Denial of examinership: another discriminatory move of the NMC

There are two categories of teachers in India's medical colleges: medical and non-medical. Medical teachers are those with MBBS as the graduate qualification and MD/MS as the postgraduate qualification in a subject specialty. Non-medical teachers are those with B.Sc in life sciences as the graduate qualification and medical M.Sc in non-clinical subject specialty as the postgraduate qualification with or without a Ph.D doctorate. While the non-clinical subjects consisting of Anatomy, Biochemistry, physiology, Pharmacology and Microbiology, which are also considered basic medical sciences, are taught by both medical and non-medical teachers, the clinical subjects such as general medicine, community medicine, forensic medicine, general surgery, orthopedics, obstetrics & gynecology etc are taught exclusively by the medical teachers. This is a general practice in many parts of the world.

Even though the graduate qualifications of both the medical and non-medical teachers are different, the postgraduate qualification is essentially the same. The curriculum and syllabus of MD and medical M.Sc courses in the five non-clinical subjects are similar and students of either course are trained similarly in the one and the same medical college by the same teachers using the same methodology and resources. Medical M.Sc courses follow the same pattern as MD courses with respect to components such as laboratory training, clinical interpretation, seminars, journal clubs, dissertations etc, therefore no qualitative difference exists in the nature of training between the two courses. After successful completion of courses, health universities mostly award postgraduate degrees under the faculty of medicine. Thus, the two classes of postgraduates are similarly placed for teaching roles. It is the knowledge imparted in the subject specialty during the postgraduate course that empowers and enables the teacher to teach that subject, and the knowledge obtained in graduate courses while helpful and supportive, is not essential.

The non-medical teachers in India have been a part of medical education for several decades. Many are working in professorial posts such as Assistant Professor, Associate Professor, and professor in medical colleges. With decades of experience behind them, senior among them also head the department. Some among them have also authored manuals, chapters in textbooks or educative websites. Some have conducted scientific research in their specialty and published scientific papers. Some are also involved in curriculum committees and overseeing the implementation of the syllabus. Despite such long and distinguished service and contribution to medical education, the non-medical teachers now face incessant discrimination imposed by the regulator -the National Medical Commission, which has now barred them from executing their academic role as undergraduate examiners.

The introduction of competency based curriculum in medical education (CBME) is being touted as the reason for this denial. The curriculum has 20% vertical and horizontal integration with other relevant non-clinical and clinical subjects. Since medical M.Sc courses include the compulsory study of Anatomy, Biochemistry, and Physiology irrespective of own subject specialty, the non-medical teachers are competent in integration with the non-clinical subjects. Integration with clinical subjects has always been a part of the medical M.Sc postgraduate course as 'applied aspects', therefore integration is never a hindrance to a non-medical teacher. Besides, all teachers, both medical and non-medical, have undergone mandatory training on the Curriculum Integration Support Program, Basic Course Workshop and AETCOM, thereby equipping all with the necessary knowledge and skills required for teaching the new curriculum. CBME is a repackaged version of the existing knowledge, not a drastically new concept. All the components that were taught earlier will continue to be taught albeit in a slightly different way, but this doesn't call for exclusion of the experienced non-medical teachers from their academic roles of educator and assessor.

Since the introduction of this curriculum, three batches of medical undergraduate students have progressed from non-clinical to clinical specialties. Non-medical teachers have also taught and assessed the students in the new format of curriculum. Barring them now doesn't make any sense. Assessing the student's performance in an exam is an integral component of an educator's academic profession.

Barring non-medical teachers will create the following issues: 1. Artificial shortage of examiners. As many departments already have faculty shortages, conducting both internal and external exams will become difficult and tasking. 2. Involving medical teachers from other colleges whether within the state or outside for every internal and university exam will unnecessarily increase cost as the colleges have to spend on their renumeration and TA/DA costs. 3. Ignoring the senior and experienced teachers will lead to students being assessed by inexperienced junior teachers, which could compromise the standards. 4. Denying the educator the academic role of assessment is a discriminatory and humiliating experience. It will hurt the self-esteem of the faculty and the cordial environment in the department will not be the best.

When the qualifying marks to pass a university exam have been reduced by the NMC to 40%, what difference does it make whether the examiner holds MBBS/MD qualification or medical MSc/PhD? When upholding the quality of medical education is not a priority, rules discriminating against the 'non-medical' teachers stand out as bogus and motivated. Pride and prejudice are the core philosophies of the NMC's undergraduate board in making policies.