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
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.