Medical education and research: India
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[http://epaperbeta.timesofindia.com//Article.aspx?eid=31808&articlexml=Admissions-to-PG-medical-courses-only-on-merit-13012015013028 ''The Times of India''], Jan 13 2015 | [http://epaperbeta.timesofindia.com//Article.aspx?eid=31808&articlexml=Admissions-to-PG-medical-courses-only-on-merit-13012015013028 ''The Times of India''], Jan 13 2015 | ||
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The court said the method, however, was given a go-by by the impugned legislation when it provided that in-service candidates seeking admission in the quota shall be granted such admission not on the basis of one of the methodologies but on the basis of seniority of such candidates. | The court said the method, however, was given a go-by by the impugned legislation when it provided that in-service candidates seeking admission in the quota shall be granted such admission not on the basis of one of the methodologies but on the basis of seniority of such candidates. | ||
| + | ==50% institutional preference for PG medical seats== | ||
| + | [http://epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=BHU-AMU-stand-together-against-med-quota-order-06062017012057 Dhananjay Mahapatra |BHU, AMU stand together against med quota order |Jun 06 2017 | The Times of India (Delhi)] | ||
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| + | Banaras Hindu University (BHU) and Aligarh Muslim Univesrity (AMU) will stand together on the same side in the Supreme Court to challenge an Allahabad High Court order doing away with 50% institutional preference in admission to PG medical seats. | ||
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| + | BHU and AMU, both central universities, are relying on the Supreme Court's 2003 judgement in the ''' Saurabh Chaudri case ''' laying down the guidelines for filling up of PG medical college seats in government colleges. The SC had held that 50% of the seats would be reserved for all-India quota to be filled through a common entrance test. The government medical colleges could give preference to candidates from their own institution to fill the balance 50% seats in post-graduation courses. | ||
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| + | On a PIL, without making the BHU or AMU a party, the HC had opened the 50% institutional quota seats in PG medical courses in these two central universities for students from any medical college in UP based on their ranking in National Eligibility cum Entrance Test (NEET). | ||
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| + | “The implication of the HC order is that the admissions to the MD, MS and MDS courses in BHU as well as AMU, which has already been finalised and completed for the year 2017, has been rendered void. The HC did not offer any opportunity to the petitioner university to establish justify the validity of 50% quota available to the university under the institutional category,“ the BHU said and sought an interim stay of the HC order. | ||
=Private medical colleges= | =Private medical colleges= | ||
Revision as of 17:17, 7 June 2017
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Medical education: India
Check on your doc before a check-up
Rema Nagarajan TIMES INSIGHT GROUP
The Times of India 2013/07/21
With the Supreme Court striking down the common entrance test for medical colleges, patients face the growing prospect of being treated by doctors whose merit may not have been adequately tested.
With the creation of more and more private medical colleges, many experts fear students will increasingly buy their way into becoming doctors from such institutes, many of which are notorious for their lack of teaching and training infrastructure.
These students do not have to face any centralized external exam to get their degrees. Exams are conducted internally, most often by private or socalled deemed universities that run medical colleges.
1 in 5 doctors bought a seat in medical school
Back-of-the-envelope calculations show that about one out of every five doctors passing out each year, or around 8,000, could be those who effectively bought seats in medical colleges. The consequences for public health are fairly obvious.
The ‘management quota’
Going by what is allowed under existing rules, nearly 15% of seats in private medical colleges across the country are in what is called the management quota. This term is widely recognized as a euphemism for seats available to those who can pay for the privilege. Estimates of exactly how much a seat costs vary, but the amount could be Rs 30-90 lakh, depending on the location of the college, its reputation and the timing of the booking.
Currently, over 25,000 seats for medical graduate admission are in private medical colleges compared to just over 20,000 in government colleges. The 15% kept aside for the management quota amounts to 3,750 seats. However, the actual quota is usually way higher than 15%. It could go up to a third of the seats, or in some cases, even over half the seats in a private college. Even a conservative third of the seats being sold as management quota would mean that over 8,000 seats are being sold.
Proxy students take the examinations
In a scam uncovered in Bangalore, it was found that qualified people were employed to write the entrance exams and such proxy students after getting allotment of seats through counselling would surrender the seat leaving it available to the management to allot at its discretion, which it would do in return for as much as Rs 75 lakh to Rs 90 lakh. This, according to several admission agents, is still a common practice.
All the money for booking the seat is collected in black and seats are booked as early as December of the year before the year of admission, way before any entrance exam. Of course, they stipulate that the admission is on the condition that the student gets 50% in class XII.
“With increasing variation in the quality of medical education and the unearthing of seat selling scams, we might need an exam for all medical graduates to test and certify their level of knowledge before they are to allowed to practice — something similar to the exam that foreign medical graduates have to clear to be allowed to practice here. Such a proposal had been made before,” said Dr Bipin Batra, executive director of the National Board of Examinations, which conducts the National Eligibility cum-Entrance Test for postgraduate medical education and the examination for FMGs. On grounds of bridging the shortage of doctors, the Medical Council of India has been approving the creation of more medical colleges and expanding the number of seats.
Medical research
2005-14, neglected state
The Times of India, Apr 21 2016
Study reveals poor state of medical research
Rema Nagarjan
60% Of Institutes Don't Have A Single Publication In 10 Years, Only 4.3% Produced Over 100 A Year
A handful of institutes, a majority of them publi cly-funded, account for the bulk of research output from medical institutions in India. At the other extreme, nearly 60% of institutes did not have a single publication over a decade. Moreover, states that have the largest number of private medical colleges produce very little of research publication.
