The NMC's Ph.D Diktat: An Overreach That Must Be Corrected

When a Regulator Colours Outside Its Lines

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There is a quiet injustice unfolding in India's medical colleges. It does not make headlines. It does not involve patients or prescriptions. It involves a group of dedicated scientists and educators - the non-medical faculty who teach Anatomy, Physiology, Biochemistry, Pharmacology and Microbiology to generations of medical students - and a regulatory clause that is, on close examination, legally indefensible, academically irrational, and procedurally unjust.

The National Medical Commission, in its Teachers Eligibility Qualifications in Medical Institutions Regulations, 2022, inserted a condition that non-medical graduates holding M.Sc. and Ph.D qualifications can be appointed as Assistant Professors only if the Ph.D was "granted by the recognized Medical College/Institute as regular on campus course in the subject concerned."

Seven words. Enormous consequences.

This article argues that this condition is wrong on every significant count - jurisdictional, legal, academic, and moral - and that the NMC has both the obligation and the opportunity to correct it.

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I. The NMC Has No Jurisdiction Over Ph.D Programs

This is the foundational argument, and it is not subtle.

The Ph.D is India's highest academic degree. It is entirely governed by the University Grants Commission (UGC) - the statutory body established under the UGC Act, 1956, with the explicit mandate to coordinate and maintain standards in university education. The UGC's Minimum Standards and Procedure for Award of Ph.D Degree Regulations (revised in 2016 and 2022) are comprehensive: they govern eligibility, mode of study, duration, coursework, guide qualifications, thesis evaluation, and the conduct of the viva voce.

The NMC, by contrast, is a creation of the National Medical Commission Act, 2020. Its mandate is to regulate medical education - that is, undergraduate and postgraduate medical courses. The Ph.D does not appear in any Schedule of the NMC Act. It is not a "medical course" in any statutory sense. The NMC neither designs Ph.D curricula, nor evaluates Ph.D theses, nor grants Ph.D degrees. Universities do - and universities do so under UGC's framework.

The legal principle here is elementary: a regulator may only act within the domain that its parent statute authorises. When the NMC prescribes the mode in which a Ph.D must be conducted as a condition of employment in a medical college, it is not regulating medical education. It is regulating doctoral education - a domain that squarely belongs to the UGC. This is a textbook case of regulatory overreach, and overreach of this kind does not survive judicial scrutiny.

If the NMC wished to set minimum qualification standards for faculty - which is entirely within its mandate - it should have stopped at saying what qualification is required. The moment it began dictating how that qualification must have been obtained, it stepped into the UGC's backyard.

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II. The "Regular On-Campus" Condition Contradicts UGC's Own Framework

The UGC explicitly recognises two legitimate modes of Ph.D: full-time and part-time. Distance mode is not permitted - a safeguard to protect quality. But part-time Ph.D, conducted under a university's prescribed norms and with all the same academic requirements - coursework, thesis, evaluation - is fully valid and fully equivalent in the eyes of the only body that has authority to make that determination.

Thousands of Indian academics - faculties, scientists, laboratory consultants - have earned their Ph.D through the part-time route, because the demands of a full-time laboratory or teaching roles made the full-time route impractical, not because they were looking for shortcuts. Their theses were scrutinised by external examiners. Their viva voces were conducted. Their universities awarded their degrees. The UGC recognised those degrees. No quality compromise occurred.

The NMC's "regular on campus" clause repudiates this entirely. It effectively tells a non-medical teacher: "Your university found your research sufficient. Your UGC-regulated degree is valid. But we - who have no role in Ph.D regulation - have decided your mode of study was wrong."

On what academic basis? None is offered. On what legal basis? None exists.

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III. Retrospective Application: A Violation of Natural Justice

The 2022 Regulations came into force upon their publication. Yet the NMC is applying the "regular on campus" condition to faculty who registered for their Ph.D programs and, in many cases, completed and were awarded degrees years before 2022.

This is retrospective penalisation - and it strikes at a principle of law so fundamental that it predates the Indian Constitution: no person should be penalised under a rule that did not exist when they acted. The Latin maxim nullum crimen sine lege - no crime without law - and its administrative law equivalent protect citizens and professionals from exactly this kind of arbitrary rule-making.

A teacher who enrolled in a part-time Ph.D program in 2015 did so in full compliance with their university's norms and UGC's framework. They made a career decision - a years-long investment of time, intellectual energy, and often personal sacrifice - under a specific regulatory environment. To now tell them that their degree is not "recognised" for appointment or promotion is not merely unfair. It is legally indefensible. Courts have repeatedly struck down regulations applied retrospectively to deprive individuals of rights or positions they had legitimately acquired.

The NMC cannot create a new eligibility condition in 2022 and then use it to nullify qualifications earned in 2012. That is not regulation. That is retroactive disqualification. It should not survive a legal challenge, and it should not have to come to that.

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IV. The Requirement of a Ph.D for Non-Medical Teachers Is Itself Poorly Reasoned

To understand the full picture, one must also examine whether demanding a Ph.D from non-medical teachers is academically justified in the first place.

Consider the parallel. A medical faculty member teaching Anatomy holds an MBBS and an MD in Anatomy - a structured, examination-based postgraduate qualification that directly trains them in the subject they will teach. Their qualification has a clear, functional relationship to their teaching role.

A non-medical faculty member holding an M.Sc. (medical) in the relevant discipline - a postgraduate programme of similar curriculum and rigour - is similarly equipped for undergraduate teaching. The M.Sc. (medical) provides the content knowledge. What additional classroom competence does a Ph.D confer?

The Ph.D is fundamentally a research degree. It certifies the ability to identify a problem, frame a hypothesis, design a methodology, generate original data, and defend original conclusions. These are valuable capacities - essential for building research culture in medical colleges. But they are not the competencies primarily needed to teach first-year medical undergraduates the histology of the liver or the mechanics of cardiac muscle contraction.

