these new medical colleges and new
AIIMS? It is for these reasons that the
government in 2004 announced them
as ‘AIIMS-like institution.’
But over a period of time a thought
process evolved to bring the new insti-
tutions out of the purview of MCI and
they were brought under the ambit of
AIIMS Act through an amendment.
That is why MCI cannot be blamed for
all the ills affecting health sector and the
establishment of the NMC is not going
to solve all the ills prevailing in medical
education and healthcare sector.
Use of human resources
Deficiency of trained medical and par-
amedical manpower has been a huge
issue for a long time but if we think that
it can be solved quickly by opening a
large number of new medical institu-
tions, it is unlikely to happen in the
short term. However, it might give divi-
dends in long-term since medical edu-
cation is a long drawn process.
In India, we have the MBBS course
of shortest duration (4.5 years), plus
one-year compulsory rotatory intern-
ship and 3-year postgraduate course
(PG), that is, 8.5 years to prepare a
specialist. If one adds three years for
super-specialisation (DM/Mch),
it totals 11.5 years at the minimum.
Most of the students do not get into
PG courses soon after internship and
they may take anywhere from one to
four years and subsequently into DM/
Mch programmes. Moreover, quality of
our graduate and postgraduate medical
education has been a casualty for a long
time. We are only focusing on producing
more graduate and postgraduate doc-
tors. What about their knowledge, skills
and attitude (compassion/empathy/
communication)? In the era of prob-
lem-based and competency-based cur-
ricula, India is the only country where
basic skill-based courses (cardiac life
support, trauma life support, paediatric
life support, critical care) are not made
mandatory by our licentiate agencies
(MCI/NBE). In developed countries,
a fresh graduate cannot start his/her
training without being certified in these
skill-based courses.
We hope that NMC will address all
these issues by bringing quality in to
medical education and training by
making far reaching changes and not
only limited to increasing graduate andpostgraduate seats. By merely changing
the name of MCI and its structure will
not be enough.Need for rational approach
We need to look at deficiency aspect of
trained medical and paramedical man-
power with a more rational approach.
We also need to rationalise utilisation
of our graduate doctors who are avail-
able and waiting for PG admission for
various public health programs at Pub-
lic Health Centres/Community Health
Centres and for the urban community.
Maybe their services can be incentiv-
ised by attractive financial remunera-
tion and future growth. This is a massive
unutilised pool of medical professionals
and largely unemployed.
There is another big pool of medi-
cal graduates studying and returning
from Bangladesh, China, East Euro-
pean nations and Nepal after complet-
ing their medical graduation. Time has
come to establish Community Practice
(General Practice of National Health
Service, UK) attractive and prepare our
large pool of graduates to deal with
ever increasing non-communicable dis-
eases (diabetes, high blood pressure,
mental health) by equipping them with
the skills to efficiently deal with large
populations and timely referral (making
organised referral system). It is a sad
irony that CME (continuing medical
education) credits have not been made
mandatory across our country.
NMC has to think and find solutions
to all these problems. It is unlikely to
solve all the ills attributed to erstwhile
MCI. It was MCI, which brought about
some semblance and enforcement of
standards by private as well as govern-
ment medical institutions (every pri-
vate medical college accepts this reality
in private but publicly denounces and
alleges MCI for corruption).The Indian Medical Association (IMA) and doctors
across the country fear that NMC Bill will make the
regulatory body a government controlled one instead
of a democratically elected one
21'LEWXSXLMROERHƼRH
solutions to all these
problems. It is unlikely to
solve all the ills attributed
to erstwhile Medical
Council of India