This was revealed in a study on the research output of all institutions in India during 2005-14 using Scopus, the largest database of peer-reviewed literature. The evaluation done by Dr Samiran Nundy, gastrointestinal surgeon and dean of Ganga Ram Institute of Postgraduate Medical Education and Research, along with two colleagues, looked at 579 institutes recog nised by the Medical Council of India (MCI) and the National Board of Examinations (NBE), which conducts the largest portfolio of examinations in medicine in India.
According to the study published in `Current Medicine Research and Practice', only 25 (4.3%) of the institutions produced more than 100 papers a year and these accounted for 40.3% of the country's total research output.Over 57% or 332 of the medical colleges did not have a single publication during this period while over 90% of NBE-affiliated colleges in Karnataka and Kerala had none.
The annual research output of the Massachusetts General Hospital and Mayo Clinic in the US was over 4,600 and 3,700 respectively.Even the most prolific research institution in India, AIIMS, published less than a third of these numbers. The top 10 medical institutes under MCI were AIIMS, Postgraduate Institute of Medical Education and Research in Chandigarh, Christian Medical College in Vellore, Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, King George Med ical College in Lucknow, Kasturba Medical College in Manipal, Tata Memorial Centre in Mumbai, National Institute of Mental Health and Neurosciences in Bangalore, Institute of Medical Sciences of Banaras Hindu University , and Maulana Azad Medical Col lege in New Delhi. These accounted for 40.8% of the research output from the 579 medical institutions. The top 25 institutes under NBE, all private, contributed just 5.6% .
Overwhelming clinical burden leaving little time for academic activities is often cited as the reason for this state of affairs. “This is belied by the fact that the most prolific Indian publications come from institutions that also deal with the largest numbers of patients. This is also true of many of the world's great hospitals, which along with providing a high standard of patient care are also leaders in publication,“ observed the study .
It said lack of guidance and absence of role models among seniors, who themselves have published little, were major factors as was inadequate institutional support in the form of funds and infrastructure. However, the lack of incentives to do research and publish could be an even more important factor, since most faculty promotions in India are usually time-bound, based on seniority and influenced by political and bureaucratic `contacts', rather than on researching and publishing, the study noted.
The policy of increasing the number of doctors by liberally allowing the creation of new medical institutions, mainly through private funding and enhancing seats has not been an unqualified success with what is generally perceived as a fall in standards of medical education, “which has now become a business venture for many politicians and is accompanied by widespread corruption both in its entry and exit processes“, the study said, while calling for an overhaul of the medical education system.
Tests for admission to medical colleges
National Eligibility cum Entrance Test (NEET)
Binding on private colleges; states to fix eligibility criteria
The Times of India, May 06 2016
AmitAnand Choudhary
No MBBS entrance test by pvt colleges: SC
The Supreme Court ruled out separate entrance tests this year by private medical colleges for admission to MBBSBDS courses but said it would consider the states' plea against implementation of NEET this year on the ground that students were caught unprepared.
The court had on April 28, 2016 made performance in the National Eligibility cum Entrance Test (NEET) the sole criteria for getting admission to government and private medical colleges and said the May 1 AIPMT would be considered as first phase of NEET. But this created confusion as by that time several states had already conducted entrance tests.
With a large number of private medical colleges and governments moving the SC seeking clarifications and modification of the April 28 order, a bench of Justices A R Dave, Shiva Kirti Singh and Adarsh K Goel on Thursday said, “There is no question of permitting examinations by private colleges.“ Tests conducted by states continue to be under the court's consideration.
The court asked the Centre, CBSE and Medical Council of India to suggest ways to accommodate states, which pleaded that they had a statutory obligation to conduct entrance examination for medical colleges run by them.They also said students, particularly from rural areas, would not be able to compete for NEET as they had prepared for state examinations held in vernacular medium. Various states, including J&K, Gujarat, Karnataka, Tamil Nadu, UP, Maharashtra and Andhra Pradesh told the bench that once they had conducted the entrance tests under the law, NEET could not have been imposed on them. Senior advocate Gopal Subramaniam and lawyer Sunil Fernandes, appearing for J&K, said the state enjoyed special status and it had been allowed to hold separate entrance test.
The bench, however, said states were free to fix eligibil ity criteria for admitting students. The Centre, which had earlier supported the states, batted for NEET and told the bench that a common entrance test did not violate state laws. “ Who is to be admitted, what should be the eligibility criteria and reservation criteria are to be decided by the states,“ solicitor general Ranjit Kumar said.
He, however, suggested that many students, who had applied for AIPMT but did not appear, should be allowed to appear in the second phase. The SG also suggested holding a composite test on July 24 .
CBSE counsel Pinky Anand said it was difficult to hold a composite test as the number of students would be huge. Around 6.5 lakh students had taken the May 1 NEET. The court adjourned hearing in the case to Friday .
3 attempts; age limit 25 (unreserved)/ 2017
Hemali Chhapia, Jan 25, 2017: The Times of India
Medical aspirants across India can now only take three shots at the National Eligibility cum Entrance Test (NEET), a cap introduced to discourage the thousands who keep trying their luck at the examination. Also, candidates must fulfil a new age criterion if they wish to sit for the medical and dental exam.
The decision was taken at a University Grants Commission (UGC) meeting on Tuesday in Delhi. The minimum age to appear for NEET is 17 years. The maximum age for open category students is 25 years, and 30 years for the reserved category . To date, there has never been a maximum age defined to take NEET, nor has there been a limit on the number of attempts. “This is a good decision,“ said Dr Pravin Shingare, director at the Maharashtra directorate of medical education and research (DMER).
