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How Medical Council of India is putting healthcare on life support

Intimidating doctors and stalling creativity by setting obsolete guidelines cannot be the way forward.

 |  4-minute read |   14-03-2016
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The Indian Medical Council Act, 1956 was constituted as an Act of Parliament through which the Medical Council of India came into existence. Education and training is the main agenda for the World Health Organisation's (WHO) Global Strategy on Human Resources for Health.

However, the doctor-patient ratio in India is far below normal, as expected, and it is the duty of the Medical Council of India (MCI), as an autonomous institution, to address this urgent crisis.

This week, the parliamentary standing committee on healthcare pulled up the MCI for failing in its mission to impart quality medical education and for being corrupt. The parliamentary committee was constituted on September 1, 2015 to review the functioning of the health department and it tabled its findings in the Rajya Sabha, stating that the MCI has been violating ethics while providing licences to the country's medical colleges.

MCI inspectors and inspections

Going by observations and estimates, there is a good number of inspectors engaged by the MCI who give reports based on their whims and fancies putting the lives of struggling medical students at great risk. The MCI has not been able to pull up such inspectors and they have enjoyed a free hand throughout.

Private medical colleges in India with visionary zeal are often discouraged and threatened of de-regulation if they do not listen to what the inspectors' demands are. The WHO and World Medical Association should set up a panel to look into the way medical education in India is being regulated and social accountability of medical schools should be emphasised. The UN offices should table the matter for discussion with India's parliamentarians and the Central government to reboot the structure.

A perpetual problem of the MCI has been headcount during inspections. On one hand, the world of academia and WHO speaks about innovations in medical education and on the other hand, faculties and residents are not permitted to go for academic deliberations, stakeholder meetings and government programmes if the MCI inspector is likely to come.

This is not only unconstitutional but also against Article 21 of the Constitution which guarantees personal liberty. This calls for deeper reflection. We cannot run regulatory councils of the 21st century with 20th century guidelines. Medical education in India is going through rapid transition and the way digitalisation is taking place with medical robotics, video consultations, webinars and video conferencing, we need to reform the structure for the new age.

Involvement of young doctors in the council

Involving young doctors as part of the council should be considered given the kind of perspectives that is likely to bring in and for the kind of future it can generate for healthcare. The MCI should come up with a young doctors' leadership summit every six months and think tanks should be created.

India faces a herculean challenge with a likelihood of becoming the diabetes capital of the world by 2025, losing two per cent of the GDP owing to humanitarian disasters, a rapid increase in cancer, chronic kidney diseases and traffic injuries, and the burden of malaria and tuberculosis in the segment of communicable diseases. How does the council intend to prepare its doctors for the future? There is no road map for this and if anything exists, it is on paper.

A more refined outlook

The MCI will need to broaden its outlook and open up to the society. Intimidating doctors and stalling creativity by setting obsolete guidelines cannot be the way forward. Modernisation may well mean using apps to reach out to patients. Bedside diagnosis is now on the decline and soon might be history with the advent of cloud storage data, and mobile apps may also scan the body in the future. Will the MCI rise to the occasion?

I would welcome the move by the parliamentary standing committee to reboot the MCI and a new draft should be introduced for engaging with young doctors, on whose shoulders rests the future of healthcare in India. It must be remembered that other nations look at India as a medical tourism hub.

"The situation has gone far beyond the point where incremental tweaking of the existing system or a piecemeal approach can give the contemplated dividends. That is why the committee is convinced that the MCI cannot be remedied according to the existing provisions of the Indian Medical Council Act, 1956, which is certainly outdated," the parliamentary committee stated.

There is hope that people are willing to shed their indifferent attitude and move on the path of encouragement which the people of India and the doctors of India rightfully deserve. Let truth triumph and may India rise to the occasion as far as healing is concerned.

Writer

Edmond Fernandes Edmond Fernandes @edmondfernandes

Dr Edmond Fernandes is CEO, Centre for Health and Development, Mangaluru, Karnataka.

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