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Status of Medical Education in India

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Status of Medical Education in India MEMBERS REFERENCE SERVICE LARRDIS LOK SABHA SECRETARIAT NEW DELHI REFERENCE NOTE For the use of Members of Parliament NOT FOR PUBLICATION No.22/RN/Ref./July/2018 STATUS OF MEDICAL EDUCATION IN INDIA Prepared by Shri Jayadev Sahu, Additional Director (23035025) and Shri Rajesh Hajare, Deputy Director of Lok Sabha Secretariat under the supervision of Smt. Kalpana Sharma, Joint Secretary and Smt. Anita Khanna, Director.---------------- ---------- The Reference Note is for personal use of the Members in the discharge of their Parliamentary duties, and is not for publication. This Service is not to be quoted as the source of information as it is based on the sources indicated at the end/in the context. STATUS OF MEDICAL EDUCATION IN INDIA Introduction Developing an effective health care delivery system and ensuring universal access to affordable health care immensely depend on the status of the medical education system and the quality of medical practitioners it produces. Building an effective need-based medical education system is a challenging task and government support in terms of policy framing, funding and appropriate regulatory mechanisms is crucial for facing this challenge. The Centre has set up regulatory bodies for monitoring the standards of medical and dental education, promoting training and research activities. This is being done with a view to sustain the production of medical and para-medical manpower to meet the requirements of healthcare delivery system for the primary, secondary and tertiary levels in the country. Medical Colleges and Intake Medical colleges: At present, there are 472 medical colleges in the country, out of which 212 in government sector and 260 in private sector with an annual admission capacity of 65183 MBBS and 26450 Post-Graduate students. Details of MBBS/PG seats are at Annexure-I and II. 51 new Medical colleges were granted permission during the academic year 2016-17 Session. Dental Colleges: At present there are 309 dental colleges in the country out of which 44 are in government sector and 265 are in private sector with annual admission capacity of 26,790 BDS and 6019 Post Graduate (MDS) seats. Details of BDS/MDS seats are at Annexure-III and IV. One new dental college has been granted permission for establishment during the academic year 2016-17. A total of 260 BDS and 165 MDS seats have been increased for the academic year 2016-17. Availability of Doctors Allopathic Doctors - As per the Medical Council of India, there are a total 10,41,395 allopathic doctors registered with the State Medical Councils/Medical Council of India as on 31 December 2017. It is estimated by Ministry of Health and 3 Family Welfare that around 8.33 lakh doctors may be actually available for active service. It gives a doctor-population ratio of 1:1596 as per current population estimate of 1.33 billion, against WHO norms of 1:1000. State-wise details of doctors registered with State Medical Councils is at Annexure-V. Ayurveda, Unani and Homeopathy (AUH) Doctors There are 7,63,000 Ayurveda, Unani and Homeopathy (AUH) doctors in the country. It is estimated that around 6.10 lakh Ayurveda, Unani and Homeopathy (AUH) doctors may actually be available for active service and together with allopathic doctors, it gives a doctor population ratio of 1:921. Location of Medical Colleges: As may be seen at Annexure-I, majority of medical colleges are concentrated in the south and west of the country. The north-eastern region has comparatively fewer facilities for medical education. The number of seats in the existing medical colleges falls short of the present demand for medical professionals. The growth of postgraduate education has been very slow, which has an effect on the preparation of the next generation of medical teachers as well as the specialist doctors to undertake clinical practice and research. More than 45.75 per cent of Government medical colleges and 60 per cent of private medical colleges are located in the States of Andhra Pradesh, Gujarat, Karnataka, Kerala, Maharashtra, Tamil Nadu and Puducherry. Medical Education -Some Issues The Medical Council of India/Dental Council of India/Indian Medical Council (AYUSH) play important roles in setting standards, curriculum development, inspection and grant of permission for setting up new institutions, undertaking subject to central Government approval where defined. In its Report, the committee for evaluation of the New Education Policy has pointed out that the Councils, and in particular the Medical Council of India comprises of elected persons who have a strong vested interest in 4 retaining their voting constituency over the larger interests of public health and medical education. It has stated that such entrenched interests of different kinds should be kept away from the functions of inspection, verification and standard-setting as well as approval for opening new institutions. The Report further states that the responsibility for manpower planning, design of