“There are some students who keep taking the test, and when they don't make the cut, join a BSc college and keep taking the medical entrance test,“ he added. In fact, the rule would also bar the facul ty of coaching classes who keep on attempting the test to understand its altering pattern. The NEET information brochures contain this information and will be distributed soon. “We often find that coaching classes field candidates and sometimes that leads to fraud and cheating,“ said an expert. This cap on age and attempts will force candidates to focus on the field where their capability and passion lie, said medical college principals.
Two years ago, it may be recalled, the All India Pre Medical Test had to be conducted again as it was revealed that 90 answers had been transmitted to the candidates during the ex amination, for a fee of Rs 15 to 20 lakh. The AIPMT-2015 scandal had at least 45 beneficiaries who were supplied with special vests fitted with SIM cards and a bluetooth device, among other equipment, to facilitate the transmission of answers.
While all-India data is unavailable, in Maharashtra, the number of older candidates competing with 17-yearold aspirants has been rising with each passing year. About 12,000 repeat aspirants took the CET in 2007, while in 2008, the number grew to 13,568. According to data collected from the DMER, the oldest candidate was 38 years old and at least another 100 aspirants were in their early 30s.
SC: Only one test
The Times of India, Apr 28 2016
AmitAnand Choudhary
Only 1 test for medical admission from this session itself, rules SC
Even as lakhs of students prepare for entrance examinations conducted by state governments and private colleges for admission into medical colleges, the Supreme Court insisted that multiple tests must give way to the National Eligibility Entrance Test (NEET) for the 2016-17 session.
The test season was to kick off from May 1when CBSE will conduct All India Pre-Medical and Pre-Dental Entrance Test.It will be followed by Maharashtra CET on May 5 and the test conducted by private medical colleges of Karnataka on May 8. Around five other entrance tests are scheduled for the next month, including the one conducted by AIIMS.
NEET, which was declared illegal and unconstitutional by SC in 2013, was restored on April 11after a five-judge Constitution bench recalled the earlier verdict and allowed the Centre and the Medical Council of India (MCI) to implement the common entrance test till the court decides afresh on its validity.
Despite the revival of NE ET, the authorities failed to implement it, forcing NGO Sankalp Charitable Trust to approach SC for enforcing the mechanism for a common test for admission in MBBS, BDS and PG courses in all colleges. New Delhi: The Supreme Court on Wednesday told the government that multiple medical entrance tests must give way to the National Eligibility Entrance Test (NEET) from the 2016-17 session itself.
Advocate Amit Kumar, appearing for the petitioner NGO Sankalp Charitable Trust, told a SC bench of Justices A R Dave, Shiva Kirti Singh and A K Goel that the Centre, MCI and CBSE were dilly-dallying in implementing the court's order on implementing the National Eligibility Entrance Test (NEET), compelling students to appear in as many as 90 entrance exams across the country for admission.
“A student seeking admission in a medical college has to shell out lakhs of rupees in taking an examination and most of the tests are not conducted in a fair manner. There is no impediment in way of implementing NEET after the Constitution bench verdict and the Centre should be directed to enforce the order in association with MCI and CBSE,“ Kumar told the bench.
The bench agreed with his contention and said NEET must be implemented from the coming academic session itself. It directed the Centre, MCI and CBSE to sit together and frame a time-schedule for conducting NEET. It directed them to place before it by Thursday a dateline for the common entrance test. The counsel appearing for the government, MCI and CBSE told the bench that there were “willing and committed“ to hold NEET for 2016-17 and agreed to place the proposed time-schedule on Thursday .
The Constitution bench had said that the controversial judgement of July 2013 by which NEET was quashed needed reconsideration as the “majority verdict“ delivered by then CJI Altamas Kabir did not take into “consideration some binding precedents and more particularly , we find that there was no discussion among the members of the bench before pronouncement of the judgement“.
Lakhs of students appear for various medical entrance examinations in more than 400 colleges and there are more than 52,000 seats available for MBBS courses. After the scrapping of NEET, states and private colleges have been conducting exams separately for the last three years.
Failing CET, but getting govt medical college
The Times of India, Apr 07 2016
Rema Nagarajan
Didn't get admission in to the best government medical college in yo ur state? Not even the bottom-rung ones? Don't worry .Your best bet may be to buy a seat in the worst private medical college in the state and pray it doesn't get permission to admit students in the coming years. If that happens, you can go to court and the state government may be ordered to accommodate you in the very colleges you could not get into.
That may sound like a bizarre strategy , but it is exact zarre strategy, but it is exactly what has been happening in many states. Several private colleges have failed to get permission to admit students after the first, second or third batch. Then the regular pattern of petitioning courts and getting accommodated in government colleges plays out.
An analysis of data on student intake allowed per college, available from 2011, showed that around 42 colleges across the country , almost all private, were barred from admitting students for a year or more in this period, in some cases since the first batch was taken in.
How can a medical colle ge given permission, and allowed to admit students one year, be found deficient subsequently and barred from intake? This is because the Medical Council of India (MCI) allows any trust, society or company to start a medical college, even if it doesn't have the required infrastructure and faculty. Medical Council of India rules need a new medical colle ge to show it has good enough infrastructure for first year MBBS students' requirements and an undertaking that the rest will be put in place.
MCI assessors inspect a new college every year for five years and issue permission for each year.When they fail to stick to their commitments, the regulator cracks down and doesn't allow further intake. This often works to the advantage students, although after a legal battle.
“College managements constantly hustle the authorities to give them permission to start taking in students even when there is almost no infrastructure.With political connections (most trusts are either run by politicians or their family members), they manage to get permission,“ said a medical college professor.
Every year, MCI decides that several colleges, which had received conditional approval and admitted students, are “not approved permitted for intake“ as the institutions do not have infrastructure. Following this, dozens of cases are filed in high courts and the Supreme Court by the management of these colleges and by students or their parents. In 2015, 27 colleges with 3,650 seats were not allowed to admit students.
