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In the constantly evolving landscape of healthcare, the foundation of a robust system lies in the quality of medical education. The recent reports presented by the Parliamentary Standing Committee (PSC) on Health and Family Welfare bring out the challenges and imperatives within the Indian medical education system. These reports delve into diverse aspects, ranging from seat shortages and international best practices to the introduction of the National Exit Test (NExT) and the broader vision for the future of medical education in India.

The PSC emphasizes the urgent need to bridge disparities in the quality of medical education across India. The variations in the distribution of medical colleges, primarily concentrated in urban areas, leave rural regions underserved. The call to enhance undergraduate and postgraduate medical seats is not merely a numerical requirement but an imperative to meet the rising demand for competent healthcare professionals.

The committee highlights the importance of optimal utilization of existing infrastructure, an approach that balances quantity with the need to maintain the highest standards of medical education. In its recommendations, the committee advocates for a comprehensive, India-specific strategy for creating specialist seats. This forward-thinking approach ensures that the medical education system aligns with the healthcare needs of the future, producing specialists in proportion to the evolving disease burden.

Recognizing the need for a fair distribution of healthcare professionals, especially in underprivileged areas, the committee calls upon the National Medical Commission (NMC) to play a leading role in devising modalities for workforce distribution. The emphasis on incentives, both monetary and otherwise, reflects a proactive approach to encourage healthcare professionals to serve in areas that need them the most.

The committee’s recommendations extend beyond infrastructure and seat numbers. The call to streamline the recruitment process and eliminate the presence of “ghost faculty” addresses the core challenges within medical colleges. By advocating for improved working conditions, transparent career progression paths, and performance evaluations, the committee reiterates the importance of nurturing a conducive environment for educators and practitioners alike.

In a significant move towards enhancing the quality of medical education in India, the PSC calls for a comparative study of international best practices by the NMC. Recognizing the adaptability of the Flexner model across countries, the committee emphasizes the need for flexibility in implementation to suit evolving requirements.

The committee suggests that India, through the NMC, should explore strategies to ensure a steady supply of healthcare professionals while maintaining educational standards. The proposal for a real-time national database and a unique registration number at the NMC level aligns with global practices, facilitating streamlined processes and efficient tracking of medical professionals. India experiences substantial migration of healthcare professionals within the country and abroad annually. Ensuring real-time monitoring of practicing healthcare professionals nationwide is crucial for effective planning. Additionally, it is essential to mobilize these professionals during public health emergencies. The ongoing implementation of a Health Professional Registry under the Ayushman Bharat Digital Mission initiative is well positioned to deliver real-time monitoring systems. This effort requires coordination between health professional education councils, as well as national and subnational governments. Given the practical reality of international migration of healthcare professionals, efforts should be made to standardize educational requirements across countries. This would facilitate such migrations without imposing undue hardships.

The introduction of the National Exit Test (NExT) into medical education demands meticulous consideration, as emphasized by the PSC. The committee’s call for judicious due diligence, considering the diverse backgrounds of medical colleges, reflects a commitment to inclusive implementation. The recommendation for a moderate evaluation criteria for the initial round of NExT is aimed at ensuring equity among all graduates. The proposal to divide India into zones, with reputed institutes functioning as mentor institutes, aligns with the goal of universalizing and standardizing both undergraduate and postgraduate medical education. As the healthcare landscape evolves, a thoughtful and inclusive examination system will ensure the test’s effectiveness, fairness, and relevance.

The PSC also calls for a substantial increase in both undergraduate and postgraduate medical seats. The urgency of this matter is pertinent given the current shortage of seats, where the demand far exceeds the available supply. The committee’s observations on existing guidelines for establishing new medical colleges and expanding undergraduate seat numbers shed light on critical questions. The detailed approach recommended for authorizing seat expansions, considering infrastructure and teaching positions, reflects a strategic expansion process.

Beyond the issues outline in the PSC report, public health and healthcare management professionals are also crucial health systems actors that need to be addressed. They fall under the regulation of the All India Council for Technical Education (AICTE). However, there is a lack of consistent guidelines regarding the necessary skills for these professionals and standardized curricula to teach them.

Furthermore, given the swift progress in medical sciences, health professionals must stay abreast of these advances to keep delivering accurate services. Several developed nations implement re-licensing exams at specified intervals to ensure professionals stay well-informed about new knowledge and skills. India requires an institutional mechanism and clear guidance to address this matter. The emphasis on evidence-based practices, critical thinking, and continuous learning shows the importance of keeping healthcare practitioners updated with medical advancements. This proactive approach not only secures present healthcare needs but serves as a long-term investment in the future of healthcare.

As the country strives to transform medical education, it is important to heed these recommendations. Collaborative efforts are needed to bridge the seat gap and pave the way for a future healthcare workforce that meets the nation’s growing needs. It is an opportune moment for policymakers, educational institutions, and healthcare professionals to join forces in ensuring that the foundation of our healthcare system is not only resilient but also responsive to the evolving needs of our citizens. As we implement these recommendations, we sow the seeds for a future where quality medical education is the cornerstone of a thriving, inclusive healthcare ecosystem in India.

Dr. N. Krishna Reddy,
President, InOrder, The Health Systems Institute
CEO, ACCESS Health International

Photo Credits: https://www.tribuneindia.com/news/comment/a-revamp-of-medical-education-is-needed-516542

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