curricula and standard-setting needs to be done by a body which is conversant with the demographics of India, the prevalence of communicable and non-communicable diseases, challenges connected with maternal and child health so that the production of doctors is planned keeping in mind the needs of specialised as well as general duty doctors. The Committee has recommended for increasing: The number of seats in the existing medical colleges falls well short of the present demand for medical professionals. The growth postgraduate education has been very slow which has an effect on the preparation of the next generation of medical teachers as well as the specialised doctors to undertake clinical practice and research. The existing framework of medical education needs significant restructuring. Entrenched interests of different kinds should be kept away from the functions of inspection, verification and standard-setting as well as approval for opening new institutions. Public investment for starting medical colleges, besides encouraging the private sector to set up medical colleges, with appropriate incentives. The Parliamentary Standing Committee on Health and Family Welfare, in its Report presented in March 2016 has made several recommendations, particularly in regard to the running of the Medical Council. Recent Initiatives/Measures The Government of India has taken various steps to increase the number of doctors. The ratio of teachers to students has been revised from 1:1 to 1:2 for all MD/MS disciplines and 1:1 to 1:3 in subjects of Anaesthesiology, Forensic Medicine, Radiotherapy, Medical Oncology, Surgical Oncology and Psychiatry in all Medical Colleges across the country. Further, teacher-student ratio in public funded government medical colleges for Professor has been increased from 1:2 to 1:3 in all clinical subjects 5 and for Associate Professor from 1:1 to 1:2 if the Associate Prof. is a unit head. This would result in increase in number of specialists in the country. Other steps include the enhancement of maximum intake capacity at MBBS level from 150 to 250, relaxation in the norms of setting up of medical college in terms of requirement of land, faculty, staff, bed strength and other infrastructure, strengthening/upgradation of existing State Government/Central Government medical colleges to increase MBBS seats, etc. The Central Government has approved the continuation and taking up additional phases of Human Resources for Health and Medical Education schemes, at a total estimated cost of Rs.14,930.92 crore upto 2019-20. It has approved the scheme for augmenting human resources for health and medical education, under which 24 new Medical Colleges will be set up in underserved areas, 18,058 UG and PG seats in medical colleges created and 248 Nursing and Midwifery schools will be set up. Salient Features: Continuation of ongoing scheme to establish 58 new medical colleges attached with existing District/Referral hospitals already approved under Phase-I by 2019-20. Selection and establishment of 24 new medical colleges attached with existing District/ Referral hospitals under Phase-II by 2021-22. The locations of proposed 24 new medical colleges in Phase-II will be selected within the identified underserved areas in Challenge Mode. increase of 10,000 UG seats by 2020-21, and 8,058 PG seats (4,058 in Phase-l by 2018-19 and 4,000 in Phase-ll by 2020-21). Auxiliary Nursing and Midwifery (ANM) Schools and 136 General Nursing Midwifery (GNM) Schools by 2019-20 in under-served districts of the country. The establishment of new medical colleges and increase of MBBS and PG seats would: increase the availability of health professionals, check the existing geographical distribution of medical colleges in the country, promote affordable medical education in the country, utilise the existing infrastructure of district hospitals, and improve tertiary care in the Government sector. 6 The Scheme will serve the following purposes: create additional 10,000 MBBS and 8,000 PG seats in the country, bridge the gap in number of seats available in government and private sector, mitigate the shortage of Doctors/specialists/medical faculty in the country by increasing the number of eats and to achieve the desired doctor population ratio, upgrade PG teaching facilities in Government medical colleges, introduce new and higher courses of study, improve the quality of medical education, medical research and clinical treatment. Regulatory Mechanisms 1. Medical Council of India (MCI) The Medical Council of India (MCI) was established as a statutory body under the provisions of the Indian Medical Council Act (IMC Act), 1933, which was later, replaced by the Indian Medical Council Act (IMC), 1956 (102 of 1956). The main functions of the Council are: maintenance of uniform standards of medical education in the country; prescribing Minimum Requirements for establishment of medical colleges; recommendation to start new medical colleges/new courses; recognition of Medical Qualifications; maintenance of Indian Medical Register and enforcing ethical conduct for medical professionals.
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