The Indian authorities changed a system — the Medical Council of India, which was regulating medical training and observe for over eight many years — resulting from allegations of inefficiency and corruption. NITI Aayog was a powerful proponent of this transformation, and even the judiciary advocated the necessity to enhance medical training. The Medical Council of India was outmoded by the Nationwide Medical Fee in 2020, by way of an Act of Parliament, which now units new requirements and laws to reform the system. This has compelled even non-public medical faculties to adjust to sure norms. The medical neighborhood, significantly academicians and educators, carefully observe the NMC’s operations.
Though it could be untimely to guage its efficiency inside simply 4 years, the regulators’ eagerness to implement important modifications to the curriculum has led to appreciable disarray and confusion. Adhering to Western medical insurance policies with out contemplating India’s distinctive circumstances has contributed to this turmoil. The implementation of the brand new curriculum has been counterproductive in lots of medical faculties. Competency-based medical training (CBME) was launched to stress sensible abilities over theoretical information. Nonetheless, the alternative happens, with extra time allotted to lectures (symposiums, group discussions, seminars, and so forth.).
Reforms have made medical training shrivelled and truncated. Beforehand, medical college students would start medical rotations from 8 a.m. to 1 p.m. after finishing one and a half years (Primary Science) of the MBBS course. They’d spend time in wards, process rooms, and working theatres, with idea courses scheduled for the night (2 p.m. to 4 p.m.). This schedule has been inverted, with college students attending clinics after 10 a.m. and idea courses within the morning. Consequently, college students are not seen with lecturers through the morning rounds, a departure from the previous when unit chiefs, associates, assistants, residents, and college students had been all current. Bedside instructing is a vital part of medical coaching, but it has practically vanished from medical faculties. College students at the moment are typically seen merely following college to get their logbooks signed, the place excessive scores are prevalent. Lecturers are deeply involved, however collective motion to handle this situation with policymakers is missing. Medical skilled our bodies and different stakeholders should significantly handle this concern.
Extra medical faculties
The graph depicting the expansion of medical schools from 1974 to 2024 illustrates a pointy enhance in each authorities and personal establishments. In 1970, India had fewer than 100 medical schools for a inhabitants of 54 crore however in the present day, there are 766 medical schools throughout each authorities and personal sectors for a inhabitants of 144 crore. The previous decade alone has seen a fast enhance in new medical schools resulting in elevated MBBS seats from 64,464 to 1,15,812 seats and PG seats from 31,185 to 73,111 seats. The variety of medical schools in India virtually doubled to 595 from 335 between 2011 and 2021. This yr, the federal government sanctioned 60 new medical schools.
In line with Western requirements, we’d nonetheless want 300 extra medical faculties based mostly on our inhabitants dimension. Since 2014, there was a fast rise within the variety of seats for undergraduate and postgraduate college students. Final yr, on the 78th Independence Day, Prime Minister Narendra Modi introduced a plan to create 75,000 new medical seats throughout India over the following 5 years. The federal government’s coverage modifications intention to remodel common and district hospitals into medical schools and ease the factors for establishing new ones. Whereas these modifications could seem helpful, a deeper evaluation suggests they might result in tutorial decline. The well-known lack of ample infrastructure and college, even in established establishments, is regarding. Many new establishments are lacking primary facilities and have a scarcity of school, threatening the standard of medical training.
Adopting the Western mannequin with out the required infrastructure and college may have catastrophic penalties for our academic system. In contrast to Western international locations, the place the faculty-student ratio fosters a conducive tutorial atmosphere, the state of affairs is reversed right here. Moreover, examination outcomes from medical schools point out a troubling development: 4 many years in the past, with extra authorities and fewer non-public medical schools, the failure price was about 20-30% amongst meritorious college students. Now the failure price is 1-2% solely, that too with mediocre college students. Some folks purpose that the decline in failure charges may point out lowered academic requirements, affecting the the general competence of future medical doctors.
The dramatic shift within the high quality of medical training, inspection requirements, and regulatory inconsistency definitely pose a significant concern. Producing well-qualified medical doctors is crucial for societal welfare. Tutorial establishments and regulatory our bodies ought to certainly prioritise these points. Common and thorough inspections are essential to make sure the standard of training.
Examinations and testing
Whereas the Nationwide Exit Check (NEXT) is a step in the appropriate route, the delays and inconsistencies are disheartening. A transparent, constant plan must be established for such essential examinations. Reforming this method requires collaboration between academicians, skilled our bodies, and regulators. Are there some sensible steps that may be taken proper now to enhance the state of affairs?
The primary situation, nonetheless, is the shortage of ample infrastructure and college. An impartial examine by an expert physique would reveal startling findings. The federal government mustn’t loosen up norms and laws merely to begin new establishments resulting from political compulsion. In the long run, this method is detrimental to the standard of medical doctors in India.
Quick motion from academicians, skilled our bodies, and policymakers is required to handle these points. The federal government’s deal with increasing medical training must be balanced with making certain ample infrastructure and enough certified college. An in-depth impartial examine is essential to uncover the extent of those issues and information obligatory reforms to safeguard the standard of medical training in India.
(Prof . R C Thampan is former professor of surgical procedure, Malabar Medical School, Hospital and Analysis Centre, Kozhikode. He may be contacted at rcthampan@gmail.com)
Printed – January 10, 2025 06:32 pm IST
