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92nd report of the Parliamentary Standing Committee of Health and Family Welfare

New UG syllabus
from next year 

NEW DELHI : The Medical Council of India will announce a new syllabus for Undergraduate (UG) medical education in mid-September.

The new syllabus will be introduced from the year 2019-20, according to Dr. Reena Nayyar, secretary of MCI.

The current syllabus was introduced over two decades ago and is being taught in all medical colleges in the country. The new syllabus, Nayyar said, focuses on skill-based and hands-on training.

“The syllabus is ready and the final content is being proof-read. It will be published in September and introduced from the next academic session, as this year it will be difficult for colleges to adopt it,” she said. “Information on new diseases has been included while irrelevant chapters not needed in general practice have been removed,” she added.

MCI has also started training teachers across India to teach the new syllabus from next year.

“Over the last six months or so, we have trained close to 40,000 teachers identified by the respective medical education departments of medical colleges, and these teachers will further train their colleagues on how to handle the new course material,” said Nayyar.

The undergraduate medical syllabus was last revised in 1997. It was heavy on theory, especially in anatomy, pathology and physiology. Students acquired clinical experience at hospitals from the third year. The new curriculum will have students observing treatment at hospitals from their first year.

Few takers for ESIC quota seats
There are hardly any takers for medical seats reserved by the Employees State Insurance Corporation (ESIC) in the medical colleges of the country due to lack of information about the facility, says a report published in Hindustan Times Lucknow on June 8.

The scheme is available for past several years but very few candidates from the state showed interest in availing the facility of cheaper medical education provided by ESIC.

The facility of admission to the medical colleges is available for the children of employees who are working in private establishments and are the members of the ESIC.

“The ESIC has reserved 332 seats in the nine medical colleges of the country where children of members of the ESIC who have cleared National Eligibility cum Entrance Test (NEET) but got low ranking could be admitted,” said AP Tripathi, additional commissioner, ESIC.

He said people of other states were taking advantage of the reserved seats but the ESIC members in UP seemed ignorant about it.

The nine hospitals are situated in Delhi (30 seats), Kerala (35 seats), Haryana (35 seats), Kolkata (52 seats), Chennai (20 seats), Bangalore (45 seats) Karnataka (45 seats) Hyderabad (50 seats) and Tamil Nadu (20 seats) he said. Besides, at a Dental College in Karnataka 22 seats were reserved for the wards of the ESIC members, he added.

If selected under ESIC quota, the students have to pay Rs 24,000 per annum as tuition fee and Rs 5,000 as caution money which was refundable, Tripathi said.

Only 11 applications from the wards of the ESIC members were received from the different parts of the state this year. While six applications were received from Kanpur, two were received at regional office Lucknow and Noida, one at Varanasi.

Delhi HC upholds CBSE upper age limits to apply for NEET
NEW DELHI : On May 11 the Delhi High Court dismissed pleas challenging a Central Board of Secondary Education (CBSE) notification laying down the upper age limits of 25 and 30 for General and reserved categories respectively to apply for the National Eligibility-cum-Entrance Test (NEET).

The court, however, struck down a clause in the notification that bars students from open schools or those who have studied privately from appearing in the test.

A Bench of Justice Sanjiv Khanna and Justice Chander Shekhar said that the proviso to the clause of the CBSE’s January 22 notification prescribing an upper age limit of 25 in the case of general category candidates and 30 years in the case of reserved category candidates was “legal and valid”.

“To this extent, the writ petitions challenging vires of proviso to clause 4 of the Regulations are dismissed,” the Bench said. The proviso to a clause of the regulations disqualifying recognised open school board candidates “is struck down and declared unconstitutional“.

“Students/candidates, who have done class 12 from NIOS (National Institute of Open Schooling) or recognised open school state boards, would not be treated as per se disqualified for selection and appearance in NEET. Their NEET results, when otherwise eligible, would be declared with other candidates,” the Bench said in its 81-page judgement.

