Medical education overhaul opportunity

Informed academics and medical practitioners are unanimous that a clean-up of the malodorous augean stables of the medical profession must begin with comprehensive disinfestation of the Medical Council of India, from which the contagion has filtered into the bloodstream of medical education and practice. Summiya Yasmeen & Swati Roy report Medical education in the country is in coma. A rash of scams in the nation’s 355 medical colleges and the apex-level Medical Council of India (MCI, estb. 1934), has cast an ominous shadow over the medical profession, its dubious practices, ethics and commitment to the Hippocratic oath. On July 17, the Central Bureau of Investigation (CBI) filed chargesheets against six medical colleges which received approval from MCI to increase capacity and introduce postgraduate programmes, despite being patently unqualified in terms of infrastructure and faculty. MCI’s reckless licensing of new colleges, permitting arbitrary increases of student admissions and approval of postgraduate programmes in medical colleges during the past decade, has raised serious doubts about the quality and competence of the country’s 816,629 practitioners of allopathic medicine who tend to dismiss India’s estimated 752,254 practitioners of alternative medicine (ayurvedic, unani, etc) as quacks. The recent flood of scandals in medical education and horror stories about medicine as practised in government hospitals graphically depicted on television screens across the country, has prompted even the usually taciturn prime minister Dr. Manmohan Singh to speak up. “There’s a perception of deteriorating quality. We cannot allow this situation to continue. We must put in place a credible regulatory and institutional mechanism to help develop standards in our medical education,” he said, while addressing students at the third convocation of the Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry on June 29. Conceding that contemporary India has perhaps the worst doctor-population ratio (1:1,700) worldwide, Singh announced a major capacity expansion drive in medical education. Six AIIMS (All India Institute of Medical Sciences)-like institutions will become operational in Bhopal, Bhubaneswar, Jodhpur, Patna, Raipur and Rishikesh in 2012-2013 offering 50 MBBS seats each, and the country’s 355 medical colleges — which qualify a mere 41,469 MBBS graduates annually — will be permitted to promote branch campuses in under-served states such as Bihar, Jharkhand, Chhattisgarh, West Bengal, Rajasthan, Uttar Pradesh, Madhya Pradesh and in north-east India. Moreover during the past two years, the Union ministry of health and family welfare, which reconstituted MCI with its nominees, has sanctioned 2,400 MBBS seats in 20 new medical colleges and 1,195 additional seats in existing colleges countrywide. However this capacity expansion drive has failed to enthuse the medical fraternity or public. With police and CBI investigations continuously exposing the medical colleges-MCI corruption nexus, there’s apprehension about the competence and professional capability of the 41,469 MBBS graduates churned out annually. “In the current scenario when there are big question marks over the authenticity and validity of MCI’s approval and licensing processes, inaugurating new medical colleges and increasing student intake could result in further deterioration of quality of MBBS and postgrad medical practitioners.…