Of the 10 private medical colleges started in 2014, six (accounting for 900 seats) were not allowed to admit students in 2015. So, what happens to the 900 students admitted in 2014 after paying lakhs as capitation fee? “When denied permission, college managements tell students and their parents to go to court and seek relief if they don't want their investment to go to waste,“ explained a lawyer.
SC: Age no bar on upper age limit
AmitAnand Choudhary, Age no bar to become a doctor: SC, April 1, 2017: The Times of India
25-Yr Age Cap For Taking NEET Erased
All aspiring medical students can now appear for NEET in 2017 irrespective of age as the Supreme Court removed the age cap of 25 years fixed by CBSE for taking the entrance examination for MBBS courses.
A bench of Justices Dipak Misra and A M Khanwilkar said the decision taken by CBSE to fix upper age limit on the administrative instruction of Medical Council of India seemed wrong and students should not be barred from appearing in the entrance examination.
The court directed CBSE to open a window till April 5 for those above 25 years to apply for the National Eligibility Entrance Test (NEET) which is scheduled for May 7. The last date for filling up forms was March 1.
The bench agreed with the submission of the aggrieved students who contended that the decision taken by the Board was illegal and unconstitutional as there were no rules or regulations for fixing upper age limit for medical entrance examination. Senior advocates Amrendra Sharan and Indu Mal hotra, appearing for the students, told the bench that about 20,000 candidates got affected due to age restrictions and pleaded the court to allow them to appear for NEET.
“As we, prima facie, find, such an age limit could not have been determined by way of a notice on the basis of the instructions issued by the Medical Council of India. It is appropriate to direct that all the desirous candidates will be allowed to fill up the forms on the online portal of CBSE on or before April 5. Any form submitted beyond April 5 shall not be accepted,“ the bench said. The court asked CBSE to take steps to make arrangements to allow the affected students to appear for the entrance test and provide additional centres to accommodate them.
Centre's omission of Urdu for NEET is bias: Petitioner
A students' organisation told the SC on Friday that the Centre had deliberately left Urdu as a medium to take NEET as the government is “prejudiced and biased“ against Muslims.
Appearing before a bench of Justices Kurian Joseph and R Banumathi, Delhi-based Student Islamic Organisation's counsel Ravindra S Garia contended that the Centre's decision to allow students to take the exam in one of the ten languages -Hindi, English, Gujarati, Marathi, Odiya, Bengali, Tamil, Telegu, Kannada and Assamese -but not in Urdu showed its bias against the minority community .
“It is deliberate and intentional on the part of the health ministry to not include Urdu as a medium for NEET exam because of the discriminatory perception of the government functionaries of viewing the language not as a part of cultural heritage and composite culture of India, but as a language associated with Muslims,“ the organisation said in its affidavit.
Taking strong exception to the allegations, Solicitor general Ranjit Kumar said it was a very serious charge against government as the students' body had termed the Centre as “communal“ and sought the court's permission to file response. The court granted the Centre one week's time to file response .
Colour blindness
SC appoints expert committee to redefine bar
AmitAnand Choudhary, SC: Colour-blind ban for MBBS regressive, Mar 26 2017, The Times of India
Can a student suffering from colour blindness be allowed to pursue medical courses?
The Supreme Court has agreed to consider a plea of two students to open the door of medical colleges for them, saying the present practice of Medical Council of India not permitting colour-blind students to take admission in MBBS courses is regressive and should be done away with.
A bench of Justice Dipak Misra and Justice A M Khanwilkar appointed an expert committee of senior doctors to find out streams in which such students could be allowed. It said students with colour blindness were allowed to study medical courses in many other countries and the rules or guidelines followed in the country needed to be revived to allow such students to pursue co urses where colour blindness might not be a handicap.
“Total exclusion for admission to medical courses without any stipulation in which they really can practise and render assistance would tantamount to regressive thinking. When we conceive of global phenomenon and universal brotherhood, efforts are to be made to be within the said parameters. The march of science, apart from our constitutional warrant and values, commands inclusion and not exclusion,“ the bench said. The court directed Medical Council of India, the apex regula Council of India, the apex regulating body in the field of medical studies and profession, to constitute a committee of experts from genetics, ophthalmology , psychiatry and medical education from AIIMS and PGIMER, Chandigarh, to examine the issue. The court directed that the committee submit its report in three months.
The court passed the order on a plea of two medical students who were denied admission in college after clearing the entrance examination in 2015 as they were suffering from partial colour blindness. They had first approached TripuraHC which had turned down their plea, compelling them to approach the apex court.
Opposing the plea of stu dents, senior advocate Vikas Singh and lawyer Gaurav Sharma, appearing for MCI, contended that the decision to bar colour blind people was taken on the basis of report of an expert committee which held that people with such handicap would not be able to perform their duty as a doctor. They said a doctor would not be able to do fair diagnosis and prognosis of a disease as it depended upon colour detection Senior advocate K V Vishwanathan, who was asked to assist the court in deciding the issue, said a colour blind person may face difficulty in the stream of pathology , surgery, skin and general medicine but could efficiently perform in the field of psychiatry, social and preventive medicine. He said a complete ban on the admission to MBBS course would be violative of constitutional principle of equal opportunity and fair treatment.
Neglected medical education
1 govt med college seat for 55k people
Massive Shortage Of Seats Allows Private Sector To Jack Up Education Cost
Rema Nagarajan | TIG
The Times of India 2013/08/12
Shortage of doctors
The shortage of doctors in India can be blamed on the government neglecting medical education for three decades from 1970 till 2000. In a 15-year period from 1951 to 1966, sustained investment in medical education led to India having one medical seat in a government college for roughly every 37,000 persons, down from one for every 71,000 in 1951.