Norms tweaked to create more PG seats
NEW DELHI : To make more PG seats available to students in medical education the Medical Council of India (MCI) has relaxed teaching norms for postgraduate education for private medical colleges -- allowing professors and associate professors to coach more PG students than at present.

The new PG Medical Education Regulations of the MCI notified on April 5, 2018 will, however, apply to only those private colleges that have been running PG courses for 10 years.

The fresh notification says one professor in a private college (which has PG courses running for 10 years) will be able to supervise three students for postgraduate education instead of two in the past.

Likewise, an associate professor heading a hospital unit will be allowed to supervise two PG students instead of one earlier. The rationalisation of student-teacher ratio at the PG level will create at least 2,000 to 3,000 additional PG seats, according to the Ministry of Health.

A similar teacher-student rationalisation principle was earlier applied to government medical colleges.

India faces an acute shortage of specialists. While there are 60,845 MBBS seats, there are only 20,000 PG seats.

The last date for applying for additional PG seats was April 7 and since the new MCI notification came just before April 7, no institution was able to apply for new seats under the amended rules.

“We have asked the MCI to relax the last date for applying for additional seats by a month to ensure that the PG seats can be added for the 2019 session. The MCI is yet to respond,” a ministry official said.

Chairman, PG Education Committee, MCI, Dr B Siwach, said that the schedule for applying for PG seats has been fixed by the Supreme Court and the ministry would have to approach the court for relaxation in that regard.

Madras HC stops seat allotment in PG classes
In an interim order on April 17 the Madras High Court directed the Director General of Health Services (DGHS), New Delhi and Tamil Nadu’s state selection committee not to allot PG medical seats to any students both under the all-India quota and state quota until further orders.

The authorities can go ahead with the counselling process, but they shall not allot seats till further orders, said Justice S Vaidyanathan in his interim orders.

The judge passed the orders on a batch of misc writ petitions (7608 of 2018), including those filed by in-service candidates, seeking direction to DGHS to comply with Post Graduate Medical Education Regulations, in admissions to PG medical courses, and award due weightage (incentive) marks for service rendered in remote/difficult areas.

Some of the petitions also wanted reservation of 50% of seats for in-service candidates under the all-India quota as well. When the pleas came up for hearing, assistant solicitor-general Karthikeyan submitted that though the first phase of counselling had been completed, admissions would not be made till the court passed final orders.

The petitions filed by Dr C Sudhan (Dr. C. Sudhan Vs. The Government of India)
and six others said they were in-service candidates in Tamil Nadu Medical Services, working as assistant surgeons in government medical facilities. They had appeared for NEET PG-2018 and secured more than 50% marks and were duly declared as eligible for admission to PG medical courses this year.

Some of the petitions also wanted reservation of 50% of seats for service candidates under all-India quota too.

“The places we serve are notified as remote/difficult by the state government and hence we are entitled for additional weightage (incentive) marks as per Regulation 9 (IV) of PG Regulations 2000 under all India quota seats. But, authorities are proceeding to conduct counselling for admissions to PG courses without awarding such weightage marks for in-service candidates,” the petitioners said.

Claiming that the move was in violation of MCI regulations, they added that it would adversely affect the interests of the petitioners who were entitled to weightage marks for service rendered by them in remote/difficult areas for determination of merit in selection.

They further pointed out that even in admissions made during the last academic year, the authorities had failed to allot the mandated 50% seats to service candidates as required by the regulation. Tamil Nadu has 1,648 PG medical seats in its 13 government medical colleges. Of this, 50% go to the all India quota for which counselling would be conducted by DGHS.

The remaining 50% would go to the state quota filled by directorate of medical education through a seperate counselling.

Out of such 50% state quota seats, in-service candidates are demanding 50% reservation.

Rules tweaked to favour some for medical seats
Desk Report
: Counselling authorities in some states slyly tweaked rules to favour some cash-rich clients, giving them admission to coveted medical seats hoodwinking the hawk eye of the apex court.

