 1,094 B.Sc (post basic) nursing seats are still lying vacant.

As the Department of Medical Education and Research has already relaxed the norms to fill the B.Sc Nursing course seats, many candidates who have scored zero or negative marks in the entrance test too have been allowed admission.

HC seeks report on sending doctors on deputation

“Their names can’t be retained on paper in one hospital and made to work elsewhere”

The Madras High Court Bench here on Wednesday directed the Director of Public Health and Preventive Medicine to file a report by Monday explaining why he allowed several government doctors and nurses appointed against sanctioned vacancies in many hospitals to work on deputation in other districts.

A Division Bench of Justices S. Nagamuthu and M.V. Muralidaran passed the order on a batch of three public interest litigation petitions seeking better medical care in government hospitals.

Recording the submission of M.R. Vairamuthuraju, Dean of Government Rajaji Hospital (GRH) here that doctors from Thanjavur, Thoothukudi and Theni had been deputed to work in GRH and doctors from here had been deputed to work in the government medical college hospital in Sivaganga, the judges wanted the DPH’s report to indicate the number of doctors and nurses sent on deputation to districts other than the ones in which they were expected to serve.

“What is the necessity for deputing the doctors? If you want you should have transferred the doctors to other districts. You cannot retain their names on paper with respect to one hospital and make them work elsewhere. We want the Director to explain why such a large exodus of doctors in the guise of deputation is allowed. We need the details of nurses also since the Dean says that 75 nurses from other hospitals have been deputed to the GRH,” Mr. Justice Nagamuthu told a Special Government Pleader.

The judges recorded the submission of one of counsel for the petitioners that the GRH had only 305 staff nurses against the requirement of 1,195 nurses as per MCI norms. “Though 75 nurses have been deputed here from various hospitals, still the strength is nowhere near the required strength,” the judges said.

In so far as the submission that none of the government hospitals in the State, except the Rajiv Gandhi Government General Hospital in Chennai, had Ceramics Dental Laboratories, the Bench wondered why the State had not established such labs, though the Dean had told the court that it would cost only Rs.6.22 lakh for a lab.

Fiat to Health Secretary

The High Court directed the Health secretary to come up with a proposal by Monday on improving healthcare facilities in government hospitals by ensuring adequate number of doctors and nurses required, as per Medical Council of India norms, in every GH besides establishing infrastructural facilities.

HC quashes secretary’s order, reinstates MK Stalin’s PA

CHENNAI: The Madras high court has quashed the order of the secretary of the legislative assembly to transfer and rescind the promotion of a deputy secretary detailed to the personal staff of leader of the opposition M K Stalin.

The court on Wednesday struck down the order saying that a person appointed on deputation to a 'tenure post' should had 'an indefeasible right' to be treated fairly and equally.

Earlier, Stalin had moved the court saying that he had upgraded M Athiseshan's post from that of personal assistant to special personal assistant on August 8, 2016. The secretary of the legislative assembly struck down the promotion and posted him back to his home department. Stalin's counsel P Wilson said the secretary could neither remove the officer unilaterally nor could the his terms of service be altered.

Justice R Subbaiah said as per Supreme Court precedence, a person appointed on deputation cannot go back to his original post before the end of the term. Similarly, the deputation cannot be cancelled without the consent of the 'individual' under whom the officer was serving. "If the deputation is not a simple transfer and if the appointment is a tenure posting, the same cannot be curtailed," the judge said.

"In view of these reasons, the order is liable to be quashed and therefore, the same is quashed and the writ petition is allowed," the judge said.

The court asked the authorities concerned to place Athiseshan 'on the terms of the original order dated June 8. He should be posted as special PA, at the earliest, the order said.

Stalin said the court had protected the dignity of the assembly by striking down the order. "The chair should uphold democratic principles and pave the way for healthy politics from now on. I urge the ruling party not to create a situation where Assembly ethos should be reclaimed by court's assistance," he said.

