New Delhi :
The National Medical Commission, which replaced the Medical Council of India, has already courted controversy in its first innings. In its recent gazetted notification titled Minimum Requirements for Annual M.B.B.S. Admissions Regulations, 2020, the percentage of non-medical teachers in the three pre-clinical specialties of Anatomy, Biochemistry, and Physiology have been halved from 30 to 15% whereas the non-medical teachers have been completely eliminated from the para-clinical specialties of Pharmacology and Microbiology. The non-medical teachers, who are scientists with medical M.Sc/Ph.D. qualifications in these specialties are agitated by this decision. The NMC was expected to adopt the guidelines from the erstwhile MCI.
“The appointment of non-medical teachers to teach the non-clinical subjects is neither new nor unique to India”, said Dr. Shridhar Rao, President of the National M.Sc Medical Teachers’ Association (NMMTA). “It is a widespread practice across several countries to employ scientists as teachers in medical colleges. The scientists’ community feels that the government must have a nuanced policy on the utility and conduct of Medical M.Sc courses with the formation of a council to regulate the courses and register the members providing professional services in diagnostic laboratories.
The first draft guidelines were the adoption of the MCI’s guidelines, which had stated, “In the department of Anatomy, Physiology, Pharmacology, and Microbiology, non-medical teachers may be appointed to the extent of 30% of the total number of posts in the department. However, in the department of Biochemistry, non-medical teachers may be appointed to the extent of 50% of the total number of posts in the department”. The NMC sought feedback from the stakeholders over its proposed guidelines. The non-medical teachers have been taken by surprise over the U-turn taken by the NMC. Some sections of the medical teachers have been clamoring for the elimination of the scientists from the medical colleges. The contributing factors attributed to this change are competition for teaching jobs and the introduction of the new competency-based curriculum.
The appointment of non-medical teachers in the medical colleges dates back to the 1960s, when the Mudaliar committee recommended opening up M.Sc courses to the science graduates so as to create teachers for teaching medical students in the non-clinical subjects. The MCI regulated these courses and used to accord permission to the medical colleges to start these courses. Over time, MCI abandoned regulating these courses and their mention went missing from the First Schedule of the IMC Act of 1956.
At some point in time around 95 medical colleges used to run these courses; now only 35 do so. Medical M.Sc courses are conducted in the medical colleges based on the same curriculum and syllabus as those of MD courses in the non-clinical subjects. With more and more doctors pursuing MD courses in these non-clinical specialties, the competition for jobs has heated up, and therefore the demands to halt the appointment of scientists. Despite this, there are still vacancies for teachers in several medical colleges across India, especially the newly established ones and the ones located in hilly, remote, and rural areas. In such medical colleges, the bulk of the teaching and diagnostic works (including COVID19 testing) is undertaken by the scientist teachers.
The gazetted document clearly states that the guidelines would be applicable for medical colleges being established from the academic session 2021-22 onwards. Despite this, there is fear and uncertainty among the community of non-medical teachers as they fear that these guidelines would be illegally extended to the existing medical colleges.
There is no clarity from the NMC over its application. Although the MCI collected data of every teacher from all the affiliated medical colleges, it has no data on the number of non-medical teachers. It is estimated that there could be 4000-5000 non-medical teachers working under the designations ranging from Professors & HOD to Tutors. At the same time, thousands of students are pursuing medical M.Sc courses hoping to get employed in medical colleges. With the implementation of these guidelines, they have lost a major employment opportunity. While these amended guidelines have brought cheers to a section of the non-clinical doctors, it has created ripples in the scientists’ communities.
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In some top medical schools of the West, 50-60% of teachers are scientists”, he added. “Medical M.Sc courses are not only similar to the MD courses, but the students of Medical M.Sc courses study human anatomy, physiology, and biochemistry in addition just as the first year MBBS students do. We are not laypersons as it is projected to be. Although our graduate degrees are different, our postgraduate degrees are similar and our practice is based on our postgraduate teaching. We are wrongly called non-medical teachers; we have been awarded Medical M.Sc degrees under the faculty of Medicine by the health universities“, said Mr. Arjun Maitra, Secretary, NMMTA.
“Like our medical colleagues, we too have undergone the mandatory training on the implementation of the new competency-based curriculum and we are capable and confident of imparting the teaching as envisaged by the NMC” stated Dr. Shridhar. “Instead of shunting us out, there must be more efforts to train and integrate us. We can consult the clinical colleagues for inputs on the horizontal and vertical integrations”, he added.
This controversy is not new. In 2018, the MCI made a proposal to halve and halt the appointment of non-medical teachers. The board of governors had junked this proposal bringing relief to thousands of scientists. But this bogey has come back to haunt them. The scientists feel that despite being in the system for several decades, their voices are not heard.
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“We never had a representation in the MCI, nor do we have one in the NMC. We are a minority but there are no checks in place to protect the interests of the minorities. Our pleas are often ignored and we are treated as non-existing entities”, stated Mr. Maitra. “Any scientific discipline grows when different backgrounds contribute. It would be in the best interest of medical education to have faculties from diverse backgrounds. Let the system have the best of both”, added Dr. Rao.
