Open letter to NITI Aayog regarding medical scientists

Open letter to NITI Aayog calling for intervention over policy directions regarding medical scientists

In the 1950s, there were very few teachers in medical colleges to teach the non-clinical subjects of the MBBS curriculum, as most MBBS graduates would pursue postgraduation in the clinical disciplines. To overcome this shortage, the Health Survey and Planning Committee, 1961 (well known as the Mudaliar Committee) under the Ministry of Health and Family Welfare (MoHFW) recommended offering M.Sc courses in the five non-clinical disciplines to the life-science graduates (B.Sc). These courses were conducted by the medical colleges with due recognition by the Medical Council of India (MCI) based on the same curriculum and syllabus as those of MD courses in these disciplines. The degrees are now awarded by the health universities under the 'Faculty of Medicine'. These scientist teachers are known as "non-medical" teachers in order to distinguish them from medical teachers, who possess basic MBBS qualification. At one point, around 100 medical colleges used to run Medical M.Sc postgraduate courses, which has now shrunk to around 35 colleges. It is estimated that around 3-4 thousand students are currently enrolled in these courses. Scientists with Medical M.Sc qualifications, like their counterparts with MD qualifications, have three main career options:
1. as non-clinical teachers in medical/dental colleges,
2. consultants in diagnostic laboratories,
3. scientists in research institutions or industries. 

Having similar educational qualifications and career opportunities, both the degree holders compete for the same jobs. Over the last few years, a section of non-clinical doctors (MBBS graduates with MD in non-clinical subjects) and their associations have lobbied hard with the government to exclude the scientists from the teaching and diagnostic roles. The first axe on the scientists fell in 2014 when the health ministry, through the guidelines under the Clinical Establishment Act, disentitled the entire scientist community from any participation in the diagnostic laboratories despite being granted eligibility by the National Accreditation Board for Testing and Calibration Laboratories (NABL). Both the Directorate General of Health Services (DGHS) and the MCI connived to pressurize the NABL to drop the eligibility of scientists. However, the MoHFW realized its folly and eventually restored the eligibility of scientists as consultants in diagnostic laboratories.

In 2018, again yielding to the lobbying from the community of "non-clinical" doctors, MCI proposed to halve and halt the appointment of "non-medical" teachers in medical colleges. Under the MCI guidelines, there are provisions to appoint scientists up to 30% (50% in Biochemistry) of faculty strength in the five non-clinical disciplines. Following a nation-wide protest by the scientists' community, this proposal was shelved, only to resurface once the National Medical Commission (NMC) replaced the MCI. Under the recent NMC guidelines published through a gazetted notification, the appointment of "non-medical" teachers have been reduced from 30% to 15% in the subjects of Anatomy and Physiology; from 50% to 15% in Biochemistry, and from 30% to 0% in Pharmacology and Microbiology. In a FAQ document released by the NMC, the new guidelines would take effect under three conditions:

1. All new medical colleges that start MBBS admission (2021-22 batch)

2. All old colleges that seek to enhance student admission

3. All new appointments in medical colleges, whether new or old

These guidelines have been like a bolt from the sky that has sounded a death knell to the scientists. These guidelines ensure that thousands of students who are currently pursuing medical M.Sc courses would be deprived of teaching jobs. "Non-medical" teachers who are currently employed in one medical college will have to remain in the same job until they resign, forced to resign or are ultimately fired; once out of a job they have all doors closed everywhere. Being on a sticky wicket, such faculties would be at the mercy of the employers and have to put up with a variety of harassments and give up hopes of any promotions or salary hikes. If a certain institution goes for MBBS seat enhancement, the new rules kick in and the "non-medical" teachers automatically become disqualified or excessive in numbers; which will lead to their sacking. All of these are inhuman scenarios and violation of basic human rights. Scientists, who had pursued these courses never bargained for such an unforeseen situation.

NMC is wrong in its decision for various reasons. Unlike what is projected, there aren't sufficient medical teachers available to fill the void; vacancies are still real. In fact, many MD postgraduate seats in the non-clinical disciplines are going vacant as there are few takers. The prejudiced position of the NMC is arbitrarily depriving the medical students of qualified teachers. Possession of a certain qualification isn't a guarantee of competency and its absence doesn't indicate incompetency. It is a fallacy to assume that the quality of medical education can be improved by purging the scientists. In fact, 21% of teachers (including clinical disciplines) in the US medical colleges are scientists. In the top 10 global medical colleges, scientists account for 70-80% of teachers in the non-clinical disciplines. There are good and poor teachers with either degree. Instead of relying purely on the nomenclature of the academic qualifications, stress must be on the skill and competencies of the teachers. Let the medical education get the best of both; let teachers be selected purely on merit. 

Besides teaching, the "non-medical" teachers are also involved in clinical diagnostic laboratories and research. The "non-medical" teachers are at the forefront of COVID testing in most medical colleges. They are solely or jointly managing these labs in many cases. India's healthcare must not be deprived of quality services that are offered by competent scientists just to please a section of medical professionals. That would be bad policy. Medical education should not be deprived of "non-medical" teachers with Ph.D. qualifications, who can engage in research and guide postgraduates and Ph.D. scholars.  India must utilize the human resource that is available to her. Policies must be made according to the prevalent education system and societal needs. 

Given the poor patient-doctor ratio, India needs more doctors engaged in direct healthcare. Currently, thousands of "non-clinical" doctors are engaged in academics without directly contributing to direct healthcare. In many western countries, there are no postgraduate courses for the doctors in the non-clinical disciplines; in such countries, doctors attend to patients whereas academics and research are mainly handled by scientists. This is a policy that India too must consider.

Finally, it is also to bring to your kind notice that ever since the MCI abandoned the medical M.Sc courses, these courses suffer from variations in curriculum across the universities and haven't been upgraded in a long time. A scientific council to regulate these courses and register the scientists offering professional services in the diagnostic laboratories is warranted. At the same time, given the dwindling job opportunities, the government must put a policy in place regarding the utility of Medical M.Sc courses. By having no representation in the erstwhile MCI and the current NMC, it becomes convenient for the regulatory body dominated by the doctors, to put competing scientists in disadvantageous positions. Our concerns have consistently been ignored both by the Education and Health ministries. The "policy paralysis" regarding the medical M.Sc courses and the biomedical scientists has to end. 

The purpose of this letter is to induce a concern among the top minds of NITI Aayog so as to formulate a futuristic policy taking into account the welfare of this minority community of scientists and their services to the nation.

NMC guidelines for non-medical teachers are bad

The undergraduate curriculum of medical course (MBBS) is broadly divided into early non-clinical and subsequent clinical phases. The non-clinical component is further composed of pre-clinical (Anatomy, Physiology, Biochemistry) subjects taught in the first year and para-clinical subjects (Pharmacology, Microbiology, Pathology, etc) taught in the second year. The non-clinical subjects are basic and foundational whereas the students study the diseases in detail in the clinical subjects (Pediatrics, Ophthalmology, General Medicine, Surgery, Obstetrics & Gynecology, etc). 

The teachers who teach the clinical subjects in all medical colleges are always doctors (MBBS + MS/MD) whereas a minority of the teachers in the non-clinical subjects are scientists (medical M.Sc / Ph.D.), also called "non-medical" teachers. In the 1950s when not many doctors were pursuing postgraduation in non-clinical specialties, a severe shortage of teachers occurred in these specialties. The Health Survey and Planning Committee (Mudaliar Committee) of 1961 recommended opening up of the M.Sc courses in the five non-clinical subjects to non-MBBS science graduates so as to create teachers to teach in medical colleges. The medical M.Sc courses (in Anatomy, Physiology, Biochemistry, Pharmacology & Microbiology) were included in the first schedule of the Indian Medical Council Act. Since the M.Sc courses were pursued by the graduates in life sciences and MD courses in the same subjects were introduced for the medical graduates, MCI quietly withdrew the regulation of M.Sc courses. It also claims that these courses are no longer in the first schedule. At one point in time around 100 medical colleges were running medical M.Sc courses in these five non-clinical subjects, now around 35 medical colleges do. 

