Right not Charity: Why NMC should regulate MBBS stipend at private medical colleges

Stipend parity has been a long-standing demand of MBBS interns practising at different private medical colleges in the country. It has been repeatedly been alleged that the interns at private medical colleges are indeed treated as slaves and not even paid enough stipend to enable them to meet their basic needs. There also have been many instances where private medical colleges have not even paid any stipend to their interns for continuous periods of time.

Health, being a state subject and many medical institutions falling under the autonomous bodies; all medicos associated with different institutions running in different states, receive stipends as per the policy of those institutions. For that reason, medicos have been urging the government to bring in uniformity in the stipend process.

Back in 2017, the executive committee of the MCI hadn't approved the recommendations made by the academic committee regarding the internship allowance for MBBS students. At that time, MCI had stated that the graduate medical education (GME) regulations didn't provide for payment of stipend to interns.

Also Read: Give uniform stipend, working conditions for all MBBS interns across the country: IMA to NMC

Following this, the Board of Governors had considered introducing a provision into GME regulation that stated: "All the candidates pursuing compulsory rotating internship at the institution from which MBBS course was completed, shall be paid stipend on par with the stipend being paid to the interns of the State Govt. Medical Institution / Central Government Medical Institution in the State / Union Territory where the institution is located."

Medical Dialogues had earlier reported that back in 2019, while considering providing uniform stipend to all MBBS interns at private medical colleges, the erstwhile Medical Council of India Board of Governors had started to contemplate for changing the Regulations on Graduate Medical Education, 1997.

However, later MCI had been replaced by the National Medical Commission (NMC) and the problems regarding stipend disparity for the private medical college interns are yet to be solved.

NMC, the apex medical education regulatory body had mentioned in the Draft Regulations for Rotational Compulsory Regulations 2021 released in April, "All interns shall be paid stipend as fixed by the appropriate fee fixation authority applicable to the institution/ university/ state."

At that time, NMC had invited suggestions regarding the Draft Regulations from various stakeholders and responding to the same, the Indian Medical Association (IMA) had written to the Chairman of NMC demanding that there should be uniform stipend and working conditions for all MBBS interns who are working in government or private medical colleges.

Also Read: Stipend Disparities Mar MBBS education in India, Will NMC intervene?

However, no changes were made in this respect, and the draft was passed in the Gazette on November 18. With this, the fate of the MBBS interns studying in private medical colleges remains at the mercy of their institutes.

Medical Dialogues had reported several instances of Private Medical Colleges paying no or minimal stipend to the students. In fact, National Students' Union of India (NSUI) had approached the Karnataka Government seeking its intervention regarding the matter. Referring to the disparity in the payment made to the MBBS interns at Government and Private medical colleges in the State, NSUI in-charge, Rajiv Gandhi University of Health Sciences (RGUHS), Sanjay Raj had urged the Government to "take immediate measures to regulate the stipend paid to the interns at the private medical colleges and also extend the covid duty incentives to them."

Also Read: Pay Equal Stipend to RGUHS Private Medical College MBBS Interns: National Students Union writes to Education Minister

As per the latest media report by the Times of India, Dr. KV Babu, who has been raising the issue and writing to the Ministry and NMC seeking an urgent response regarding the matter, opined that even though the Draft has been passed, the Central Government has the power to intervene.

"The central government has the power to intervene and change this decision of the NMC. Section 45 of the NMC Act states that the commission and the autonomous boards 'in exercise of their powers and discharge of their functions under this Act, be bound by such directions on questions of policy as the Central Government may give'. This issue has been hanging fire from 2017, from the time of the MCI," he told TOI.

Recently, the issue was raised by an MP from Kerala, Binoy Vishwam, who in a letter directed to NMC on December 8 pointed out that the MBBS interns get stipends "as a matter of right and not charity". Criticizing the NMC's notification, he has further mentioned that it allowed "for great ambiguity and arbitrariness" in the stipend. "It may also result in management of private colleges denying a stipend to MBBS interns as they have complete discretion without any safeguarding mechanism," stated the letter.

It should be mentioned in this context that the MBBS interns in the Government medical colleges receive an amount of Rs 25,000 as monthly stipend, the interns belonging to the private institutes receive an amount that is 30% lesser than what is paid in the Government institutes.

While commenting on the issue, Prashanth S, Students National Convenor of IMA MSN recently told Medical Dialogues, "We had earlier approached the NMC regarding the issue. However, at that time the officials had informed us that as NMC doesn't own the authority to distribute funds, it was beyond NMC's power to bring a Uniform Stipend Policy."

"However, I feel that even if NMC cannot change the policy, it can issue directions to the medical colleges regarding the matter," he added.

When asked about the stipend issue in Private Medical Colleges, "He pointed out that receiving stipend for the work they are doing is their right. However, unfortunately, in most of the private medical colleges students are not paid any stipend at all, which is highly unfair and against the Minimum Wages Act."