Over the 47 years since then, the situation has worsened dramatically with one government medical college seat for over 55,000 today. This has resulted in the private sector taking over medical education in a big way. That, in turn, has meant spiralling costs, question marks over quality and a sharp geographical skew. Even with the private sector included, India now has one MBBS seat for every 26,042 people, only a small improvement from one for every 33,521 in 1966. In contrast, the period from 1951 to 1966 had seen the ratio cut by more than half.
A look at the data on medical seats and colleges available with the Medical Council of India (MCI), the regulator for medical education and doctors, shows that the availability of medical seats has improved in recent years. Almost half (47%) of the available seats have been created since 2000. However, 72% of the seats added since 1970 are in the private sector.
Why should this be a matter of concern? There are several good reasons for this to be cause for worry. For starters, private medical education is expensive making it inaccessible for most Indians. In private colleges, the cost of graduating is Rs 15 lakh-40 lakh or more, not including capitation fees. In a government college, it ranges from a mere Rs 10,000 as tuition fee in Delhi’s Maulana Azad Medical College for the entire MBBS course to about Rs 1.5 lakh in Trivandrum Medical College, one of the more expensive government medical colleges.
The quality of education in private medical colleges, too, has been a matter of great concern as they are less transparent and have proved difficult to regulate. The fact that many are owned by political heavyweights does not help.
The lost states, the lost decades
The private sector has also led to a geographical skew in the distribution of seats. Over half the private sector seats are concentrated in just four states—Karnataka, Tamil Nadu, Andhra and Kerala—though they account for just 21% of India’s population. In Karnataka, for every government seat, there are almost four private medical seats, while in Kerala there are two private seats for every government seat. However, in the poorer states like Bihar, UP, West Bengal, Rajasthan, Assam, Jharkhand, Chhattisgarh, and in the northeast, medical education remains largely dependent on government medical colleges. In most of these states, no new government medical colleges were created for decades between 1960s and 2000. In over two decades following Independence, the government created 69 medical colleges with over 8,500 seats. This was followed by three decades (1970-99) of utter neglect, when the population almost doubled from 548 million to over a billion, while the government added barely 2,000 more medical seats. The surge of the private sector started in the 80s as government investment in medical education declined drastically, but it has accelerated since the turn of the century.
After the government woke up to the crisis in medical education and took steps to increase government investment and also relaxed the norms for running a medical college, there has been a surge in the number of medical colleges, both public and private, especially in the last three years.
Aformer member of the Board of Governors of the MCI, Dr Ranjit Roychoudhury, had this to say: “We lost three decades starting from the 70s. The government stepped back from medical education thinking that the private sector would be able to fill in. At the time, the problems of private medical education were not envisaged, such as the question of inequity, quality of education and the geographical skew. We are now trying to rectify this problem.”
2000-2013
Since 2000, the government has created 9,300 medical seats, almost as many as it did in half a century from 1950 till 2000. But the 9,300 seems a pittance compared to the 17,700-plus private sector seats created in the same period. Almost 60% of the latter were in four southern states. In 2013, for the first time since 1975, the government has created more medical seats than in the private sector. In 2013, Centre created 1,300 seats in 14 new colleges. Another 3,013 have been added to existing colleges. Thus, in just this year, the government has created twice as many seats as it did in 30 years from 1970 to 2000. Is the trend finally changing for the better? Let’s hope so.
Foreign educated Indian doctors (FEIDs)
2012-14: Indian doctors with foreign medical degrees
The Times of India, Nov 06 2015
Sushmi Dey
China beats all to be biggest doctor factory for Indians Not just Chinese consumer products, India also receives thousands of “made in China“ doctors. China is today the largest contributor of MBBS doctors to India followed by Russia, Ukraine and Nepal, according to data collated by the National Board of Examinations, which conducts Foreign Medical Graduate Examination (FMGE) screening tests. The FMGE is a voluntary entrance test introduced in 2002 as a qualifying exam for Indian students holding medical degrees from other countries and intending to practice medicine in India. The Medical Council of India (MCI) recognises this exam.
As many as 11,825 Indian students, who have Chinese MBBS degrees, took the FMGE test during 2012-2014, while 5,950 were from schools in Russia and 3,163 in Nepal. The rush for foreign destinations, experts say , is fuelled by those who fail to get admissions in Indian colleges. Of over 5 lakh Indian MBBS aspirants each year, about 4,500 get seats in government colleges.
While UK, Germany and Singapore attract candidates, the numbers are comparatively smaller than those who go to China and Nepal for European institutes are costlier. The number of doctors who train in countries like China and Russia has risen sharply in recent years, but they must clear the Foreign Medical Graduate Examination (FMGE) for provisional or permanent registration with Medical Council of India or any state medical council. There's an impression, however, that the calibre of doctors who train in these countries isn't on a par with those qualifying from Indian institutions.
The National Board of Examinations that conducts the FMGE ranks foreign universities or medical institutes on their candidates' performance in the screening test. While the government plans to increase PG seats in some super-specialty departments in a few key institutes, including AIIMS, there are no such plans for basic MBBS course.
2012-16: Poor ‘pass percentage’
The Times of India Jan 04 2016
The pass % of foreign medical degree holders in the screening test for recognition of their degrees in India is steadily declining. Student bodies complain about deliberately set tough questions to discriminate them against students from Indian universities.The examination bodies say that pass % is going down because of the increasing number of repeaters
2014-16: Poor performance in screening tests in India
The Times of India, May 25 2016
Pushpa Narayan
Statistics show students with medical degrees from foreign countries are finding it increasingly difficult to pass the screening test that allows them to practice in India.