Excerpt from the report of Mudaliar Committee

The Teachers Eligibility and Qualifications (TEQ) guidelines of the MCI made a provision to appoint scientist teachers in Anatomy, Physiology, Pharmacology & Microbiology up to 30% of faculty strength, and up to 50% of faculty strength in Biochemistry. There are currently a couple of thousands of non-medical teachers in the various medical colleges across India working in designations ranging from Tutor to Professor & HODs. Similarly, there are plenty of non-medical teachers in centrally administered medical institutions such as AIMMS, PGI, JIPMER, ESI, etc. The appointment of scientists as teachers in the non-clinical specialties is not unique to India; it is practiced almost everywhere. In the top 10 medical colleges of the world, up to 60% of teachers are scientists. In some colleges, some departments are almost entirely composed of scientists. In the US, 21% of teachers in medical colleges are scientists. Although it may seem rational that only doctors should teach MBBS students, it must be borne in mind that non-clinical subjects can be taught effectively by the scientists, who are trained in the same subjects. 

https://journals.physiology.org/doi/full/10.1152/advan.00172.2019

One may still wonder how can a scientist teach medical students even if the subjects are non-clinical. This is because the curriculum and syllabus of medical M.Sc courses are similar in content and quality to the MD courses on the same subjects. Often, both the medical M.Sc and MD courses are conducted in the same medical college by the same faculty using the same curriculum. Both the degrees are offered under the 'faculty of medicine' by the health universities. In addition, the students pursuing medical M.Sc courses have to compulsorily undergo one-year course in Anatomy, Physiology and Biochemistry of the human body (similar to first year MBBS course) so that they are well-versed with the structure and functioning of human body.  Therefore, it can be conveniently concluded that while the underlying graduate degrees are different, the postgraduate degrees are almost similar. 

Medical M.Sc course prospectus

Due to faulty government policies, the number of MBBS UG seats rose in the medical colleges but the number of MD/MS PG seats didn't rise proportionately. There were more doctors but fewer opportunities to take up postgraduation in clinical subjects, hence an increasing number of doctors started pursuing MD in non-clinical subjects. This created competition for the teaching jobs in medical colleges. At the same time, the MCI inexplicably reduced the student-teacher ratio, thereby making the competition for limited jobs even more fierce. 

When the MCI got replaced by the NMC, it published a draft adopting the MCI guidelines regarding the appointment of non-medical teachers. It sought feedback from the stakeholders. Thousands, including non-medical teachers and "non-clinical" medical teachers sent their feedback. In just 7 working days, NMC went through these feedback and decided to reduce the permissible intake of non-medical faculty from 30% to 15% in Anatomy and Physiology, from 50% to 15% in Biochemistry, and from 30% to 0% in Microbiology and Pharmacology. This was the result of incessant lobbying by the community of non-clinical doctors who wanted all the teaching jobs for themselves. In 2018, following a representation from an association of non-clinical doctors MCI had proposed to halve and halt the appointment of non-medical teachers. A sub-committee was formed to examine this issue. The board of governors in supersession of MCI rejected that proposal. Again, following another representation from the same association, the MCI's board of governors  categorically stated in January 2020 that non-medical teachers are required as medical teachers are in short supply. Under pressure from the lobbyists, NMC took a U-turn in October 2020. 

NMC's orginal draft guidelines dated 13/10/2020

25th meeting of BOG held on 6th January 2020

The points that the lobbyists use against the non-medical teachers are the increased availability of medical teachers and the introduction of the new competency based medical curriculum (CBME). While there is no doubt that more numbers of non-clinical doctors are now available for the role of teachers, the vacancies still exist. Many positions are still going vacant for the want of medical teachers, which could have otherwise been filled by the scientist teachers. These conditions force the colleges to deprive the students of teachers rather than appoint scientist teachers. Even to this day, several colleges are managing with non-medical teachers because there is a shortage of medical teachers. For the last few years many PG seats in the non-clinical specialties are going vacant, hence the shortage of medical teachers is likely to continue for several years. 

The CBME involves early clinical exposure and integration (horizontal and vertical) with other non-clinical and clinical subjects right from the first year of the MBBS course. The lobbyists claim that since only the medical teachers have exposure to patients during their own MBBS days, they are better equipped to deal with the new curriculum. While medical teachers can certainly do well, we believe that it is not essential. Only 20% of the syllabus has integrations; there are several chapters that don't need integration at all. All the current teachers, whether medical or non-medical are supposed to undertake Curriculum Implementation Support Programme (CISP), Revised Basic Medical Education as well as Attitude, Ethics & Communication (AETCOM) trainings. In fact, most non-medical teachers have already undertaken these training programs. A non-medical teacher can always seek the help of medical teachers of other specialties to fill the gap. In any case, the 30% limit means only 1-2 non-medical teachers are present in the department whereas the rest (70%) teachers are doctors, who should be able to compensate the shortcomings, if any. 

Besides teaching, the non-medical teachers in the department of Biochemistry and Microbiology also take part in clinical diagnostic laboratory, train MD students, and participate in research activities. In the present COVID pandemic, non-medical teachers have been in the forefront of establishing and running the COVID testing laboratories. Scientists should be an integral component in both medical teaching and diagnostics, as is practiced in many parts of the world. Instead of supporting the scientists, upgrading them, or utilizing them better, the NMC has gone for their exclusion. This certainly is a flawed move. 

Through its FAQ document, NMC has clarified that the new guidelines would be applicable only to the new colleges that would admit students into the 2021-22 batch. The new guidelines would also apply to those medical colleges that would seek enhancement in students' admission. Also, any new appointment into the medical college, whether old or new, will have to follow the new guidelines. This effectively means that a non-medical teacher would be forced to stay put in the same college until retirement, and all possibilities to seek new employment in any college, whether new or old, would be denied. Also, the colleges that opt for seat enhancements will be forced to terminate existing employees in order to fulfill the new guidelines. This will mean that hundreds of teachers would lose jobs. Also, the students who are pursuing medical M.Sc courses hoping to join medical colleges as teachers will have their doors closed by the time they complete their education. It is to be noted here that many medical colleges clearly state in their course prospectus that students can get teaching jobs in medical colleges. These students would be cheated of their chances to earn a livelihood. Having pursued medical M.Sc courses, there are limited avenues of employments outside the medical colleges. In many Western countries, there are no PG courses for doctors in the non-clinical specialties; these areas are mostly serviced by the scientists. In a country that has skewed patient-doctor ratio, more doctors are required to provide direct healthcare, something which our government must seriously consider. 

In every way, the scientists stand to lose, therefore they are protesting it. The entire community of non-medical teachers and students pursuing these courses are alarmed, anxious, and tensed. The scientists' community feel that since NMC is populated and dominated by the doctors, this body would always take the side of doctors whenever there is a conflict of interest. Although NMC is an independent body, the scientists feel that the ministry should step in as it is expected to impartially safeguard the interests of all the stakeholders. For far too long the ministry has pandered to the doctors' community and neglected all others involved in healthcare and medical education. It is time for the government to stand up to the scientists' community and restore their due place. The scientists' community has demanded that the previous MCI norms on the appointment of non-medical teachers be restored. 

The NMC's new guidelines for non-medical teachers are bad for various reasons.

1. It is assumed that only those with MBBS/MD are good teachers and all scientists are bad. This is a myth. There are good and bad teachers with either qualification. In fact, many scientists are excellent teachers. These guidelines will deprive medical students of potentially good scientists teachers.

2. It is assumed that since scientists lack clinical exposure (both theoretically & practically), they will not be able to do justice to the new competency-based curriculum (CBME), which has horizontal and vertical integrations with clinical subjects right from the first year. All teachers, whether medical or non-medical, have undergone the mandatory MCI-monitored curriculum implementation support programme for the implementation of CBME. The integration component is only 20%. It should not be assumed that an undergraduate student in the first or year will start practicing from the third year onwards. The first two phases of MBBS are para-clinical; they get to learn about all the ailments in the clinical subjects anyway. It is wrong to assume that the quality of medical education would not be met due to the presence of one or two scientist teachers. 70-100% of teachers in the non-clinical subjects are anyway doctors. They can always compensate for what a scientist teacher lacks. The NMC must invest some efforts to train the scientist teacher. The scientist teacher can always consult the clinical teacher for inputs, learn, and teach. After all, the scientist has studied the same thing that the medical teacher has learned in the MD curriculum. Basic medical education is undeniably useful, but the teachers from either background teach mainly on the basis of their postgraduate curriculum.