The honest answer to why the NMC insists on a Ph.D for non-medical faculty - while making no such demand of medical faculty beyond their MD - is one of parity by years of training, not by functional need. Medical faculty spend 8½ years in formal education before eligibility (MBBS plus MD). Non-medical faculty, with only a bachelor's and master's degree (B.Sc plus M.Sc), fall short of that duration (6 years). The Ph.D (2-3 years) fills the gap - not educationally, but arithmetically.

If that is the reasoning - and it appears to be - then it should be stated honestly and examined critically. Credential parity is not educational equivalence. And building a faculty policy on arithmetic rather than academic logic produces exactly the kind of arbitrary rule we are now discussing.

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V. The Human Cost Is Real

Behind the clauses and sub-regulations are real people. Associate Professors who taught medical students for fifteen years. Scientists who published in peer-reviewed journals. Tutors who supervised undergraduate students. Academics who pursued a part-time Ph.D because their department needed them in the laboratory and classrooms while they studied - exactly as the UGC's framework intended to accommodate.

These individuals now find themselves in an impossible position. Their degrees are valid in every court of law, every university senate, every UGC record. But under this NMC clause, they may be passed over for promotion, denied appointment, or rendered ineligible for positions they are otherwise fully qualified to hold - purely because their mode of doctoral study does not match a label the NMC had no business applying.

This is not a minor procedural inconvenience. For many, it represents the derailment of a career. That the NMC applied this rule retrospectively makes it not just legally suspect, but profoundly unjust.

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VI. What the NMC Must Do

The correction required is not complicated. It requires neither a legislative amendment nor a prolonged consultative process. The NMC must:

First, delete the words "as regular on campus course" from the relevant provision. The qualification required should be M.Sc. (relevant medical subject) and Ph.D — full stop. Whether that Ph.D was full-time or part-time is a matter exclusively between the candidate, their university, and the UGC.

Second, A saving clause within the amendment to nullify adverse actions taken during the 2022–amendment period, so that the injustices done to those affected are reversed.

Third, acknowledge in future consultations that its mandate over faculty qualifications ends at what qualification is required, not how that qualification was pursued. Respecting the jurisdictional boundary with the UGC is not a courtesy - it is a constitutional and statutory obligation.

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And, finally

India's non-medical faculty in non-clinical departments are not peripheral figures. They are the scientists who ensure that medical students understand, before they ever see a patient, how the human body is built, how it functions, how drugs work, how laboratory tests assist diagnosis and how chemistry underpins life. They deserve a regulatory environment that respects their qualifications, acknowledges their academic standing, and holds itself to the same standards of rationality and legality that it demands of others.

The NMC's insertion of four words - "regular on campus course" - into a subordinate regulation has caused disproportionate harm. It was made without adequate legal basis. It was applied retrospectively without justification. It contradicts the framework of the only body authorised to regulate doctoral education. And it discriminates against a category of faculty who had done nothing wrong.

Good governance demands self-correction when an error is identified. The case has been made. The burden is now on the NMC to act - not in the interest of any one category of teachers, but in the interest of the principle that regulation must be lawful, rational, and just.

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The Overlooked Pillars of Medical Education: A Case for Equal Recognition

Introduction: The Current Crisis

Medical education stands at a critical juncture where artificial hierarchies and discriminatory practices threaten its very foundation. The ongoing debate about M.Sc/Ph.D qualified teachers in medical colleges reveals deep-rooted biases that have no place in modern academic institutions. Medical education in India has been supported by two categories of teachers in basic and non-clinical subjects: those with MBBS/MD and those with medical M.Sc/Ph.D. These qualifications are remarkably similar in structure, following identical curricula, syllabus, infrastructure, faculty, and teaching methodologies within medical colleges. These educators, who have been integral to medical education since the 1970s or earlier, possess postgraduate qualifications equivalent to their MD counterparts in their respective subjects, yet face systematic discrimination that undermines both their contributions and medical education as a whole.

The Terminology Problem and Global Context

The fundamental misconception begins with terminology - referring to these educators as "non-medical" faculty despite their specialized medical science qualifications is both inaccurate and prejudicial. While their undergraduate backgrounds may differ, their postgraduate qualifications equip them with the expertise necessary for teaching non-clinical subjects. This is evidenced by global practices, particularly in the United States, where up to 90% of medical college faculty in basic medical sciences hold M.Sc & Ph.D qualifications.

Quality Teaching: Beyond Basic Qualifications

The quality of medical education depends on teaching ability, subject expertise, and dedication - not merely the possession of an MBBS degree. Often, M.Sc/Ph.D teachers demonstrate exceptional commitment and teaching excellence, precisely because they must constantly prove their worth in a system that views them with suspicion. This contrasts with some MD holders who, secure in their positions, may not maintain the same level of educational rigor.

The Faculty Shortage Crisis

The current crisis in medical education is exacerbated by artificial restrictions on hiring M.Sc/Ph.D teachers. About 50-90% of MD seats in non-clinical subjects remain vacant annually, despite desperate measures like reducing eligibility percentiles to zero, waiving tuition fees, and offering incentives. This shortage is particularly acute in remote, rural, and hilly regions, where M.Sc/Ph.D qualified teachers play a crucial role in maintaining educational standards. Many medical colleges function with skeletal staff in non-clinical subjects, inevitably affecting education quality. The system's refusal to fully utilize qualified M.Sc/Ph.D teachers in even such situations is self-defeating. Private medical college associations have recognized this reality, advocating for the removal of hiring caps for M.Sc qualified teachers.

Regulatory Conflict and Political Reality

The Ministry of Health and Family Welfare's support for continuing with M.Sc qualified teachers, based on their assessment of ground realities, stands in stark contrast to the National Medical Commission's (NMC) position. While the Ministry of Health and Family Welfare supports the continuation of M.Sc qualified teachers, the NMC has taken an increasingly hostile stance, often acting more like a doctors' welfare association than a neutral regulatory body. This unprecedented divergence between a regulatory body and its governing ministry highlights the influence of vested interests over practical necessities.

