Medical Colleges Under Tight Scrutiny of National Medical Commission
New Delhi: Medical Colleges have come under extremely tight scrutiny of the National Medical Commission (NMC), as the Apex Medical Regulator has stressed on meeting the faculty as well as infrastructure requirements.
Earlier, medical colleges were facing physical inspections, where a team of assessors would go and visit medical colleges and assess those facilities. This process was widely criticized and accused of being full of bribery and corruption. It was alleged that the assessor would take bribes and approve medical colleges.
However, under the new system, the Apex Medical Regulator is slowly moving online in terms of inspection of medical colleges as well as overseeing the fulfilment of requirements. Although online, with features, like AEBAS and biometric attendance system, it is being difficult for medical colleges to engage ghost faculties.
"We are not conducting physical inspections, as far as possible. So the colleges have to fill up the report and NMC follows the reports," Dr. Aruna Vanikar, the President of NMC UG Medical Education Board (UGMEB) told Medical Dialogues.
She further informed that NMC has been in talks with the medical colleges across the country on a daily basis to ensure that the medical colleges have been complying with the requirements regarding faculty numbers, biometric attendance, clinical materials and other rules. The process is ongoing and NMC has already reached out to the administrators of around half of the medical colleges.
"The UG Board has started taking action as our aim is to ensure the best quality of medical education. If medical students are not trained, how will they treat patients in the future?
Previously, the Government Medical Colleges used to give an affidavit stating that they would fulfil the requirements as per the rules. However, later, many of these colleges failed to fulfill such requirements.
"That's why, as a first step, we have started imposing fines. Such practices are not going to be allowed anymore," Dr Aruna Vanikar said, adding that no written communications have been issued yet and it will be done in the coming time.
"We have a team of experts and if everything is found to be ok, no action is taken against the colleges. However, majority of the colleges have failed in this," she further mentioned.
Medical Dialogues had earlier reported that for the first time, taking note of deficiencies in faculty and clinical material, NMC imposed fines on medical colleges for violating the Maintenance of Standards of Medical Education Regulations, 2023 (MSMER) rules. As per a recent media report, the Commission slapped a fine of up to Rs 3 lakh on government medical colleges in Tamil Nadu, including the colleges in Dharmapuri, Ramanathapuram, and Nagapattinam. Apart from these colleges, the Commission reportedly has also issued show-cause notices to many other colleges for deficiencies in Aadhaar-based biometric attendance.
NMC in the Maintenance of Standards of Medical Education Regulations, 2023 or MSMER 2023 had mentioned that the Commission may impose several forms of penalty such as issuing a warning to the medical college to rectify or comply, imposing monetary penalty up to Rs 1 crore, imposing penalty up to Rs 5 lakhs to the faculties of the medical college for misconduct. It may also withhold the accreditation process, recommend to the Medical Assessment and Rating Board (MARB) of NMC to withhold the application process for any new course including an increase of seats in the existing course, reduce the number of students in the next or subsequent academic years, stop admission to one or more courses, recommend for withdrawal of permission, withhold or withdraw accreditation for up to five academic years.
The provisions of monetary penalties, as mentioned in the MSMER-2023 Regulations stated, "Monetary penalty not exceeding INR one crore per violation or act of omission by the medical institution."
"Monetary penalty not exceeding Rupees five lakh for the faculty/Head of the Department (HoD)/ Dean/Director/doctor submitting false declaration/documents/records (including patients’ records). Further, they can also be charged or penalized for misconduct under the Registered Medical Practitioner (Professional Conduct) Regulations in vogue," the regulations further mentioned.
Tight Scrutiny of NMC to Ensure Quality of Medical Education:
Under the new rules, the National Medical Commission (NMC) has done away with the requirements of getting recognition for the medical seats separately. Now, all the permitted seats are recognized. Therefore, after getting admitted to the MBBS course, the students do not have to worry about the recognition of the seats and they finish their course with a recognized degree. However, due to this, the need to ensure that medical colleges are complying with the prescribed standards of medical education has become more important than ever.
Stressing the need to ensure that the medical students are getting quality medical education, Dr. Vanikar further informed that this is why NMC has asked the colleges to give an Annual Declaration, through which the colleges will have to fill up the details explaining how their performance was last year. Referring to the AEBAS and biometric attendance system, she informed that the rules regarding this were implemented in 2022 to regularly check whether the faculties and resident doctors were regularly working or not.
"We are not doing any policing. Once a day they have to mark their attendance- only on the working days and not the holidays. Out of all these working days, only 75% of the working days attendance is mandated," Dr. Aruna Vanikar said.
Notably, NMC has persistently urged medical colleges to adopt the Aadhaar-enabled biometric attendance system (AEBAS). This move is aimed at ensuring transparency and authenticity in faculty attendance.
Minimum Number of Faculties:
The Apex Medical Regulator has also prescribed what should be the minimum number of teachers required to impart education to the students at the medical colleges. Dr. Vanikar informed that "As of now, we have not implemented the new MSR 2023, under which the required number of college faculties has been increased. Till the coming academic year, we have asked the colleges to comply with the requirements under MSR 2020."
Informing that NMC gave enough time to the medical colleges to comply with the faculty requirement, she added, "Till February, several colleges did not have the required number of professors and association professors. However, if it is found that they have appointed the required number of faculties, no action is being taken against them."
Indian Medical Colleges have been reeling under a shortage of adequate faculty for a long time. Last year, in an assessment conducted for the academic year 2022-2023, NMC had unveiled a disconcerting reality within a majority of medical colleges. Those institutes were riddled with ghost faculties and senior residents, coupled with none meeting the mandated 50% attendance requirement.
Last year, 349 out of the total 654 medical colleges across the country got a show cause notice from the Apex Medical regulator for violations of the Minimum Standard Requirements 2020 including a deficiency in having the required faculty numbers
Clinical Material:
Apart from the required number of faculties, the medical colleges also need to ensure that there is adequate clinical material available to impart education to the medical students. However, several colleges have been found to be lacking adequate clinical material such as blood bank facilities, enough number of OPD patients etc.
Dr. Vanikar informed that for every medical student, there should be 8 OPD patients every working day and there should be around 80% bed occupancy. Similarly, for anatomy classes, Cadavers are required. Further, there are some specific requirements regarding basic clinical investigations, operative load, number of deliveries conducted etc. Regarding the Family Adoption Programme, she said me that every student should adopt three households.
Referring to the annual MBBS examinations, she added, "We have done away with the Inspector Raaj. The senior-most examiner is Assessor and he reports whether the examination was conducted properly or not. He will give the data regarding the internal and external examination." She further added that NMC has asked for Faculty Declaration from the colleges and the faculties have been directed to submit their own CVs.
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