3. It is assumed that the new guidelines would apply only to the new colleges that will establish from 21-22 onwards. Our prior experience tells us there is a strong tendency among the medical colleges (especially private) to apply them as and when they wish. There are already reports of scientist teachers being sacked or asked to leave, even in instances where these rules don't apply. The exclusion of scientist teachers in the rules will give opportunity and armament to the employers to harass the existing scientist teachers and compel them to leave. Once out of job, the new rules will make it impossible to get another job in any new/old medical college.

4. It is assumed that the newly established colleges will get medical faculties. The shortage of medical teachers (including in non-clinical subjects) are very much real even now. In several instances, the positions are going vacant despite several rounds of placement advertisements and interviews. This is more so in rural, remote, under-developed or hilly areas, where most doctors don't want to go. The students will be deprived of teachers in such colleges. Currently, in these scenarios, the scientist teachers are carrying the most burden.

5. It is assumed that by selectively applying new rules to the new colleges, the quality of medical education will improve by ousting all scientist teachers. The new CBME curriculum will be applicable to all the medical colleges, both old and new. In fact, the number of students admitting to the MBBS course will be much higher in the current 542 medical colleges. The existing scientist teachers will continue in the established colleges for another decade or two until all the scientists are eventually flushed out of the system. The benefit of limiting scientists in the new colleges is negligible.

6. It is assumed that the currently employed scientist teachers will be unaffected by the new regulations. The current scientist teachers will be forced to stay in the same job because no medical college, new or old, will hire them anymore. They will be forced to work without promotion or pay hikes. The job insecurity will persist forever and their entire career will be spent on fearing termination. They could be exploited to any extent.

7. It is assumed that currently employed teachers in medical colleges under various stages of recognition will be unaffected by the new rules. As and when these colleges seek to increase their student admission, the new rules would apply. In such a scenario the current scientist teachers will be perceived as a liability. Therefore, those medical colleges that are eying to increase student admission in the foreseeable future will not regularize the current scientist teachers, resulting in their termination. 

8. Since the medical M.Sc courses were offered to the science graduate since the 1960s merely to create teachers in the non-clinical subjects, around 35 medical colleges continue to admit students for these courses. A career as a teacher in medical colleges is the prime reason why students opt for these courses. Currently, 3000-4000 students are pursuing the three-year courses. Their chances of employment are now completely wiped out. Similarly, hundreds of scientists are pursuing Ph.D. hoping for promotion or placements. Their career too would be over before it begins.

9. It is assumed that the medical teachers will be able to handle academics (teaching & practical demonstrations) and diagnostic laboratories all by themselves. In many colleges they are, but in many other colleges, it is the scientists who are jointly or mostly doing this. Not only these, but scientists are also contributing to the growth of scientific knowledge through research and publications. The contributions of the scientists must not be belittled. The fact the medical teachers are forced to undertake a course in Research Methodology, whereas the Ph.D. scientists have already gone through it in their Ph.D. curriculum. Such scientist teachers are better suited to be PG research guides.

10. It is assumed that by purging the scientists from medical teaching, the standards of education can be raised. This is similar to Hitler holding the Jews responsible for Germany's miseries and consequently purging them- "the final solution". The fact that premier central institutions such as AIIMS, JIPMER, PGI, etc continue to employ scientist teachers without any bias, is indicative that scientists are an integral part of medical education. The same is the practice in developed countries; 21% of teachers in US medical colleges are scientists. It is the golden rule in surgery that every attempt to save the body part must be undertaken before taking the easy but radical measure of amputation. Here, the NMC has gone straight for the amputation.

Timeline of events regarding signatory role in diagnostic laboratories

Timeline of events regarding signatory role in diagnostic laboratories

Several lakhs of diagnostic laboratories (aka pathology laboratories) exist in India. Only a few are run professionally (Thyrocare, Dr Lal PathLabs, SRL, Apollo, Metropolis etc). The situation is worse in small cities and towns.

In order to maintain quality and standards, accreditation by agencies are followed. National Accreditation Board for Testing and Calibration Laboratories (NABL), a constituent body of Quality Council of India is the leading accreditation body in India. Only 1076 "medical labs", including those in the public sector, private sector, and medical colleges are currently accredited for various tests. Accreditation is a voluntary endeavor.

Diagnostic lab reports are routinely signed by doctors (MBBS/DCP/MD/DNB) and clinical scientists (medical M.Sc/Ph.D) in the specialties of Biochemistry and Microbiology. Pathology Reports are exclusively signed by the doctors with MD/DNB/DCP in Pathology.

January 2005 - The Executive Committee of the Medical Council of India (MCI) and the Adhoc Committee appointed by the Supreme Court approved the recommendation of its own ethics committee that persons with M.Sc. qualifications with or without Ph.D are entitled to independently or solely sign a medical Biochemistry report in a clinical laboratory.

August 2010 - In order to bring quality and accountability to the various types of clinical establishments (including labs), union health ministry enacted the Clinical Establishments Act (CEA) 2010. Health being a state subject, it is the prerogative of the states to adopt the central act, modify it or formulate their own. As of now, the central act is applicable only in ten states and six union territories.

May 2012- Rules under the CEA are framed. The National Council for Clinical Establishments is formed.

NABL had prescribed M.Sc qualification for signatory role in the diagnostic laboratories for accreditation in 2013 or earlier.

March 2014- National Council for Clinical Establishments under the Chairmanship of Director General of Health Services, Government of India in releases a draft on minimum standards for various categories of Clinical Establishments for implementation of the Clinical Establishments Act. Seeks feedback from the stakeholders. It was the first instance to evoke controversy. It excluded the clinical scientists from signatory role. NMMTA objects.

December 2015 -  NMMTA files a grievance with the Health and Family Welfare Department through an online portal. The grievance was forwarded to the MCI, which replied "matter is not under the purview of MCI" and the grievance was closed without addressing the issue.

July 2016- The National M.Sc Medical Teachers' Association (NMMTA) files a Writ Petition in Bangalore High against these guidelines. Union Health Ministry, NABL and MCI are respondents.

August 2016- NABL writes to the MCI asking for its opinion on the qualifications prescribed by it.

December 2016 - Union Health Ministry writes to NABL pressurizing it to fall in line with its guidelines. Seeks response.

January 2017 - NABL responds to the ministry; states that laboratory accreditation is voluntary; it grants accreditation in accordance with International stand ISO 15189. It stressed that the authorized signatories can be M.Sc (non-medical or Medical) with experience in working in clinical laboratory. It added that NABL assesses not just the qualification but also the knowledge and competence of personnel. It said it was awaiting MCI's reply to its letter.

May 2017- Union Health Ministry publishes draft guidelines through a gazette notification and seeks feedback from the stakeholders.

March 2017 - NMMTA members held a protest event "Delhi Chalo" at Delhi. It included dharna, procession, and press conference. Memorandum was submitted to MoHFW.

July 2017 -  MCI responds to NABL letter, replies stating "all lab reports to be signed/countersigned by persons registered with MCI/State Medical Council". NABL writes to all the accredited labs to comply with the MCI "order".

July 2017  -  NMMTA files an online grievance with the PMO, which forwards it to MoHFW. The ministry closes the grievance stating that as per its guidelines tests reports in the basic composite labs which are machine-generated or reports of basic laboratory test where interpretation is not required may be submitted by lab technicians/ Medical Laboratory Scientist.

August 2017 - A team of NMMTA office-bearers meet the top officers at PMO, NITI Aayog, and MoHFW as well as the union health minister and submit memoranda against the CEA guidelines.

August 2017 - Similar WP filed in Delhi High Court by another association of scientists- the Association of Clinical Biochemists and Microbiologists.