Professional Discrimination and Its Impact

The discrimination faced by M.Sc/Ph.D teachers extends beyond institutional policies to professional relationships, where they often face hostility rather than collegial support. The discrimination faced by M.Sc/Ph.D teachers represents a form of academic apartheid, driven by competition for jobs and a misplaced sense of superiority. Despite being numerically fewer, these educators face systematic exclusion through carefully crafted regulations and institutional biases. The overwhelming number of representations against them should not be misconstrued as legitimate opposition but rather as coordinated efforts to maintain professional monopoly. 

Moving Beyond Pride and Prejudice 

Quality education depends on teaching ability, subject expertise, and dedication - not merely the possession of an MBBS degree. The attempt to discredit M.Sc/Ph.D teachers through coordinated PR campaigns and misinformation reflects poorly on the professional ethics of those opposing their inclusion. Teaching excellence is an art that transcends basic qualifications.

Proposed Solutions and Transition Measures

The solution lies not in reservations or quotas, but in merit-based hiring without arbitrary caps, allowing institutions to select the best educators regardless of their basic qualification. For those concerned about maintaining standards, implementing standardized testing for faculty positions could ensure quality while providing equal opportunities. Additionally, if policy makers decide to phase out M.Sc teachers, it should be done with careful consideration for those already in the system, allowing them to continue their careers with full rights to job mobility and promotions.

The Reality of Medical Education Today

The reality remains that medical education needs qualified teachers more than these educators need these positions. With over 80% of medical colleges failing to meet minimum requirements, the focus should be on improving educational standards rather than perpetuating discriminatory practices. The current system's resistance to change, despite clear evidence of faculty shortages and the proven capabilities of M.Sc/Ph.D teachers, reflects a deeper problem of professional elitism that must be addressed for the advancement of medical education in India.

The Regulatory Maze 

The confusion between MSR and TEQ documents has created additional challenges. The existence of two separate documents outlining teacher eligibility guidelines creates unnecessary complexity and contradictions. This regulatory overlap, combined with frequent changes in guidelines, has made it nearly impossible for the already overburdened judiciary to address these issues effectively.

Conclusion: The Path Forward

The solution lies in recognizing and protecting minority stakeholders within the medical education system. The Ministry must exercise its authority over the NMC to ensure fair treatment and equal opportunities for all qualified educators. In conclusion, the path forward requires recognizing that quality medical education depends on teaching excellence, subject expertise, and dedication - qualities not exclusive to any one qualification. The artificial barriers and discrimination against M.Sc/Ph.D teachers must end, replaced by a merit-based system that prioritizes educational outcomes over professional prejudices. Only then can medical education truly serve its purpose of producing competent healthcare professionals for tomorrow.

India’s Doctor-Population Ratio

 India’s Doctor-Population Ratio: A Closer Look at the Reality Behind the Numbers

India’s healthcare system is often seen as a paradox: while the country grapples with a shortage of doctors in many regions, it also boasts a seemingly impressive number of medical practitioners. According to official figures, as of June 2022, there are over 13 lakh allopathic doctors (MBBS), alongside a significant number of AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) practitioners. These numbers suggest that India may already have surpassed the World Health Organization’s (WHO) recommended doctor-population ratio of 1:1,000. However, the true scenario is more complex, and understanding it requires digging deeper into these statistics and examining the factors that shape doctor availability in India.

The Numbers on Paper: 1:834 Ratio

The Ministry of Health and Family Welfare (MoHFW) reports that as of mid-2022, there were 13,08,009 allopathic doctors registered with State Medical Councils and the National Medical Commission (NMC). If we factor in 5.65 lakh AYUSH doctors, the doctor-population ratio in India is 1:834—well above the WHO’s standard of 1:1,000. 

On paper, India has clearly met, and even surpassed, the international benchmark for the number of doctors. This would seem like cause for celebration, suggesting that the country’s healthcare system is well-equipped to meet the needs of its 1.4 billion people.

The 80% Availability Factor

However, the reality is more nuanced. The MoHFW estimates that only 80% of the registered allopathic doctors are actively practicing medicine in India. The remaining 20% have either retired, migrated, stopped practicing, or never engaged in patient care. This means that the actual number of practicing doctors is much lower than the total number of registered practitioners.

If we apply this 80% figure to the total of 13.08 lakh allopathic doctors, the number of practicing doctors reduces to approximately 10.46 lakh. Adding the 5.65 lakh AYUSH doctors into the mix, the effective doctor-population ratio becomes 1:834, which is still above the WHO recommendation—but the actual number of healthcare professionals available for active patient care is far less than the full registration count suggests.

Non-Practicing Doctors: A Silent Contributor to the Ratio

The situation becomes even more complicated when we consider doctors who are registered but do not directly engage in patient care. In every medical college, there are departments such as Anatomy, Physiology, Biochemistry, Pathology, Microbiology, Pharmacology, and Forensic Medicine, which are primarily focused on teaching and research rather than direct clinical practice. Each medical college typically employs 50-75 faculty members in these non-clinical departments, adding up to a total of around 42,500 non-practicing doctors across the country. 

Even if a portion of these doctors engages in private practice outside their teaching hours, they do not contribute to the active healthcare workforce. This brings into question whether they should be considered part of the doctor-population ratio when evaluating healthcare access for the general public.

A Shift to Other Professions

Many doctors, after completing their education, opt to shift to careers outside direct patient care. These can include roles in healthcare administration, pharmaceutical companies, research, business, or even government positions. While these doctors hold medical degrees, they do not contribute to clinical healthcare, further skewing the real doctor-population ratio. There is no official record of how many of these doctors have moved to other professions, but the shift is significant enough to suggest that the number of doctors available for active patient care is lower than official statistics indicate.

