NMC proposes changes in TEQ regulations- here's how doctors, non-medical teachers react

New Delhi: One of the key changes introduced by the National Medical Commission (NMC) in the recently released Draft Teachers Eligibility Qualifications (TEQ) 2024 Regulations is to increase the pool of faculties to teach in medical colleges.

While on the one hand, NMC has allowed Diploma holders appointed as Senior Residents before 08.06.2017 of working as specialist/Medical Officers in a Government Medical College for six years to join the medical colleges as Assistant Professors, it has also specified that a non-teaching Consultant/Specialist/Medical Officer, possessing Postgraduate Medical Degree, working for at least four or ten years in a minimum 220 bedded teaching/non-teaching Government Hospitals shall also be eligible to become Assistant or Associate Professor respectively of that broad speciality.

Similarly, NMC has also specified that non-medical teachers can teach Anatomy, Biochemistry and Physiology provided that they have an MSc and PhD degree in that particular speciality.

However, the Commission has made it clear that the permission to allow non-medical teachers as faculties in medical colleges will only be given during the "transitional period" i.e. when there are not a sufficient number of qualified teaching faculties available for the respective subjects.

How do Doctors React?

A section of the medical fraternity has, however, expressed its objections to these proposed changes introduced by NMC, as few of them expressed their doubts that it might negatively affect the quality of medical education.

A contrarian view on the newly proposed TEQ 2024 Rules, was given by Dr. Kabir Sardana, a Professor of Dermatology at the Atal Bihari Vajpayee Institute of Medical Sciences and Ram Manohar Lohia Hospital, New Delhi, who told Medical Dialogues, that the new TEQ is "very backward-looking" and "incorrect".

He said, "These regulations will kill research and just satisfy a magical number of so-called faculty who possibly did not attain the rank or merit to get an MD course or a faculty position. In fact when NMC stopped diploma it was as they realised this is achieving any high standards.Compare this with the West where faculty positions have a lot of emphasis on research and in India we are doing away with the most basic requirement, a thesis! It's equivalent to a PhD in DU. How many DU faculty members have been appointed in 100 years without having even done a thesis, None!"

"But this is not to say that only a MD or a diploma is a good doctor, good clinicians are there across the spectrum, but a faculty position has to have some merit to it. How paradoxical that all other faculty even non teaching doctors have to have a MD or DNB ,but by some magical quality diplomas do not !" he further mentioned.

"It's the end of merit and a high point of back door entry to satisfy a magical Doctor-patient ratio that is illogical as doctors don't go to villages to practise," he added.

Dr. Rohan Krishnan, the Chief patron of the Federation of All India Medical Association (FAIMA) has also strongly opposed NMC's decision of "allowing diploma holders / non-medicos and almost anyone to teach MBBS students" as "hilarious".

"It is so shameful that @MoHFW_INDIA is going to create an army of improperly trained MBBS doctors , who will be out of jobs. The situation of Dentists today is so bad that it makes me feel bad, lack of jobs, torture by corporates, Govt unable to help them!!!! All because fools and boot lickers sits on top of the seat of council and don’t guide the politicians properly!!!!" Dr. Krishnan mentioned in an X (formerly Twitter) post.

Speaking to Medical Dialogues in this regard, he added, "I think that it's a regressive step taken by NMC. NMC is doing anything in its process of increasing the number of seats in the medical colleges. They are not bothered about the quality of medical education which is very sad. It is safe to say that NMC is in very bad hands and the entire process of giving seats to medical colleges stings of corruption."

"Opening medical colleges, especially, private medical colleges, like this in the country is going to be catastrophic. What about the quality of education? What about the students who are going to get graduated? There will be a large number of doctors who are not qualified, who are not good for anything and later on they will suffer in terms of jobs and everything and the patients will also suffer," he added.

Dr. Karan Juneja, the National Co-Convenor of the IMA Junior Doctors' Network, has also expressed his concerns over these new rules, highlighting that "Quality of medical education is essential."

Speaking to Medical Dialogues, Dr. Lakshya Mittal, the National President of United Doctors' Front (UDF) opined that while addressing faculty shortages in the rapidly growing number of medical colleges is a necessity, this move should not come at the cost of compromising the quality of medical education.

"One of the key issues is the inclusion of non-medical teachers in foundational pre-clinical subjects like Anatomy, Biochemistry, and Physiology. These subjects form the backbone of medical education, and only those with a medical background can provide the necessary clinical perspective for teaching. While non-medical teachers may have expertise in their respective fields, they lack the clinical insight and interdisciplinary knowledge required for the Competency-Based Medical Education (CBME) curriculum, which emphasizes integrated learning and early clinical exposure," Dr. Mittal said.

"Furthermore, the inclusion of diploma holders as faculty members raises questions about maintaining uniform academic standards. While diploma holders have practical expertise, the depth of knowledge and academic rigor of MD/MS programs is unmatched and critical for the teaching profession," he further added.

Regarding the proposal to allow the non-teaching consultants or specialists with hospital experience to transition into academic roles as assistant or associate professors, he mentioned, "Although clinical experience is invaluable, teaching requires a distinct skill set that includes research acumen, effective communication, and the ability to guide students academically. A lack of formal teaching experience could hinder the quality of instruction provided to medical students."

He also demanded clarity regarding the "transition period" and said, "It is imperative that the NMC specifies a defined timeline for these relaxations to prevent them from becoming permanent, especially in private medical institutions that may exploit such provisions to bypass the recruitment of highly qualified faculty."

Dr. Indranil Deshmukh, the National Convener of IMA JDN has also opposed the inclusion of non-medical graduates as faculty members in medical colleges, as proposed in Draft TEQ 2024 Regulations. "This practice poses a serious threat to the quality of medical education and the future of healthcare standards in India. Teaching positions must be reserved exclusively for individuals with recognized medical qualifications to ensure the highest educational standards and the best outcomes for medical students and patients alike," he said.

