Medical Council asked to expedite MBBS seat enhancement


Stung by the Medical Council of India (MCI)’s feet dragging over the MBBS seats cancellation-restoration issue, the union health ministry has urged the statutory body to urgently take a call on compliance reports filed by educational institutions all over the country.

Union health minister Dr Harsh Vardhan said here on Wednesday that about 10,000 meritorious students face a bleak future because of the MCI’s obsession with minor details.

“Most of the deficiencies in the MCI’s reports are about problems with air-conditioning, or about partition walls in buildings and, of course, the shortage of faculty which is an old irritant. But even though most of the colleges have complied with the MCI’s demands, there has been no acknowledgement. This cannot be expected of MCI,” Dr Harsh Vardhan said.

The minister said senior officials of the ministry, including health secretary Lov Verma, and joint secretary Vishwas Mehta have been forwarding the recommendations of the hearing committee and compliance reports submitted by the various medical colleges. But MCI’s response is awaited, causing anxiety in all quarters, he added.

“The ministry has sent 150 cases, most of them government colleges, for review to MCI but there has been no response. I respect MCI’s autonomy but expect that it appreciates the agony of thousands of meritorious boys and girls whose future is jeopardised by procrastination,” Dr Harsh Vardhan said.

The minister disclosed that he has received numerous delegations of students, doctors, institution managements, members of parliament and other stakeholders complaining of MCI’s attitude.

“Reports are flooding the ministry of medical colleges, including reputed government-owned ones, cutting their intake of undergraduates for the current academic year. This is worrying for the government because the long-term effect would be a deeper crisis in the availability of qualified doctors. As it happens, India has just one doctor per 1,700 people compared to the global average of 1.5 per 1,000. The government has a policy of meeting the shortfall by opening more medical colleges over the next decade,” according to a statement by the union health ministry.

“MCI had undertaken to send its recommendations to the health ministry for issuance of letters of permission by June 15, 2014 as per a revised schedule made in May. In follow up, the government’s deadline for issuing letters of permission or denial was set for July 15, 2014. But with MCI reneging on its undertaking, the government is dismayed that it would not be in a position to mitigate the suffering of the students,” the statement said.

Dr Harsh Vardhan said, “It is disturbing that amidst all the reports of students’ agony over the delay, the non-seriousness of the MCI’s Executive Committee is appalling. Yesterday they had a meeting but we are yet to receive word on its outcome.”

In a letter to MCI president Dr Jayshreeben Mehta, health secretary Lov Verma has suggested that MCI should file an interlocutory application before the Supreme Court in the Priya Gupta case. The objective should be to get an extension to August 8, 2014 so that the passing of the present deadline does not have a destructive impact, the statement added.

Source: India Medical Times

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Medical Graduates Should Be Offered Diploma Courses To Make Them Specialists

To tide over the acute shortage of medical specialists in India, the country needs medical educational institutions on the line of the College of Physicians and Surgeons (CPS) in Maharashtra which would offer diploma courses in fields like anaesthesia, gynaecology, and paediatrics to medical graduates, according to experts.

Talking about the acute shortage of medical specialists in the country, Dr Devi Shetty, founder and chairman, Narayana Health, recently pointed out that while the US has 19,000 undergraduate medical seats and 32,000 postgraduate seats, in India it is the opposite – the country has close to 50,000 undergraduate medical seats but only 14,000 PG seats.

“The low number of PG seats results in a shortage of specialists. This can have terrible consequences on the ground. For example, India has one of the highest maternal mortality rates in the world and this is unrelated to the amount of money we spend on healthcare. The reason is that we have created a regulatory structure where only a specialist can perform certain tasks, and the country simply doesn’t produce enough of these specialists,” he said.

Dr Shetty suggested that to tide over the problem, the country needs medical educational institutions on the line of the College of Physicians and Surgeons (CPS) in Maharashtra which would offer diploma courses in fields like anaesthesia, gynaecology, and paediatrics to medical graduates.

