National Medical Commission releases new draft Postgraduate Medical Education Regulations 2021, invites comments

The regulations will come into force on the date of their publication in the official gazette and will be applicable from the 2021-22 academic session.

Ranging from the timeline to the curriculum of PG programmes - MD, MS, PG Diploma, DM and MCh courses, the regulations clearly outline assessment rules, recognition of medical colleges, counselling/admission schedules, period training for medicos and the prior qualifications for admissions to all specialities, PG and SS.

The guidelines also specify minimum faculty required for each department at medical colleges, teacher-student ratio, training path, residency programmes as well as exam conducts for PG and SS candidates along with infrastructural requirements for imparting the courses.

One major feature of the regulations pertains to the selection of PG students mentioning the conduct of NExt, its score and continuation of NEET PG as the gateway for admissions to MD, MS, PG Diploma, DM and MCh courses in India.

Some of the salient features include:

Duration

Postgraduate Medical Education in broad specialties shall be of three years duration in the case of degree course and two years in the case of Diploma after MBBS and in the case of Super specialties the duration shall be of three years after MD/MS.

Curriculum

Postgraduate curriculum shall be competency-based, the draft guidelines clearly mandate adding that keeping in view the general objectives of postgraduate training, each discipline shall aim at development of specific competencies which shall be defined and spelt out in clear terms. Each department shall produce a statement and bring it to the notice of the trainees in the beginning of the programme so that he or she can direct the efforts towards the attainment of these competencies.

A modular approach to the course curriculum is essential for achieving a systematic exposure to the various sub-specialties concerned with a discipline. Learning in postgraduate programme, though essentially autonomous and selfdirected, shall also include assisted learning. A combination of both formative and summative assessment is vital for the successful completion of the PG programme.

Goals of postgraduate medical education programme:

The goal of postgraduate medical education shall be to produce competent specialists and/or Medical teachers:

i. Who shall recognize the health needs of the community, and carry out professional obligations ethically and in keeping with the objectives of the national health policy;

ii. Who shall have mastered the competencies, pertaining to the specialty, that are required to be practiced at the secondary and the tertiary levels of the health care delivery system;

iii. Who shall be aware of the contemporary advance and developments in the discipline concerned;

iv. Who shall have acquired a spirit of scientific inquiry and are oriented to the principles of research methodology and epidemiology; and

v. Who shall have acquired the basic skills in the teaching of medical professionals.

General objectives of post-graduate training expected from students at the end of post-graduate training

At the end of the postgraduate training in the discipline concerned the student shall be able to:

i. Recognize the importance of the concerned specialty in the context of the health needs of the community and the national priorities in the health sector.

ii. Practice the specialty concerned ethically and in step with the principles of primary healthcare.

iii. Demonstrate sufficient understanding of the basic sciences relevant to the concerned specialty.

iv. Identify social, economic, environmental, biological and emotional determinants of health in a given case, and take them into account while planning therapeutic, rehabilitative, preventive and promotive measure/strategies.

v. Diagnose and manage majority of the conditions in the specialty concerned on the basis of clinical assessment, and appropriately selected and conducted investigations.

vi. Plan and advice measures for the prevention and rehabilitation of patients suffering from disease and disability related to the specialty.

vii. Demonstrate skills in documentation of individual case details as well as morbidity and mortality rate relevant to the assigned situation.

viii. Demonstrate empathy and humane approach towards patients and their families and exhibit interpersonal behavior in accordance with the societal norms and expectations.

ix. Play the assigned role in the implementation of national health programme, effectively and responsibly.

x. Organize and supervise the chosen/assigned health care services demonstrating adequate managerial skills in the clinic/hospital or the field situation.

xi. Develop skills as a self-directed learner, recognize continuing education needs; select and use appropriate learning resources.

xii. Demonstrate competence in basic concepts of research methodology and epidemiology, and be able to critically analyze relevant published research literature.

xiii. Develop skills in using educational methods and techniques as applicable to the teaching of medical/nursing students, general physicians and paramedical health workers.

xiv. Function as an effective leader of a health team engaged in health care, research and training.

NMC recognition to Medical Institutes:

On the subject of starting postgraduate medical courses and their recognition, the draft spells out the compulsions of application and permission from the apex medical regulator as well as the Eligibility Certificate and Feasibility Certificate (EC and FC) and department of Blood Bank with components of blood separation unit.

In addition, the guidelines specify the penalty in case of Failure to seek timely recognition.

Selection of PG students

One major feature of the regulations pertains to the selection of PG students mentioning the conduct of NExt, its score and continuation of NEET PG as the gateway for admissions to MD, MS, PG Diploma, DM and MCh courses in India.

According to the draft regulations, the common Final year MBBS exam, NExt will be the basis for admission to the postgraduate broad speciality courses in each academic year, once it becomes operational and till such time, NEET-PG examination will continue.

Moreover, the NExt score obtained by the candidates will be valid for a period of 3 years from the date the person has become eligible to be granted a license to practice as a medical practitioner, for admission to postgraduate broad speciality courses. After the expiry of the validity of the marks, the medico will have to appear again for the test and qualify to be eligible for admission to postgraduate broad speciality courses.

Common counselling:

The NMC draft regulations clearly specify, "There shall be a common counseling for admission in all Medical Educational Institutions to all Postgraduate Broad -Specialty courses (Diploma/ MD/ MS) on the basis of merit list of the National Exit Test and to all Postgraduate SuperSpecialty courses (DM/MCh) on the basis of merit list of the National Eligibilitycum-Entrance Test."

District residency programme (DRP)

The District Residency Programmes will be implemented with the PG (broad specialty) batch that has joined for the postgraduate course in 2021.

This DRP aims to expose the postgraduate student to District Health System and involve them in health care services being provided at the District Hospital for serving while learning and to acquaint them with the planning, implementation, monitoring and assessment of outcomes of the National Health programmes at the district level.

Its other objective is to orient the medicos to promotive, preventive, curative and rehabilitative services being provided by various categories of healthcare professionals under the umbrella of National Health Mission.

In doing so, the postgraduate medical students would also be contributing towards strengthening of services of the District Health System as specialty resident doctors working as members of the district teams.

The responsibility of NMC on this programme would be to develop a transparent electronic platform to facilitate and ensure rule-based placement of PG residents to various institutions under the District Residency Program. They shall also develop requisite norms, tools, guidelines for implementation (log book, feedback form, learning resources etc.), maintain a dashboard on the programme and above all, continuously monitor the quality of the training programme.

PG Examinations

Obtaining a minimum of 40% marks in each theory paper and not less than 50% cumulatively in all the four papers for degree examination and three papers in diploma examination shall be mandatory. Obtaining of 50% marks in Practical examination shall be mandatory for passing the examination as a whole in the said degree/diploma examination as the case may be. Hence a candidate shall secure not less than 50% marks in each head of examination which shall include Theory and Practical including clinical and viva voce examination. No grace mark is permitted in Postgraduate Examination either for Theory or for Practical.

No new Diploma courses 

No new Diploma courses shall be permitted from 2021 onwards. All the Rules and Regulations of erstwhile MCI regarding existing Diploma courses shall be applicable till all the Diploma courses are phased out and the last Diploma candidate has cleared the examination.

The comments are to be submitted to the NMC via email at president.pgmeb@nmc.org.in before the 30th of August 2021.

To read the full draft regulations, click here

To view the official NMC notice, click here