September 2017 - Delhi HC rules that the technical reports, which don't contain a diagnosis, can be signed by scientists with M.Sc qualifications. It states, "a technical report stating test results and indicating the analysis of samples without recording any opinion thereon, would not fall within the scope of medical laboratory reports". It also added "all test reports must necessarily bear a disclaimer to the effect that the report are strictly for the use of medical practitioners and pathologists and the reports are not medical diagnostic results".

November 2017 - The union health ministry convenes another meeting of the stakeholders on the issue of signatory roles in the diagnostic laboratories. NMMTA put forth arguments on the eligibility of scientists with medical M.sc qualification.

December 2017 - The Supreme Court while taking up a special leave petition of a dispute between Gujarat's pathologists and laboratory technicians ruled "We dispose of all these special leave petitions and other pending applications, if any, by taking a view that the stand of the Medical Council of India that Laboratory Report can be countersigned only by a registered medical practitioner with a post graduate qualification in pathology is correct". Scientists with M.Sc/Ph.D were not a party to this case and hence their qualification was not contested.

December 2017 - MCI writes to NABL and all the State Medical Councils to abide by the Supreme Court's ruling.

March 2018 -  NMMTA withdraws its writ petition in the Bangalore High Court frustrated over the delay caused by the respondents in filing replies.

March 2018 - MoHFW convenes a meeting to discuss the Supreme Court's judgment. NMMTA was not invited to the meeting. The subcommittee felt that this judgment overrides the Delhi HC's judgment.

April 2018 - NMMTA files a fresh writ petition in the Delhi High Court over the CEA guidelines for the diagnostic laboratory.

May 2018 - Union Health Ministry publishes the guidelines for diagnostic laboratories through a gazette notification and once again excludes clinical scientists with Medical M.Sc/Ph.D qualifications.

May 2018  - Association of Clinical Biochemists and Microbiologists files a writ petition in the Delhi High Court. Other petitioners join and all cases are subsequently clubbed together.

August 2018 - NMMTA organizes a protest event at Delhi. Its officers bearers meet officials of NITI aayog and MoHFW and submits a memorandum.

August 2018 - NABL convenes a meeting for several stakeholders and decides to stop prescribing eligibility norms for diagnostic labs.

October 2018 -  NMMTA submits MCI a dossier with several documents and evidence supporting the eligibility of scientists to interpret and sign lab reports. Also, the situation and data from other parts of the world are also provided.

December 2018 - NMMTA team visits MCI headquarters and meet BoG's chairman and secretary and requests them to consider the eligibility of scientists.

May 2019 - NMMTA office bearers met the Secretary, & Additional Secretary of MoHFW at New Delhi and requested the ministry to consider their qualifications. A dossier with a variety of documents and evidence was submitted for consideration.

August 2019 - Delhi High Court directs MoHFW to not only consider the representations made but also give hearing to one member of each of the petitioners before reaching a final conclusion.

August 2019: A letter was sent to the Under Secretary of the Ministry of Health and Family Welfare with objections & recommendations on the Human Resource guidelines for the three categories of the diagnostic laboratories. It was requested to include medical M.Sc (with or without Ph.D) as a recognized qualification for all the three categories of the laboratories.

September 2019 - MoHFW convenes another meeting of the stakeholders. NMMTA once again presents its eligibility and requests the ministry to consider M.Sc qualifications.

November 2019: Letter is written to the Board of Governors in supersession of MCI asking them to recognize the qualifications of M.Sc/Ph.D for signing lab reports. A letter is also written to the Union Health Minister asking the ministry to consider M.Sc qualifications for diagnostic labs under CEA.

January 2020 - MoHFW convenes another meeting of the stakeholders. NMMTA argues and gives written submission to include M.sc/Ph.D qualification.

February 2020 - MCI reverses its hostile position and restores the signatory authority to scientists with M.Sc/Ph.D qualifications and writes to MoHFW stating its position.

February 2020 - NMMTA has written to the MoHFW and urged to modify the CEA guidelines based on MCI's letter and provide eligibility to scientists with M.Sc/Ph.D qualifications in Microbiology & Biochemistry in all the three categories of labs to interpret and sign lap reports.

February 2020 – MoHFW updates its human resource guidelines on diagnostic laboratories through a gazette notification wherein signatory grants are given to persons with M.Sc in Medical Microbiology & Medical Biochemistry in all the three categories of labs, although Ph.D is required for medium and advanced labs. Also, the scientists can’t provide any diagnostic opinion.

non medical teachers in medical colleges

मेडिकल कॉलेजों में गैर-चिकित्सा शिक्षकों की भूमिका

इन दिनों मेडिकल कॉलेजों में एक विषय चर्चा का मुद्दा बना है. इस बहस को छेड़ा है MCI ने.  5  जून के कार्यकारी समिति की बैठक में यह प्रस्ताव लाया गया की मेडिकल कॉलेजों में गैर चिकित्सक शिक्षकों की भर्ती ३०-50% से १५-25% तक की जाय. इस विषय पर राय देने के लिए AIIMS के तीन प्रोफेसरों की एक उप समिति घटित की गयी है. इस उप समिति ने अभी तक अपना राय MCI को नहीं भेजा.

यह प्रस्ताव क्यों आया और इसके लागू होने से क्या प्रभाव हो सकते हैं, यह जानने के लिए हमें १९६० की ओर जाना होगा. यह वह समय था जब मेडिकल कॉलेजों में प्री-क्लिनिकल और पारा-क्लिनिकल विषयों में शिक्षकों कि भारी कमी थी. अधिक्तर डॉक्टर MBBS के बाद अपने MD के लिए क्लिनिकल विशयों का चयन करते थे, इस कारण से प्री-क्लिनिकल और पारा-क्लिनिकल विषयों में शिक्षकों की कमी आई. इस कमी को दूर करने के लिए स्वास्त्य मंत्रालय द्वारा घटित एक समिति (मुदालियर समिति) के सुझाव पर गैर-MBBS स्नातकों को मेडिकल कॉलेजों में मेडिकल M.Sc कोर्स के लिए भर्ती करना तय हुआ.

MCI द्वारा मान्यता प्राप्त मेडिकल कॉलेजों में वही विषय पढाये जा सकते हैं जो Indian Medical Council अधिनियम के प्रथम अनुसूची में उल्लेख हों. मेडिकल M.Sc कोर्स का उल्लेख भी इसी उनुसूची में है. तब के मेडिकल कॉलेज मेडिकल M.Sc कोर्स शुरू करने से पहले MCI की अनुमति लिया करते थे.  यूँ तो M.Sc कोर्स दो साल के होते हैं लेकिन मेडिकल M.Sc कोर्स तीन साल के होते हैं. मनुष्य के शरीर के रचना और कार्यप्रणाली को समझने के लिए कोर्स का प्रथम वर्ष MBBS के प्रथम वर्ष के पाठ्यक्रम जैसा होता है. बाकी के दो साल में अपने चुने हुए विषय पर अध्ययन करते हैं. ये विषय हैं - प्री-क्लिनिकल में एनाटोमी, बायोकेमिस्ट्री और फिजियोलॉजी तथा पारा-क्लिनिकल में फार्माकोलॉजी और माइक्रोबायोलॉजी. इन्ही विषयों पर मेडिकल कॉलेजों में MD कोर्स भी होते हैं. ये दोनों कोर्स साथ साथ कॉलेज के प्राध्यापक ही पढ़ाते हैं. इन दोनों कोर्स का पाठ्‍यक्रम और अध्ययन सूची एक सामान होते हैं.  करीब ३० फ़ीसदी गैर-मेडिकल शिक्षकों ने Ph.D भी हासिल की है.

करीब १९८० के दशक में MCI ने मेडिकल M.Sc कोर्स से अपने नाता तोड़ लिया. वह अब इस कोर्स की प्रथम अनुसूची में उल्लेख की भी पुष्टि नहीं देती. MCI-अधिकृत मेडिकल कॉलेजों में कितने गैर-डॉक्टर  शिक्षक हैं, इसका ब्यौरा भी MCI के पास नहीं है.

