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Medical Education Reforms (5 November 2020)

Medical Education Reforms (5 November 2020)

Why in News:

NMC (National Medical Commission) releases new regulations for MBBS admissions, establishment of medical colleges.

Context:

In a significant step towards affordable medical education, the National Medical Commission has notified its first major regulation. Titled as “Minimum Requirements For Annual MBBS Admissions Regulations, 2020”, the notification issued replaces the “Minimum Standard Requirements for Medical Colleges, 1999” of the erstwhile Medical Council of India. The new Regulation shall be applicable to all new medical colleges proposing to be established, and to the established medical colleges proposing to increase their annual MBBS intake from the academic year 2021-22. During the transitory period, the established medical colleges will be governed by the relevant regulations existing prior to the current notification. The new standards have been defined keeping the functional requirements of the institution(s). These allow optimization and flexibility in utilizing available resources, and harnessing modern educational technology tools to facilitate moving towards quality education, even when resources are relatively scarce.

Background:

Last month, NMC had replaced the Medical Council of India (MCI) as the apex regulator for medical education in India.

NMC will be an overarching body that will frame policies and co-ordinate the activities of the autonomous boards, including the Under-Graduate Medical Education Board, Post-Graduate Medical Education Board, Medical Assessment and Rating Board, and the Ethics and Medical Registration Board.

One of the mandates of NMC is to look at the cost of medical education.

NMC will also work to regulate fees and all other charges in 50% seats in private colleges, as well as deemed to be universities.

Summary of the Debate

The key Changes:

  • These regulations title Minimum Requirements For Annual MBBS Admissions Regulations, 2020 has just been released and basically, these will come into force from next academic session and these regulations have basically gotten a lot of explanation, in terms of infrastructure, faculty requirement, bed requirement and also has promoted small group teaching, early clinical exposure and competency based education.
  • The new regulations have deleted the quantum of land required for setting up a medical college and its affiliated teaching hospitals. The earlier requirement for setting up a medical college was 25 acre of land and in metros, it was 5 acres.
  • The new regulation is promoting e-learning, digitally linked resources which are all shared amongst the medical colleges, skill lab and all the medical education technology, because it is mandating all teaching spaces to be enabled for e-learning and also digitally linked to one another.
  • A well-equipped “Skills Laboratory" for training students is essential now, as per the new regulation.
  • It made mandatory the Department of Physical Medicine and Rehabilitation and the Department of Emergency Medicine for the training of undergraduate medical students.
    • Department of Physical Medicine and rehabilitation: It will fill a large gap for those in need of comprehensive rehabilitative care.
    • Department of Emergency Medicine: It will ensure access and prompt, appropriate response to emergencies particularly trauma.
  • The availability of a fully functional 300 bed multi-speciality hospital for at least 2 years at the time of application for establishing a new medical college has been made mandatory.
  • It also defines a Medical Education Unit for training medical teachers in educational pedagogy.
  • Student counselling services has been mandated recognizing the increasing stress observed amongst medical students and residents in recent times.
  • Human resource of teaching faculty has also been rationalized.

Salient features:

  • To be a force multiplier for experts, you needed the digital connectivity to the last mile in India. Now, the covid has compressed that very quickly and a lot of new activity happened on digital space.
  • It has been estimated that up to 50 percent of the patients will not have to travel to a hospital. Their diagnostics, their initial treatment can be done on tele-medicine, whether it is video or whether it is telecommunication.
  • The graduates will be totally tech savvy, they will be able to communicate very easily and parallelly, the children who are growing up in even villages are becoming tech savvy.
  • Government has started the Digital Medical Record which is transportable across the country.
  • Under Aatm Nirbhar program, the Doctors will also start thinking of helping our own scientists, our own laboratories, our own industry to develop new technology to become self-sufficient so that we are not dependent on people importing expensive equipments from overseas.

Impact on the Medical college:

  • Medical college will think it in a different manner because their logistic will be more than what was required earlier, may not be adequate but now with the present changes, they are in a better position to train more students than what they are presently doing. So, they can ask for an increase in the number of seats with their existing facility.
  • This similar application to government institution, the number of seats can be increased there as well and the government seat in the private institution can be released available to the private candidates and that will reduce the cost of medical education in the private colleges with the enhanced seat by another 60 to 70 percent. The students who are going outside India for acquiring medical education need not go.
  • Because of the allowance of consortium, housing body, unutilized engineering colleges, hospital which are running, all they can come together and can start a new medical college and as a result, the cost of building infrastructure would be low and that will reduce the cost of training each student for four and a half year period and this will enhance the chances of getting interest on their investment.
  • If the returns are better, the more people will come to start new colleges and will be able to train a larger number of doctors, practitioners in the shortest possible time and that is what India needs.

Challenges:

  • World Health Organization (WHO) set the ratio of 1: 1000 for doctor and population, but India has only one doctor for 1700 people.
  • Making faculties accept whatever in coming in digital platform in a shortest span of time may be challenging. All of them would not be prepared to accept it so easily.
  • Today especially the private medical education is quite unaffordable and lots of our students who somehow miss the government seats.
  • India is extremely short of Doctors, who are trained to a level, where not only their education is how to learn about giving care to the patient which was just medical, but also be comprehensive in their ability to deal with the disease pattern, be emotionally connected and be very sort of courteous, understand how to talk to families, what is the role of the traditional medicine in India.

Way Forward:

  • The need of the hour is to looking at all the ethical concerns because the commercialization and marketing of medical education and medical care is happening.
  • The quality of the educators should be standardized.
  • Introduction of some of the new frontier technologies like AR, VR, etc. will have to be introduced progressively across the whole system.
  • If India is going to be an inspirationally leading the world economy, then they have to spare the fund for things which they are presently doing.
  • The focus should be on reducing the cost of medical education so that a meritorious student will not fall sigh of go jumping into it by taking a bank loan.

Important points made by the Guests

Dr. Naresh Trehan, Chairman and Managing Director of Medanta

  • These reforms have been long due in coming and they are very progressive, it is very positive step taken forward in the interest of healthcare India.
  • There are many aspects with this new progressive thinking which the NMC has put in place enabling the best of people, best of hospitals, which are already existing, which have good faculty, very good clinical material, their services can be used for training doctors to a level which will be much higher than what we have been able to do when there were hospitals made in some rural area because of the requirement of the land, some hospital had to be made where pre-patients were admitted, the clinical materials limited and one of the biggest thing it has done is taken away the distinction between the life of a poor and the life of a well to do person.

Prof. Mahesh Verma, Member, National Medical Commission & Vice Chancellor, GGS IP University, Delhi

Some of the areas which NMC is already looking at is:

  • Growth, regarding number of seats in UG and PG.
  • Distribution and availability of doctors all across.
  • Improving quality of education.
  • Having a uniform NEET examination for UG and PG and also planning the EXIT exam, where there is the standardization that everybody will be assessing the same parameters.

Prof. Rajendra Pandey, Vice Chancellor, West Bengal University of Health Sciences

  • It will be easier for the students to adapt because a lot of training earlier used to take actually on patients, before they can have enough experience to do successfully and without or with least complications. But, now digitally on different platforms, they can be trained adequately before they actually perform on patient.

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