The number of students taking the test has doubled but the pass percentage dropped from 50.12 in 2005 to 10.7 in 2015. In this period, the pass rate fluctuated around 20%, dropping to an all-time low of 4.93% in June 2014, when only 293 students passed. There has been an 80% drop, between 2005 and 2015, in Indian medical graduates from foreign universities passing the mandatory screening test that the National Board of Examinations holds.
According to the Indian Medical Council Act, 2001, citizens with undergraduate degrees from outside India should clear the screening test conducted twice every yearJune and Decemberbefore they do a one-year in ternship in one of the MCIrecognised medical colleges.One has to score 50% to clear the test. Students say the the test is extremely tough.“Most questions are from postgraduate medical tests,“ said Raghuram Nayak, who completed his graduation in Ukraine in 2012. The students' association of foreign medical graduates say the board has made the test difficult to discourage students from going abroad and opt to study in private colleges here that charge as much as Rs 1 crore.
These students aren't even considered graduates in India unless they pass the test. “ Many of students spend lakhs in coaching centres to clear the test,“ said Raghuram. Officials at NBE deny these.
An expert committee which studied 11 question papers from 2013 to 2015 submitted a report to the ministry of health stating that 52.78% of the questions were of “low difficulty“ and 42.22% questions were of “moderate difficulty“. Board executive director Dr Bipin Batra said the test had no negative marking and most students find it difficult because public health priorities of other nations are different from ours.
PG Medical courses
Admissions only on merit: SC
The Times of India, Jan 13 2015
Admissions to PG medical courses only on merit: SC
Admissions to post-graduate medical courses can be done only on the basis of merit of students appearing in the entrance examination, the Supreme Court said while quashing Kerala government's decision to reserve seats for doctors working in its hospitals and other departments. The apex court said the state overstepped its jurisdiction by making a law earmarking 40% of total seats available to the state quota for its medical officers who were to get admission on the basis of their seniority , without appearing in the entrance examination.
A bench of Justices T S Thakur and R Banumathi said regulations framed by the Medical Council of India were binding and state governments could not make any rule in violation of the regulations. “Regulation 9 (of MCI) is, in our opinion, a complete code by itself inasmuch as it prescribes the basis for determining the eligibility of the candidates including the method to be adopted for determining the inter se merit which remains the only basis for such admissions. To the performance in the entrance test can be added weightage on account of rural service rendered by the candidates in the manner and to the extent indicated,“ it said.
The court said the method, however, was given a go-by by the impugned legislation when it provided that in-service candidates seeking admission in the quota shall be granted such admission not on the basis of one of the methodologies but on the basis of seniority of such candidates.
50% institutional preference for PG medical seats
Banaras Hindu University (BHU) and Aligarh Muslim Univesrity (AMU) will stand together on the same side in the Supreme Court to challenge an Allahabad High Court order doing away with 50% institutional preference in admission to PG medical seats.
BHU and AMU, both central universities, are relying on the Supreme Court's 2003 judgement in the Saurabh Chaudri case laying down the guidelines for filling up of PG medical college seats in government colleges. The SC had held that 50% of the seats would be reserved for all-India quota to be filled through a common entrance test. The government medical colleges could give preference to candidates from their own institution to fill the balance 50% seats in post-graduation courses.
On a PIL, without making the BHU or AMU a party, the HC had opened the 50% institutional quota seats in PG medical courses in these two central universities for students from any medical college in UP based on their ranking in National Eligibility cum Entrance Test (NEET).
“The implication of the HC order is that the admissions to the MD, MS and MDS courses in BHU as well as AMU, which has already been finalised and completed for the year 2017, has been rendered void. The HC did not offer any opportunity to the petitioner university to establish justify the validity of 50% quota available to the university under the institutional category,“ the BHU said and sought an interim stay of the HC order.
Private medical colleges
Can't have own entrance test
The Times of India, Mar 9, 2016
Yogita Rao
The SC move is aimed at checking deliberate suppression of vacancy position in PG seats by the states.
The Supreme Court dismissed a plea by the association of Maharashtra's private medical colleges to be allowed to conduct its own common entrance test (CET) for medical and dental college admissions. It means students will be admitted to state as well as private colleges on the basis of a single test conducted by the state CET cell.
The Maharashtra Unaided Private Professional Educational Institutions (Regulation of Admission and Fees) Act, 2015, that lays down the state CET clause, was challenged by the Association of Managements of Unaided and Private Medical and Dental Colleges in the Bombay HC in August 2015, and the case finally reached the SC. Though this petition was meant only for the medical postgraduate entrance test, the order is being seen as precedence for all other entrance tests that will be conducted by the state under the provisions of the new act.
A petition challenging the law itself is still pending in the HC. Association chairman Kamal Kishore Kadam said the apex court has asked them to wait for the outcome of the main petition, challenging the law. "We will see if it is possible to file a fresh petition in the HC. The government is taking away several powers given to us by a past SC order. They do not give us any money to run the institutes, how can they seek control over them?" asked Kadam. "Some of our institutes are ready to run into losses, but we will not fill our seats with students allotted by the state government," he added. A potential standoff seems brewing with a government official saying the state may act against institutes that refuse to admit students allotted by the competent authority as per the provisions of the existing act.
Counselling by private colleges banned
AmitAnand Choudhary, SC bans counselling by pvt med colleges, Sep 23 2016 : The Times of India
`Process To Be Carried Out By States'
After setting out implementation of the national eligibility cum entrance test (NEET) as the single window exam for admission in all medical colleges, the Supreme Court said on Thursday that private medical colleges cannot conduct counselling for admission to MBBS and BDS courses.