मेडिकल M.Sc प्राप्त स्नातकोत्तर मेडिकल कॉलेज के प्री-क्लिनिकल और पारा-क्लिनिकल विषयों में अध्यापक नियुक्त होते थे और अनुभव के साथ प्राध्यापक और विभाग के प्रमुख भी बन जाते थे. चूंकि वे डॉक्टर नहीं हैं, उन्हें नॉन-मेडिकल शिक्षक कहा जाता है. किसी समय में देश के ९० से भी अधिक मेडिकल कॉलेजों में मेडिकल M.Sc कोर्स चलाये जाते थे, अब इनकी मात्रा ३० के करीब आ गयी है. इसकी वजह MCI द्वारा MBBS और MD सीटों में अचानक वृद्दि है. अब पहले की तुलना में डॉक्टर प्री-क्लिनिकल और पारा-क्लिनिकल विषयों में MD के लिए भर्ती होने लगे. इससे अत्यधिक डॉक्टर शिक्षक की नौकरी ढूँढने लगे. उन्ही की तरह मेडिकल M.Sc वाले भी नौकरी के अभ्यर्थी बने. नौकरी की इस होड़ ने हालत प्रदूषित कर दिया

डॉक्टरों को लगने लगा की मेडिकल कॉलेजों में शिक्षक के पहले हकदार वे ही हैं और मेडिकल M.Sc वाले उनके रोज़गार और पदोन्नति में बाधा बन रहे हैं. अपने रोज़गार के अवसरों की सुरक्षा के लिए और प्रतिस्पर्धा को ख़त्म करने के लिए अनेक प्रकार के प्रयास शुरू हुए. पहले मेडिकल M.Sc कोर्स पर सवाल उठाये गए और फिर उनके सामर्थ्य और योग्यता पर प्रश्न उठाये गए. कहा जाने लगा की सिर्फ एक डॉक्टर हो मेडिकल स्टूडेंट को बेहतर पढ़ा सकता है क्योंकि उनके पास क्लिनिकल अनुभव होता है.

MCI के नियम-अनुसार प्री-क्लिनिकल और पारा-क्लिनिकल विषयों में गैर-डॉक्टर शिक्षकों की संख्या ३० फीसदी (बायोकेमिस्ट्री में ५० फीसदी) से अदिकतम नहीं हो सकती. इन गैर-क्लिनिकल विषयों की शिक्षा देने के लिए सिर्फ डॉक्टर ही हो, ऐसा आवश्यक नहीं है. यह तो शुरुआत के पहले दो वर्षों में पढाई जाती है, बाकी के 2½ वर्षों में क्लिनिकल विषय ही पढाये जाते हैं, जो सिर्फ मेडिकल शिक्षक ही देते हैं. अगर गैर-मेडिकल शिक्षक के पास क्लिनिकल अनुभव नहीं है तो बाकी के ७० फीसदी मेडिकल शिक्षक उसकी भरपाई क्यों नहीं कर सकते? जो बात ५० साल से सही थी वह अब नौकरी के आभाव में गलत लगने लगा है.

गैर-ड़ोक्टोरों द्वारा मेडिकल छात्रों को पढाना कोई अनोखी बात नहीं है और न ही इस देश की विशेषता है. पश्चिम के कई देशों में भारत से भी पूर्व चला आ रहा है. इन देशों के अधिकांश मेडिकल कॉलेजों में प्री-क्लिनिकल और पारा-क्लिनिकल विषयों में गैर-डॉक्टर शिक्षक ही पढ़ाते हैं. विश्व के 10 शीर्ष मेडिकल कॉलेजों में गैर-डॉक्टर शिक्षकों की मात्रा 60 फीसदी तक है. इन कई देशों के वैद्यकीय शिक्षा प्रणाली में प्री-क्लिनिकल और पारा-क्लिनिकल विषयों में MD कोर्स ही नहीं होते. उनका तथ्य है की डॉक्टर का मूलभूत भूमिका रोगियों के चिकत्सा का है, न की केवल एक शिक्षक का. भारत में डॉक्टरों की कमी को देखते हुए सरकार को प्री-क्लिनिकल और पारा-क्लिनिकल विषयों में MD कोर्स को बंद या कम कर देना चाहिए ताकि अधिकतम डॉक्टर स्वास्थ्य और  चिकित्सा के काम आ सके.

फिलहाल, दोनों पक्ष MCI, MCI द्वारा घटित उप समिति और स्वास्थ्य मंत्रालय को अपना पक्ष रख रहे हैं. IMA सहित अनेक डॉक्टरों के संघों ने MCI के प्रस्ताव का समर्थन किया है, वंही गैर-मेडिकल वर्ग के लोग परेशान हैं.

एक अनुसार के मुताबिक समूचे भारत में , इन पांच गैर-क्लिनिकल विषयों में कुल १३ फ़ीसदी शिक्षक गैर-मेडिकल हैं. अगर स्वास्थ्य मंत्रालय MCI के इस प्रस्ताव को स्वीकृति देती है तो गैर-मेडिकल शिक्षकों की नौकरी खतरे में आ सकती है. जो शिक्षक कई साल और दशकों से सेवावृत हैं, उन्हें निष्काषित किया जा सकता है या फिर अपमानजनिक स्थिथिओं में रहना पड़ सकता है. सैंकड़ो विद्यार्थी जो मेडिकल M.Sc या Ph.D कर रहे हैं, उनका भविष्य भी अँधेरे में है.

गैर-मेडिकल शिक्षकों का मानना है कि MCI ने सदैव ही उनके साथ सौतेला व्यवहार ही किया है, पांच दशक से साथ रहने पर भी उन्हें कभी अपना नही माना, वैद्यकीय परिवार का हिस्सा नहीं माना. डॉक्टर न होने की वजह से मेडिकल कॉलेजों में अनेक प्रकार के भेदभाव को झेलना पड़ता है. उन्हें रोज़ाना तौर पर अपने आप को सिद्द करना पड़ता है, इसलिए उन्हें अपने काम में तत्परता दिखानी पड़ती है. अपनी लगन और क्षमता के चलते, ये स्किक्षक मेडिकल छात्रों के प्रशंसा के पात्र बनते हैं. कई बार शिक्षकों के नौकरी के साक्षात्कार में गैर-मेडिकल लोग मेडिकल अभ्यार्ति से बेहतर प्रदर्शन कर चयन होते हैं.

अपने वर्ग के लोगो को नौकरी मिले इस फितरत में दुसरे वर्ग की सोशल मीडिया में बदनामी की जा रही है. अपने को श्रेष्ट और दुसरे को नालायक सिद्द करने की प्रक्रिया शुरू हो गई है. इस तरह वैद्यकीय शिक्षकों में एक अस्वस्थ वातावरण छा गया है, जिनका असर विद्यार्थियों पर पड़ सकता है. इस समय सरकार को पक्षपात किये बिना चाहिए की अनैतिक लॉबिंग की अनदेखा करें और निर्णय ले की मेडिकल शिक्षा में दोनों वर्गों के शिक्षकों को अवसर मिले. अछि शिक्षा के लिए उत्तम योग्यता वालों का चयन हो, न सिर्फ डिग्री के नाम पर. सिर्फ इसलिए की अब गैर-क्लिनिकल डॉक्टर उपलब्ध हैं, गैर-मेडिकल लोगों की अनदेखी हो, यह बात सही नहीं है. साथ में सर्कार को इन अल्पसंख्यक गैर-मेडिकल शिक्षकों के हितों की भी रक्षा करनी चाहिए. इन दोनों देग्रीयों के बीच स्पर्धा के बजाय दोनों साथ मिलकर काम करें तो सबका भला होगा. बदलते सन्दर्भों में युवा वर्ग को मीडियल M.Sc कोर्स में भर्ती होने से पहले उसके कैरियर के अवसर की जांच करनी होगी. साथ ही में, जो मेडिकल कॉलेज ये कोर्स चला रहें हैं, उन्हें भी इस कोर्स के भविष्य और उपयुक्ति पर विमर्श करना होगा

Are our biomedical scientists getting their due?

