How to Identify Fake Patients during medical college inspections? Check out NMC guidelines

New Delhi: To address the issue of medical colleges admitting fake patients to fulfil the requirements of bed occupancy, investigation, etc., the Medical Assessment and Rating Board (MARB) of the National Medical Commission (NMC) has specified the guidelines for identifying such fake patients during inspection.

As per the guidelines mentioned by NMC under the “Establishment of Medical Institutions, Assessment & Rating Regulations, 2023", the assessors may identify fake patients if it is noted that a large number of patients were admitted on the day of assessment or the day before if such patients do not have any minor ailments that could be treated on OPD basis if there are no evidence of investigations such as X-ray, blood tests etc.

In the pediatric ward, fake patients can be located if the children were seen playing without any significant problem, if multiple patients were admitted from the same family, if a large number of patients were admitted through preventive health checkups, etc.

Specifying these guidelines, the NMC Medical Assessment and Rating Board also clarified that if any institute gets the assessor's remarks on "fake patient practice", they would be punished under Chapter 5 of "Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses & Assessment and Rating Regulations, 2023".

Also Read: NMC Notifies Guidelines for MBBS Course under Establishment of New Medical Institutions, Starting of New Courses, Increase of Seats, Assessment and Rating Regulations 2023

As per the existing rules, MARB conducts the inspection before granting permission to set up new medical institutes, start new medical courses or increase seats in existing courses.

While inviting applications for the Establishment of a New Medical College or institution intending to offer MBBS courses and increase the number of UG seats in an established Medical College or Institution for the Academic year (AY) 2025-2026, MARB mentioned that "For the purpose of training the students, certain minimum clinical exposure of patients have been defined in the MSR criteria of UG and PG Board in the form of bed occupancy requirements, etc."

Practice of Fake Patients: 

However, MARB addressed the practice of admitting fake patients by the medical colleges facing NMC inspection and mentioned "MARB Guidelines-for assessment of medical college/institutions-2024", notified on 05.12.2024, "It has been observed since a long time that some medical institution/ colleges indulge in admitting fake patients (person who does not require any treatment or in-patient treatment) to fulfil the requirement of bed occupancy, investigation, etc."

Guidelines for identifying fake patients:

The following will be the guidelines for identifying fake patients: -

 Observation of assessor/s that large numbers of patients were admitted on the day of assessment or the previous day.

 Such recently/previously admitted patients have no/minor/insignificant ailments/problems which can be treated on Outpatient (OPD) basis with oral medications.

 Patients who are admitted without any evidence of investigations like x ray , blood tests etc. ( before or after admission) or treatment which is generally done for admitted patients like Intravenous (IV) fluid, injections, catheterization, giving medicines etc.

 In pediatric ward, most of the admitted children were playful and joyous without any significant problem.

 Observation of assessor/s that multiple patients from the same family were admitted.

 Observation of assessor/s that patients were admitted in large numbers through preventive health checkups/ camps.

 Any other justifiable observation of the assessor.

If the assessor/ assessors find fake patients they may document them in a below-mentioned table or collect relevant documentary evidences.

Institutes may face NMC Action for Indulging in "Fake Patient Practice": 

The MARB guidelines specified that if the NMC assessor makes these above mentioned observations in their remarks, "it will be considered as indulgence of institution in “fake patient practice” which will be considered as a serious violation and it will invite punishment as per the Chapter 5 (Sanctions and Penalty) of “Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses & Assessment and Rating Regulations, 2023”, in short “Establishment of Medical institutions, Assessment & Rating Regulations, 2023”

The penalties:

a. Issuance of warning with accommodation of reasonable time for compliance or rectification as the case may be by the medical institution.

b. Monetary penalty not exceeding INR one crore per every non-compliance committed by the medical institution.

c. Withholding processing of application for any new scheme/s for that academic year or for a such number of years.

d. Reducing the number of students in the next or subsequent academic years to be admitted by the medical institution.

e. Stoppage of admission to one or more of the courses in the next or subsequent academic years.

f. Recommending to NMC for withdrawal of recognition.

g. Withholding and withdrawal of rating of the medical institution for a period up to five academic years.

h. Any attempt to pressurize MARB or NMC through individuals or agency will lead to immediate halt of the processing the application/request by the medical Institution

Also Read: NMC notifies MARB Guidelines for assessment of medical institutions 2024, invites applications for New Medical Colleges, MBBS seats increase