MEMBERS REFERENCE SERVICE LARRDIS LOK SABHA SECRETARIAT NEW DELHI REFERENCE NOTE For the use of Members of Parliament NOT FOR PUBLICATION No.22/RN/Ref./July/2018 STATUS OF MEDICAL EDUCATION IN INDIA Prepared by Shri Jayadev Sahu, Additional Director (23035025) and Shri Rajesh Hajare, Deputy Director of Lok Sabha Secretariat under the supervision of Smt. Kalpana Sharma, Joint Secretary and Smt. Anita Khanna, Director. ---------------- ---------- The Reference Note is for personal use of the Members in the discharge of their Parliamentary duties, and is not for publication. This Service is not to be quoted as the source of information as it is based on the sources indicated at the end/in the context.
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MEMBERS REFERENCE SERVICE
LARRDIS
LOK SABHA SECRETARIAT
NEW DELHI
REFERENCE NOTE
For the use of Members of Parliament NOT FOR PUBLICATION
No.22/RN/Ref./July/2018
STATUS OF MEDICAL EDUCATION IN INDIA
Prepared by Shri Jayadev Sahu, Additional Director (23035025) and Shri Rajesh Hajare, Deputy Director of Lok Sabha
Secretariat under the supervision of Smt. Kalpana Sharma, Joint Secretary and Smt. Anita Khanna, Director.----------------
---------- The Reference Note is for personal use of the Members in the discharge of their Parliamentary duties, and is
not for publication. This Service is not to be quoted as the source of information as it is based on the sources
indicated at the end/in the context.
STATUS OF MEDICAL EDUCATION IN INDIA
Introduction
Developing an effective health care delivery system and ensuring universal access to
affordable health care immensely depend on the status of the medical education system and
the quality of medical practitioners it produces. Building an effective need-based medical
education system is a challenging task and government support in terms of policy framing,
funding and appropriate regulatory mechanisms is crucial for facing this challenge.
The Centre has set up regulatory bodies for monitoring the standards of medical and dental
education, promoting training and research activities. This is being done with a view to
sustain the production of medical and para-medical manpower to meet the requirements of
healthcare delivery system for the primary, secondary and tertiary levels in the country.
Medical Colleges and Intake
Medical colleges: At present, there are 472 medical colleges in the country, out of which
212 in government sector and 260 in private sector with an annual admission capacity of
65183 MBBS and 26450 Post-Graduate students. Details of MBBS/PG seats are at
Annexure-I and II. 51 new Medical colleges were granted permission during the academic
year 2016-17 Session.
Dental Colleges: At present there are 309 dental colleges in the country out of which 44
are in government sector and 265 are in private sector with annual admission capacity of
26,790 BDS and 6019 Post Graduate (MDS) seats. Details of BDS/MDS seats are at
Annexure-III and IV. One new dental college has been granted permission for
establishment during the academic year 2016-17. A total of 260 BDS and 165 MDS seats
have been increased for the academic year 2016-17.
Availability of Doctors
Allopathic Doctors - As per the Medical Council of India, there are a total
10,41,395 allopathic doctors registered with the State Medical Councils/Medical
Council of India as on 31 December 2017. It is estimated by Ministry of Health and
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Family Welfare that around 8.33 lakh doctors may be actually available for active
service.
It gives a doctor-population ratio of 1:1596 as per current population estimate
of 1.33 billion, against WHO norms of 1:1000. State-wise details of doctors
registered with State Medical Councils is at Annexure-V.
Ayurveda, Unani and Homeopathy (AUH) Doctors
There are 7,63,000 Ayurveda, Unani and Homeopathy (AUH) doctors in the
country. It is estimated that around 6.10 lakh Ayurveda, Unani and Homeopathy
(AUH) doctors may actually be available for active service and together with
allopathic doctors, it gives a doctor population ratio of 1:921.
Location of Medical Colleges:
As may be seen at Annexure-I, majority of medical colleges are concentrated in the
south and west of the country. The north-eastern region has comparatively fewer facilities
for medical education. The number of seats in the existing medical colleges falls short of
the present demand for medical professionals. The growth of postgraduate education has
been very slow, which has an effect on the preparation of the next generation of medical
teachers as well as the specialist doctors to undertake clinical practice and research.
More than 45.75 per cent of Government medical colleges and 60 per cent of private
medical colleges are located in the States of Andhra Pradesh, Gujarat, Karnataka, Kerala,
Maharashtra, Tamil Nadu and Puducherry.
Medical Education -Some Issues
The Medical Council of India/Dental Council of India/Indian Medical Council
(AYUSH) play important roles in setting standards, curriculum development, inspection
and grant of permission for setting up new institutions, undertaking subject to central
Government approval where defined. In its Report, the committee for evaluation of the
New Education Policy has pointed out that the Councils, and in particular the Medical
Council of India comprises of elected persons who have a strong vested interest in
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retaining their voting constituency over the larger interests of public health and medical
education. It has stated that such entrenched interests of different kinds should be kept
away from the functions of inspection, verification and standard-setting as well as approval
for opening new institutions. The Report further states that the responsibility for
manpower planning, design of curricula and standard-setting needs to be done by a body
which is conversant with the demographics of India, the prevalence of communicable and
non-communicable diseases, challenges connected with maternal and child health so that
the production of doctors is planned keeping in mind the needs of specialised as well as
general duty doctors. The Committee has recommended for increasing:
The number of seats in the existing medical colleges falls well short of the present
demand for medical professionals. The growth postgraduate education has been very
slow which has an effect on the preparation of the next generation of medical teachers
as well as the specialised doctors to undertake clinical practice and research.
The existing framework of medical education needs significant restructuring.