Several findings and reports, including those of the parliament's standing committee and NITI Aayog, have consistently found fault with the way Medical Council of India (MCI) handled medical education in India. MCI was tasked with "maintenance of uniform standards of medical education", in which it had failed miserably. Barring few exceptions, the current standards of medical education are abysmal. It is no wonder that despite having 460 medical colleges, not one features in the global top 100 ranking. With the possible replacement of MCI with the National Medical Commission (NMC), India is set to change the way it conducts its medical education.

Healthcare is not only about medical education or the creation of doctors; there are other components to it, which also needs the government's attention and focus. Like the council for medical education, there are separate councils for dentistry, nursing, pharmacy and traditional Indian medicines. There are several other branches associated with the healthcare, whose professionals include physiotherapists, optometrists, laboratory technicians, imaging technologists etc, who have no such councils. Some states have their own paramedical councils but the center hasn't framed one yet. The bill "Allied and Healthcare Professional’s Central Council" drafted in 2015 is in the cold storage. Health is a state subject, it is the responsibility of the government to ensure high standards and good quality in all aspects of the healthcare. The central government has passed the Clinical Establishments Act  (CEA) to regulate all institutions that offer healthcare; however, it is subjected to the adoption by the states.

Lost in the conundrum and din of medical education and the clinical establishments, a vital component of healthcare- the biomedical scientists have been largely ignored. Not much is known about them or there are misconceptions floating around. These are the persons with Medical Master of Science (M.Sc) degree obtained in the medical colleges and awarded by the health universities under the faculty of medicine. Along with all the medical courses, Medical M.Sc courses also feature in the first schedule of the Indian Medical Council Act, 1956. Many of these biomedical scientists hold Ph.D as well.

Owing to the critical shortage of teachers in the non-clinical subjects of the MBBS course, medical M.Sc postgraduate courses were thrown open to the non-doctors. Graduates with B.Sc in any branch of life sciences  (including BAMS, B.V.Sc, BDS etc) could enroll in these three-year courses. At some point in time, more than 90 medical colleges in India conducted these courses, many of which have stopped now. The MCI, which used to sanction permission to run these courses in the medical colleges, has stopped this practice. The process of enrolling persons with these degrees in the medical council's register too has stopped. Essentially, MCI washed its hands off completely from this course. With none to regulate them, the onus was on the respective universities, which resulted in variations in the conduct of these courses. However, in principle, the curriculum and syllabus of the Medical M.Sc course in the pre-clinical subjects (Anatomy, Biochemistry & Physiology) and para-clinical subjects (Pharmacology & Microbiology) are mostly similar to those of M.D degree in these specialties. 

The two courses often run parallel to each other in the same department using the same set of teachers, laboratories, and resources. Like their counterparts pursuing MD courses, students of the medical M.Sc courses too undertake seminars, journal presentations, dissertations, case discussions, etc during their training period. The first year of these courses is similar to the syllabus of the first year MBBS, so that people from non-medical background understand the basic structure and functioning of the human body. Depending on the policies of the individual institution, they are also exposed to the central diagnostic laboratory, hospitals, and the teaching modalities. In the diagnostic specialties of Biochemistry and Microbiology, the principles of diseases processes, methods of diagnosing them with laboratory tests, principles and procedures, quality control and interpretation of laboratory reports are an integral part of the syllabus. Students of these courses undergo an examination pattern similar to that of MD courses and are examined by Professors of the medical colleges. Persons with medical M.Sc degree are deemed qualified to undertake the roles of teachers in non-clinical subjects, consultants in diagnostic laboratories and scientists in research institutions.

Following the recommendations in the report of the Health Survey and Planning Committee of 1961, chaired by Dr. A.L Mudaliar, the then V-C of Madras University, biomedical scientists with medical M.Sc degree were appointed as teachers in these five non-clinical subjects. As per the MCI's Teachers' Eligibility and Qualification (TEQ) guidelines, these so-called 'non-medical' persons can be appointed to the extent of 30% (50% in Biochemistry) of the permitted faculty strength in the medical colleges. With a Ph.D in their specialty, they can be promoted up to the post of Professor. Until 1998, these non-medical teachers could be appointed as Head of the Department (HOD), but not anymore.

In the last 5-10 years, there has been a surge in the number of MBBS graduates taking up MD in these non-clinical subjects, resulting in the competition for the teaching jobs. Ever since the MCI reduced the teacher-student ratio, the job opportunities have decreased drastically. Non-medical teachers who upheld education for the last five decades are now not only unwanted but also deemed unsuitable. Massive propaganda and lobbying have made the MCI suggest the reduction in the intake of non-medical teachers to 15% (25% in Biochemistry) and then stop it after three years. Non-medical teachers are alarmed. Not only it will deny opportunities to those who are pursuing the course but will also eventually affect those in service.  When the eligibility is removed, it would become easier to harass the employees or even terminate them. The health ministry must not permit the MCI, which is on the verge of extinction, to make major policy changes.

All these years, persons with medical M.Sc in Biochemistry and Microbiology have been working as consultants in the clinical diagnostic laboratories. In the medical colleges, where they are working as Professors, they have trained the MD students in the principle and practices of laboratory diagnostics. These biomedical scientists have been working as biochemists or microbiologists in government laboratories. National Accreditation Board for Testing and Calibration Laboratories (NABL), a premier agency dealing with the accreditation of laboratories has recognized these courses for their role in diagnostics, including signatory roles. Although MCI had accepted the recommendation of its own ethics committee in 2005 recognizing medical M.Sc as a qualifying degree to sign laboratory reports, it took a U-turn in 2017. The competition for jobs in the diagnostics has led to massive lobbying with the government and the MCI. In the guidelines on diagnostic laboratories under the CEA, medical M.Sc qualification finds no place. The MCI and the health ministry connived to exclude medical M.Sc holders as consultants. Aggrieved over this injustice, the biomedical scientists have approached the courts.

The other option available to these biomedical scientists is to work as scientists in the research institutions. Those run by the central/state governments and by the private organizations are far too few. Roles such as quality control officers or microbiologists in pharmaceutical industries are also few. Genuine research in most medical colleges are scarce; government colleges lack funds and private institutions don't want to invest in research. The research grants provided by the government or universities are few, highly competitive and open to all. A career in research is almost non-existent.

While the government seems to be promoting skill India, the trained and skilled biomedical scientists are being denied opportunities in their area of specialty just to accommodate one profession. Inappropriate exclusion of the degree from the first schedule and subsequent denial of opportunities have pained the community of biomedical scientists a lot. There is no official record of the number of biomedical scientists with medical M.Sc produced to date. It would do them a lot good if the degree were brought back into the ambit of MCI (or the forthcoming NMC). The inclusion of this degree in the allied and healthcare professionals council would be unjustified as the health ministry has clarified that medical M.Sc courses don't come under the allied or paramedical health profession. Creation of a council exclusively for the biomedical scientists would be worthwhile. This council would not only regulate the course but also register the persons with medical M.Sc/Ph.D degrees.

In the medical colleges of many Western countries, teaching in the non-clinical subjects are often taken up by the non-doctor scientists. In the world's top ten medical colleges, non-medical teachers constitute up to 60% in these specialties, highlighting the fact that one doesn't have to be a doctor to teach in the basic non-clinical subjects. In most medical schools of the developed countries, there are no MD courses in these non-clinical subjects. Instead, MD courses are offered only in the clinical subjects. In our country where the patient-doctor ratio is 1:1596, the society needs more doctors to attend to the patients than teach in the colleges alone. Doctors not participating in the direct healthcare is a wastage of professional manpower resources. Edging out non-medical teachers just to accommodate the medical teachers is both inappropriate and unethical. 

The honorable Delhi High court had ruled that laboratory reports are technical reports, not medical reports, therefore the biomedical scientists are eligible to sign them. The health ministry must exhibit magnanimity and permit them to render their services as consultants and sign laboratory reports. Given that there is an acute shortage of specialist doctors in these specialties, the government must permit the suitably trained biomedical scientists to render their services to the society. 

