National Medical Commission starts its innings on a wrong foot

The National Medical Commission, which replaced the tainted Medical Council of India, has already courted controversy in its first innings. In its recent gazetted notification titled Minimum Requirements for Annual M.B.B.S. Admissions Regulations, 2020, the percentage of non-medical teachers in the three pre-clinical specialties of Anatomy, Biochemistry, and Physiology have been halved from 30 to 15% whereas the non-medical teachers have been completely eliminated from the para-clinical specialties of Pharmacology and Microbiology. The non-medical teachers, who are scientists with medical M.Sc/Ph.D. qualifications in these specialties are agitated by this decision. The NMC was expected to adopt the guidelines from the erstwhile MCI.

“The appointment of non-medical teachers to teach the non-clinical subjects is neither new nor unique to India”, said Dr. Shridhar Rao, President of the National M.Sc Medical Teachers’ Association (NMMTA). “It is a widespread practice across several countries to employ scientists as teachers in medical colleges.   The scientists’ community feels that the government must have a nuanced policy on the utility and conduct of Medical M.Sc courses with the formation of a council to regulate the courses and register the members providing professional services in diagnostic laboratories.

The first draft guidelines were the adoption of the MCI’s guidelines, which had stated, “In the department of Anatomy, Physiology, Pharmacology, and Microbiology, non-medical teachers may be appointed to the extent of 30% of the total number of posts in the department. However, in the department of Biochemistry, non-medical teachers may be appointed to the extent of 50% of the total number of posts in the department”. The NMC sought feedback from the stakeholders over its proposed guidelines. The non-medical teachers have been taken by surprise over the U-turn taken by the NMC. Some sections of the medical teachers have been clamoring for the elimination of the scientists from the medical colleges. The contributing factors attributed to this change are competition for teaching jobs and the introduction of the new competency based curriculum.

The appointment of non-medical teachers in the medical colleges dates back to the 1960s, when the Mudaliar committee recommended opening up M.Sc courses to the science graduates so as to create teachers for teaching medical students in the non-clinical subjects. The MCI regulated these courses and used to accord permission to the medical colleges to start these courses. Over time, MCI abandoned regulating these courses and their mention went missing from the First Schedule of the IMC Act of 1956.

At some point in time around 95 medical colleges used to run these courses; now only 35 do so. Medical M.Sc courses are conducted in the medical colleges based on the same curriculum and syllabus as those of MD courses in the non-clinical subjects. With more and more doctors pursuing MD courses in these non-clinical specialties, the competition for jobs has heated up and therefore the demands to halt the appointment of scientists. Despite this, there are still vacancies for teachers in several medical colleges across India, especially the newly established ones and the ones located in hilly, remote, and rural areas. In such medical colleges, the bulk of the teaching and diagnostic works (including COVID19 testing) are undertaken by the scientist teachers.

The gazetted document clearly states that the guidelines would be applicable for medical colleges being established from the academic session 2021-22 onwards. Despite this, there is fear and uncertainty among the community of non-medical teachers as they fear that these guidelines would be illegally extended to the existing medical colleges.

There is no clarity from the NMC over its application. Although the MCI collected data of every teacher from all the affiliated medical colleges, it has no data on the number of non-medical teachers. It is estimated that there could be 4000-5000 non-medical teachers working under the designations ranging from Professors & HOD to Tutors. At the same time, thousands of students are pursuing medical M.Sc courses hoping to get employed in medical colleges. With the implementation of these guidelines, they have lost a major employment opportunity. While these amended guidelines have brought cheers to a section of the non-clinical doctors, it has created ripples in the scientists’ communities.

In some top medical schools of the West, 50-60% of teachers are scientists”, he added. “Medical M.Sc courses are not only similar to the MD courses, but the students of Medical M.Sc courses study human anatomy, physiology, and biochemistry in addition just as the first year MBBS students do. We are not laypersons as it is projected to be. Although our graduate degrees are different, our postgraduate degrees are similar and our practice is based on our postgraduate teaching. We are wrongly called non-medical teachers; we have been awarded Medical M.Sc degrees under the faculty of Medicine by the health universities”, said Arjun Maitra, Secretary, NMMTA.

“Like our medical colleagues, we too have undergone the mandatory training on the implementation of the new competency-based curriculum and we are capable and confident of imparting the teaching as envisaged by the NMC” stated Dr. Shridhar. “Instead of shunting us out, there must be more efforts to train and integrate us. We can consult the clinical colleagues for inputs on the horizontal and vertical integrations”, he added.

This controversy is not new. In 2018, the MCI made a proposal to halve and halt the appointment of non-medical teachers. The board of governors had junked this proposal bringing relief to thousands of scientists. But this bogey has come back to haunt them. The scientists feel that despite being in the system for several decades, their voices are not heard.

“We never had a representation in the MCI, nor do we have one in the NMC. We are a minority but there are no checks in place to protect the interests of the minorities. Our pleas are often ignored and we are treated as non-existing entities”, stated Maitra. “Any scientific discipline grows when different backgrounds contribute. It would be in the best interest of medical education to have faculties from diverse backgrounds. Let the system have the best of both”, added Dr. Rao.

“We request the government to take note of our precarious position, safeguard our interests and provide us justice by reinstating the previous MCI norms”, said Dr. Rao with optimism.

To an unstarred question posed in the Lok Sabha in 2018, “whether thousands of non-medical teachers who are already working in medical colleges are facing any threat to their jobs”, Ashwini Kumar Choubey, the minister of state in the Ministry of Health and Family Welfare had replied, “does not arise”. The scientists’ community wonders if the ministry intends to remain true to its words.

MB Bureau

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