According to a news report published in the Hindustan Times on September 13 the Government-designated counselling authorities in states such as Bihar, Karnataka, Punjab and Puducherry allegedly adopted inconsistent norms to enrol students in the last round of admission to medical colleges for MBBS courses.

These norms contravened guidelines set by the Supreme Court, Medical Council of India and the Health Ministry, the report said.

Citing an instance of Bihar the report said that the state opened the final counselling session at 5 pm on August 31, the last day of admission, and asked candidates to bring demand drafts of more than Rs 10 lakh drawn in favour of colleges.

Parents alleged that no banks are open from 5 pm to midnight. But candidates, who came through commission agents, had their demand draft ready in advance in favour of the colleges that they were supposed to be assigned after the counselling.

Similar irregularities happened in Karnataka, Madhya Pradesh, Puducherry and Punjab.

The allegations defeat the purpose of the Supreme Court-mandated National Eligibility cum Entrance Test (NEET), for more than 60,000 MBBS seats in 474 private and government colleges in India.

Introduced last year to weed out corruption in medical education, NEET provides students rankings by which colleges offer admission through state-run counselling sessions. Complaints of irregularities surfaced in the final leg, called left-out or mop-up round, of the counselling process.

The report quoted Deepak Kumar Gupta of Gorakhpur, Uttar Pradesh who said he got a text message from Karnataka officials at 11 pm on September 4 to appear in a final-leg counselling session the following day by 11 am in Bengaluru.

He took a morning flight from Lucknow and reached the admission office at 10 am.

“The officer rejected my application because I didn’t have the draft. I requested for time or take money through NEFT (online transfer). But it was turned down,” he alleged.

Such irrational demands were allegedly made to deny deserving candidates seats and give admission to lower-ranked students.

Allegations have surfaced that officials and touts connived to deny meritorious students seats and these were then sold on the sly.

“We have access to the majority of private colleges in Bihar, Karnataka, Uttar Pradesh and Puducherry,” the news report quoted a tout from east Delhi as having said.

Bihar medical education director Prabhat Kumar dismissed the allegations.

“We started counselling at 3 pm and allowed transfer of money through NEFT as well. We gave time till 1 pm the next day,” he said.

But Kumar admitted the mistake of not mentioning the payment mode in the official advertisement. Students denied the NEFT, or online payment, option.

Candidates scoring as low as 107 got seats during the second leg of admissions in Puducherry. But students such as R Akash, with 128 marks, didn’t get admission despite officials calling a final round to fill 96 vacant seats.

Punjab’s counselling authority, Baba Farid University of Health Sciences (BFUHS), informed on September 2, which was a Saturday and a holiday for Eid, that students should appear for the final round with a demand draft at 11am on Monday.

BFUHS vice chancellor Raj Bahadur denied any wrongdoing. He said: “We accepted bank drafts of any amount in the name of BFUHS so that colleges don’t refuse admission to candidates.”

In Madhya Pradesh, the final round began at 4pm on September 10 and ended at midnight, the last day of counselling.

“A candidate with 191 marks was selected, but students with more than 400 marks were left out,” a student alleged.

A Madhya Pradesh official clarified that it was done to give preference to candidates from the home state.


 NEET applicable to minority institutions, rules SC

By Rajiv Shukla
: In a landmark judgement the Supreme Court on April 29 upheld National Eligibility cum Entrance Test (NEET) as valid, "fair and reasonable" that cannot be said to be taking away any of the Constitutional rights of minority institutions."  

Delivering their judgement in Christian Medical College Vellore Association Vs Union of India and others case a three-judge Bench, comprising Justices Arun Mishra, Vineet Saran and M.R. Shah, said that there was no violation of rights of unaided/aided minority educational bodies to administer their institutions under Articles 19(1)(g) and 30, read with Articles 25, 26 and 29(1) of the Constitution.

