A parliamentary panel has called for restructuring the Medical Council of India (MCI), stating that its current composition is “biased” against larger public health goals and is an “exclusive club” of medical doctors from corporate hospitals and private practice.
The Committee, which presented its report in Rajya Sabha, said the elected MCI neither represents “professional excellence nor its ethos”, and that more than half of the members are either from corporate hospitals or in private practice.
“The Committee is surprised to note that even doctors nominated under Section 3(1)(a) and 3(1)(e) to represent state governments and Central government have been nominated from corporate private hospitals which are not only highly commercialised and provide care at exorbitant cost but have also been found to be violating value frameworks,” the report said.
It said the current composition of MCI is biased against the larger public health goals and public interest and that the Council is an exclusive club of medical doctors as the IMC Act does not call for diversity of background of the members.
“The Committee is of the considered view that the composition of the MCI is opaque and skewed and diversity needs to be brought into this because having only medical doctors in the Council is not an enabling factor for ensuring reforms in medical education and practice,” said the Committee as it recommended opening Council membership to diverse stakeholders such as public health experts, health economists, health NGOs, patient advocacy groups, etc.
The Committee also recommended that government should move swiftly towards removing all possible roadblocks to the Common Medical Entrace Test (CMET) for admission to MBBS and PG courses, including legal issues and immediately introduce the same to ensure that merit, and not the ability to pay, becomes the criterion for admission to medical colleges.
“It is public knowlegde that the majority of seats in private medical colleges are allotted for a capitation fee going upto Rs 50 Lakh and even more in some colleges despite the fact that the capitation is not legal.
“This has serious implications for our whole system of medical education and healthcare. One clear implication of this skewed process of admissions by way of sale of seats is that there may be large number of students entering the system who may not be up to the required standards,” it said.
The Committee also said the existing minimum standardrequirements, as mandated by the MCI, are irrational and rigid, proving to be big impediment in the establishment and expansion of medical colleges.
“The Committee, therefore, recommends that physical infrastructure requirement be pruned down in such a way that it should have just about 30-40 per cent standing value in the total assessment of a medical college,” the report said.
The Committee also recommended complete restructuring of the undergraduate education and suggested that the PG entrance exam should be held immediately after the final MBBS examination so that graduate doctors could concentrate on practical skills during internship.
“The Committee also observes that the medical education in India is increasingly depersonalised and has failed to instill human values of care, concern, courtesy and compassion.
“The Committee feels that young doctors should not only have parctical skills but also lot of soft skills. It therefore recommends that soft skills (including ethics) should be made one of the cornerstones of the syllabus of medical education,” the report said.
The Committee also recommended that the current system of PG medical education be restructured taking the best of both systems that is all Indian common entrance exam for all seats and common exit evaluation for all candidates as practised by DNB (Diplomate of National Board) and the training and evaluation processes of the university based system into one national qualification.