There is a distinct possibility that three years from now if you visit a specialist doctor, he might have scored a zero or even negative marks in the National Eligibility cum Entrance Test (NEET PG) to become a specialist.
You are sure to be shocked, if I tell you that he might also have graduated from a medical college where the departments of Respiratory Medicine and Emergency Medicine did not exist.
There has been a slew of diktats issued by the Ministry of Health and Family Welfare (MoHFW) which are going to have far-reaching effects not only on the medical education in the country but also on the health of the nation as a whole.
As per a recent notice dated 20 September, issued by the Medical Counselling Committee of the National Medical Commission (NMC), the qualifying percentile for postgraduate courses (medical and dental) for NEET PG counselling 2023 has been reduced to ZERO across all categories by the MoHFW.
Apart from this being a shocking move in itself, what also raises an eyebrow is that this has been done midway during the counselling.
Up until the ministry's direction came, the cut-off percentile for the NEET PG this year was:
General category - 50
Persons with disability category - 45
Reserved category - 40
Now, the cut-off percentile across all categories will become zero. The NMC has also been directed to allow the candidates to edit their choices before another round of counselling begins.
The Standard of Education Will Be Impacted
What completely defies the logic is that the same government which has now, by this notice, reduced the NEET PG qualifying percentile to zero, had strongly opposed reducing the qualifying percentile in the Delhi High Court on July 29, 2022.
The argument then was that "minimum qualifying percentile for admission is required to be maintained to ensure minimum standard of education and general standards for admission to professional courses".
The argument that reduction of the qualifying percentile to zero does not in any way change the ranks on the list does not hold water because not only the new eligible candidates would compete for the vacant seats in various disciplines, but the old registrants have also been given the option of editing their choice, thus cornering the seats in coveted specialities by paying much higher fees because most of these vacant seats are in the private medical colleges.
The message is that if you can pay, marks do not matter.
There is also another argument that most of the vacant seats are only in the non-clinical or paraclinical disciplines where the career options are very limited and mostly in teaching.
Even if that be so, these students with evidently low merit would become the teachers who are then likely to teach the basic subjects on which the foundation of a doctor rests. The outcome can be well imagined.
Requirements To Run PG & Specialty Courses Diluted
As per another recent gazette notification published by the NMC on 16 August, the departments of Respiratory Medicine, Physical Medicine and Rehabilitation, and Emergency Medicine have been deleted from the mandatory list for the undergraduate MBBS course curriculum.
Three years ago as per the “Minimum Requirements for Annual MBBS Admissions Regulations, 2020” issued by the NMC on 28 October 2020, these three departments formed a part of the list of 24 departments required mandatorily in a medical college imparting undergraduate medical education and training.
Now sample this. The NMC has published a draft “Minimum Standard of Requirements for Post-Graduate Courses-2023 (MSR-2023)” and has invited comments from public at large.
As per the draft, it is clear that the requirements to run postgraduate and super specialty courses have been diluted – including a reduction in the teacher-student ratio (more students per teacher now) ostensibly to produce more specialists and superspecialists so as to work in areas where no specialists are available.
There are 703 medical colleges currently operative in India. Out of these,
388 are government medical colleges
312 are in the private sector
They are producing 1,07,583 doctors every year, the largest number in the world. And this number does not include AYUSH doctors.
As can be seen, a large number of incompetent and unemployable doctors, including specialists, are going to be produced in this country, not only because of the dismal quality of students themselves, but also because of the poor quality of medical teachers – because teachers would also be eventually coming out of the same lot.
Slippery Slope For Medical Education & Public Health
It is quite clear that, if such steps are implemented, the course of medical education and of public health at large would be put on a very slippery slope until it hits rock bottom.
What can be easily foreseen is that there will be hundreds of thousands of patients who would be forced to undergo substandard treatment at the hands of incompetent doctors leading to rancour and conflicts, including malpractice cases in the courts that are already seeing increasing violence against doctors and medical establishments.
It doesn't take a genius to understand that vested interests are at play. It will not be out of place to mention that a large number of these private medical colleges, where the seats are going vacant and for which the whole exercise has been done, are owned wholly or partially by politicians, many of them sitting MPs or MLAs.
What defies any rational thinking or logic is that the authorities are bent on doing an exercise even when they fully realise the impact on the health of the nation.
Currently NMC is completely under the control of the Central government and has many boards and committees constituted by nominated members. None of them is elected. Therefore, it ceases to be an autonomous body.
Doctors are the only professionals who are being governed and regulated by a nominated body.
If the standard of medical education is to be restored, some power and authority will have to be vested in an independent thinking autonomous body.
Unfortunately, as the adage goes, if “wishes were horses, beggars would ride.”
(Dr Ashwini Setya is the Adjunct Professor in Gastroenterology, ESIC Medical College, Faridabad, and Senior Consultant with Medanta Institute of Digestive & Hepatobiliary Sciences, New Delhi. Dr Setya is also an advisor and consultant in Medical Law and Ethics. He can be reached at firstname.lastname@example.org. This is an opinion piece, and the views expressed are the author's own. The Quint neither endorses nor is responsible for them.)