However, Dr. Aviral Mathur, the President of the Federation of Resident Doctors' Association (FORDA), termed NMC's decision to expand the faculty pool by including diploma holders and non-medical teachers as 'creative'.

Dr. Mathur told Medical Dialogues, "While it's clear that addressing faculty shortages is important, one has to wonder if diluting the expertise in our medical colleges is the best way to go about it. After all, medical education is a highly specialized field, and the idea of non-medical professionals teaching future doctors raises some interesting questions about the standards we aim to uphold."

"If the goal is really to fill vacancies, a more sensible approach might be to focus on making specialized branches more appealing. Offering competitive salaries, career growth, and support for research could attract qualified professionals without compromising the quality of education. Reforms are necessary, but they should prioritize the integrity of our medical education, not just the speed at which we fill positions. After all, a well-trained doctor is the product of rigorous education, not a compromise on standards," he added.

Meanwhile, the PG medical diploma holders, who have been fighting for their promotion for the last 7-8 years, have praised NMC for allowing them to join the medical colleges as faculties. Several of these PG medical diploma holders have been stuck in their positions as Senior Residents over the years without getting any promotion.

Earlier, speaking to Medical Dialogues, Dr. Z.A Golewale from PG Diploma Doctors Association had questioned why could Diploma holders, having years of experience in medical colleges, not be considered as medical college faculties when DNB students having no experience of working in a teaching hospital be considered for the same.

"We have been working as senior residents for years and are involved in teaching and clinical work and still they did not allow us as faculties. When you can rely on someone to treat the patient and you are risking the lives of the patients at their hands, then why restrict them in medical colleges?" he questioned.

Reactions from Non-Medical Teachers:

Non-medical teachers have, however, expressed their concerns and objections to the newly released Draft TEQ 2024 Regulations, especially regarding the criticism received from the medical fraternity and the NMC's clarification that non-medical teachers would be allowed during the "transitional period" only.

Defining the "transition period", NMC has mentioned in the Draft that in a speciality (subject) if enough faculty having qualifications of that speciality are not available, one with related qualifications and training/experience is made eligible to become faculty of that speciality for limited period till adequate number of faculty with qualification of such speciality are available. NMC has specified that this limited period is called a "transition period" and conditions required to be fulfilled for his will be called transition period criteria. The Commission has also mentioned that the duration of the transition period will be decided by NMC based on the recommendations by the Post Graduate Medical Educational Board (PGMEB).

Addressing the strong opposition expressed by the doctors against the NMC's decision to include the non-medical teachers in the medical college faculty pool, the MSc Medicine Association mentioned in an X (formerly Twitter) post, "Even though we are trained and graduated from Medical Institutions, hold Medical Qualifications, practising for years, just because we came from non-MBBS backgrounds, they want to disqualify us, they want us to give away our practice, our years of investment of professional training and experience, hard earned qualifications, PG and PhD."

The association also pointed out how the authorities did not listen to their concerns and prayers and added, "While NMC without any brain and empathy speaks of Transition Period to show us door to exit, there are around more than 30 plus Medical Institutions conducting MSc Medical Postgraduate courses as on today including @aiims_newdelhi @OfficialJipmer @RMLDelhi. Though we appealed to these institutions to take a stand on this issue in the interest of their alumni and the students pursuing these courses currently, appealed to the authorities including National Medical Commission, none felt the need or the responsibility to act upon this."

Highlighting how the NMC's decision to possibly barring the non-medical teachers to join medical colleges as faculties, the association further added, "What shall we do now? Those who qualified in Anatomy to teach MBBS students now should go to burial grounds and do practice? Those who are experts in Medical Biochemistry and Medical Microbiology qualified to teach MBBS, now should work in an unknown diagnostic lab in your area as a technician with 10 or 12k salary? Those Physiologists who are qualified to teach MBBS students, now should become a biology teacher and start conducting tuitions for school kids? For 100s or 1000s of monthly fee. You want us to start fresh? After investing our youth, potential years of a career and employment, and then to lose everything in Medical field and go out at these mid ages. Where do we start?"

The National M.Sc Medical Teachers' Association (NMMTA) has also raised serious concerns over the recently proposed TEQ 2024 Regulations alleging that it threatens to "destabilize medical education in India and jeopardize the careers of thousands of experienced educators."

"Introducing these TEQ guidelines at this stage may be inappropriate, given that the contentious issues are already under consideration by the Supreme Court," the association further opined in a recent release.

NMMTA highlighted that for more than five decades, Medical M.Sc and Ph.D qualified professionals have been the backbone of medical educations in non-clinical subjects including Anatomy, Biochemistry, Physiology, Microbiology, and Pharmacology. It also pointed out that despite this contribution, the new regulations appear designed to systematically exclude these qualified professionals from the medical education.

Addressing the Draft Regulations, the association pointed out that the Draft discriminates qualification requirements as an additional Ph.D requirement has been imposed specifically on M.Sc qualified teachers. As per the association, this is creating unnecessary barriers, especially revealing the inequitable treatment despite M.Sc and MD being equivalent postgraduate qualifications.

Apart from this, the association has also opined that the undefined "transition period" is creating widespread uncertainty and potential displacement of currently employed teachers.

NMMTA has also called out the "Unjustified prohibition on non-medical persons heading departments" and disregarding the decades of teaching and administrative experience. As per the association, NMC has disregarded global standards also where non-medical faculty constitute up to 90% of medical teachers

Commenting on the matter, Dr. Arjun Maitra, NMMTA President mentioned in a release, "These regulations represent an unprecedented assault on the dignity and job security of thousands of qualified medical teachers."