Gynaec cancer among 18 super-specialities to get medical council nod

CHENNAI: The Medical Council of India has cleared the decks for at least 18 new specialised courses which will equip doctors with the expertise needed to treat ailments that may be beyond their current realm of knowledge. Officials said most of these specialities are meant to treat diseases like gynaecological cancer that were rare some years ago, but are increasingly becoming common.

The general body of the MCI that met in New Delhi on Tuesday resolved to permit five post-graduate courses and 13 super-speciality courses that can be started in medical colleges by 2017. Insitutions offering these courses should have qualified faculty, necessary infrastructure and have to be approved by the Supreme Court-appointed oversight committee.

The academic committee proposed a post-graduate deg ree (MD) in marine medicine, similar to aviation medicine. Several years ago, aviation medicine was recognised as a medical speciality as it combines preventive, occupational, environmental and clinical medicine with the physiology and psychology of man in flight. Like in aviation, travel by sea can also contribute to outbreaks of communicable diseases. It is concerned with the health and safety of all those who fly . Our sea traffic has increased as well. Our naval fleets need similar care, said Bengaluru-based cardiac surgeon Dr Jawali Vivekanand Sidramappa, member of the academic committee. Like in aviation, travel by sea can also contribute to outbreaks of communicable diseases - as there are ships sailing to all corners of the world from India.

Similarly, the committee said MD degrees in laboratory medicine and palliative care were in great demand.Although diseases like cancer are increasingly curable, many continue to pose a challenge. Doctors trained in palliative medicine will be able to offer end-of-life care to patients. A year-long diploma in allergy and clinical medicine has also been agreed up on. Also, with an increase in the incidence of gynaecological cancers - breast, cervical, uterine and ovary - across the country , gynaecologists and oncologists have been demanding specialised courses. The estimated burden of gynecological cancer in 2015 was 160,000, which include 93,000 cases of cervical cancer and 134,000 breast cancer cases.

According to senior oncologist Dr V Shanta from the Cancer Institute, Chennai, cervix, breast and overy cancer cases comprise to 55% of the cases. Post-graduate students in gynaecology and oncology streams can do a specialised course MCh gynaecology oncology . The other super-speciality courses that have been approved by the MCI are DM in clinical immunology and rheumatology, critical care, virology, infectious diseases, neuroradiology , neuroanesthesia, paediatric neurology , paediatric hepatology and paediatric oncology , besides MCh in hepato-pancreato-biliary surgery , vascular surgery and reproductive medicine.

The academic committee has already prepared the requisites, including the qualification and number of staff and infrastructure required, to start these courses. The committee has also recommended that a department of family medicine be started in all medical colleges offering undergraduate courses.

"It is extremely important to bring back the family physicians. Most countries still have them and it is they who refer patients to specialists. When we establish departments and inculcate ideal practices, we may be able to revive them. Slowly , we may even offer post-graduate and super-speciality courses," he said.

MCI says corporates can run medical colleges

CHENAI: The Medical Council of India has permitted corporates and "for profit" institutions to start medical colleges in the country.

Nearly two months after the Niti Aayog committeerecommended privatisation of medical colleges, the general body of the council that met in New Delhi on Tuesday resolved to allow corporate companies to start medical colleges in the country. If the Supreme Court-appointed oversight committee and the ministry of health and fami ly welfare approve this, corporates can apply for starting new colleges, officials said.

Educational institutes in the country are now being run by government or registered not-for-profit society or charitable trust. Foreign direct investment rules also prohibit investments from foreign companies in these societies or trusts. Though a group of doctors in the general body raised concerns that allowing corporates will further commercialise education, a majority of them said allowing corporates will improve standards to the level of Harvard and Oxford universities.

"Many private institutions are anyway making profit through non-transparent and illegal means. If we legalise corporates they would charge a very high fee, but they will be forced to pay income tax," said Coimbatorebased laprascopic surgeon L P Thanagavelu, a member of the MCI, who was present at the meeting. "There were many recommendations from the members on how this could be done, but a majority thought it was a good idea. Some of them recommended that a portion of the seats in these institutions should go to students from economically weaker sections or to merit students entering private colleges through the state quota," he said.