The Real Doctor-Population Ratio: More Than Just a Number

In light of these factors, it becomes clear that the real doctor-to-population ratio in India is much more complex than the figure of 1:834 suggests. The number of active practitioners is reduced by several factors—non-practicing doctors, those working in non-clinical fields, and the 20% of registered allopathic doctors who are unavailable for active care.

Furthermore, the distribution of doctors across India is highly uneven. While urban areas may have a surplus of healthcare professionals, rural and underserved regions face acute shortages. The doctor-to-population ratio in these areas could be far worse, exacerbating health disparities. The WHO’s recommendation of 1:1,000 is based on global averages, but for a country as vast and diverse as India, a more localized and nuanced approach is needed.

Conclusion: Addressing the Gaps in India’s Healthcare System

India’s doctor-population ratio is undeniably better than the WHO's standard, but this does not guarantee universal access to quality healthcare. The disparity between registered doctors and those actively practicing medicine, coupled with regional inequalities and the movement of doctors into non-clinical fields, points to a need for a more refined understanding of healthcare availability. 

To truly address the gaps in India’s healthcare system, policymakers must look beyond raw numbers and focus on improving the distribution of doctors, ensuring that the healthcare workforce is adequately trained, incentivized, and supported to provide care where it is most needed. Improving the quality of medical education, expanding rural healthcare infrastructure, and creating policies that encourage doctors to practice in underserved areas will be key to ensuring that India’s healthcare system lives up to the promise suggested by its doctor-population ratio on paper.

Denial of HODship to teachers with medical M.Sc, Ph.D qualifications

Essay: Advocating for Teachers with Medical M.Sc and Ph.D Qualifications as Heads of Departments in Medical Colleges

The ongoing debate over whether teachers with medical M.Sc and Ph.D qualifications should be allowed to become Heads of Departments (HODs) in medical colleges is framed by misconceptions and discriminatory policies. This essay aims to present a well-reasoned argument in favor of such teachers being eligible for HOD positions. It systematically addresses concerns, clarifies myths, and highlights the drawbacks of denying them leadership roles.

I. Understanding the Role of HOD in Medical Colleges

1.1. Administrative Nature of the HOD Role

The primary function of an HOD is administrative rather than clinical. Responsibilities include managing faculty, coordinating teaching schedules, and promoting research and collaboration among departments. These responsibilities are not tied to patient care or clinical duties, making it reasonable to appoint individuals with non-clinical qualifications.

1.2. Experience-Based Leadership

There is no formal training or certification required to become an HOD. Leadership skills are honed through years of academic and administrative experience within the department. Teachers with M.Sc and Ph.D degrees often have long tenures in these roles, equipping them with the same practical administrative skills as their MD counterparts.

II. Academic Equivalence of M.Sc and MD Degrees

2.1. Comparability in Education and Role

Both MD and medical M.Sc programs prepare educators for non-clinical subjects such as Anatomy, Biochemistry, and Physiology and para-clinical subjects such as Pharmacology and Microbiology. The expertise required to teach these subjects does not hinge on clinical qualifications but on academic rigor and pedagogical skills.

2.2. Postgraduate Qualification as the Benchmark

Teaching expertise stems from postgraduate education, not the undergraduate degree. While MD holders may have clinical exposure, the focus of M.Sc and Ph.D training is aligned with academic teaching and research, making these qualifications equally relevant in non-clinical departments.

III. Myths and Misconceptions Debunked

3.1. Myth: M.Sc is for Research, Not Teaching

Fact: Medical M.Sc programs were established specifically to create educators for medical colleges. The curriculum aligns with MD programs, focusing on teaching foundational medical sciences.

3.2. Myth: Lack of Clinical Experience Makes M.Sc Holders Ineligible

Fact: Clinical experience is not required to teach non-clinical subjects. Teachers with medical M.Sc and Ph.D qualifications have deep expertise in their fields and contribute effectively to academic and research programs.

3.3. Myth: M.Sc Courses Are Unstructured

Fact: M.Sc programs follow a structured syllabus, often overlapping with MD courses. Examinations and coursework are conducted by the same faculty, ensuring similar academic standards.

3.4. Myth: MD Is Superior to M.Sc and Ph.D

Fact: Both, M.Sc and Ph.D degrees offer similar specialized academic training. Holding a Ph.D, in fact, reflects higher academic achievement, as it involves advanced research skills beyond what MD programs cover.

IV. Addressing Discrimination and Bias

4.1. Prevalence of Academic Apartheid

The preference for MD holders over M.Sc and Ph.D educators reflects an unfounded bias. This practice undermines academic inclusivity and dismisses the contributions of highly qualified teachers with non-clinical qualifications.

4.2. Global Perspective on Leadership in Medical Education

In Western countries, educators with M.Sc and Ph.D degrees routinely hold leadership positions in medical schools. Denying similar opportunities in India contradicts international standards of academic fairness and meritocracy.

4.3. Structural Discrimination in Policy

The National Medical Commission (NMC) regulations have historically favored MD graduates, often altering guidelines to limit the participation of M.Sc and Ph.D teachers. This systemic bias reflects an unjust monopolization of authority within academic governance.

V. Legal and Ethical Dimensions

5.1. Violation of Equality and Meritocracy

Denying teachers with M.Sc and Ph.D qualifications access to HOD roles constitutes discrimination. Once appointed as professors, these educators should be entitled to all associated responsibilities, including department leadership.

5.2. Judicial Review and Accountability

NMC regulations that restrict leadership roles for M.Sc and Ph.D holders can be challenged under principles of equality. Courts have a duty to ensure fairness and prevent arbitrary discrimination in academic governance.