The case, a transferred case (Civil) No.98 of 2012 had been lingering for quite some time and in due course of time a number of similar cases were filed on the issue which were clubbed together for judgement.

Most of the petitioners argued that the State had no power to compel an unaided minority institution to admit students through a single centralised national examination so long their admission setup satisfied the triple test of having a fair, transparent, and non-exploitative process. They said that they had the fundamental right to choose the method and manner of admitting their students.

Rejecting their contention the apex court said that the provisions of the MCI/DCI Act and the regulations cannot be said to be ultra vires or taking away the rights guaranteed under Article 30(1) read with Articles 19(1)(g), 14, 25, 26 and 29(1).

"The regulatory measures are intended for the proper functioning of institutions and to ensure that the standard of education is maintained and does not fall low under the guise of an exclusive right of management to the extent of maladministration," the court said.

Delivering their ruling the bench relied heavily on T.M.A. Pai Foundation
and Ors. v. State of Karnataka and Ors., (2002); Islamic Academy of Education and Ors. v. State of Karnataka and Ors., (2003); P A Inamdar and Ors. vs. State of Maharashtra and Ors., (2005) and Ahmedabad St. Xavier's College Society and Anr. vs State of
Gujarat and Anr., (1974).

Noting that NEET has been prescribed by the Legislature in the larger public interest that has to prevail, and added that the provisions were reasonable conditions of recognition/affiliation binding on all such institutions whether run by majority or minority.

Earlier, the apex court had, in 2013 quashed NEET but later in 2016 it allowed review petitions against the 2013 verdict and chose not to put a stay on NEET.

Cabinet okays National Medical Commission bill

By Sanjiv Dube
The draft of the National Medical Commission (NMC) Bill, 2019, which had been drifting on for three years has finally been approved by the Union cabinet but may still take some time in Parliament considering the nature of reforms it proposes.

In the first place, the reforms that the bill proposes would affect the business of private medical colleges in the southern states and their lobby, very strong as it is, may place numerous legal and political hurdles in the way.

According to clause 10 (i) of the bill the NMC will have the authority to "frame guidelines for determination of fees and all other charges in respect of fifty per cent of seats in private medical institutions and deemed to be universities." This will affect the business interests of the owners who may oppose its implementation.

Currently, the fee of courses in professional courses is decided by a state-level fee fixation committee where private players manipulate things to have their way. Now things would be decided by the Central government.

The biggest reform is proposed in the admission test and the passing out, final examination. Clause 14 (2) of the bill says that "The Commission shall conduct the National Eligibility-cum-Entrance Test in English and in such other languages, through such designated authority and in such manner, as may be specified by regulations."

The bill says, in no uncertain terms, that "all" medical institutions would subscribe to the National Eligibility-cum-Entrance Test conducted by the NMC or a "designated authority" which could be an existing one like the National Testing Agency (NTA).

Clause 15 (1) says that there shall be a National Exit Test (NEXT) -- the final year MBBS exam which will serve three purposes -- it will serve as the licentiate test for MBBS pass-outs; as the PG entrance test and the Foreign Medical Graduate Test. This will save MBBS passouts from appearing at a separate admission test after clearing the MBBS final exam. Similarly they would also not be required to appear in a separate exam after MBBS to obtain a licence to practise.

Every year about 80,000 students take admission in MBBS courses in about 480 medical colleges in the country, while 1.5 lakh students appear for entrance exams for admission to around 50,000 PG seats.

The most important aspect of the NMC bill is the introduction of a new cadre of non-MBBS, "mid-level health cadre" with limited rights to prescribe medicines.

Clause 32 (1) of the bill says that "the Commission may grant limited licence to practice medicine at mid-level as Community Health Provider to such person connected with modern scientific medical profession who qualify such criteria as may be specified by the regulations: Provided that the number of limited licence to be granted under this sub-section shall not exceed one-third of the total number of licensed medical practitioners."

Like China, this will give a big relief to country's rural population who have to run to cities for petty ailments. However, this clause will affect the interests of the licensed medical practitioners who will certainly find their catchment area being reduced. The Indian Medical Association, will certainly oppose this clause.

