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In a bid to save livelihood of thousands of non-medical teachers and students who are pursuing medical M.Sc or Ph.D courses, the Union health and family welfare ministry has decided to reach out to National Medical Commission (NMC), asking it to reconsider implementation of new regulations which has reduced permissible percentage of non-medical teachers in anatomy, physiology and biochemistry departments of medical colleges to 15 per cent. The regulations have done away with the requirement of non-medical teachers in pharmacology and microbiology departments.
The non-medical teachers having medical M.Sc/Ph.D qualifications teach Anatomy, Physiology, Biochemistry subjects to MBBS students in the first year and Pharmacology and Microbiology subjects in second year.
The health ministry’s move came after the National M.Sc Medical Teachers' Association (NMMTA), an association of postgraduates possessing medical M.Sc/Ph.D qualifications, reached out to health secretary Rajesh Bhushan recently seeking roll back of NMC’s new regulations.
The NMC had on October 28, 2020 issued notification regarding implementation of “Minimum Requirements for Annual MBBS Admissions Regulations, 2020” for medical colleges having 50/100/150/200/250 MBBS seats.
These regulations will be applicable for medical colleges being established from academic session 2021-22 or medical colleges seeking permission for an increase in intake capacity from academic session 2020-21.
Every medical college and medical institution approved for MBBS admissions annually has 16 departments including anatomy, physiology, biochemistry, pathology, microbiology, pharmacology, forensic medicine & toxicology, community medicine, general medicine, paediatrics, psychiatry, dermatology, respiratory medicine, general surgery, orthopaedics and radio-diagnosis.
As per the regulations, in departments of Anatomy, Physiology, Biochemistry, non-medical teachers may be appointed to the extent of 15% of the total number of posts in the department subject to non-availability of medical teachers.
Earlier in 2018, Medical Council of India (MCI) had proposed to reduce and subsequently halt the appointment of non-medical teachers. Due to intensive protest from NMMTA, this proposal was shelved.
When NMC replaced the MCI, it adopted the MCI guidelines retaining the same percentage of non-medical teachers, but sought feedback from the stakeholders within a week.
Following feedback, NMC amended its guidelines reducing the permissible percentage of non-medical teachers to 15% in Anatomy, Physiology & Biochemistry departments and doing away with the requirement of non-medical teachers in Pharmacology and Microbiology departments.
Though NMC insists that the non-medical faculty who are already in employment in recognized colleges or in various stages of recognition will not be affected by the implementation of new regulations, there are already reports of terminations of non-medical teachers in colleges where these regulations don’t apply, said Dr Sridhar Rao, president of NMMTA.
Besides this, the NMC regulations have made it impossible for the non-medical teachers to seek new teaching jobs in both old and new colleges. NMC has advised that new appointments, whether for new or old colleges shall be based on its new amended regulations. A non-medical teacher will now be forced to remain in the same medical college and all opportunities to shift jobs are closed, said Dr Rao.
Therefore, once removed from a job or forced to resign, there are absolutely no job avenues left. Being forced to remain in the same job, the employers now have the liberty to abuse them, deny them promotions, salary increments, examinership roles etc, he added.
Also, the new guidelines would apply to an old medical college if it seeks to increase student admission. In such a case, colleges would terminate existing non-medical teachers or won’t regularize the current teachers serving in probationary period.
While those with qualifications in Anatomy, Physiology and Biochemistry have at least 15% chance, those in Pharmacology and Microbiology have zero chances. Many non-medical teachers are now in their middle-ages. At this stage, it is impossible to change the field of career, having spent years to decades in this profession, stated NMMTA president.
There are 3,000-4,000 students currently pursuing medical M.Sc courses in 35 medical colleges in the country. Their career stands destroyed even before it begins, he claimed.
Taking exception to the points being used against non-medical teachers such as increased availability of medical teachers and introduction of new competency based medical curriculum (CBME), Dr Rao said “While there is no doubt that more numbers of non-clinical doctors are now available for the role of teachers, the vacancies still exist. Many positions are still going vacant for the want of medical teachers, which could have otherwise been filled by the scientist teachers. These conditions force the colleges to deprive the students of teachers rather than appoint non-medical teachers. Currently, several colleges are managing with non-medical teachers due to shortage of medical teachers. For the last few years many PG seats in the non-clinical specialties are going vacant, hence the shortage of medical teachers is likely to continue for several years.”
He further said the CBME involves early clinical exposure and integration (horizontal and vertical) with other non-clinical and clinical subjects right from the first year of the MBBS course. It is claimed that only medical teachers have exposure to patients during their own MBBS course, they are better equipped to deal with the new curriculum. While medical teachers can certainly do well, we believe that it is not essential. Only 20% of the syllabus has integrations; there are several chapters that don't need integration at all. All medical or non-medical teachers are supposed to undertake Curriculum Implementation Support Programme (CISP), Revised Basic Medical Education as well as Attitude, Ethics & Communication (AETCOM) training. In fact, most non-medical teachers have already undertaken these training programs. A non-medical teacher can always seek the help of medical teachers of other specialties to fill the gap. In any case, the 30% limit means only 1-2 non-medical teachers are present in the department whereas the rest (70%) teachers are doctors, who should be able to compensate for the shortcomings, if any.
Non-medical teachers should be an integral component in both medical teaching and diagnostics, as is practiced in many parts of the world. Instead of supporting, upgrading them, or utilizing them better, the NMC has gone for their exclusion. This certainly is a flawed move, he rued.
The prejudiced position of the NMC is arbitrarily depriving the medical students of qualified teachers. Possession of a certain qualification isn't a guarantee of competency and its absence doesn't indicate incompetency. It is a fallacy to assume that the quality of medical education can be improved by purging the scientists. In fact, 21% of teachers (including clinical disciplines) in the US medical colleges are scientists. In the top 10 global medical colleges, scientists account for 70-80% of teachers in the non-clinical disciplines. There are good and poor teachers with either degrees. Instead of relying purely on the nomenclature of the academic qualifications, stress must be on the skill and competencies of the teachers. Let the medical education get the best of both; let teachers be selected purely on merit.
Given the poor patient-doctor ratio, India needs more doctors engaged in direct healthcare. Currently, thousands of "non-clinical" doctors are engaged in academics without contributing to direct healthcare. In many western countries, there are no postgraduate courses for the doctors in the non-clinical disciplines; in such countries, doctors attend to patients whereas academics and research are mainly handled by scientists. This is a policy that India too must consider.
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