VI. Benefits of Inclusive Leadership in Medical Colleges

6.1. Enhanced Academic Innovation

Teachers with M.Sc and Ph.D degrees bring unique research perspectives and pedagogical insights, fostering innovation in non-clinical subjects.

6.2. Collaboration and Interdisciplinary Growth

Experienced educators from diverse backgrounds promote collaboration across departments, enriching the academic environment through varied expertise.

VII. Summary: Why Denying HOD Roles to M.Sc and Ph.D Educators Is Harmful

1. Administrative competence is not tied to clinical qualifications; experienced professors, regardless of degree type, are capable of managing departments.

2. Postgraduate qualifications like M.Sc and Ph.D are academically equivalent to MD degrees in non-clinical subjects.

3. Bias against non-clinical educators reflects outdated prejudices, not academic or administrative merit.

4. Global best practices demonstrate that leadership roles are often held by educators with diverse qualifications.

5. Excluding qualified educators undermines institutional diversity and innovation.

6. Systematic changes in policy have unfairly limited opportunities for M.Sc and Ph.D holders, reflecting institutional bias.

7. Legal frameworks support merit-based appointments, and the exclusion of certain educators can be challenged as discriminatory.

8. Collaboration and interdisciplinary growth suffer when educators from diverse backgrounds are denied leadership roles.

9. Academic apartheid reinforces hierarchical mindsets that harm educational progress.

10. Inclusivity in leadership fosters fairness, equity, and better academic outcomes.

Conclusion

It is unjust to deny teachers with medical M.Sc and Ph.D qualifications access to HOD positions. Leadership roles in non-clinical departments demand academic, managerial, and collaborative expertise—qualities that are not the exclusive domain of MD holders. Promoting inclusive academic governance will strengthen medical education and reflect a commitment to fairness and progress. The NMC must recognize the value these educators bring and adopt more inclusive policies for department leadership.

 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.

 Problems, more problems, and solutions

The so-called non-medical teachers possessing medical M.Sc/Ph.D qualifications who are working in various capacities ranging from Tutors to Professors & HOD are protesting against the unjust norms set by the NMC.

Clarity on the medical M.Sc courses:

The majority of MBBS graduates typically opt for specialization in clinical disciplines, and they consider pursuing postgraduate studies in non-clinical disciplines as a last resort, often after numerous unsuccessful attempts to secure clinical seats. As a result, thousands of postgraduate seats in non-clinical subjects remain vacant each year.

With the establishment of more medical colleges and an increase in MBBS seats within these colleges, the shortage of faculty members has become more pronounced. This shortage is particularly acute in newly established colleges, as well as those situated in remote, hilly, and suburban areas. Due to the scarcity of medically qualified teachers, the education system resorted to appointing non-medical teachers starting in the 1960s. However, historically, the permissible ratio of non-medical teachers was limited to 30% (50% in Biochemistry).

Medical M.Sc courses in the five non-clinical subjects were initially included in Schedule-I of the Indian Medical Council Act. However, as MBBS graduates began to show less interest in these courses and opted for MD programs in the same subjects, the Medical Council of India (MCI) gradually stopped taking interest in these courses. In the late 1980s, MCI stopped granting permission to medical colleges to initiate these courses, and eventually, it completely withdrew its support from them.

At one point, over 100 medical colleges used to offer these courses, but now the number has dwindled to less than 30, including in AIIMS. These courses are primarily conducted within medical colleges, utilizing identical curricula, syllabi, and resources as MD programs. They run concurrently with MD courses, guided by the same teaching methods and faculty. However, regardless of their chosen specialty, all students are required to complete a mandatory one-year study in human anatomy, physiology, and biochemistry, mirroring the curriculum of first-year MBBS students.

All aspects of the M.Sc. course, including university examinations, resemble those of the MD course. Successful candidates are awarded their degrees by the health university under the faculty of medicine. Although there may be differences in the graduate degrees between medical and non-medical teachers, their postgraduate degrees are quite similar. Consequently, aside from clinical practice, both groups of degree holders are well-suited for similar roles and employment opportunities.

It is unfortunate that the regulatory body consistently provides inaccurate information in its affidavit when referring to the medical M.Sc courses. It appears to use misinformation as a political tool to advance its agenda.

Appointment of non-medical teachers:

The practice of appointing non-medical teachers to instruct in non-clinical subjects, which form the foundation of medical sciences, is not exclusive to India. In fact, the percentage of non-medical teachers varies widely in different countries, ranging from 30% to 100%. Only 8-11% of teachers in non-clinical subjects at medical colleges in the United States hold medical qualifications, while the majority are non-medical professionals.

The appointment of non-medical teachers in the non-clinical subjects should be a matter of policy, rather than a temporary measure extended to medical M.Sc postgraduates. The regulations outlined by the World Federation of Medical Education (WFME) emphasize the importance of balanced participation from both medical and non-medical teachers.

The presence of teachers with either set of qualifications brings dynamism to teaching, a fact emphasized by the Board of Governors in supersession of MCI when rejecting a demand to exclude non-medical teachers. Non-medical teachers should be an integral part of medical education to prevent a monopoly of one-degree holders, which can lead to stagnation. Both sets of degree holders can complement each other, rather than compete with each other.

It is incorrect to assume that possessing a specific qualification or lacking it has a direct impact on the quality of teaching. Within both sets of qualifications, there are excellent, mediocre, and subpar teachers. The crucial factor determining a teacher's ability to educate effectively is their postgraduate degree, whether it's a medical M.Sc or MD; the undergraduate degree may have minimal influence. Thus, the quality of teaching ultimately depends on the individual's knowledge, skills, and attitude as a teacher. Medical education should draw benefits from both sets of qualifications, and the selection should prioritize the best candidate, regardless of their specific qualification.

