The Future of Medical Colleges in India on Uncertain Grounds

New Delhi: Medical Institutions in operation though declared unfit to carry out academic study related to medicine, are still being granted MBBS certification by the MCI. A strength of ten thousand medical students happen to be part of such institutions. It is understood that these academic bodies of learning suffer from a shortage of basic facilities asked for by the MCI in running of a medical institution offering an MBBS course .

The Medical Council of India's minimum standard requirement to start any medical institution in the country calls for a minimum provision of accommodation in the college and its associated teaching hospitals, staff (teaching and technical both) and equipment in the college departments and hospitals.

An MCI led inspection has revealed a 99% shortage of resident doctors and a scarcity of 57% faculty. The scarcity of resident doctors implying the institution's inadequacy in running the hospital facility round the clock and the absence of faculty, a reflection on the quality of courses being conducted.

The other drawbacks of these medical institutions brought to light are bed occupancy of just 10.36%, no operations being conducted for student assessment, and no patients housed in the ICU. The NRI Institute of Medical Sciences, Visakhapatnam being a standing reflection of this poor state of affairs.

The rot seems to have seeped in and little is being done to clear it.

The Education Regulator, is the official who is supposed to be conducting inspections for institutional certification to be granted for new batch admissions. If the institution is found lacking in standard , the state is supposed to intervene and do the needful to facilitate pursuance of medical courses by students .

Speaking on the issue the MCI, Secretary,Dr. Reena Nayyar made clear that the apex body was following the provisions of the Indian Medical Council Act, 1956, and it was the responsibility of the state governments to hasten upgrading of the standard of institutions as the MCI did not support shift of students from one college to another.

The present situation as it stands is that due to absence of hospital facility in a particular area, the state government grants permission in the form of an 'essentialist certification' for initiation of one; of course with the MCI's consent. However, the condition to it being that the medical college would be able to fulfil MCI's essential institutional requisites within a 5 year framework of establishment. More often than not the institutions are unable to fulfil the MCI requirements, ending up as ill equipped medical hubs.

Another issue that seems to be emerging is the quality and training provided to students at these ill equipped institutions of medicine . The MCI seems to be coming down harshly on them; however, the state governments are found reluctant to take severe stands. This delayed pace on the part of the state governments is resulting in unqualified, ill equipped doctors joining the work stream; an injustice to both the practice and the patient.

The MCI seems to be insisting on the shutting down of these medical institutions, prior to student shift in the face of inspection failures. The matter seems to be taking on serious dimensions for students as there are roughly 50 batches facing an uncertain future; the MCI refuses to give consent to all these institutions for further admissions. There are 29 colleges that are facing MCI refusal on further batch admissions. Some of the prominent names being Government Medical College, Bettiah & West Champaran, Bihar. Refusal to these institutions has come in the face of not being able to fulfil minimum infrastructural requirements.

Other medical colleges include Srinivas Institute of Medical Research Centre (Srinivasnagar),Viswabharathi Medical College (Kurnool), Gold Field Institute of Medical Sciences & Research (Faridabad), Lord Buddha Koshi Medical College & Hospital (Saharsa) as well as The Oxford Medical College, Hospital & Research Centre, (Bengaluru).

The situation is quite bad in many recognized colleges which despite initial approval, have failed to create faculty, residents, as well as clinical materials for successive years as the batch progresses. All this puts a critical part in place that the opening as well as running of a medical college needs to be rechecked, if the careers and future of millions of students has to be made safe in future.

Another twist in the MCI functioning lies in the fact that annual inspections are done by it for four continuous years, before a final recommendation is made to the Central government about the status of a medical institution. It has been observed, that even if an institution does not clear the second and third inspection, however, qualifies for the fourth, the MCI gives a positive recommendation to the centre. This leading to an opinion that state governments should get caution money from MCI for creation of facilities.

Supporters of such medical institutions are of the opinion that barring a college would result in deterioration of its reputation, as it would lead to employees leaving due to insecurity, and the future of the students being affected.

Millions aspire to join medicine and status of institutions of this kind are bound to act as deterrents for others wanting to enter the field.