“This can convert the entire 50,000 medical graduates produced in India every year into specialists who can then help reduce maternal mortality in India,” Dr Shetty said, adding, “If we want to deliver better healthcare outcomes, India doesn’t require money. We only require policy changes. This will not happen till the Government looks at medical education as integral part of the country’s development.”

Dr Shetty was speaking at ‘The Future of Healthcare: A Collective Vision’, a global healthcare conference that was held here on March 3-4. The event, hosted by The Healthcare Alliance, witnessed the participation of thought leaders, policy makers, senior government officials, and business and health leaders from over 15 countries.

Calling for major changes in the existing health system, Dr Naresh Trehan, chairman and managing director, Global Health (Medanta-The Medicity), said, “Healthcare is basically disease management. We should build our system from the ground up to create a new blueprint of India’s healthcare.”

“We have over 800,000 ASHAs (Accredited Social Healthcare Activists) in India but they are ill trained and don’t have any medical skills. Their costs are a huge burden on the exchequer and nothing gets accomplished in return. All we have to do is to upscale their skills so that they can be the eyes and ears of the healthcare system on the ground. They need to monitor hygiene and find out who in the community needs medical assistance. This will be a big help in ensuring quick diagnosis of diseases and reducing the incidence of NCDs (non-communicable diseases),” Dr Trehan said.

Outlining his views on the role of technology in ensuring greater access to quality healthcare, Shivinder Mohan Singh, executive vice chairman, Fortis Healthcare, said, “Technology has played a vital role in healthcare in the last 30 to 40 years, whether it is diagnosis or treatment. Going forward it is going to trigger more changes in healthcare than any other factor.”

Singh said, “Healthcare access will get radically transformed with technology whether it is in terms of proximity through devices planted in our bodies or by low-cost healthcare using innovative technological solutions or the speed with which information is shared.”

“A healthcare ecosystem would be created in future where different silos begin to talk to each other about patients and exchange information. Healthcare delivery is going to become more personalized in terms of tailor-made treatments for an individual,” he added.

Talking about the need for better integration of different systems of medicine, Singh said: “Allopathy has taken a predominant share of the existing market in healthcare, but I think we can’t avoid for too long the benefits that other health sciences bring to the table. Some kind of integration of different health disciplines is bound to happen in future.”

He also emphasized that the onus of taking charge of one’s health has to rest on the individual. “We need to be more concerned for what we do to our health rather than what healthcare would do to us. We need to take ownership of our own bodies and mind and not outsource these to healthcare providers. People need to focus more on preventive care rather than just landing in sick care – this is going to the mantra of healthcare in future,” he said.

Dr Shetty expressed concern about the nursing profession in India, which he said would die down in a few years if urgent measures were not taken.

“There is zero career progression for nurses. Nursing is now considered a dead-end career. Admissions to nursery colleges in India have come down by 50 per cent. Half of the nursing colleges in Karnataka have shut shop. In the years ahead, there will be an acute shortage of nurses in the country,” he said.

Dr Shetty further said, “There is a critical need to empower nurses by offering them a path to upgrade their skills and become specialists. About 67 per cent of anaesthesia in the US is given by nurse anaesthetists. In India, we don’t allow a nurse who has worked in critical care for 20 years to even prescribe a Paracetamol tablet!”

Dr Shetty also highlighted the need to look for alternative ways of funding healthcare, such as by a surcharge on mobile phone bills, to bring down the cost of building hospitals, develop patient management software, and establish one or two health cities with 3,000 to 5,000 beds in each metro where cutting-edge work can be done.

Source: India medical times

High Court directs MCI to review forensic medicine curriculum in MBBS course

current practice in forensic medicine cover

The Nagpur bench of Bombay High Court has directed the Medical Council of India (MCI) to review the curriculum of forensic medicine in the MBBS course and find out if any revision of the curriculum is needed.

Peeved by the “inadequate and irrational” curriculum of forensic medicine in the MBBS course, a Sevagram-based doctor Indrajit Khandekar had approached the judiciary seeking its immediate revamp.