MD in non-clinical subjects:

In many developed countries, medical colleges do not provide MD programs in non-clinical subjects. Typically, these subjects are primarily taught by scientists holding Ph.D. degrees, with only a few doctors who have a keen interest in research. MD programs are primarily offered in clinical subjects. In contrast, India has a significant number of non-clinical doctors, who are included in the count of doctors for calculating the doctor-patient ratio. However, these non-clinical doctors do not engage in patient care or contribute directly to healthcare services. Therefore, offering MD degrees in non-clinical subjects in India is irrational. Instead, these programs be replaced with medical M.Sc courses for MBBS graduates, as was the practice in the past.

Monopoly, dominance, and NMC's abuse of position:

Both the MCI and the present NMC are predominantly composed of medical professionals. In contrast, the General Medical Council in the UK maintains an equal representation of both medical and non-medical individuals. Initially, there was a proposal to limit the composition of medical professionals to 60% in the NMC, but this proposal was thwarted by the medical community, ultimately resulting in the dominance or hegemony of doctors in the NMC.

 Despite divisions among doctors regarding clinical and non-clinical specialties, they consistently unite when their interests are at stake. They tend to prioritize their own interests and often restrict or exclude non-medical individuals from various competitive arenas. This behavior can be seen as an abuse of their dominant position. 

When the NMC solicits public feedback, the majority of the responses come from the medical community, which represents a substantial majority. Conversely, the feedback from non-medical individuals constitutes a small minority and can easily be overshadowed. Consequently, it's important to recognize that all feedback received by the NMC tends to be inherently biased.

Over the years, the NMC has systematically eroded the authority of non-medical teachers and has consistently modified regulations to place them at a disadvantage. These changes in norms are inherently discriminatory and are intended to disenfranchise non-medical teachers. This pattern of denials and restrictions can be attributed to the underlying concepts of pride and prejudice within the medical community.

The pride that doctors take in their qualifications often leads to a prejudice against non-doctors, resulting in a general unwillingness or resistance to extend the same rights or dignity to non-doctors as they afford themselves. This sense of self-supremacy, which is seen as a 'superiority complex', prevents them from treating others with the same level of respect and equality. In essence, this is nothing but 'academic apartheid'. When the regulatory body itself practices discrimination at the highest level, it sets a discouraging precedent, encouraging individuals at the college level to perpetuate discriminatory practices.

Discriminations, and denials of opportunities:

Unjust Ph.D. Requirement: There is an unwarranted insistence on requiring a Ph.D. for the Assistant Professor position, despite the absence of such a mandate by the UGC. The demand for a Ph.D. for entry-level demonstrator roles appears to be a deliberate attempt to undermine the value of a Ph.D. and restrict the appointment of non-medical teachers. Equating postgraduate and doctoral qualifications (MSc+PhD) with an undergraduate degree (MBBS) is both belittling and unfair.

Discrimination Against Medical MSc: Despite the equivalent quality of medical MSc and MD courses, medical MSc is unfairly treated and not recognized as a basic qualification. Medical MSc is intentionally excluded as a postgraduate qualification in the NMC's faculty declaration form, despite there being a substantial number of graduates, ranging from 5000-8000.

Exclusion from Faculty Training programs: Non-medical teachers are systematically and unethically being denied/excluded from faculty training programs like the revised basic course workshop, CISP, and AETCOM.

Denial of Examiner Opportunities: Fundamental roles of a teacher to serve as undergraduate examiners are being denied to non-medical teachers despite possessing decades of teaching experience.

Limited Tenure for Tutors/Demonstrators: The tenure for tutor/demonstrator roles has been restricted to a mere 3 years, seemingly designed to discourage non-medical teachers from continuing in these positions.

Rejection of Feedback and Appeals: Feedback and appeals submitted by non-medical teachers or their associations are persistently rejected as if we don’t exist or our issues don’t matter.

Denial of HODship: Senior professors possessing non-medical qualifications are unfairly denied the opportunity to head departments despite seniority and decades of experience.

In essence, non-medical teachers are subjected to a second-class status, characterized by restricted roles, rights, and privileges. 

Political lobbying and the after-effects:

As the MCI transitioned into the NMC, a group of non-clinical medical professionals made concerted efforts to exert pressure on the NMC in order to exclude non-medical teachers from the medical education system. Their previous attempt to influence the MCI had proven unsuccessful. 

The NMC responded by significantly reducing the allowable percentage of non-medical teachers, lowering it from 50% to 15% in Biochemistry and from 30% to 0% in both Pharmacology and Microbiology. While these changes were initially meant to apply to new medical colleges starting from 2020 onwards, they were, in practice, being applied retrospectively to all colleges.

Existing non-medical teachers, particularly tutors and demonstrators, were facing termination of their contracts or non-renewal, citing the new regulations. Even those with four years of teaching experience and M.Sc qualifications were being denied promotions to the Assistant Professor position. Previous guidelines that required a Ph.D. for the Associate Professor and higher positions were being ignored. Instead, a Ph.D. was being demanded for the Assistant Professor position in MSR 2020 guidelines, a requirement not mandated by the UGC. Taking it a step further, NMC has now mandated a Ph.D. as a requirement for the lowest entry-level non-teaching position of tutor in the MSR 2023 guidelines. This change appears to be aimed at discouraging non-medical candidates from entering the field of medical education. Furthermore, the term of employment for tutors was limited to three years, seemingly to prevent them from getting promoted to higher posts.

Individuals in Pharmacology and Microbiology were among the hardest hit by these changes, as they were effectively barred from applying for teaching positions in any other institution. They faced restrictions on transferring to different colleges or relocating to other cities. In essence, they found themselves trapped within the same college and were at the mercy of the college management. These limitations hindered their opportunities for career advancement and their ability to explore new job prospects. Such restrictions appear to contradict the principles enshrined in Articles 19(1)(e) and 16, which uphold the rights of citizens to move freely between states and seek employment anywhere within India.