The admission process, the court said, would be done through centralised counselling conducted by the state governments concerned.This means that educational institutions will not be able to reach out to prospective students through “offer letters“ on the basis of NEET results.
The court passed the order on a petition filed by the Madhya Pradesh government seeking contempt proceedings against private colleges which, it said, were defying the SC order by holding their own counselling for admission in MBBS and BDS courses. The order has wider application as private colleges in other states are also conducting counselling which has been challenged in the court.
“If any counselling has been done by any college or university and any admission has been given so far, such admission shall stand cancelled forthwith and admission shall be given only as per centralised counselling done by the state government,“ a five-judge Constitution bench said. The SC, however, refused to pass any punitive order against the colleges on the contempt plea and allowed them to send their representatives to participate in the counselling process.
Deemed universities’ upheld for 2016: SC
SC upholds MBBS admissions by deemed univs, Sep 29 2016 : The Times of India
In a big relief to deemed universities in Maharashtra and Kerala, the Supreme Court on Wednesday refused to quash the admission process carried out by them for MBBS/ BDS courses on the basis of their own counselling in defiance of the government decision for centralised counselling.
Considering that admission for over 80% of the seats has been completed and classes have started in some deemed universities, a bench of Justice A K Sikri and Justice L Nageswara Rao upheld the admission but restrained them from holding further counselling for more intake.
“...will not disturb the admissions already made by the respondent universities... keeping in view that respondents are deemed universities,“ the bench said.
Sale of private MBBS, MS, PG seats
The Times of India, January 30, 2016
Rema Nagarajan
You would never find advertisements for “confirmed admission“ to any IIT or AIIMS or one asking you to book a seat in advance in any of these premier institutes Neither are there advertise ments promising you selection for the civil services or place ment in an all-India service of your choice. Yet, the media is full of ads for MBBS seats in colleges across the country How, if the system is merit-based, can anyone promise “direct admission“? Behind this promise is a black market in medical seats in private colleges. With agents and college manage ments colluding to sell many of the 30,000-plus MBBS and over 9,600 postgraduation seats in private medical colleges, back-of-the-envelope calculations by TOI suggests hat about Rs 12,000 crore in hard cash changes hands in his black market every year. Of the 422 medical colleges n India, 224 are private, accounting for 53% of MBBS seats.Many of these colleges are running with little or no facili ies, no patients and fake facul y. The going price for an MBBS seat could range from Rs 1 crore in colleges in Bangalore to Rs 25-35 lakh in some in UP . Seats in MD in radiology and dermatology cost up to Rs 3 crore. The prices could esca late or drop depending on how early you ap proach a college for a seat. If you book in advance, you could get a discount! Howev er, once the medical entrance results have been announced, the same seats at the private colleges will be sold for almost double the advance booking price. The sale of MBBS seats alone is worth almost Rs 9,000 crore annually .
Consortia of privately managed colleges and deemed universities that run medical colleges claim to conduct their own entrance examinations to take in students strictly on merit. However, in state after state, the exams have been exposed as a farce with students who pay money to buy seats being accommodated whether they appear for the exam or not and no matter what they score, while the so-called merit students are bumped off the list on various pretexts; with many even threatened and bullied into vacating seats.
While the 15% NRI quota seats are allowed to be allotted at the management's discretion in most states, in reality , even the management quota and a chunk of the so-called merit seats are sold off, bringing the proportion of seats sold to over 50%, the proportion rising to 80% or even 100% in some cases depending on how strict the regulation is in each state. The quota set aside for management varies from state to state. For instance, in MP and Maharashtra, the management quota is about 43%. This, plus the NRI quota brings the seats set aside to almost 60%.
With just 23,600 seats available for post graduate medical education, the demand for the same is very high. Thus, there is great demand for the 9,400plus seats in the private sector, including over 1,300 diploma seats. By a conservative estimate, about 40% of these seats also get sold. All told, the sale of post-graduate seats alone is estimated to be worth about Rs 2,900 crore. Add the highly valued seats for super-specialisation, about 370 in the private sector, of which again at least 40% is sold, and the postMBBS education black market figure crosses Rs 3,000 crore.Thus, along with the MBBS seat sale, the total amount comes to about Rs 12,000 crore.
The bulk of the money is paid in cash, leaving no trace of the transaction. And despite the advertisements giving the game away , the government has not cracked down on this black market or taken steps to arrest the rot in the medical education system.
Capitation fees gone; private colleges’ fees zoom up/ 2016
The Times of India
The Times of India
With the National Eligibility-cum-Entrance Test (NEET) becoming a hurdle to charging capitation fees, private medical colleges across India have substantially hiked tuition fees, while the cost of medical education in government colleges remains the same.
Tamil Nadu saw the highest jump in cost of private medical education. At Chennai's SRM Medical college, the tuition fee is now Rs 21 lakh a year or Rs 94.5 lakh for the four-and-a-half year MBBS course, against Rs 10 lakh per annum last year. This does not include expenses on books and lodging.
In Katihar Medical College in north Bihar, the annual tuition fee has been revised from Rs 8 lakh to Rs 12.5 lakh. In Delhi, at the Hamdard Institute of Medical Sciences, tuition fees in the management quota is up from Rs 15 lakh to Rs 18 lakh.