India's contribution to research in the basic medical sciences is abysmal. There are hundreds of Ph.D holders in medical colleges, who are not engaging in active research. This is a wastage of human resources. The government must formulate a policy to engage these scientists and provide the necessary funds and ecosystem for research to thrive. It is time ripe for the policymakers in the government (health ministry and NITI Ayog) to constitute a committee and look into the genuine grievances of our biomedical scientists. The government has to take a call on the utility of these courses and that of the scientists. It must address the present and future of our scientists. If India were to rise in the quality of its healthcare, medical education or research, there must be a shift from dependence on academic qualification to competence. The mere possession of a certain academic qualification is neither a guarantee of competence nor its absence an indicator of incompetence. The policies must be based on training and certification. No single profession can claim monopoly; it is only when the diverse fields come together that the society benefits, which deserves to get the best of all. The concerned ministries and the departments have to come together and sort this mess out. The need of the hour is to be inclusive. It is time to end the policy paralysis. It is time to raise our biomedical scientists.

exclusion of non-medical teachers by the MCI

Exclusion of non-medical teachers by the MCI

Open letter to all the MPs in the government and in the opposition

This is to bring to your kind notice of the following facts and issues.

Indian Medical Council (IMC) Act, 1956 was passed with the aim of regulating and strengthening medical education. Medical Council of India was created under this Act.

In order to address the shortage of non-clinical doctors to teach in the pre-clinical subjects of Anatomy, Physiology & Biochemistry and the para-clinical subjects of Pharmacology & Microbiology, graduates from the science faculty were offered 3-year medical M.Sc courses in the medical colleges. The syllabus and curriculum of medical M.Sc courses are mostly similar to that of MD courses in these subjects.  In the original IMC Act, medical M.Sc courses were included in the First Schedule. These courses were offered in the medical colleges after seeking permission from the MCI. In the 1980s, MCI stopped giving permission to medical colleges to run these courses. MCI now claims that it has nothing to with these courses. Despite that, over 90 medical colleges offered these courses and many continue to offer them.

As per the MCI’s current 1998 guidelines on the Teachers Eligibility and Qualifications (TEQ), persons with medical M.Sc can be appointed as teachers in these five non-clinical departments, subjected to the ceiling of 30% (50% in Biochemistry). With Ph.D. and suitable publications, they can be promoted up to the post of Professors. Since these teachers don’t hold MBBS degree, they are called ‘non-medical teachers’ even though their course is conducted by the medical college and the degree is awarded under the faculty of medicine.

Prior to the 1998 amendment of the MCI’s TEQ guidelines, these non-medical teachers could ascend to the post of Professor without the need for Ph.D. Now, one needs to have Ph.D. beyond the post of Assistant Professor. Earlier, they could head the department, now they are disallowed. Despite being eligible as per MCI guidelines, several health universities refuse to permit these non-medical teachers from rendering their academic services as examiners. Many non-clinical teachers are complaining of discriminations at work with respect to academic roles, promotions, salaries etc. This kind of academic apartheid is unacceptable.

Since persons with medical M.Sc degree study only the medical aspects of their subject like the doctors, their knowledge and skills are restricted only to the medical fields. They are unsuitable for roles & occupations outside the medical field. By virtue of their education, they are suitable to be employed as teachers in the non-clinical departments, consultants in the diagnostic laboratories or as scientists in the research institutions.

There are very limited opportunities for these biomedical scientists in research at the central or state research organizations. After the formulation of the guidelines on the diagnostic laboratories under the Clinical Establishments Act (CEA), these qualified and skilled persons have been wrongly denied their role in diagnostic laboratories. Now the MCI proposes to reduce their presence to 15% (25% in Biochemistry) and stop it after three years. What are they supposed to do if the jobs and opportunities in their field of expertise are being denied to them? There is a threat of job loss to over thousands of non-medical teachers who are already working in medical colleges. Those who are already working as consultants in labs are either being removed or demoted. It is the government’s responsibility to address their concerns.

In the Western Countries, biomedical scientists are held in high esteem; with the right training and Ph.D., they can be head or directors of diagnostic laboratories. Why is our government denying the roles for which our biomedical scientists were trained and educated? In most of the Western medical colleges teaching in the non-clinical subjects are often conducted by the non-medical teachers. In fact, many colleges don’t even offer MD courses in these non-clinical subjects; MD courses are offered only in the clinical subjects. In our country where the patient-doctor ratio is 1:1596, the society needs more doctors to attend to the patients than teach in the colleges alone.

Once included in the first schedule by the parliament, does the MCI have the authority to remove it without sanction from the parliament? Who authorized derecognition of medical M.Sc courses? When was it published in the Gazette? UGC mentions medical M.Sc as a two-year course but most medical colleges are conducting them as a 3-year course. Who is supposed to regulate and standardize these courses? Is there any council for regulating these courses and registering the persons with these degrees? How many colleges are currently conducting these courses? How many students have been produced till date with these degrees? What is the role that the government sees for these biomedical scientists? How many biomedical scientists are required for the next five years? Does this government have any policy after all? MCI has formed a subcommittee to downsize and remove non-medical teachers? Did this subcommittee seek feedback from the stakeholders? Does the health ministry approve of this subcommittee? What is the government doing to safeguard the interests of these biomedical scientists who have no redressal mechanisms for their grievances?

The government must take this matter seriously. Just because they are a minority of few thousands, their rights can’t be ignored. A committee must be formed by the ministry or the parliament to look into their grievances. They can’t be subjected to discriminations and denials of opportunities just because sufficient doctors are now available. It has come to our notice that several non-medical teachers are being sacked. Having served for decades, can they now seek a new profession? Disentitling one just to favour another is unethical and immoral. The government can’t take sides, it is responsible for all sections of the society.

These degree holders must be given their rightful place in the diagnostic laboratories by amending the CEA guidelines and their roles retained in the teaching to the extent of 30-50% in medical colleges. The government must promote research in basic medical sciences by giving importance to M.Sc / Ph.D. holders. They must be given representation in the proposed National Medical Commission to prevent further discrimination. Under no circumstances, people already in employment must be affected by the amendments. The government must either reinclude medical M.Sc degree in the first schedule and ask MCI to regulate the course or set up a new council for the medical scientists that is distinct from the paramedical or allied health professions.

This government must be questioned.

https://twitter.com/NMMTA_Assn/with_replies

Should you take up medical M.Sc courses in India

Medical M.Sc courses, should you join them? An eye-opener! 

So you have done Bachelor’s degree in…
• Chemistry, Botany & Zoology,
• Biochemistry, Microbiology, biotechnology,
• Veterinary science, ayush or dental sciences
• Any other life sciences
• And now, for some strange reason, you want to undertake M.Sc in medical subjects.

What is medical M.Sc course?
• It is a 2-3 year post graduate course.
• Conducted mostly in medical colleges.
• The degree is awarded under the faculty of medicine by the health university.
• Some non-medical colleges & non-medical universities too offer them under the faculty of science.
• Subjects offered are:
• Anatomy, Biochemistry, Physiology, Pharmacology, and Microbiology

What is the duration of this course?
• UGC considers this as a two-year course.
• In most medical colleges, it is of 3 years.
• Irrespective of the specialization sought, the course is divided into two parts:
• Part 1: compulsory for all, one-year in Human Anatomy, Physiology & Biochemistry
• Part 2: two years of subject specialization
• The first part makes the degree “medical” and separates it from general M.Sc.

How to get admitted to these courses?
• Decide if you want to pursue in a medical or non-medical institution.
• Check if the course is of 2 or 3 years of duration.
• Some institutions hold entrance test, some based on B.Sc performance.
• Some offer this to people with specific specialization in Bachelor’s degree.
• Cross check with peers or seniors, do some background check and research on the Internet.
• Meet the counseling department (if exists).

Who governs medical M.Sc courses?
• Nobody!
• Medical Council of India has disowned it.
• UGC is clueless!
• It is left to the individual university and the affiliated colleges to run them as they wish.
• The duration, curriculum, and syllabus vary across the universities.
• Neither MoHFW nor HRD wants to address this anomaly.
• It’s a total chaos…. students are being taken for a ride.

