New Delhi: Responding to the proposal whether final year MBBS students can be posted as interns at the public hospitals in order to ensure availability of healthcare services, the apex Medical Council, Medical council of India has replied that the same is not possible given the current regulatory mechanism.
In particular, the council noted that the current curriculum of MBBS course does not call for a practical internship in the final year of their study. Internship comes only after the student has successfully undergone the final year MBBS exam. Moreover, for the purpose of the internship, which is basically “hands on training” under Supervision, the state council issues a “provisional registration,” which given the current legal mandate would not be possible to issue to a final year MBBS student, who has not completed the exam.
Thus, the council observed that in the context of the present binding regulatory provision, the proposal would be untenable. Having said that, the council, not averse to the proposal, also noted that a posting as a part of curriculum design for the final MBBS could be incorporated to mitigate the said requirement, if deemed appropriate.
Medical Dialogues team had earlier reported that Member of Parliament Baramati, Maharashtra Shri Supriya Sule in the month of December 2017 had introduced a bill on Universal Health Coverage(Medical and Financial Assistance)Bill, 2017 in the Lok Sabha. The Bill proposed posting Final Year MBBS students as interns in public hospitals to address the problem of shortage of medical practitioners. The Ministry of Health then forwarded the proposal to the MCI to provide comments on the feasibility of the proposal.
The executive committee of the council had formed a sub- Committee comprising of Dr. Ved Prakash Mishra, Chairman, Academic Committee; Dr. Dileep Mhaisekar and Dr. Vijay Prakash to study the Bill and submit a report. The committee report stated the following
….The Committee observed that the word “intern” is availed in the Graduate Medical Education notified by the Medical Council of India whereunder a student who passes final MBBS examination is required to complete one year rotating internship as an “intern” in a recognised medical college which amongst other things in terms of the stipulated posting also includes a “rural health posting for a period of 2 months””.
The said “rotating internship” is primarily for the purposes of “hands on training” of the MBBS examination passed student under supervision for the purposes of consolidation of skills and competencies which upon registration with the concerned State Medical Councils and as a “”registered medical practitioner”” would be availing the same on his own.
The said internship is carried out for a period of one year with a “”provisional registration”” procured by the said MBBS passed learner with the concerned State Medical Council for the purposes of pursuing the same.
Upon satisfactory completion the rotating internship of one year, done with a “”provisional registration”” with the concerned State Medical Council that the concerned learner becomes eligible for the conferment of MBBS degree by the examining university.
As such, it is evident that one year rotating internship is an integral part of learning after passing final MBBS examination and it is only on its satisfactory completion and certification thereto that the learner becomes entitled for the conferment of the MBBS degree by the examining university and thereby is eligible to seek “”permanent registration”” with the concerned State Medical Council.
It is upon registration with the concerned State Medical Council that he/she gains the status of a “registered medical practitioner” and thereby is entitled to the privileges conferred on him/her of practising modern medicine as a profession. He/she turns out to be a “first contact physician” as a registered medical practitioner.
In the backdrop of classical sense of meaning and scope of the word “internship”, a final MBBS student being availed as an “intern” in a public hospital could be only for the purposes of a posting to be scheduled within the prescribed curriculum, but then same could not be for the purposes of availing services out of him as during his period of learning final MBBS, as he/she is not entitled for “provisional registration”” with the concerned State Medical Council. “
As has been explicitly brought out in the preceding paragraphs that the entitlement of the “provisional registration”” with the concerned State Medical Council accrues only after passing final MBBS examination of the concerned examining university and not before.
Given the report of the sub-committee, the Executive Committee of the MCI made the following observations
In view of the aforesaid statutory provisions which is explicitly depicted in the governing Graduate Medical Regulation notified by the Medical Council of India with the prior approval of Govt. of India u/s 33 of the Indian Medical Council Act, 1956 has a binding effect by virtue of its mandatory nature. As such, the same is not open for any condonation, concession or marginalization of any type in any manner.
In view of the above, the committee is of the considered opinion, that contemplation in clause 10 of the proposed private member bill in the context of present binding regulatory provision is untenable. However, a posting as a part of curriculum design for the final MBBS could be incorporated to mitigate the said requirement, if deemed appropriate”….