Recently Telangana HC held that Medical Assessment & Rating Board Has Power Under National Medical Commission Act to Shift Students To Other Colleges.
What were the recent changes in the Indian medical education system?
Replacement of MCI - Medical Council of India, which was regulating medical education and practice for over eight decades — was superseded by the National Medical Commission in 2020.
NMC – It is a statutory body in India that regulates medical education, medical professionals, institutes, and research.
Function- It grants
Recognition of medical qualifications
Accreditation to medical schools
Registration to medical practitioners
Monitors medical practice and assesses the medical infrastructure in India.
Composition – Chairperson, 10 ex officio members, 22 part time members
Boards - The commission consists of four autonomous boards
Under-Graduate Medical Education Board (UGMEB),
Post-Graduate Medical Education Board (PGMEB),
Medical Assessment and Rating Board and
Ethics and Medical Registration Board
Introduction of CBME - NMC has released new guidelines for the Competency-Based Medical Education (CBME) curriculum for MBBS students, set to be implemented from the 2024-25 academic year.
Increase in medical colleges -In 1970, India had fewer than 100 medical colleges for a population of 54 crore .
Today, there are 766 medical colleges across both government and private sectors for a population of 144 crore.
Increase in medical seats - Rapid increase in new medical colleges leading to increased MBBS seats from 64,464 to 1,15,812 seats and PG seats from 31,185 to 73,111 seats.
India crossed the WHO recommended a doctor to population ratio of 1:1000, by achieving 1:900.
What is CBME curriculum?
CBME – It is an outcomes-based approach to the design, implementation, and evaluation of education programs.
It assesses learners across the continuum that uses competencies or observable abilities.
Different from traditional curriculum - Unlike traditional curricula, which emphasize theoretical knowledge, the CBME curriculum focuses on practical competencies and real-world applications
Aim - To create a new generation of Indian Medical Graduates (IMGs) who are equipped with the knowledge, skills, and attitudes necessary to function as primary healthcare providers in the community.
Outcome-Based Learning - The curriculum shifts from broad competencies to detailed, phase-specific subject competencies.
Integrated Approach - It promotes horizontal and vertical integration of subjects.
Horizontal integration refers to aligning topics across different subjects in the same phase, while vertical integration connects subjects across different phases.
Ethics and Communication- A new module titled "AETCOM" (Attitude, Ethics, and Communication) has been introduced, focusing on building these essential competencies in future doctors.
Learner-Centric Education - The curriculum is more learner-centric and patient-centric, encouraging active student participation and self-directed learning.
What are the recent issues with medical education?
Reduced practical experience – Though CBME was introduced to emphasise practical skills over theoretical knowledge , more time is being allocated to lectures (symposiums, group discussions, seminars, etc.).
Reduction in ward timing - Previously, Theory classes were held in the afternoon after the clinical roation in the morning.
Now It has been inverted this schedule has been inverted, with students attending clinics after 10 a.m. and theory classes in the morning.
Less Bedside teaching - Bedside teaching is a crucial component of medical training, yet it has nearly vanished from medical schools.
Decline in quality - Drastic decline in failure rate from 20-30% to 1-2%, indicate lowered educational standards, affecting the the overall competence of future doctors.
Inadequate infrastructure - Many new institutions are missing basic amenities , laboratories and access to practical learning from hospitals.
Regulatory inconsistency - Relaxing norms and regulations merely to start new institutions due to political compulsion.
What lies ahead?
Producing well-qualified doctors is essential for societal welfare.
Academic institutions and regulatory bodies should indeed prioritise these issues.
Regular and thorough inspections are crucial to ensure the quality of education.
Government’s focus on expanding medical education should be balanced with ensuring adequate infrastructure and sufficient qualified faculty.
Recommendations by the Parliamentary panel
Bridging the widely varying quality of medical education across India.
Enhancing the number of under- (UG) and post-graduate (PG) medical seats.
Optimal use of existing infrastructure to expand medical education facilities.
Chalking out a comprehensive India-specific approach for the creation of seats for specialists.
Streamlining the recruitment process to prevent “ghost faculty” (teachers who exist only on paper but paid a salary) in medical colleges.