Muslim Educational Society president P A Fazal Gafoor said it would be impossible for the council to have two systems of ownership."Already we have trusts and societies running 'not-forprofit' colleges. They were not paying income tax and accepting donations? What will happen to them? Should we allow them to be converted into profit-making companies? It is sad that such recommendations should come from the centre," he said.Until now, the MCI had permitted companies that make no profit to start medical colleges, but no companies came forward, he added.

A majority of the members said companies would be able to pump in money to establish better infrastructure and human resources.

பாலிடெக்னிக் கல்லூரி முறைகேடு: 524 மாணவர்கள் மீது நடவடிக்கை

கோவை: பாலிடெக்னிக் கல்லுாரிகளில் நடந்த பருவத்தேர்வின் போது, எழுந்த முறைகேடுகள் தொடர்பாக, 524 மாணவர்கள், இரண்டு முதல்வர்கள் மீது நடவடிக்கை மேற்கொள்ளப்பட்டுள்ளது. தமிழகத்தில், தனியார், அரசு மற்றும் அரசு உதவிபெறும் பாலிடெக்னிக் என, 529 பாலிடெக்னிக் கல்லுாரிகள் செயல்படுகின்றன. தற்போது, நடந்து வரும் பருவத்தேர்வுகள், நவ., 26ல் நிறைவடைகிறது. இதில், நடந்த முறைகேடு குறித்து, சென்னையில் நேற்று நடந்த, தேர்வு முறைகேடு நடவடிக்கை குழு கூட்டத்தில் அதிரடி உத்தரவுகள் பிறப்பிக்கப்பட்டுள்ளது.இதனால், 56 கல்லுாரிகளில், 74 செய்முறை தேர்வுகள் ரத்து செய்யப்பட்டுள்ளது. இத்தேர்வுகள், தீவிர கண்காணிப்புடன் மீண்டும் நடத்த உத்தரவிடப்பட்டுள்ளது. மேலும், 200 பேருக்கு ஒரு தேர்விலும், 314 பேருக்கு அனைத்து பாடத்தேர்வுகளில் பங்கேற்க தடை விதிக்கப்பட்டுள்ளது. 10 மாணவர்களுக்கு இரண்டு பருவம் கல்லுாரிக்கு வருவதற்கு தடை விதிக்கப்பட்டுள்ளது.முறைகேடுகளுக்கு துணையாகயிருந்த இரண்டு கல்லுாரி முதல்வர்கள் மூன்று ஆண்டுகள் பணிபுரிய தடைவிதிக்கப்பட்டுள்ளது.

 தொழில்நுட்ப தேர்வு முறைகேடு நடவடிக்கை குழு, மாநில அதிகாரி ஒருவர் கூறியதாவது: ஒவ்வொரு தேர்வு முடிவு சமயங்களிலும், தேர்வு முறைகேடு தடுப்பு குழுவால் புகார்கள் மீது நடவடிக்கை எடுக்கப்படும். சென்னையில், நேற்று நடந்த ஆய்வு கூட்டத்தில், 56 கல்லுாரிகளில் நடந்த, 76 செய்முறை தேர்வுகளுக்கு தடைவிதிக்கப்பட்டு மறு தேர்வு அறிவிக்கப்பட்டுள்ளது. கோவையில் மட்டும், 29 தேர்வுகள் ரத்து செய்யப்பட்டுள்ளது குறிப்பிடத்தக்கது. மேலும், 524 மாணவர்கள் மீது, மூன்று பிரிவுகளின் கீழும், இரண்டு கல்லுாரி முதல்வர்கள் மீதும் நடவடிக்கை எடுக்கப்பட்டுள்ளது. இவ்வாறு அந்த அதிகாரி கூறினார்.