SC verdict, death knell for standards of medical education

The recent Supreme Court judgement while allowing a writ petition by a Chennai-based private medical college and hospital to the effect that “Once a medical college is recognised under section 11 of the Act along with medical qualification, thereafter, for increase in the admission capacity in any course of study or training that is recognised under section 11 of the Act, only permission from Central Government as per the scheme under section 10A of the Act is required” – is a very disappointing verdict if viewed against the present state of  standards of medical education in our country.

In effect, what does this judgement mean? It means once an institution acquires the recognition of the MCI, it becomes a totally independent entity not answerable to the apex body. This is a terrible situation because the apex body should at all times have the power and discretion to inspect, consider the facilities, staff strength and the ultimate intentions of the management of the institution and the apex body alone should have the power and the authority to decide matters like student intake.

This was the situation earlier and when the proliferation of medical colleges began a couple of decade and there was a public outcry which included medical professionals that the MCI should not only be made stronger and empowered to be the sole and final arbiter in matters like recognition and admission intake in both under graduate and post graduate course in these colleges.

An attempt was actually made during then prime minister Rajiv Gandhi’s reign to modify the act and strengthen the MCI to be the sole arbiter in these matters. But for some reason, when the bill came to be passed, it came to pass that the MCI became just a recommendatory body with the Central Government’s approval becoming mandatory.

Either it was the bureaucrats or the politician–bureaucrat nexus which played a determining role in undermining the MCI powers knowing fully well that they would take the final decisions. And they alone would have the power of dispensing favours. What has been the effect? Huge numbers of medical colleges have come up.

They get MCI approval by hook or by crook. The MCI itself has not covered itself with glory, if you go by its various decisions, (and not to mention the fact that its president spent a long time in jail) each one more surprising than the other. The minimum area required to build an ideal medical college campus with hospitals, hostels, play grounds, libraries and such essential facilities has been reduced; the number of general ward beds per student has been drastically reduced and in one of the latest and bizarre moves the minimum number of teachers and their qualifications have also been reduced!

What happens to the student/teacher ratio? For instance, in some pre-clinical and para-clinical subjects, MSc graduates can replace medical graduates, a decision which will be welcomed by the managements because their salary bills will become reduced.

These days, one is told that many of the new medical colleges which are coming up, magically produce teachers at the time of MCI inspection. In their hospitals, there are special units whose job is only to produce well written case sheets of non-existent admissions.

Make MCI strong

If only the inspectors, instead of just peeping into the ward, looking around and walking away, went in and questioned a few random patients, they will be staring at healthy people probably advised bed rest! There are agents who produce teachers of various ages and experience to be shown against teaching vacancies. Their attendances would have been marked, they are there for the physical verification and they are paid to make these guest appearances.

All this is to hoodwink the MCI and somehow get the recognition. With the MCI recently reducing minimum number of associate and assistant professors, I am told that some of the medical college have actually started sacking the redundant (according to MCI) staff members while at the same time constantly trying for increased admissions.

What one has to realise is that a teacher in a medical college which has both under graduate and post graduate training programmes will also be responsible for teaching and training nurses and supervising paramedical staff like physiotherapists and other laboratory technologists whose quality of service ultimately determines the patient care. And this, if well done, will only benefit the students who are eager to learn.

ssion to teach. They are teachers more by sufferance than choice. It is a well-known fact th-at private practice is what many teachers actually concentrate on while holding on to teaching posts of professors solely for the status these prefixes often bring them.

In such a situation, if you create conditions approved by the highest court in the land where once you get a recognition of the apex body for say 150 admissions, the institution can forget about the apex body and increase the admissions to 250 without increasing the teachers, teaching beds, laboratory and other facilities, it is an open invitation to disaster. Who is going to control these institutions? We are a country with a new slogan “Make in India.” Should we not take care of standards of all education, technical and medical education in particular?

We should all wake up. What is badly required is quality medical education and a need to selflessly promote the establishment of a strict, fair and sensible apex body by modifying the present MCI and give it all powers in matters of medical education. Its decisions should be final and not just recommendatory. Otherwise, this the latest judgement will be the death knell of standards of medical education in India.

(The writer is former Director, Kempegowda Institute of Medical Sciences, and former Registrar, Rajiv Gandhi University of Health Sciences, Bengaluru)