Respiratory Medicine, Emergency Medicine, PMR Depts no longer mandatory to start new medical colleges, Doctors question move

New Delhi: Doctors and faculties in medical colleges across the country are worried over the recent decision of the National Medical Commission (NMC) to remove three departments including Respiratory Medicine from the mandatory list of undergraduate medical education or MBBS course.

According to the "Guidelines for Under Graduate Courses under Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses & Assessment and Rating Regulations, 2023", which were notified on August 16, 2023, three departments- Physical Medicine and Rehabilitation (PMR), Respiratory Medicine, and Emergency Medicine are not included in the list of departments that every medical college/institution must have for being approved for undergraduate medical admissions on annual basis.

Medical Dialogues had earlier reported that the draft NMC Minimum Standard Requirements for Establishment of New Medical College/Increase of seats in MBBS Course Regulations, 2023 mentioned a list of 24 mandatory departments in the medical colleges.

However, in the final version, NMC curtailed the list to 21 departments, and the departments of Physical Medicine and Rehabilitation (PMR), Respiratory Medicine, and Emergency Medicine, which were included in the draft, were eliminated from the mandatory list.

Also Read: NMC Releases Draft Regulations of Minimum Standard Requirements for Establishment of New Medical College, Increase in MBBS Seats, invites comments

Upset with the Commission's decision to remove the Respiratory Medicine Department, the Indian Chest Society has now written to the Union Health Minister Mansukh Mandaviya and urged him to reinstate this.

In the letter dated August 23, 2023, the Association mentioned, "The roots of the TB and Chest Disease department trace back to the influential recommendations of the Bhore Committee in 1946. This forward-thinking committee recognized the importance of specialized medical departments to address emerging healthcare challenges. Since then, the field of TB and Chest Disease has grown and evolved through the continuous advancement of medical knowledge and technology."

Pointing out how TB remains a persistent public health concern, the association further mentioned, "In the face of escalating pollution-related lung diseases, the role of specialized respiratory medicine departments becomes even more crucial. The rise of respiratory ailments due to pollution, along with the burden of occupational lung diseases, necessitates a robust medical education system that equips future medical professionals with the necessary expertise to address these pressing health challenges."

The association expressed its concern over removal of Respiratory Medicine Department and added in the letter, "The decision to remove Respiratory Medicine from the mandatory department list is a matter of grave concern for us. This decision could potentially hinder the training and development of medical professionals who are pivotal in combating TB, pollution-related lung diseases, occupational lung diseases, smoking-related lung issues, and asthma."

Seeking the intervention of the Health Minister to reinstate the department, the association stated, "We earnestly request your kind intervention to reconsider and reinstate the Respiratory Medicine department in the mandatory curriculum for undergraduate medical education. By doing so, you would be contributing to the health and well-being of millions of citizens, as well as ensuring the continued legacy of specialized care in this essential medical field."

As per the latest media report by Indian Express, the decision of NMC has puzzled several doctors and it is being viewed as a letdown. Experts across government medical colleges have also written to the Commission in this regard and sought clarity. Commenting on this, Dr Radha Munje, Head of the Department of Respiratory Medicine, Indira Gandhi Government Medical College, Nagpur, told the Daily that after the pandemic they were expecting increased training of students in Respiratory Medicine so that they become able to tackle respiratory diseases. “However, we are clueless as to why this department has been left out,” Dr Munje added.

“More than 25 per cent cases of TB are diagnosed at medical colleges and without this respiratory medicine department it is a big question as to how we are going to eliminate TB under the National TB Elimination Programme – especially within the 2025 target,” mentioned Dr Avinash Lamb, Professor and Head of Department of Respiratory Medicine, Government Medical College, Aurangabad.

Demanding to reinstate the Respiratory Medicine Department, Dr Surya Kant, professor and head, department of respiratory medicine, King George’s Medical University, Lucknow, and also chairman of the North Zone Task Force of the National TB elimination Programme wrote to the Union Health Minister on August 21.

Previously, the Madurai Respiratory Society separately wrote to Minister Mandaviya on August 18 and expressed its concern over the decision of the Commission to remove Respiratory Medicine (TB and Chest Diseases) department from the mandatory list.

The Hindu adds that the members of Madurai Respiratory Society expressed concern over the NMC decision. Speaking to reporters secretary R. Prabhakaran, president M. Palaniappan and treasurer S. C. Vivekananthan said that they have written to the Union Health and Family Welfare and sought his intervention for reconsidering the decision and reinstate the Respiratory Medicine Department.

The office-bearers said that by reinstating the department, the Centre would be contributing to the health and well-being of millions of citizens, as well as ensuring the continued legacy of specialized care in this essential medical field.

As per the latest media report by Hindustan Times, raising the issue of removing Physical Medicine and Rehabilitation (PMR), Dr Sanjay Kumar Pandey, national secretary of the Indian Association of Physical Medicine and Rehabilitation (IAPMR) recently wrote to the Union Health Minister Mansukh Mandaviya and mentioned in the letter, “It is shocking to find that the specialty of PMR has been removed from the undergraduate MBBS curriculum. This is in stark contravention to your lawful duty towards divyangjan (differently abled) mentioned in the RPwD Act, 2016, because ensuring right to health for divyangjan is possible only if the budding physicians are well aware of PMR practice during their undergraduate training in MBBS.”

“Removing PMR as a mandatory department in a medical college for MBBS curriculum will affect the new crop of medical graduates, who will be ignorant to the medical needs of the differently-abled in India, where nearly 2.5% of India’s total population are divangjan,” said Dr Pandey.

IAPMR issued a press release in this regard and mentioned, "The Indian association of Physical Medicine and rehabilitation (IAPMR) is highly disappointed and shocked to know the removal of Physical Medicine and Rehabilitation subject from the recent NMC notification for mandatory subject list for undergraduate curriculum dated 16.08.2023."

"Appalled at the deletion of Physical Medicine and Rehabilitation (PMR) for undergraduate MBBS training, the Indian Association of Physical Medicine and Rehabilitation, a National association of subject expert has urged Union Health Minister Shri Mansukh Mandaviya, in a letter sent on 19.08.2023, to reinstate Physical medicine and Rehabilitation subject to the NMC regulation," it further added.