Dr Khandekar, who is in-charge of Clinical Forensic Medicine Unit (CFMU) and associate professor at Mahatma Gandhi Institute of Medical Sciences (MGIMS) in Sevagram (Wardha), had challenged the existing syllabus before the Nagpur bench of Bombay High Court on the ground that it has no provision for bedside practical teaching of clinical forensic work and forensic postmortem (FPM) work like other clinical subjects. The plea was based on a 464-page study report of the petitioner.

In an order issued on March 13, a division bench comprising Justice B P Dharmadhikari and Justice P R Bora directed the MCI that they shall look into the suggestions given in representation made by the petitioner for revamping the curriculum of forensic medicine in accordance with law and to proceed further and find out whether any revision of the curriculum is necessary or not.

The petitioner’s counsel Anil Kilor had contended that because of lack of bedside practical teaching of medico-legal aspects half-baked and inadequately trained MBBS doctors are being produced in the country.

“Government expects all types of medico-legal work (MLW) from such doctors when they join as Casualty Medical officer (CMO) or Medical Officer after completion of MBBS degree. A quality medico-legal work cannot be expected from such pseudo-experts. That’s why at present quality of medico-legal work in the country is very poor and abysmal which helps in acquittal of accused in majority of cases and also leads to miscarriage of justice,” the counsel argued.

According to the petitioner, there are instances where judiciary has passed strictures against doctors and even government has taken serious actions against doctors for poor quality of medico-legal work.

“But, unfortunately all concerned agencies including government never tried to correct the actual reason — i.e., only theoretical teaching of forensic medicine and lack of bedside practical teaching — behind this. Till the curriculum is amended and properly implemented no one should expect good quality of medico-legal work from the doctors,” said Dr Khandekar.

Kilor further pointed out shortcomings in medico-legal examination in assault cases, recording of dying declaration, sexual violence exam, injury report preparation, age estimation, alcoholic and weapon exams, burn and dowry cases including postmortem exam etc.

According to Dr Khandekar, the key reasons for the poor quality of medico-legal work are production of half-baked and untrained doctors by the MCI; allowing such untrained doctors by the government to do medico-legal work; and private medical colleges not allowed to do postmortem exam.

Dr Khandekar suggested that functional forensic autopsy and clinical forensic medicine units (CFMU) should be set up in every private and govt medical college; clinical forensic and forensic autopsy posting schedule should be provisioned in the syllabus itself for bedside practical teaching like other 15 clinical specialties and all medico-legal work of casualty, trauma centre and hospital should be handed over to the department of forensic medicine under CFMU.

He further suggested compulsory internship in CFMU and autopsy units for a period of one month; optimum teacher student ratio for bedside practical teaching; provision for court visits for MBBS students in batches; and teaching of the subject should be taken up in the later part of the clinical years.

Source: India Medical Times

MCI mulls shortening of MBBS course duration by 1 year

The duration of the MBBS course could be shortened by one year with the Medical Council of India (MCI) thinking about introducing specialist skills for undergraduates earlier than what is the practice at present.

Official sources said that the MCI academic council is likely to meet next week to finalise the new curriculum and send it to the government for approval.

The MBBS course presently stretches for five-and-a-half years four-and-a-half years of academic studies and one year of internship.

Sources said that the curriculum is seen as devoting too much time to general medical studies and the various aspects of the human anatomy, which may not be of much use to students who opt for specialisation in later years.

The new curriculum, which they said would take away nothing while giving more freedom to students, envisages adequate skill training at the initial level while introducing students to clinical and analytical courses.

“The idea is to let students study in detail the subject of their choice and develop expertise in that topic instead of studying all subjects in detail. It will save a lot of time and sharpen their skills,” they said.

Experts believe that students should be allowed to carry on studying their subject of specialisation once they become conversant with the human anatomy.

They were also of the view that the present curriculum did not provide sufficient skills in the early years, which they said was crucial at a time of growing specialization and super -specialization.

Source: zee news