The Standing Committee on Health and Family Welfare headed by Ram Gopal Yadav submitted its report on the Medical Council of India (MCI) has said that the Council has failed in its mandate in ensuring quality medical education being imparted by colleges, failed to maintain uniform standards of medical education, both at the undergraduate and post-graduate levels and has failed to produce a competent basic doctor.
There have been allegations that the MCI has been reduced to only a advisory body and seems to push and protect the interest of private sector. There are issues of corruption and mis-governance in MCI, which are taking toll of medical services in India.
Salient features of report
The Parliamentary Standing Committee has called for a complete restructuring of the Medical Council of India (MCI), the apex medical education regulatory body in the country on the ground that it has failed in its mandate as a regulator of medical education and profession.
The Committee has recommended for immediate bifurcation of the two major areas- medical education and the ethical conduct of the medical professionals, so that they can receive full attention.
It has called for providing an architecture that is more in tune with the current needs of the country and replace the principle of election with nomination of the members of the MCI.
It has also suggested to replace MCI with an architecture consisting of four independent boards to deal with curriculum development, teacher training, and standard setting for undergraduate and post-graduate education; accreditation and assessment processes of colleges and courses for ensuring uniformity in standards; and the registration of doctors, licensing and overseeing adherence to ethical standards.
Inspections and Corruption
The Committee has been informed by an expert that the desk evaluation of the application for establishment of a medical college is done by the Executive Committee followed by physical inspection to verify the information supplied by the applicant. Inspectors appointed by the MCI do the physical verification. One permanent inspector, an MCI permanent staff, leads, along with 3-4 external Inspectors chosen by the Executive Committee of the MCI.
As informed by the Ministry, as per the Delhi High Court order dated 20th December, 2013, all the assessment should be conducted as surprise inspection. However, it is in the Committee's knowledge that some medical colleges have prior information of inspection dates and are thus able to keep ready the required number of ghost faculty and fake patients.
The Committee observes that the current system of inspections is flawed and opaque in the sense that there is no provision for constructive feedback and the whole procedure is oriented towards penalizing rather than improving. The Committee also observes that though Section 17.3 of the IMC Act, 1956 requires to forward "a copy of any such report to the university or medical institution concerned..." no such report is submitted to the university concerned. This opaqueness means that these inspections give enormous scope for money to exchange hands. It is ironical that the evaluation of quality of teaching and training and the final product, i.e. the doctor, does not figure in inspection reports.
No criteria for recruiting evaluators
The Committee also observes that MCI regulations do not provide any clear-cut-criteria for recruiting suitable evaluators. The obvious fallout of this is an arbitrary and partisan selection of inspectors. The Committee is amazed to take note of media report titled "The murky word of medical college inspections" that despite hundreds of faculty members from 183 government medical colleges being available, certain 'serial inspectors' were part of almost half the inspections conducted in the year 2014 and of the 261 inspections done during 2014, inspectors from medical colleges in Gujarat were involved in as many as 100 inspections and another 40 involved faculty from Bihar. The Committee observes that this cannot be a mere coincidence but reeks of a serious scam. The Committee, therefore, recommends that in order to unravel the truth, an in-depth probe may be conducted into the arbitrary appointment of inspectors in the year 2014 and an action taken note furnished to the Committee within three months from the presentation of this report.
Mushrooming of medical colleges, the alleged high capitation fees and rampant corruption afflicting the Medical Council of India (MCI) has made reforms in the regulatory scheme imperative. The Parliamentary Standing Committee, endorsing the view of Dr. Ranjit Roy Chaudhery, has recommended major reforms relating to MCI.
The Committee has recommended the establishment of a robust and autonomous accreditation mechanism separately. Since the existing system of inspections of medical colleges has not been able to promote quality and resulted, instead, in slashing of thousands of medical seats on flimsy grounds, the Committee recommends, even at the cost of repetition, that the current system of annual inspection be scraped and an autonomous accreditation body on the lines of the National Accreditation and Assessment Council which is an autonomous body established by the University Grants Commission and is mandated to assess and accredit institutions of higher education, be established in the domain of medical education to deal with issues of quality.