Will dis­solv­ing the MCI help doc­tors?

NOT OKAY? Scrap­ping the Med­i­cal Coun­cil of In­dia will be ‘un­demo­cratic’ and will ‘crip­ple’ the func­tion­ing of the med­i­cal pro­fes­sion, say doc­tors

Hindustan Times (Delhi) - HT Education - - Front Page - Gauri Kohli HT Ed­u­ca­tion Cor­re­spon­dent

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). They have called it “an un­demo­cratic move.”

One of the pri­mary re­spon­si­bil­i­ties of the MCI is to reg­u­late med­i­cal ed­u­ca­tion in the coun­try, but it was the NITI Aayog which sug­gested the creation of NMC in Au­gust 2016. The pro­posed bill talks about form­ing the NMC, which will be a pol­icy-mak­ing body for med­i­cal ed­u­ca­tion.

Scrap­ping MCI, how­ever, might not be the right move in the long term, ex­perts have said.

The pro­posed NMC Bill 2016 sug­gests that the Cen­tral gov­ern­ment 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 non­med­i­cal 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 and med­i­cal as­so­ci­a­tions.” The Com­mis­sion will also be re­spon­si­ble for con­duct­ing the Na­tional El­i­gi­bil­ity-cum En­trance Test and a Na­tional Li­cen­ti­ate Ex­am­i­na­tion for ad­mis­sion into post­grad­u­ate cour­ses in med­i­cal col­leges.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 the UG and PG lev­els, re­spec­tively. They will also be given the task to de­velop a com­pe­tency-based cur­ricu­lum (in­clud­ing as­sess­ment) at the two lev­els and pre­scrib­ing guide­lines for set­ting up med­i­cal in­sti­tu­tions, be­sides con­duct­ing ex­ams.

But will dis­solv­ing MCI help achieve th­ese goals? Dr Arun Aggarwal, for­mer pres­i­dent, Delhi Med­i­cal Coun­cil and pro- fes­sor­fes­sor of ex­cel­lence­ex­cel­lence, 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 post­grad­u­ate 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 MCMCI, 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. Achiev­ing high growth in health­care to meet the grow­ing needs is an area of high pri­or­ity. Re­forms in med­i­cal ed­u­ca­tion are also nec­es­sary. The needs of med­i­cal pro­fes­sion like pro­fes­sional au­ton­omy and iden­tity have to be ad­dressed,” says Dr Bipin Ba­tra, ex­ec­u­tive di­rec­tor, NBE. I nstead of di s s ol vi ng t he Med­i­cal Coun­cil of I ndia (MCI), the gov­ern­ment should an­a­lyse other is­sues af­fect­ing med­i­cal ed­u­ca­tion in the coun­try. Dr KK Aggarwal, na­tional pres­i­dent elect, In­dian Med­i­cal As­so­ci­a­tion ( IMA), says, “Cur­ricu­lum de­sign and up­date in a time-bound man­ner based on the per­ceived needs of the coun­try and global trends is nec­es­sary. Putting a ro­bust fac­ulty de­vel­op­ment pro­gramme in place is also re­quired be­sides mon­i­tor­ing con­duct of ex­ams. A na­tional pool of teach­ing fac­ulty needs to be cre­ated while putting in place a choice-based credit sys­tem in med­i­cal ed­u­ca­tion with trans­fer­able cred­its,” he says.

Hav­ing mul­ti­ple ex­ams to ad­mit stu­dents at var­i­ous lev­els of med­i­cal ed­u­ca­tion must also be done away with, say ex­perts. “An exit exam for med­i­cal grad­u­ates will help stu­dents in a big way. NEET has been in­tro­duced and it is a move in the right di­rec­tion,” says Dr Arun Aggarwal, for­mer pres­i­dent, Delhi Med­i­cal Coun­cil and pro­fes­sor of ex­cel­lence, Maulana Azad Med­i­cal Col­lege, Delhi.

In the draft Na­tional Med­i­cal Com­mis­sion Bill be­ing con­sid­ered by the NITI Aayog, an exit exam has been pro­posed for the un­der­grad­u­ate level. It is ex­pected to help as a method for qual­ity cer­ti­fi­ca­tion of grad­u­at­ing doc­tors.

Stu­dents and young doc­tors be­lieve that the au­thor­i­ties must first match the demand and sup­ply of health­care pro­fes­sion­als. Dr Man­ish Prab­hakar, pres­i­dent, I ndian Med­i­cal Stu­dents’ As­so­ci­a­tion, says, “We are still fol­low­ing the old pat­tern of med­i­cal ed­u­ca­tion. The health­care delivery sys­tem in In­dia is poor­est among all de­vel­op­ing coun­tries. We have 462 med­i­cal col­leges with 63,535 seats pro­duc­ing around 60,000 doc­tors each year and 25,577 PG seats with 14,000 clin­i­cal seats and the rest are non-clin­i­cal and pre-clin­i­cal seats.

“In a coun­try with a pop­u­la­tion of 1.25 bil­lion, pro­duc­ing 60,000 MBBS doc­tors and around 14,000 clin­i­cal spe­cial­ists and even fewer su­per spe­cial­ists is the real prob­lem. More than half of the MBBS doc­tors after get­ting t heir de­gree start pre­par­ing for PG en­trance but with fewer seats at the PG level, less than one-third qual­ify. The rest pre­pare again and this num­ber is in­creas­ing year-on-year,” he adds. De­mon­eti­sa­tion has changed their lives but stu­dents in Delhi are scrimp­ing and sav­ing to get by on ₹ 100 a day.

Raghav Mal­ho­tra, a mass com­mu­ni­ca­tion stu­dent from IP Univer­sity, says his daily khar­cha in­cludes ₹ 40 on snacks, ₹ 20 for trav­el­ling by the Metro or bus, ₹ 20 for an iced tea or cold drink and ₹ 20 on sta­tionery – usu­ally note­books or pens. Dan­ish Gird­har, a man­age­ment stu­dent, does not spend more than ₹ 100 on trav­el­ling by the Metro, bus or E-rick­shaw and on can­teen food. Get­ting notes pho­to­copied (which most stu­dents do re gu­larly) i s also ex­pen­sive so stu­dents say they are spend­ing time dur­ing Metro or bus com­mutes copy­ing teach­ers’ hand­outs – pen on pa­per. In­ter­est­ingly, stu­dents in PG ac­com­mo­da­tion have stopped eat­ing out and started cook­ing with per­mis­sions from their land­lords and land­ladies.

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