MBBS with 6 months of Ultrasound Training cannot call themselves Sonologists: NMC

New Delhi: MBBS doctors even with six months of certificate training in Ultrasonology cannot call themselves 'Consultant Sonologist', reiterated the National Medical Commission (NMC) in the recently released E-Book "Professional Conduct Review- Lessons from Case Archives".

Taking a cue from a previous case, the Apex Medical Commission pointed to a broader implication that a physician should not claim to be a specialist and do speciality practice unless he/she has a special qualification in that branch.

In this regard, the Commission also reiterated that the registered medical practitioners should register their additional qualifications with the respective state medical councils.

The E-Book titled "Professional Conduct Review-Lessons from Case Archives" by the Ethics and Medical Registration Board (EMRB) was released by NMC on October 05, 2023, at the Board's Conference Room in NMC, New Delhi, in the presence of NMC Chairman Dr. B.N. Gangadhar.

Medical Dialogues had earlier reported that altogether nine (9) case archives were discussed in Volume I of the book. In respect of each and every case, NMC discussed different topics including Communication Between Doctor and Patient's Relatives, Allegations of Wrong Diagnosis Leading to Delay in Treatment, Specialty Practice-Without Adequate Qualification/Training etc.

For each of the cases, the book elaborates on different aspects such as the keywords, context/category, abstract, summary of the case, discussion, decision of State Medical Councils or NMC Ethics Board, lessons learned from the case, take-home message, etc.

Also Read: NMC unveils its first publication, an E-Book titled Professional Conduct Review - Lessons from case archives

One of the cases relates to one Dr. R, who was engaged in private practice as a Consultant Sonologist since 2004 without the required qualification/training. The concerned doctor did not have a Postgraduate qualification and he only obtained 6 months ultrasonology training certificate according to Preconception and Prenatal Diagnostic Technique Act, 1994 (PCPNDT Act, 1994).

However, taking cognizance of this malpractice, the Indian Medical Association (IMA) filed a complaint against him in the State Medical Council (SMC). After due deliberations, the SMC removed his name from the State Medical Register for 2 months and warned him to refrain from practicing as a Consultant Sonologist/Radiologist.

Despite such an order by the SMC, the doctor continued performing ultrasound for other indications beyond his training and use the title of consultant sonologist. He also appealed against this order in the High Court, which ultimately redirected the matter to the NMC Ethics Board.

While considering the matter, the Commission noted that after obtaining an MBBS degree, Dr. R did 6 months of certificate training in ultrasound according to the PCPNDT Act.

"However, such training does not permit him to practice as a consultant radiologist/sonologist in areas beyond his certification. However, he was performing ultrasound for other illnesses beyond the scope of this specific certificate training under the PCPNDT Act," opined the Commission.

After hearing and due deliberations, EMRB, NMC directed Dr. R to submit an undertaking to not go beyond the PCPNDT Act and refrain from using the title 'Consultant sonologist' in the future.

NMC Observations: 

Referring to this case, NMC in the E-Book reiterated how after the introduction of short-term certificate courses in ultrasonology for specific purposes, several doctors misuse this certification to extend their expertise to areas beyond the scope of training.

NMC observed that such a practice by the medical practitioners can be intentionally misleading to the patient who is not in a position to verify and discern the qualification. Further, it can also lead to wrong diagnosis and harm to the patient, opined the Commission.

Noting that this unethical practice can ultimately jeopardize the reputation of the medical fraternity in the eyes of the public and undermine trust in the profession, the Commission clarified, "Medical Practitioners may acquire skills and training in various areas related to a particular field to benefit the patient. However, the use of the title 'consultant/specialist' should be restricted to those who are qualified in the particular specialty. Care should be taken not to mislead the public through sign boards, visiting cards, announcements, etc."

Referring to the case, the Commission reiterated that as per Clause 7.20 of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, "A physician shall not claim to be a specialist unless he/she has a special qualification in that branch..."

At this outset, NMC reminded in the book that the Registered Medical Practitioners should register their additional qualification with the respective medical councils.

The Commission also referred to clause 7.13 of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 to clarify that "it is improper for a physician to use an unusually large sign board and write on it anything other than his name, qualifications obtained from a University or a statutory body, titles, and name of his specialty, registration number including the name of the State Medical Council under which registered."

"The same should be the contents of his prescription papers. It is improper to affix a signboard on a chemist's shop or in places where he does not reside or work," mentioned NMC.