It's all about jobs for doctors and filling vacant PG seats:

The persistent vacancy rates of 40-50% in postgraduate (PG) seats within non-clinical specialties are expected to perpetuate the shortage of medical teachers in these fields. Additionally, medical colleges are grappling with revenue losses stemming from these unoccupied PG seats. In certain states, private medical colleges have established agreements with the government, obliging them to allocate a specific percentage of PG seats at reduced fees. Consequently, these institutions allocate non-clinical PG seats to the government quota while retaining the more lucrative clinical seats for themselves. 

Given the lack of interest among MBBS graduates in non-clinical seats, medical colleges are compelled to relinquish the clinical seats, which negatively affects their interests. Thus, there is a pressing need to address the vacancies in non-clinical seats. To address these vacancies, efforts have been made to attract MBBS graduates by offering incentives such as freebies, lowering the qualifying percentile to accommodate lower-scoring MBBS students for PG seats, reducing tuition fees, or even providing the seats free of charge.

Most MBBS graduates aspire to pursue clinical practice, as non-clinical subjects do not provide opportunities for clinical work. Typically, careers in non-clinical fields are centered around teaching in medical colleges. While there is some competition for teaching positions from M.Sc/Ph.D. candidates, this is a relatively minor factor that discourages MBBS graduates from pursuing PG studies in non-clinical subjects.

Despite the numerous vacancies in PG seats, a significant number of MBBS graduates are currently pursuing MD degrees in non-clinical subjects with the hope of securing faculty positions in medical colleges. The association of non-clinical medicos has actively lobbied the NMC to create provisions that would facilitate job opportunities for these individuals.

As a result, the undergraduate board of the NMC made the decision to significantly reduce and eventually stop the appointment of non-medical teachers. This decision serves a dual purpose: firstly, it aims to encourage the occupancy of MD seats in non-clinical subjects, and secondly, it seeks to create job opportunities for medical postgraduates, albeit at the expense of non-medical candidates.

The primary role of the NMC is to establish policies and guidelines that maintain the quality of medical education, rather than engaging in political strategies to occupy PG seats or secure jobs for doctors. By doing so, the NMC appears to be behaving more like an association of doctors focused on advancing their self-interests, rather than fulfilling its role as a regulator.

Role of ministry in ensuring justice:

While the MCI and NMC primarily are bodies 'of the doctors, by the doctors and for the doctors' furthering the interests exclusively of doctors, the union government is entrusted with the responsibility of safeguarding the welfare of all stakeholders. While the regulatory body tends to be self-centered, the policies of the Ministry of Health and Family Welfare (MoHFW) are grounded in reality and uphold principles of universal justice and equality. The NMC Act empowers the government to supersede the NMC on any matter, including policies. Given the inherent bias of the NMC, it is unlikely to ensure a level playing field for non-medical individuals. Therefore, the ministry's intervention is entirely justified. However, it is shocking that the NMC, after initially submitting an affidavit to the Delhi High Court to comply with the ministry's directives, later reversed its stance and exhibited defiance.

Unjustifiable pretexts - myths vs facts:

The rationale employed by the NMC to disqualify non-medical teachers appears to be weak and unsubstantiated. For individuals who have already covered Anatomy, Physiology, and Biochemistry in the first year of their medical M.Sc. program, integrating these subjects for non-medical teachers should pose no significant challenge. In practice, integration with clinical subjects has been ongoing for many years, albeit under the term "applied aspects," even if it was not formally recognized as "integration." Non-medical educators have successfully implemented these integrations since their introduction a few years ago. It's worth noting that while some non-medical teachers may have been excluded from participating in teacher training programs, many have actively participated in critical training sessions, including the revised Basic Course Workshop (rBCW), Curriculum Integration Support Program (CISP), and Attitude, Ethics, and Communication (AETCOM).

The integration component constitutes only a minor portion, approximately 20%, of the overall syllabus. It's crucial to recognize that the fundamental aspects of health and illness, such as the human body, diseases, and diagnostic and treatment methods, remain constant. A shift in curriculum, therefore, does not alter these core principles. The new curriculum cannot be used as an excuse to disqualify teachers who have been teaching for years/decades or prevent them from the academic role of examiner. Furthermore, the early clinical exposure component comprises just 9 hours in each subject. This relatively minimal requirement can easily be fulfilled by medical teachers, who already make up a significant majority, ranging from 70% to 100%, of the faculty.

Non-medical teachers constitute a small minority, with some colleges lacking any non-medical teachers at all. At most, they can make up to 30% of the total faculty strength. The majority of faculty members in these institutions are medical teachers. Hence, the claims of subpar teaching quality cannot be solely attributed to this minority group of teachers.

Proposal to shift non-medical teachers into research:

The NMC's current proposal plans to relocate non-medical teachers, some of whom have served as Professors for several years or even decades, to research positions, ostensibly to create job openings for doctors. However, this plan is illusory, as there simply aren't enough doctors to fill these positions. Forcibly redirecting an individual's career against their wishes is not only unethical but also inhumane. The process of shifting will not happen as envisaged. While permanent government employees may be accommodated into new positions, privately-run institutions are more likely to terminate the employment of non-medical faculties resulting in job loss of thousands. 

It is to reiterate that medical M.Sc courses are historically meant to create teachers for undergraduate teaching, these are no different from MD courses and the false notion that M.Sc courses are meant for research has to be debunked.

In conclusion, what needs to be done?

1. The presence of non-medical teachers should be an integral part of medical education, and colleges should have the freedom to appoint them on merit up to a limit of 30%.

2. All forms of discrimination against non-medical teachers must be abolished.

3. The NMC Act should be amended to ensure that every board, committee, or sub-committee includes 50% non-doctors to ensure fairness and equity.

4. All discriminatory and contested guidelines in the CBME and MSR 2023 should be amended immediately or withdrawn.

5. In order to strengthen and regulate the standards of medical M.Sc courses, a new body 'National Commission for Scientists in Healthcare and Medical Education' must be framed.

