A new competency based curriculum for MBBS will be introduced from 2019-20

A new competency-based curriculum for MBBS will be introduced from 2019-20, informs Arun Singhal, Joint Secretary, MoHFW, in an interaction. He further highlights about the advantages of NEXT, NEET and NMC

Many state government and student authorities of the Medical Council of India (MCI) are not convinced by NEXT (National Exit Test). What are your views on this issue?

The concern of students over a licentiate exam at the end of five and half years of study is understandable. However, the need for a licentiate exam was felt to ensure quality of medical doctors graduating from medical colleges and to move to outcome-based monitoring of medical colleges rather than process-oriented monitoring. This licentiate exam will also be taken by foreign medical graduates. Thus, the licentiate exam will become a single window examination for medical graduates with degrees from foreign universities to study and practice further in India.

Many medical students and parents complain that graduating as a doctor is probably one of the most time-consuming courses. As already five and a half years goes in completing a degree. Two years in MD or MS and another couple of years on DM/ MCh.

Medicine is a vast field of study and the profession of medical doctors is one of great responsibility. The curricula of medical courses, both undergraduate and post-graduate, have been designed by experts under the aegis of Medical Council of India (MCI) and the duration of courses has been set to comprehensively educate and train individuals aspiring to practice medicine.

The Government of India is going to introduce a new curriculum for MBBS this year with a much higher focus on skills and competencies. The intention is to produce MBBS doctors who can provide primary treatment for all major ailments as far as possible, so that there is space for MBBS doctors to contribute effectively towards healthcare in the country. This curriculum is of crucial importance in the context of timing of the licentiate exam. There is a school of thought that the licentiate exam, which would have theory and skills components, can now be held after four and a half years of the MBBS programme, so that students can focus on acquiring practical knowledge during their internship rather than spending time on coaching for NEET-PG or licentiate exam. The final view in this regard would of course be taken by National Medical Commission after its formation.

Can you elaborate on the benefits of the NEET exam and why certain states like Tamil Nadu is opposing it?

It is the first time that a uniform entrance examination has been implemented over the entire country including private colleges and deemed universities in any sphere of higher education. Medical aspirants now do not need to take multiple exams for admission to graduate medical courses. NEET has also led to curbing of corruption surrounding admission to undergraduate level courses by putting in place a transparent examination and counselling process. All states, including Tamil Nadu, have now successfully introduced NEET.

How will National Medical Commission Transform medical education in India? How will the proposed National Medical Commission prove to be more effective than the existing Medical Council of India? How will it curb corruption in medical education?

A rigorous and independent selection of members through a transparent process will ensure greater accountability. It is meant to put an end to the oppressive regime of inspections carried out by MCI and spur investment in the medical education sector by simplifying procedures and focusing on outcomes instead. It is not in any way meant to inconvenience students, but to facilitate provision of better quality of education to more and more students at reasonable fees.

Many public health workers inform that cost of medical education may increase if the government has limited control on the fees that colleges can charge medical students?

There was absolutely no provision of regulation of fees in the IMC Act. Regulation of fees of 40 per cent seats is definitely a step in the right direction. The proportion of regulated seats has a direct impact on the fees of remaining seats and a reasonable balance has to be struck so that the fees of unregulated seats do not become unviable.

Allowing traditional medicine practitioners into allopathy has triggered a major debate. Do you think it is a good move? Reasons.

There is a shortage of allopathic doctors in the country. They are indispensable as far as tertiary and secondary level care is concerned. However, at the primary and preventive care level, routine ailments can be handled by individuals with shorter duration courses or courses with alternate specialisations, as they already possess basic knowledge of medicine and, in many cases, are already providing care at the primary level. The proposal is to allow limited powers of prescribing allopathic medicines after undergoing a scientifically-designed bridge course.

When we talk about higher education in pharmacy many students opt to go abroad like Ireland, China, Malaysia and the US. Is there not enough opportunity here in India? The dual control of pharmacy education by Pharmacy Council of India and All India Council for Technical Education has been a issue for a long time and it is affecting quality and prospects of pharmacy professionals for some time now. Your comments.

We have a reasonable numbers of pharmacists in the country. The demographic dividend available to us provide huge opportunities to fulfill demand of allied health professionals all over the world.

Is there any specialised course in nursing, which is on anvil, many nurses urge that introduction of M.Sc in Critical Care Nursing and inform that it will help to upgrade the nursing practice and integrate nursing education with bedside practice. Do you think hospitals should also go in for Nursing Excellence Accreditation by NABH which will improve overall standards? Your comments.

A two-year post graduate residency programme titled the Nurse Practitioner in Critical Care (NPCC) programme has been launched by the Ministry of Health & Family Welfare in 2017-18 with an aim to prepare registered B.Sc nurses for advanced practice with specialised competencies/ skills to function as expert nurses. These specialised nurses will function in ICUs as trained and empowered human resources to provide safe, competent and cost effective critical care.

Establishment of accreditation processes always result in improvement in quality. Any step that envisions improvement in quality of care would always be encouraged.

Overall how do you see the medical education in India? Can we, as a nation, take lessons from other countries on a particular model for medical education?

India is a unique democracy with its own advantages and challenges. The field of medical education in India has seen revolutionary changes in recent times. From multiple, time consuming, entrance examinations for admission to undergraduate medical courses, we have now moved to one single entrance examination, which is a first-of-its-kind step in the country. A new, competency-based curriculum for MBBS is being introduced from 2019-20 onwards. Medical education cannot be seen in isolation with factors like service delivery conditions, infrastructural capabilities of the states and, to some extent, political will. Policy-making, therefore, has to be a dynamic process, especially in a country like India, where regional variations have to be accounted for while setting standards and laying down guidelines at the Centre. As a nation, we need to utilise the most feasible and practical models based on learnings from different experiences around the world.

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