Why was this course started?
• In the 1950s, doctors preferred clinical subjects for specialization after MBBS.
• There were no takers for pre-clinical (Anatomy, Biochemistry, Physiology) & para-clinical (Pharmacology, Microbiology) subjects.
• There was an acute shortage of teachers in these subjects.
• It was initially introduced for doctors; they didn’t take it.
• Mudaliyar Committee suggested it be offered to non-doctors with B.Sc in science background.
• The course is designed to be of 3 years in order to have basic concepts of the human body.
• Non-doctors were appointed as teachers in medical colleges.

What is the qualification of teaching faculty in these five subjects?
• In medical colleges, the teachers are doctors with MD in their respective subjects.
• They teach and train medical M.Sc students.
• They guide in research and dissertation.
• They train in diagnostic techniques and clinical applications.
• They set question papers, evaluate dissertation and assess students in theory and practical examination.

Why do medical colleges run these courses?
• Any medical college can start medical M.Sc course as it does not require MCI’s approval.
• Approval may be required only from the affiliating university, which is easy to obtain.
• There is no board or council to overlook the quality of education.
• Easy money (as fees) for colleges without any extra investment.
• PG students can be utilized as free-labour (diagnostic laboratory or MBBS practicals) under the excuse of training.
• Gullible & ignorant students keep joining these courses without undertaking basic research on their utility & career options.

What is the general curriculum for this course?
• The first year consists of Anatomy, Physiology & Biochemistry similar to that of Phase I of MBBS course
• One must pass the exam to enter the second part.
• The subsequent 2 years are for specialization; syllabus is same as that of MD courses in these subjects.
• Consist of Practicals, Dissertation, Seminars, Journal clubs, Case discussions, Laboratory postings, & Internal assessment exams.
• Final exam consisting of theory & practical examination (3 days) just as for MD courses.
• However, both the curriculum & syllabus vary across the universities.

What are the career scopes after pursuing this course?
Anatomy:
• Teaching in medical colleges
Biochemistry:
• Teaching in medical colleges, consultant in diagnostic laboratories, scientist in research institutions
Physiology:
• Teaching in medical colleges, scientist in research institutions
Pharmacology:
• Teaching in medical colleges, pharmaceutical companies, scientist in research institutions
Microbiology:
• Teaching in medical colleges, consultant in diagnostic laboratories, scientist in research institutions, pharmaceutical companies

Which industry hires candidates with medical M.Sc?
• Because degree holders are educated in medical subjects, they are unfit for non-medical areas.
• Since they learn what the doctors (in PG course) learn, their employment is in medical field only.
• Persons with medical M.Sc in Biochemistry & Microbiology can’t compete with general M.Sc candidates outside the medical field.
• Education empowers them to render their services as:
• teacher in medical colleges
• consultant in diagnostic laboratories
• scientist in research institutions

What is the current employment scenario?
• Persons with medical M.Sc degree in these 5 subjects are
• Unwanted as teachers in medical colleges; there is tremendous lobbying against medical M.Sc degree holders
• Denied role to work as consultant in diagnostic laboratories
• No or limited avenues for research
• So, what will you do with your degrees if you are disallowed to work in the area of your specialization?
• What’s the point of spending 3 years and lakhs of rupees just to be told you are ineligible or unqualified?
• What’s the worth of your degree?

Want to work as a teacher in medical college?
• You will have to start career as tutor/demonstrator (a non-teaching post) even with a Postgraduate degree.
• The department may or may not assign you any teaching job; you may be asked to handle only MBBS practical classes.
• This job may not be permanent; may be offered on a contractual basis.
• After three years as tutors, you are eligible to be promoted as Assistant Professor even if you don’t have Ph.D.
• Most colleges will neither hike your pay nor promote you.
• No guarantee of promotion even if you obtain Ph.D.
• Salary will always be lesser than that of doctors for the same post.
• The competition for jobs is so high that doctors with MD now take up tutor posts.
• Many new job advertisements don’t mention or entertain Medical M.Sc degree holders even for the tutor posts.
• Some doctors relentlessly pursue negative propaganda against medical M.Sc degree & lobby with college, university, MCI and health ministry.
• You may be treated as a “second-class citizen” at your place of work & have to live with loss of dignity and respect.
• If you have good skills, you could be exploited without giving you any credits.
• Although you are a Biomedical Scientist, you will always be called a “non-medico” by all & sundry.
• You can’t set question paper, evaluate answer scripts or be an examiner for MBBS practical examination.
• Although permitted by the MCI, there is lobbying by the doctors at every level of the University to deny roles in the examination process.
• It is considered humiliating to be guided by a non-doctor for MD dissertation.
• You can’t be an examiner for your own degree (medical M.Sc) examination.
• Without Ph.D, you can’t expect any self-respect, no matter how you good your knowledge & expertise are.
• There are very few opportunities to pursue Ph.D while in-service.
• Your employer may not cooperate, may not offer resources, salary, leaves or depute you for Ph.D.
• Despite possessing Ph.D, promotion and salary hikes may be denied on flimsy grounds.
• Despite having Ph.D, severe efforts would be made to deny roles in the MBBS examination.
• You can never become an MD examiner.
• Non-medicos are banned from becoming HODs, Deans or Principals.
• Since non-medicos are perceived as “outsiders”, they are constantly scrutinized and forced to prove themselves on a daily basis.
• Even a gold medallist in medical M.Sc is no match for a MD, who might have taken several attempts just to pass.
• Because doctors “own” the system, all their shortcomings are naturally ignored or overlooked.
• This is the reason why MCI hasn’t been able to raise the standards of medical education in five decades.
• Some colleges don’t promote non-medical teachers beyond the post of Associate Professor despite possessing requisite eligibility.

Want to work in diagnostic laboratories?
• There is tremendous lobbying by doctors at all levels to keep non-doctors from working as consultants in the diagnostic laboratories.
• Doctors want to establish a monopoly by denying eligibility of others citing vague laws or deliberately misinterpreting them.
• If you don’t have “clinical exposure” you are not eligible to interpret laboratory test reports.
• Since you don’t have MBBS degree & not registered in central or state medical councils, you are not eligible to practice in the laboratory.
• Even with Ph.D, you are only as good as a technician even if you have studied the same what the MD holders have.
Want to work in diagnostic laboratories?
• You can’t sign the laboratory test report because they wrongly consider it as a medical report.
• Your laboratory report must be counter-signed by a doctor who may not have any specialization.
• You might have set up the lab, established SOPs and set quality control protocols, but you can never be considered as a consultant.
• Reports signed by you are dangerous to the lives of patients.
• Since you are not registered in any council, you are unaccountable.
• You are simply a worthless person who knows nothing and can’t be trusted.

Want to be a scientist in research institutions?
• There are very few central or state research institutions in India.
• Whenever the field is “medical”, the first preference is always doctors.
• A person with MBBS, M.D is anytime superior to medical M.Sc with Ph.D.
• You are low in the ranking of preferences for appointment as scientists.
• Your wage will always be lesser than doctors for the same designation.
• You will have to compete with doctors and reservation quota for scientist’s job.
• Despite having “medical” degree, you will be considered along with general M.Sc as a “non-medical” candidate.
• You can never rise to the top levels in any organization you may work.

What is your worth in the medical field?
• Since you are not a doctor, you are assumed to be stupid & ignorant.
• Since you lack “clinical exposure” you are no good at anything medical.
• All your academic training are of doubtful value. Your Ph.D is fake and manipulated.
• Doctors set your syllabus, train you, enskill you, guide you, & assess you; they also belittle and discredit your degree.
• In your field, you can NEVER reach the top because it comes in direct conflict with doctors, which they can never tolerate.
• You will always remain subservient & subordinate to the doctors.
• If you are good in your trade, you will be perceived as a threat.
• Since you are a "scientist", you would be taunted of your academic degree and asked to display cutting-edge research results and patents.

So, will you take up this course?
• Sure, why not?
• Who needs dignity, self-respect, and growth if one has medical M.Sc degree?
• If the above means nothing to you, go ahead and take a plunge.
• Don’t lament later that you were not warned.
• Best wishes to you.

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