“We request the government to take note of our precarious position, safeguard our interests and provide us justice by reinstating the previous MCI norms”, said Dr. Rao with optimism.
To an unstarred question posed in the Lok Sabha in 2018, “whether thousands of non-medical teachers who are already working in medical colleges are facing any threat to their jobs”, Ashwini Kumar Choubey, the minister of state in the Ministry of Health and Family Welfare had replied, “does not arise”. The scientists’ community wonders if the ministry intends to remain true to its words.
Implications of the NMC’s decision to exclude scientists:
1. Thousands of students who are pursuing medical M.Sc courses have their careers vapourised even before they complete their courses. Remember, these courses are run for the sake of creating teachers to impart teaching in the non-clinical subjects. Because these courses are conducted in medical colleges on the lines of MD courses, there are very few job opportunities outside healthcare and medical education.
2. Many medical colleges are going for enhancement of student admission; this is what the government wants in order to create more doctors for the country. NMC states that the new regulations apply to new colleges that start admission for the 2021-22 batch but also to any college that applies for an increase in the seats. The moment an existing college applies for seat enhancement, the new regulations kick in. The college would then be forced to terminate the employment of existing non-medical teachers. Again, thousands of teachers would be jobless in the midst of their careers.
3. All new appointments for new or existing colleges are to follow as per the new guidelines. This means a non-medical teacher would be stuck in the same job until retirement or expulsion. If the teachers resign or are forced to resign, all doors are closed for new employment as per the new regulations. Due to this insecure and precarious situation, the college management will harass the employee, knowing very well that there is no other way out. Promotions would be denied. Salary hikes would be denied. Worse, the salary could even be cut. The faculty will have to put up with every harassment, humiliation, and insult and will have to work as a slave with no dignity at all.
4. Monopoly of one category of professionals promotes mediocrity & stagnation. All disciplines of science, including medicine, thrive when people from diverse backgrounds contribute. Contributions of scientists will be completely absent if these guidelines are implemented. Most medical colleges of the world have scientist teachers in the non-clinical departments. Professional competition by scientists will be actually good for the academic environment. Scientist teachers with Ph.D. can promote research and guide the postgraduate students on research better.
5. There are adequate medical teachers in the non-clinical disciplines is a lie. In many medical colleges, the postgraduate seats (MD) in these subjects go vacant year after year as there are no takers. Many existing medical colleges still have many vacancies despite several advertisements and rounds of interviews because they insist on MD degree holders and there are none available in the job market. The medical colleges located in the remote, underdeveloped, or hilly areas are less attractive to the doctors; in such colleges, the non-medical teachers supplement the deficiencies. Sadly, NMC prefers ignoring these vacancies to having them filled by the non-medical teachers.
6. It is a false notion that medical education can be improved by purging the scientists. All these many decades, non-medical teachers constituted only 30% of faculty. How can poor quality be attributed to the minority whereas 70% of medical teachers absolve themselves of their contribution? Mere possession of a certain qualification alone is no indication of competency. There are good and terrible teachers with either qualification. In fact, since the non-medical teachers are always under constant scrutiny, they tend to outperform the medical teachers. Some of the best teachers in medical colleges are often non-medical teachers. By this draconian rule, medical education and the students would be deprived of good educators.
7. Non-medical teachers not only involved in teaching, but they also contribute to the diagnostic laboratory in the attached hospital and undertake research activities. By purging the scientists, the work burden on the medical teachers will increase leading to a fall in the quality of teaching and research.
8. With no job opportunities, the medical M.Sc courses will die a natural death. The nation would be deprived of a class of biomedical scientists, a class which is valued all over the world except in India, which is dominated by prejudiced policymakers.
9. In the present COVID pandemic, it is the scientific community of the medical colleges that have come to the fore in establishing PCR laboratory for testing. In many medical colleges, these PCR labs are solely or jointly managed by scientists. If it were not for the scientists, how would these colleges have managed to start and run these labs? If scientists are eliminated, are the medical colleges equipped to replace them? Being trained scientists, they are better able than doctors in dealing with technologies and more adept at working in a wet lab.
10. Given the skewed patient-doctor ratio, India needs more doctors to deal with direct healthcare. With the artificial vacuum created, thousands of doctors would be diverted to the non-clinical disciplines, which don’t cater to direct healthcare. In western countries there are no or few postgraduate courses for doctors in the non-clinical subjects; these are dealt mainly by the scientists and the doctors cater to direct patient healthcare. India needs more clinical doctors; not non-clinical doctors.
About NMMTA:
NMMTA is a national-level association of persons, registered at Delhi with office bearers from different parts of India and members from 23 states across India. The association was created with the intention of bringing together all persons with a medical M.Sc degree in the subjects of Anatomy, Physiology, Biochemistry, Pharmacology and Microbiology that are conducted in medical institutions and awarded under the faculty of medicine. The association, which is an all-India, non-profit making professional learned body, is registered by the Registrar of Societies, District East, Government of NCT of Delhi. The date of incorporation of this association is 14th August, 2013 and the registration number is 660/2013
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