Amidst Air Pollution Crisis, Indian Chest Society slams NMC for Removing Respiratory Medicine

New Delhi: The Indian Chest Society (ICS) took a dig at the National Medical Commission (NMC) recently for removing the Respiratory Medicine Departments from the MBBS medical colleges hospitals across the country while highlighting the impact of this decision amid the escalating air pollution crisis in India.

During a Press Conference held on November 21st, ICS referred to the worsening AQI index along with NMC's decision to remove Respiratory Medicine Departments and opined that this decision threatens to undermine the nation's capacity to manage respiratory health effectively.

It pointed out how the Delhi Government has also directed all its hospitals to set up teams of specialists to tackle patients with respiratory ailments due to severe air pollution. ICS highlighted how the Delhi Health Department has asked the hospitals to monitor and report daily cases of respiratory ailments, including both outpatient (OPD), and inpatient (IPD) cases, and to promptly flag any unusual increase in the number of cases.

Previously, ICS along with the Indian Association of Physical Medicine and Rehabilitation filed a Public Interest Litigation (PIL) challenging the NMC's decision before the Bombay High Court.

Also Read: MBBS Curriculum: Why are Respiratory Medicine Specialists at Loggerheads with NMC

Medical Dialogues had earlier reported that last year, the Undergraduate Medical Education Board (UGMEB) of NMC had removed three departments- Physical Medicine and Rehabilitation (PMR), Respiratory Medicine, and Emergency Medicine from the list of departments that every medical college/institution must have to be approved for undergraduate medical admissions on an annual basis. The provision for a separate department for respiratory medicine is also absent in the newly released Competency-Based Medical Education 2024 guidelines.

NMC had claimed that this decision was taken to decrease the burden on the UG Medical Students and the Commission had justified its decision by pointing out that these subjects would be included as a part of General Medicine.

However, referring to the alarming AQI levels and the decision of NMC to remove Respiratory Medicine Department, Dr. Neel Thakkar, Vadodara-based pulmonologist and a member of the Indian Chest Society told Medical Dialogues, "India is witnessing alarming AQI levels, with Delhi recently recording its highest-ever AQI of 1,081, and cities in Gujarat, including Ahmedabad and Vadodara, reporting 'Poor' air quality. This surge in pollution has led to a rise in respiratory ailments COPD, Interstitial lung disease and lung cancer straining the healthcare system."

"Absence of the subject of respiratory medicine in MBBS curriculum and of the department of respiratory medicine in the newer medical colleges will add to the morbidity and mortality related to respiratory ailments in India and needs urgent solutions for reinstatement of the speciality," he added.

ICS arranged a Press Conference on Thursday to discuss the issues concerning the Air Pollution Crisis and Removal of Respiratory Medicine Departments and how it poses a threat to Public Health. 

Renowned doctors including Dr. Rakesh Chawla (Vice-President of ICS), Dr. G C Khilani (Chairman of ICS North Zone), Dr. Manoj Goel, Principal Director & HoD Pulmonary Medicine at Fortis Medical Research Institute Gurugram, and Dr. Arun Madan, Prof & HoD of Respiratory Medicine Department of Hindu Rao Medical College were Keynote speakers at the event.

Issues like public health risks due to worsening AQI levels, rising respiratory illnesses, possible practical actions for individuals and communities and the requirements for policies to improve air quality and healthcare infrastructure were discussed. Further, the NMC's decision to remove the Respiratory Medicine Department from the medical college hospitals and how it threatens the nation's ability to tackle pollution-related health crises was also discussed.

The Indian Chest Society expressed its deep concern over the escalating air pollution crisis in India, where Air Quality Index (AQI) levels surpassed 1000 in several regions.

ICS opined that extreme pollution was driving a sharp rise in respiratory and cardiovascular illnesses, disproportionately impacting vulnerable populations, including children and the elderly. The body also expressed its concerns over NMC's decision to remove respiratory medicine department from medical colleges across the country.

Dr. Arun Madan, Prof & Head, Department Of Respiratory Medicine Hindurao Medical College Delhi pointed out that for decades, medical college hospitals have functioned as critical hubs for advanced respiratory care and training. 

He added that NMC's decision to exclude Respiratory Medicine Departments from these institutes, formalized through the "Guidelines for Undergraduate Courses under Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses & Assessment and Rating Regulations, 2023" (UG-MSR 2023), raises serious concerns about its impact on public health and the nation’s ability to combat respiratory diseases.

Dr. G.C. Khilnani - Director Department of Respiratory Medicine, PSRI Hospital Delhi , Ex Prof & Head AIIMS Delhi, Chairman Indian Chest Society (North Zone) highlighted that India is among the most polluted nations globally, with over 99% of its population exposed to PM2.5 levels exceeding WHO safety guidelines. This dire situation demands urgent action to mitigate pollution and strengthen medical infrastructure capable of addressing its health consequences, he opined.

According to Dr. Manoj Goel (Principal Director & Head Department of Pulmonary Medicine, Fortis Medical Research Institute Gurugram), effective policies are critical to reduce air pollution and its health impacts. These include adopting clean technologies in industries, expanding renewable energy use, improving urban planning for energy-efficient cities, and implementing advanced waste management practices.

He pointed out that according to the World Health Organization (WHO), achieving even the first interim air quality target could prevent 300,000 deaths annually, highlighting the importance of coordinated efforts across sectors.