New Delhi: The Union health ministry and the National Medical Commission (NMC) are not on the same page about the 2023 Minimum Standard Regulations Under-Graduate (MSR-UG), which lays down the guidelines for setting up new medical colleges and initiating new courses, besides regulating student intake capacity.
Medical education regulator NMC, thePrint has learnt, updated the regulations in a notification in August 2023. The notification nearly doubled the number of hospital beds, faculty members, patients, etc., required to set up new medical colleges, increase seats in existing colleges, or start new courses from the 2024-25 academic year.
Sources in government said the Union health ministry feels the new regulations have “unrealistic” infrastructure and faculty requirements, which medical colleges are finding difficult to fulfill.
“We have asked the NMC to defer the MSR-UG guidelines for two years and suggested a review of the regulations before their implementation,” a top official in the health ministry told ThePrint.
ThePrint reached health secretary Apurva Chandra via emails and phone calls but received no response by the time of publication. This report will be updated if and when a response is received.
The 2023 MSR-UG also included a controversial clause, which said the NMC would permit new MBBS colleges and more undergraduate seats in existing colleges based on the state population — 100 MBBS seats for every 10 lakh population. The NMC, however, deferred the plan after pushback from southern states, which have already breached this ratio.
Now, health ministry sources have cited a letter by the All India Medical Education Federation (AIMEF), a voluntary association of government and non-government medical institutes, saying that 58 medical colleges applied for an increase in MBBS seats this year, but 56 faced rejection under the 2023 MSR-UG. ThePrint has seen a copy of the letter.
The letter, undersigned by Dr Virendra Kumar, managing director, AIMEF, has been sent to the Prime Minister’s Office (PMO), apart from the health ministry and the NMC. It also said that of the 253 applicants seeking renewal of UG courses, 212 faced rejection under the new regulations.
ThePrint could not independently verify the authenticity of the letter as there was no footprint of the association on the internet.
Dr. Aruna Wanikar, chairperson of the NMC UG board, said the regulations were announced after consultations with medical institutes and government representatives, intending to raise the standards of existing and new colleges.
“If we have to, we will defer the new regulations, or else, we will review them. But, the reality is that many institutes, even today, are not following the Aadhaar-enabled biometric attendance system (AEBAS) and close-circuit TV monitoring that also has to link with the NMC national command centre despite these regulations existing from before the 2023 MSR-UG. We are just trying to enforce stricter norms for raising the standard of medical training,” she said.
Overall, 708 institutes in the country offer an MBBS degree to students. The number of UG medicine seats in India was 1,08,848 in 2023.
Also read: After pushback from South, NMC defers plan to add MBBS colleges & seats according to population
‘Criteria too strict’
The AIMEF has argued that under MSR 2020, a medical college with 150 MBBS seats needed 330 beds, but now, it needs a minimum of 605 beds.
The minimum number of patients required in the outpatient department of such colleges has also been raised from 600 to 1,200 per day. The minimum bed occupancy required in such colleges has been raised from 198 to 484 at any given time.
Similarly, the minimum number of operation theatres required in such colleges has been increased from four to nine.
More importantly, according to the AIMEF, the minimum number of professors required in such institutes has been raised from six to 19, associate professors from 18 to 40, assistant professors from 30 to 55, and senior residents from 25 to 58.
Overall, the required number of faculty members, including the posts mentioned above and tutors or demonstrators, has been increased from 122 to 204.
“Through MSR-2023, the NMC has increased the requirement of faculties. However, the NMC knows that recruitment is a lengthy process. Moreover, faculty is not easily available in the market,” the AIMEF wrote in its letter.
“The NMC very tactfully, just to harass medical colleges, added the requirement of senior residents (SRs) in non-clinical branches, too, because the NMC is quite confident that to get SRs in non-clinical branches for three to four years is impossible,” it alleged.
In the latest regulations, said the federation, the NMC abruptly put a cap of 150 seats for new colleges. Old colleges, who applied in the past for an increase to more than 150 seats, can apply for the same again. But they can do this only once and that too in 2024-25.
The NMC has failed to understand that some colleges must have been preparing for an increase in seats for more than two to three years, said the AIMEF.
Setting up medical colleges is a complex process, and the AIMEF letter said it takes up to three to four years for a college with 250 seats to set up a 1,200 bed facility.
“Without thinking about the colleges preparing for an increase in seats, the NMC made a weird regulation,” the AIMEF said.
It has suggested putting the 2023 MSR-UG in abeyance for two years and reexamining the regulations. “For this year, all the applications pending for the academic year 2024-25 might be processed in accordance with the old MSR immediately,” it said.
‘Important to raise standards’
Medical education experts ThePrint spoke to endorsed the NMC’s move to introduce stricter norms for increasing MBBS seats and opening new colleges.
“I feel NMC should permit only those states, which do not have sufficient number of medical colleges for the needs of its population, to open new institutes,” said Dr. C. V. Birmanandhan, former V-P of the Medical Council of India, which preceded the NMC.
Dr. Surapaneni Krishna Mohan, vice-principal of the Panimalar Medical College Hospital and Research Institute in Kerala, said the new MSR was progressive and a step in the right direction.
“Asking the medical education institutes to fulfill the infrastructure- and faculty-related requirements is important to ensure that standard institutes are there to impart quality medical education to students,” he said.
(Edited by Madhurita Goswami)
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