Entrenched interests of different kinds should be kept away from the functions of
inspection, verification and standard-setting as well as approval for opening new
institutions.
Public investment for starting medical colleges, besides encouraging the private sector
to set up medical colleges, with appropriate incentives.
The Parliamentary Standing Committee on Health and Family Welfare, in its Report
presented in March 2016 has made several recommendations, particularly in regard to the
running of the Medical Council.
Recent Initiatives/Measures
The Government of India has taken various steps to increase the number of doctors.
The ratio of teachers to students has been revised from 1:1 to 1:2 for all MD/MS
disciplines and 1:1 to 1:3 in subjects of Anaesthesiology, Forensic Medicine,
Radiotherapy, Medical Oncology, Surgical Oncology and Psychiatry in all Medical
Colleges across the country. Further, teacher-student ratio in public funded government
medical colleges for Professor has been increased from 1:2 to 1:3 in all clinical subjects
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and for Associate Professor from 1:1 to 1:2 if the Associate Prof. is a unit head. This would
result in increase in number of specialists in the country. Other steps include the
enhancement of maximum intake capacity at MBBS level from 150 to 250, relaxation in
the norms of setting up of medical college in terms of requirement of land, faculty, staff,
bed strength and other infrastructure, strengthening/upgradation of existing State
Government/Central Government medical colleges to increase MBBS seats, etc.
The Central Government has approved the continuation and taking up additional
phases of Human Resources for Health and Medical Education schemes, at a total
estimated cost of Rs.14,930.92 crore upto 2019-20. It has approved the scheme for
augmenting human resources for health and medical education, under which 24 new
Medical Colleges will be set up in underserved areas, 18,058 UG and PG seats in medical
colleges created and 248 Nursing and Midwifery schools will be set up.
Salient Features:
Continuation of ongoing scheme to establish 58 new medical colleges attached with
existing District/Referral hospitals already approved under Phase-I by 2019-20.
Selection and establishment of 24 new medical colleges attached with existing
District/ Referral hospitals under Phase-II by 2021-22.
The locations of proposed 24 new medical colleges in Phase-II will be selected
within the identified underserved areas in Challenge Mode.
increase of 10,000 UG seats by 2020-21, and
8,058 PG seats (4,058 in Phase-l by 2018-19 and 4,000 in Phase-ll by 2020-21).
Auxiliary Nursing and Midwifery (ANM) Schools and
136 General Nursing Midwifery (GNM) Schools by 2019-20 in under-served
districts of the country.
The establishment of new medical colleges and increase of MBBS and PG seats would:
increase the availability of health professionals,
check the existing geographical distribution of medical colleges in the country,
promote affordable medical education in the country,
utilise the existing infrastructure of district hospitals, and improve tertiary care in the
Government sector.
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The Scheme will serve the following purposes:
create additional 10,000 MBBS and 8,000 PG seats in the country,
bridge the gap in number of seats available in government and private sector,
mitigate the shortage of Doctors/specialists/medical faculty in the country by
increasing the number of eats and to achieve the desired doctor population ratio,
upgrade PG teaching facilities in Government medical colleges,
introduce new and higher courses of study,
improve the quality of medical education, medical research and clinical treatment.
Regulatory Mechanisms
1. Medical Council of India (MCI)
The Medical Council of India (MCI) was established as a statutory body under the
provisions of the Indian Medical Council Act (IMC Act), 1933, which was later, replaced
by the Indian Medical Council Act (IMC), 1956 (102 of 1956). The main functions of the
Council are:
maintenance of uniform standards of medical education in the country;
prescribing Minimum Requirements for establishment of medical colleges;
recommendation to start new medical colleges/new courses;
recognition of Medical Qualifications;
maintenance of Indian Medical Register and
enforcing ethical conduct for medical professionals.
2. Dental Council of India (DCI)
The Dental Council of India (DCI) was established as a statutory body under provisions of
the Dentists Act, 1948 (XVI of 1948) with the main objective of regulating the standards of
dental education and dental ethics in the country and for making recommendations to the
Central Government for opening of new dental colleges.
3. Indian Nursing Council (INC): The Indian Nursing Council is an autonomous
body under the Government of India, Ministry of Health and Family Welfare. Indian
Nursing Council Act, 1947 enacted by, giving statutory powers to maintain uniform
standards and regulation of nursing education all over the country.
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4. Pharmacy Council of India (PCI)
The Pharmacy Council of India (PCI) is a body constituted under section 3 of the
Pharmacy Act, 1948 to regulate the profession and practice of Pharmacy. The objective of
the Council is to prescribe minimum standards of education required for qualification as a
Pharmacist, uniform implementation of educational standards, approval of course of study
and examination for Pharmacist, withdrawal of approval of qualifications granted outside
India and maintenance of Central Register of Pharmacists.
Legislative Measures
The National Medical Commission Bill, 2017 introduced by the Minister of Health
and Family Welfare, Shri J. P. Nadda in Lok Sabha on 29 December 2017 seeks to repeal
the Indian Medical Council Act, 1956 and provide for a medical education system to
ensure: (i) availability of adequate and high quality medical professionals, (ii) adoption of
the latest medical research by medical professionals, (iii) periodic assessment of medical
institutions, and (iv) an effective grievance redressal mechanism.
References:
Annual Report 2016-17, Ministry of Health and Family Welfare, URL: https://mohfw.gov.in/sites/default/files/14201617.pdf
Draft National Education Policy 2016 (Ministry of Human Resource Development) URL: http://www.nuepa.org/New/download/NEP2016/ReportNEP.pdf
Parliamentary Standing Committee Report on Health and Family Welfare (Rajya Sabha) dated March, 2016 on MCI (http://164.100.47.5/newcommittee/reports/EnglishCommittees/Committee%20on%20