It's all about securing jobs and filling empty PG seats under the guise of prescribing quality

The current landscape of medical education in India has been marked by a series of challenges and controversies, particularly concerning the roles and actions of the National Medical Commission (NMC), the Union Government, and the petitioner association, the National M.Sc Medical Teachers’ Association (NMMTA). These issues have raised concerns about the fairness, transparency, and inclusivity of the system, as well as the balance between medical and non-medical professionals.

Roles of the NMC:

The NMC, as the regulator of medical education, holds significant responsibilities. It is empowered to set standards and guidelines, making it essential for them to engage in discussions and gather feedback from stakeholders while framing these standards. Additionally, the NMC is expected to follow prescribed quorum procedures when framing guidelines or adopting resolutions. Moreover, it should operate under the guidance and policies set by the Union Government and adhere to the norms established by international bodies such as the World Federation of Medical Education. The NMC should ideally maintain a bipartisan, fair, transparent, and inclusive approach in its practices and not let policies be dictated by personal or collective pride or prejudices.

Roles of the Union Government:

The Ministry of Health and Family Welfare (MoHFW) plays a pivotal role in setting the overarching policies for medical education and directs the NMC to follow these policies. The Union Government holds the authority to ask the NMC to amend or withdraw issued guidelines as needed.

Roles of the Petitioner Association (NMMTA):

The NMMTA serves as a vital entity in safeguarding the interests of its members, who are dedicated educators and professionals with non-medical backgrounds. They hold medical M.Sc postgraduate degrees in specialized fields such as Anatomy, Biochemistry, Physiology, Pharmacology, and Microbiology, often accompanied by Ph.D. qualifications. The association can file feedback on guidelines or appeals with the NMC or the MoHFW and seek legal remedies.

Current Issues:

One of the key issues that have emerged is the association of non-clinical medicos lobbying with the Medical Council of India (MCI) and later with the NMC to exclude non-medical teachers from the medical education system. Initially, the MCI proposed to amend the guidelines, reducing the permissible percentage for non-medical teachers to 15%. The Ministry of Health intervened, leading to the proposal's abandonment. However, the association continued to lobby with the NMC, which resulted in alterations to the guidelines.

The NMMTA appealed to the NMC, but their appeal was rejected. Subsequently, they filed a second appeal, leading to the Union Ministry directing the NMC to revert to the previous norms. However, the NMC submitted an affidavit agreeing to comply and later defied the ministry's directives.

The reasons behind the NMC's actions are a combination of explicit and implicit factors. Explicitly, the introduction of Competency-Based Medical Education (CBME) with horizontal and vertical integrations, coupled with the perceived availability of sufficient medical teachers, served as reasons for the changes. Implicitly, these actions are seen as an attempt to create job opportunities for medical professionals at the expense of non-medical candidates and to fill the vacant MD seats in non-clinical subjects, which have historically been undersubscribed.

Several thousand non-clinical MD seats in non-clinical subjects remain vacant each year, leading to significant revenue loss for medical colleges. One hypothesis suggests that medical colleges tend to retain pricey clinical seats and offer non-clinical seats to government quotas to fulfill their obligations. However, non-clinical subjects remain unpopular among MBBS graduates, who overwhelmingly prefer clinical practice. Non-clinical subjects are often pursued out of desperation after failing to secure clinical seats, and competition from non-medical candidates adds to the complexity.

Despite the persistent vacancies in PG seats in non-clinical subjects, hundreds of candidates continue to enroll in these courses. As they cannot practice in any clinical specialty, they rely on teaching positions for employment. Consequently, the NMC has taken it upon itself to disqualify non-medical candidates and provide jobs to medical graduates.

The association of non-clinical medicos and the subsequent framing of guidelines by the NMC appear to be primarily motivated by facilitating jobs and filling vacant MD seats, all under the guise of a new curriculum and syllabus. Global norms set by the World Federation of Medical Education (WFME) advocate for a balance between medical and non-medical faculties, yet the NMC seems to be disregarding these norms to favor its own members. The NMC is increasingly resembling an association of doctors, akin to the Indian Medical Association. The original draft of the NMC Act proposed that only 60% of its members would be doctors, but this ratio was changed to grant doctors full control. In contrast, the regulatory body of the United Kingdom includes 50% laypersons, a practice that helps keep a check on doctors' self-interests. It is no secret that doctors may sometimes prioritize their self-interests and attempt to disregard any unethical practice (as discussed in detail in this Times of India article: https://timesofindia.indiatimes.com/blogs/staying-alive/how-docs-have-fought-to-keep-pharma-funding-going/).

The NMC may assert that its decisions align with general feedback received from the public. However, it is essential to note that the medical community, encompassing both clinical and non-clinical professionals, has collectively advocated for the exclusion of non-medical individuals. Given the substantial majority held by medical professionals in this feedback, it is evident that it may be inherently biased. In situations of conflict of interest, doctors tend to prioritize their own interests, indicative of an abuse of the dominant position. 

While the NMC seems to operate as 'of the doctors, by the doctors, and for the doctors,' the Union Government has a broader responsibility to accommodate all stakeholders and protect everyone's interests. Therefore, it is justifiable for the Union Government to direct the NMC to revert to the old guidelines, ensuring a fair and balanced representation of medical and non-medical professionals. It is essential to note that when there is a conflict of interest, doctors often tend to favor themselves. This apparent abuse of dominant position involves changing yardsticks, shifting goalposts, and amending rules to portray one group as eligible and another as ineligible, all to promote self-interests.

In conclusion, the current challenges and controversies surrounding Indian medical education call for a balanced and fair approach that upholds the principles of inclusivity and transparency. The struggle for balance between medical and non-medical professionals is a critical issue that requires careful consideration and a commitment to providing quality education and opportunities for all stakeholders.