IMA demands withdrawal of NMC Draft on PG Medical Education Regulations
New Delhi: Calling the new Draft regulations for Post-graduate medical education as "anti-student" and "anti-democratic" the Indian Medical Association (IMA) has now demanded withdrawal of the draft bill by National Medical Commission (NMC).
The association has further proposed that the Apex medical education regulatory body, NMC should "try to initiate dialogue with the stakeholders to understand the ground reality and do course corrections to ensure uniform standards of education is provided and equally uniform pattern of the scale of pay, stipend and facilities are provided to interns, faculties and residents too."
Starting from the issue of common counseling, IMA has raised several issues in its official statement- including the lack of clarity regarding the National Exit Test (NExT), objections against the time period for District Residency Programme, and dual degree in postgraduation.
Medical Dialogues had recently reported that the National Medical Commission (NMC) released the Draft Postgraduate Medical Education Regulations 2021. The Draft focused on several issues including the nomenclature of PG courses, Selection of PG students, Common Counseling process as envisaged by NMC, inclusion of District Residency Programme among others.
Objection to Common Counseling:
Referring to the Section 11.1 of the Draft that talks about the common counseling, the Association mentioned in its release that the new regulations would ensure that these entire seats will be filled by the central government and state governments will have no role in this.
"India being a federal state, leaving the role of states in Medical Education will be disastrous," mentioned the association.
Opining that the existing system of admission and selection criteria must be continued, IMA referred to several reasons in its support. They are:
1. The state medical colleges are staffed and managed by the budget of state government and when not even 50% of seats are earmarked for the respective state, the maintenance and running of the institution will lose its charm and priority.
2. When the students are getting admission in non-native states, the language barrier and social contact will negatively render their services.
3. The compassion, empathy, and community connections are amplified when students are getting in touch with their own known people, instead of people and society not connected with them.
4. The public health system of the state will be jeopardized as the students will not have to serve locally after postgraduation and will go to their native state.
Lack of Clarity regarding NExT Exam:
IMA in its Press Release has also pointed out towards the lack of clarity regarding the NExT exam. Calling the rules of allowing candidates write the exam only once in three years, IMA mentioned, "NMC is still in a dilemma and has not given any clarity on the proposed NEXT exam. However, this notification says, when a student writes his exam, the mark he scores will be valid for three years and he can rewrite the exam only after three years. This is a great injustice step to the students. As it has proposed to conduct the NEXT exams in 2023, the NMC should come out with the pattern and type of examination after having wider democratic consultation with the student's body, faculty, States, and largest professional body IMA."
Duration of the District Residency Programme:
Although IMA has welcomed the District Residency Programme by principle, it has objections against the three months time period designated for this.
"Making it for three months period will result in overcrowding and impact the works in the Medical College departments. Even for non-clinical postgraduates spending three months in the District Hospital will hamper the continuous theory and practical training. IMA demand, the training period in district hospital shall be reduced to one month," mentioned the Press Release.
Uncertainty over Broad Specialties Converted into Super Specialties:
IMA has mentioned in the release that the conversion of Broad Specialties into Super Specialties have been done without due considerations of the opinions of the students and "often changing this like this will create uncertainty and heartburn for the students preparing for the NEET SS exams."
Dual Degree Programme:
Pointing out that the idea of opening up a dual degree programme in postgraduation and allowing candidates to pursue Ph.D is a good idea, IMA has opined, "but in reality, will jeopardize the clinical acumen and involvement of postgraduates inpatient care."
Thus, demanding that NMC should withdraw the "anti federal, anti-student and anti-democratic, anti-patent care, and public health draft bill", IMA has lashed out at NMC mentioning, "The NMC which has been formed with great fan fire and promises are now running into a nonperforming body and playing the role of silent spectator when the issues of interns, medical students, and also the registered doctors are raised. NMC fails to respond to the death of 1589 doctors death in covid-19 nor issues of violence on doctors. However, they want to make inroads of mixopathy and centralizing powers at the cost of states."
Speaking to Medical Dialogues regarding the matter, Dr. J A Jayalal, President of the Indian Medical Association (IMA) said, "We are totally opposing the new NMC guidelines. Earlier, 50% states were reserved for the States and now these seats would be controlled by the Centre. It will affect the public health system prevailing in each state. Even after running a medical college, paying the staff their salaries, and maintaining the institute, what interest would the States have if they have no control over the admission process? They will stop maintaining the institutes, and would lose interest in getting NMC recognition as well."
Mentioning that such a move by NMC would force students to come to other states for pursuing their education where they would face language barrier, he added, "Coming to another state to pursue medical education would be difficult for a student as the student would have to always face the barriers of language and social custom. Also, if the students are studying in their own state, they would be naturally empathetic and compassionate towards the people of the locality. However, this won't happen if they are studying in a different state it would be difficult for them to develop the same kind of empathy for people.
This is one of the major problems that the healthcare system is facing- the lack of community connection, which could only get developed if the students are studying in their respective states."
"Further, the issue of district residency for three months is another aspect of the Draft Regulations that the IMA is opposing against. We don't have proper infrastructure in the district level to host the PG residents for three months. If a Surgery PG student is going to a district hospital, who would monitor or train them? It can be implemented for a period of one month instead," added the IMA Chief.
Referring to the National Exit Test (NExT) that the NMC is planning to implement, Dr. Jayalal said, "Besides, there is no clarity regarding NExT examination as well. The notification says that the NExT score would be valid for three years, so would the students be eligible to write the exam again only after three years? Also, the concept of "Dual Degree Programmes", as proposed in the Draft, is good as a concept but hard to implement. If a student is simultaneously pursuing PhD along with PG medical education, they would not see the physical patients and it would ultimately fail the original purpose of PG medical education."