In government colleges, the sums range from as little as Rs 9,000 for the entire MBBS course in Rajasthan to Rs 4.4 lakh in Punjab. While most private medical colleges come under the purview of the Supreme Courtappointed fee committees in each state, deemed universities rarely come under the states' radar, leaving room for them to arbitrarily fix fees -a trend seen across the country . At Dr D Y Patil Medical College, Navi Mumbai, for example, the official fee is hiked by 3% every year. In 2013, the annual fee stood at Rs 8.5 lakh. This year, it's up by 32%. Students now have to pay Rs 16.5 lakh annually or Rs 76.2 lakh for their entire course. Similarly , at Chennai-based Saveetha University, the annual tuition fee has gone up from Rs 9 lakh last year to Rs 15 lakh now.
Private universities say their overheads have been very high. “MCI stipulations for hospitals and college infrastructure are very stringent. We also need to woo faculty from clinical practice, which isn't easy ,“ said Dr Raj Bahadur, vice-chancellor, Baba Farid University of Health Sciences, Faridkot, which conducts centralised counselling for medical colleges in Punjab. Some heads also cited competition from other medical colleges as a reason for pushing up their fees.
Data collected by TOI from across the country suggests that studying medicine in the private sector could be most expensive in Tamil Nadu and cheapest in Gujarat and Karnataka. However, in many states, capitation fee is collected in cash over and above the hiked fees. For instance in Maharashtra, many private colleges are learnt to be taking Rs 40-60 lakh or Rs 70-75 lakh in the deemed universities. This makes it difficult to estimate the actual cost of private sector medical education.
That explains why activists are sceptical about capitation fees having been scuppered by NEET. “Even after the hiking of fees, a few colleges are still taking capitation fees in cash. But most are at least declaring higher fees instead of collecting cash under the table. To make it even more foolproof, the PAN number of the parents making the payment should be attached. And for every admission in the NRI quota, passport and citizenship details should be on record to be examined later in case of doubt of any fraud,“ said Dr Anand Rai, one of the whistleblowers in the Vyapam scam in Madhya Pradesh.
Members of state fee committees say they are aware of the climb in cost of medical education postNEET, but are helpless. “We can't do anything about it unless the public takes it up with the courts,“ said Dr C V Bhirmanandam, a member of the fee committee in TN.Committee members say they can only review tuition fees, not other charges.
“For medical colleges, these figures translate into business, but for parents and aspiring doctors they mark the end of their dream,“ said K Srinivasan, who was asked to pay Rs 40 lakh for his daughter's admission at a deemed university in Chennai.
(Put together by TOI's network of health reporters across India)
Women studying medicine
The Times of India Jan 10 2016
More women studying medicine, but your doctor still likely to be a man
Rema Nagarajan
The first Indian woman physician, Anandibai Joshi, graduated in 1886. About 125 years later, Indian women started to outnumber men in admissions to medical colleges and the trend continues to grow stronger by the year: over the last five years, India has produced over 4,500 more female doctors than male ones.
In India, women constituted 51% of the students joining medical colleges, cornering 23,522 seats in 2014-15 compared to 22,934 men. This increase is in keeping with the worldwide trend. In fact, in the neighbourhood, Pakistan and Bangladesh have much higher proportions of women in medical colleges, 70% and 60% respectively.
However, there is a serious shortage of female doctors in India. According to a paper titled Human Resources for Health in India, published in 2011 in the medical journal Lancet, only 17% of all allopathic doctors and 6% of those in rural areas are women. This is less than one female allopathic doctor per 10,000 population in rural areas (0.5), whereas the ratio is 6.5 in urban areas. The number of female doctors per 10,000 population ranges from 7.5 in Chandigarh to 0.26 in Bihar.
According to a paper on women in medicine published in the journal, Indian Anthropologist, by sociologist Dr MitaBhadra, the gender gap persists at the post-graduation and doctoral levels -the percentage of female doctors here is around onethird of male doctors. She also observed that positions of leadership in academics and administration are still mostly occupied by men.
In Pakistan, though 70% of medical students were women, only 23% of registered doctors were female because a large number of those who graduated never took to practising. Bangladesh produced 3,164 female doctors and just 2,383 male doctors in 2013. The trend of more women joining the medical profession is welcomed as female doctors are seen as more committed and caring.
A paper on women in medicine published by Dr 46.5 Rakesh Chadda and Dr MamtaSood of the psychiatry department 37.3 of AIIMS in the Indian Journal of Gender Studies noted that medicine has been a 38 male-dominated profession because it demands long working hours that are disadvantageous to women who, even today , struggle to juggle career and family responsibilities.
The paper noted that though women were earlier largely restricted to fields like obstetrics, gynaecology and paediatrics, this was changing. “There has always been a preponderance of women in preclinical subjects like anatomy , physiology and biochemistry and paraclinical subjects like pharmacology , pathology and microbiology rights from the '70s. However, when a department is headed by a woman, the percentage of women faculty in the department goes up. In departments headed by women the women faculty was 49% as compared to just 19% in those headed by men,“ says Dr Chadda, giving the example of the neurology depart ment in AIIMS, which saw a lot of woman faculty joining when the HOD was a woman. “It is probably because the head of the department becomes a role model and more women are encouraged to join,“ said Dr Chadda.
There are skews within the medical profession in most parts of the world with some medical specialties, such as surgery and other disciplines requiring emergency duty with irregular hours, being male-dominated. Even in the UK, though women account for over 56% of those opting for medical education, 44% are pediatricians, 49% are in public health and only 8% are surgeons, according to a Royal College of Physicians report.
Among the OECD countries, in 10, predominantly from the erstwhile Eastern Bloc, the proportion of female physicians is more than 50%, ranging from a high 73.8% in Estonia to 50.2% in Spain. In two non-OECD countries for which the OECD had data, Latvia and Lithuania, females accounted for over 74% and 70% of physicians. In contrast, only one in five doctors in Japan and Korea were women. In the US, it is one in three.
