New NMC regulations on MBBS admissions call for ease on land requirements

The regulations- Minimum requirements of MBBS admissions and establishment of medical colleges amendments- have come into force with its recent publication in the official gazette and will be applicable to medical colleges being established from the 2021-22 academic session.

Medical Dialogues has been extensively reporting about the regulations. The new Regulation has deleted the quantum of land required for setting up a medical college and its affiliated teaching hospitals (all buildings are expected to conform to existing building bye-laws).

The notification defines the minimum requirements of space for all student-centric areas in the institution and the functional areas required. The Standards outlines the sharing of all available teaching spaces by all departments (compared to the inflexibility in the regulations so far) thereby mandating all teaching spaces to be enabled for e-learning and also digitally linked to one another (it was only desirable earlier).

There are many new features in these regulations that would promote better medical teaching. Besides having regular teaching, the rules also call for smaller group teaching to promote better understanding of concepts. The size of each batch for such small group teaching shall be about 15 students. The common resource pool of teaching rooms, student practical laboratories, museums and lecture theaters and any other available area that can be utilized for teaching purposes as prescribed in these regulations shall all be utilized for small group teaching and shared by the teaching departments.

The rules also call for every medical college shall have one Rural Health Training Center affiliated to it

A major change from the draft has been that in the department of Anatomy, Physiology, Biochemistry, non-medical teachers may be appointed to the extent of 15%of the total number of posts in the department subject to the non-availability of medical teachers.

All medical colleges wanting to offer MBBS course and renew their seats from the medical regulator, will now compulsorily have their official website where certain details need to be published for the general public. This effect is set to bring more transparency in the operations at all medical colleges across the country as all the information pertaining to the medical institutes and the admission procedures being conduced there will be available online and the malpractice of some unscrupulous elements duping the innocent medical aspirants will expectedly reduce.

Also Read:Medical Colleges to now mandatorily have their website for MBBS admissions: New NMC regulations

The National Medical Commission (NMC), since its constitution on September 25, 2020, has come out with a detailed list of requirements applicable for setting a new medical college, and to the established medical colleges proposing to increase their annual MBBS intake from the academic year 2021-22, the health ministry said.

The requirement for the number of beds in a medical college hospital has been reduced from 530 to 430 for a 100-seat college, and from 930 to 830 for a 200-seat college, according to the new regulations notified. The beds required in various departments of a teaching hospital have been rationalised to align with the annual student intake, teaching time to be spent in clinical specialties and the minimum clinical material required for undergraduate medical training which has resulted in about 10 per cent reduction in teaching bed needs compared to the earlier regulations. The human resource of teaching faculty has also been rationalised under the new regulations. Over and above the minimum prescribed faculty, the provision for 'visiting faculty' has been made to enhance the quality of training, the ministry said.

The medical college and its affiliating teaching hospital should provide for proportionate additional beds, infrastructure, faculty and another human resource in any speciality depending upon the needs and patient load.

The new standards have been defined by keeping the functional requirements of the institution(s). These allow optimization and flexibility in utilising available resources, and harnessing modern educational technology tools to facilitate moving towards quality education, even when resources are relatively scarce.

In tier 1 and tier 2 cities, hilly and north-east states and notified tribal areas, the campus could also be on two plots of land – one housing the teaching hospital and the other the medical college with hostels for students and interns, the notification stated.

If the campus is housed in more than one plot of land, the distance between each one of these plots should be less than 10 kms or less than that of 30 minutes travelling time. "Provided that where the government district hospital is being considered for use as the teaching hospital of a medical college, all constituents of the district hospital, even if they are on two plots of land, will be considered as the affiliated teaching hospital, provided that the main district hospital has at least 300 beds or in Hilly and North-East states has 250 beds," it said.

According to the new regulations, every medical institution shall have a skills laboratory where students can practice and improve skills pre-specified in the curriculum. The purpose of the skills laboratory is to provide a safe and non-threatening environment for students to learn, practice and be observed performing skills in a simulated environment thus mitigating the risks involved in direct patient exposure without adequate preparation and supervision. The skills laboratory shall have a total area of at least 600 sq m for intake up to 150 MBBS students annually and 800 sq m for intakes of 200 and 250 MBBS students annually, and should have trainers or mannequins required to achieve skills outlined in the competency-based undergraduate curriculum document, the regulations added.

It also defines a Medical Education Unit for training medical teachers in educational pedagogy. The space required for Library and the number of books and journals have been rationalized and reduced. Student counselling services has been mandated recognizing the increasing stress observed amongst medical students and residents in recent times.

Recognizing that a well-functioning hospital is at the core of medical training, the new regulation now mandates the availability of a fully functional 300 bed multi-speciality hospital for at least 2 years at the time of application for establishing a new medical college (the earlier regulations did not specify the period of functionality). The beds required in the various departments of the teaching hospital have been rationalized to align with the annual student intake, teaching time to be spent in the clinical specialties and the minimum clinical material required for undergraduate medical training which has resulted in about 10% reduction in teaching bed needs compared to the earlier regulations.

The human resource of teaching faculty has also been rationalized in the new Regulation. Over and above the minimum prescribed faculty, provision for "visiting faculty" has been made to enhance quality of training.

Two new teaching departments have now become mandatory in all medical college hospitals for the training of undergraduate medical students. These include the Department of Emergency Medicine (which has replaced the earlier Casualty Department) and will ensure access and prompt, appropriate response to emergencies particularly trauma; and the Department of Physical Medicine and Rehabilitation which shall fill a large gap for those in need of comprehensive rehabilitative care.

The Regulation has also outlined "desirable" and "aspirational" goals beyond the minimum requirements stated in the standards so as to stimulate medical institutions to strive for excellence. These elements will be utilized by the National Medical Commission while rating the medical institutions in the country.

Also Read:NMC releases final Regulations On MBBS Admissions, Establishment Of Medical Colleges, details