Is the end of CPS courses near? NBE refuses to takeover CPS courses, States contemplating Withdrawal

Mumbai: Already struggling with controversies, the courses run by the College of Physicians and Surgeons (CPS) have received another blow from the National Board of Examinations (NBE), which has refused to bring these courses under its aegis. 

Opposing any third pathway of courses beyond the courses offered by NMC and NBE, it has allowed the institutes offering CPS courses to independently seek its accreditation if they wished.

At this outset, States including Rajasthan, Madhya Pradesh, Odisha, and Karnataka may reportedly reduce the intake for the CPS courses or discontinue them, adds TOI.

While it is uncertain if the State of Maharashtra would stop these courses, there are likely to be reforms in these courses, if they are allowed to continue. However, it is unlikely that the counselling process for filling up the CPS seats would commence immediately.

Established in 1912, CPS Mumbai is an autonomous body that imparts Postgraduate medical education and offers fellowship, diploma, and certificate courses for medical professionals. For the Diploma courses, the tenure is two years; in case of Fellowship, the tenure is three years. After obtaining the qualification granted by CPS Mumbai, the practitioners become allowed to register themselves as specialists in the concerned specialty.

The controversy regarding CPS admissions in Maharashtra commenced after referring to significant gaps in the standards of institutes offering College of Physicians and Surgeons (CPS) affiliated courses, the medical education department of Maharashtra recently wrote to the Union Health Ministry asking for its opinion on whether counselling can be conducted for around 1,100 CPS seats.

Writing to the Centre, the department referred to the inspection of the Maharashtra Medical Council conducted last year and how during the inspection, MMC had found "severe deficiencies" in several institutes.

Earlier, the State Medical Education Department sent a show-cause notice to the CPS management demanding an explanation regarding the deficiencies found in its affiliated institutes by March 21. Meanwhile, CPS approached Bombay HC and filed a plea in this regard seeking to restart the admission process. The HC bench declined to interfere with the show-cause notice issued to CPS by Maharashtra State Medical Education Department as the bench clarified that the College of Physicians and Surgeons need to show that the courses are working as planned.

Meanwhile, taking cognisance of the letter by Maharashtra Medical Education Department, the Central Government had earlier set up an eight-member committee to look into the matter.

NMC recommendation to Derecognise CPS Courses: 

Adding to the ongoing controversy, recently the Post Graduate Medical Education Board (PGMEB) of the National Medical Commission (NMC) recommended to the Union Health Ministry for withdrawing the popular DPB- Diploma in Pathology and Bacteriology, DCH - Diploma in Child Health and DGO- Diploma Gynecology and Obstetrics courses run by CPS from the next academic year.

This recommendation has been given by the NMC Board after discussing the issue meeting held on 12.04.2023. NMC PG Board expressed its disagreement with the Ministry for providing equivalence to the CPS courses and pointed out that such courses do not come under the purview of NMC.

After NMC, the National Board of Examinations (NBE) also offered rejection to the CPS courses by refusing to bring them under the aegis of the NBE. This decision was revealed by the NBE officials during a meeting on May 25.

The NBE nominees are included in the eight-member panel set up by the Union Health Ministry, to address the functioning of the CPS courses, which are more than 100 years old.

After holding several meetings, the panel discussed the possibility of NBE taking over the CPS courses. Finally, it concluded that “NBE shall not be able to take up the courses..." NBE currently offers PG medical courses such as Diplomate of National Board (DNB).

In fact, the body also expressed its opposition for a third pathway of courses beyond the courses conducted by NMC and NBE. However, the governing body of NBE has recommended the institutes running CPS courses to apply for NBE accreditation, considering the fact that they fulfilled the norms.

As per the latest media report by the Times of India, amidst this controversy and uncertain future of CPS courses, States including Odisha, Rajasthan, Madhya Pradesh and Karnataka might reduce the intake capacity for CPS courses or discontinue them altogether.

Maharashtra: 

Where it all started, the State of Maharashtra is yet to take any decision regarding continuing the CPS courses in the State. TOI adds that the State may not do away with the CPS courses altogether, but there are likely to be some reforms if they are allowed to continue.

However, the latest media report by Hindustan Times suggests that the State Medical Education Department of Maharashtra has almost arrived at a decision to stop these courses. Further, in an attempt to compensate for the loss of CPS seats, the State is also contemplating increasing around 1000 seats in Diplomate National Board (DNB) courses.

In this regard, to ascertain how these seats can be increased, the Medical Education Department has appointed a committee headed by Lt Gen (Dr) Madhuri Kanitkar, vice-chancellor of the Maharashtra University of Health Sciences.

This panel also includes the Director of the State Public Health Department Dr Nitin Ambadekar, Joint Director of Medical Education Dr. Ajay Chandanwale, and Assistant Professor Dr. Rakesh Waghmare. This committee will consider the possibility of starting new DNB courses in Government Hospitals and Colleges. The report by the Committee is likely to be submitted next week.

Issuing a GR on May 29, the Medical Education Department informed that some seats for DNB courses could be increased in the district hospitals. Further, some MD/MS seats can be added according to the recommendations of the National Ayurvidyan Commission. There is also a possibility of commencing DNB courses in government medical colleges, where admission to MD/MS courses cannot be initiated. 

Meanwhile, TOI adds that noting States' feedback, MUHS VC Lt General Madhuri Kanitkar has emphasized the effectiveness of courses in upskilling doctors. In this regard, she has suggested that these courses are supervised by the State Medical Education Department, potentially limiting them to in-service candidates if required.

Although self-financed institutes and open candidates could also be included, they would have to strictly adhere to the regulations. Kanitkar further stressed that the State Government should take decisions regarding faculty, fees, examinations, and related matters, with a transparent system in place.

Rajasthan: 

CPS courses were introduced in Rajasthan with the aim of enhancing the skills of doctors in rural areas and dealing with the scarcity of specialist doctors. These courses were offered via a collaboration between the Department of Medical and Health Services and CPS Mumbai. Rajasthan Medical Council used to give accreditation for these courses.

In fact, in order to ensure that successful candidates joined Government Service, the State Health Department had made it mandatory for the candidates to serve the government hospitals for a period of three years. While more than 200 doctors completed the course back in 2016, the course was later discontinued alleging it to be infeasible.

As per the latest media report by the Times of India, the health department has clarified that it is not ready to reconsider its stance in this regard and after the no from NBE, the rejection for these courses has only been solidified. Commenting on this, a senior health department official told the Daily, "The course has been halted here. Over 200 doctors working in rural areas had benefited from it. Currently, there is no possibility of restarting it."

Gujarat: 

In the case of Gujarat, popular courses were running in the State such as Diploma in Gynaecology and Obstetrics, Diploma in Child Health. Referring to the issue of CPS courses, Gujarat officials have highlighted the positive impact of CPS graduates to improve the availability of healthcare facilities in rural and tribal areas. However, with the NMC's derecognition, these courses will not be offered in Gujarat institutes.

Other States: 

In the case of Karnataka, the CPS courses had been running since 2018 in six State Institutes for only in-service candidates. However, the admissions stopped back in 2021. Since 2020, there has been no admission in CPS courses in Madhya Pradesh as well. Altogether 17 institutes in Odisha used to offer 3 CPS diploma courses. However, with the number of candidates going down, the State might discontinue these courses from 2023-2024. 

Also Read: NMC tells Health Ministry to derecognise 3 popular CPS Diploma courses, details