India’s medical education regulators have rejected applications from 170 medical colleges and teaching hospitals, including some in Bihar, to start postgraduate seats.
The Medical Council of India (MCI) has cited faculty problems, poor infrastructure, and — in a few cases — inflated patient numbers.
An MCI committee on PG education has rejected the applications for 440 courses among the cumulative count of over 800 courses that the medical colleges had proposed to start from the academic year 2014-15, council documents show.
The panel’s decisions, based on inspections of medical colleges, reflect the challenge India faces in efforts to expand the number of PG medical seats and reveal how many medical colleges without the required infrastructure or patient-loads are scrambling to add PG seats.
India’s 381 medical colleges currently offer about 50,000 undergraduate MBBS seats, and those who graduate can compete for 24,242 seats for PG courses leading to MD or MS degrees in a specific field — from cardiology to surgery to paediatrics, among other branches of medicine.
“Almost every student who completes MBBS wants to do a PG course — there is a huge demand,” said Siri Bhagwan Siwach, chairman of the MCI’s panel on PG education. “But medical colleges should scrutinise the requirements to be met by them before they apply to take more students,” Siwach told The Telegraph.
While the panel has approved more than 265 proposals for new PG courses or for extra seats in existing PG courses, it turned down 440 applications for new PG courses. Had all the applications been approved, several hundreds of additional seats would have opened up for PG courses this year. The colleges whose proposals have been rejected have the option of trying to improve their deficiencies and approach the MCI again for a future academic year.
The panel, for example, rejected proposals by the Nalanda Medical College, Patna, Jawaharlal Nehru Medical College, Bhagalpur, Katihar Medical College, Katihar, and the Narayan Medical College, Sasaram, to start various PG courses. The panel has turned down the Nalanda Medical College’s proposal for a PG course in pathology and applications from the Jawaharlal Nehru Medical College to start PG courses in anaesthesia, biochemistry, community medicine, dermatology, and pathology.
While the MCI panel has approved MD in psychiatry at the Katihar college, it turned down its proposals to increase PG seats in dermatology, general surgery, and radiology. It also approved a PG course in anatomy at the Narayan Medical College, but rejected its plans for PG courses in biochemistry, community medicine, forensic science, and pharmacology.
The panel has also approved a PG course in radio-diagnosis at Burdwan Medical College in Bengal, approving an intake of four students in 2014-15. It has also allowed the college to increase its PG seats in psychiatry, community medicine, and obstetrics and gynaecology.
The rejected applications had come from medical colleges across the country — Ajmer, Bangalore, Chennai, Navi Mumbai, Patna, Puducherry, Rohtak [Haryana], among other cities. “The colleges are competing to add PG seats in an environment of huge deficiencies,” said K. Michael Shyamprasad, a cardiothoracic surgeon in Chennai who was a former member of a government task force on medical education, but is not connected with the MCI.
A member of the MCI panel told The Telegraph that some of the inspection reports the panel has used to take decisions on PG courses suggest that a few medical colleges have tried to inflate the numbers of the patients they manage.
“A large patient load is very important in PG training,” the panel member said.
An inspection report on the Kalinga Institute of Medical Sciences, Bhubaneswar, for instance, suggests that 27 of the 95 admitted children in the hospital had mild symptoms of illnesses that did not require hospitalisation and that the college was inflating out-patient attendance figures.
The misleading claims aren’t restricted to private colleges. A government medical college in Anantapur (Andhra Pradesh) that had applied to start a PG course in orthopaedics claimed it was handling six to seven operations a day although the average was one operation.
Many colleges had shortages of faculty and resident doctors. Under the MCI requirements, a professor is allowed to take two PG students, and an associate professor can take one student. The panel also noted that some senior faculty had postgraduate degrees that were “not recognised”.
“It’ll be difficult to tackle the faculty shortage issue,” said Abhay Shukla, a physician and public health specialist with Sathi-Cehat, a non-government agency in Pune. “As long as we have senior, experienced faculty leaving teaching hospitals for the private healthcare sector.”
Many applications for PG courses are yet to be assessed, but the approvals so far will mean extra seats this year in many colleges. The Index Medical College, Indore, for example, can take seven students this year for PG in general surgery. Burdwan Medical College can increase its PG seats in obstetrics and gynaecology from six to 10 students. The Indira Gandhi Institute for Child Health, Bangalore, can raise its PG paediatrics seats from six to nine.