The Bill reflects the concerns of the Parliamentary Standing Committee on Health, which had submitted its report on the Bill last year after the Bill was introduced in Lok Sabha. With the dissolution of the 16th Lok Sabha, the old Bill has lapsed and it needs to be revived.

After its introduction in the lower house in 2017, the Bill, which aims to replace the Medical Council of India Act, 1956, and included the contentious provision of a “bridge course” to allow practitioners of alternative medicines to pursue allopathy, was referred to a department-related Parliamentary Standing Committee following massive protests from the medical fraternity.

The first version of the Bill proposed a national-level licentiate exam for all MBBS graduates for getting licence to practice in India.

But it was removed following strong protests by several doctor bodies.

The provision of the ‘bridge course’ was strongly opposed by health bodies, including the Indian Medical Association, which claimed that allowing AYUSH doctors to practice modern medicine would promote “quackery”, although the ministry had argued that the provision seeks to address the “acute shortage” of doctors.

The panel gave its recommendations in March 2018, following which the health ministry scrapped the provision of 'bridge course and also made some other changes as suggested by the committee before moving the official amendments in the Lok Sabha.

“It has been left to state governments to take necessary measures for addressing and promoting primary healthcare in rural areas,” the amendment states.

March 2016. Parliamentary Standing Committee on Health presents a report calling MCI corrupt, recommends its replacement

Aug 2016. PM appoints special panel, which presents report on draft National Medical Commission Bill to replace IMC Act

July 7, 2017. GoM led by Arun Jaitley clears Bill

Dec 15 2017. Cabinet approves NMC Bill for first time

Dec 29 2017. JP Nadda introduces NMC Bill in LS

Jan 1, 2018. Consideration of NMC Bill in LS deferred as IMA protests provisions to let AYUSH practitioners dispense medicine after a bridge course, hold exit test after MBBS course to license passouts; Bill sent to parliamentary panel.

March 20 2018. Parliamentary panel rejects govt proposals for separate licensing exit tests for MBBS passouts and bridge course for AYUSH practitioners.

July 17, 2019. Central Government approves new draft NMC Bill dropping all controversial clauses.

Govt introduces bill to replace Ordinance

By Our Correspondent
On December 14 the Union government introduced a Bill in Lok Sabha to replace an Ordinance to supersede the existing Medical Council of India (MCI) and vest its powers in a board of governors until the said regulatory body is reconstituted.

The Bill called the Indian Medical Council (amendment) Bill, 2018 was introduced by Union Health Minister J P Nadda in the Lower House.

Amidst uproar over Rafale deal and other issues the minister moved the Bill in Lok Sabha to replace the Ordinance, promulgated by President Ram Nath Kovind on September 26, providing for reconstitution of the MCI within a period of one year.

Moving the bill the minister read out the statement of objects and reasons for the Bill :“The working of the said council has been under scrutiny since long time and the same was examined by various expert bodies including the department related parliamentary standing committee on health and family welfare, which in its ninety-second Report, in March, 2016, severely indicted the said council.”

The parliamentary committee recommended that the government should bring “a new comprehensive” bill in the Parliament “at the earliest” so as to restructure and revamp the regulatory system of medical education and medical practice and to reform the MCI.

“Accordingly, the National Medical Commission Bill, 2017 was introduced in Lok Sabha in December, 2017 and the same is pending,” he added.

Immediate steps

However, in the meantime, in view of “the arbitrary action by the said council” in disregard to the provisions of “the said Act and regulations made thereunder”, immediate steps were required to be taken by the government to put “an alternative mechanism” in place of the council so as to bring transparency, accountability and quality in the governance of medical education in the country, he said.

“Hence, it has been decided to supersede the MCI and entrust its affairs to a board of governors consisting of eminent doctors for a period of one year or until the said council is reconstituted, whichever is earlier,” he said while moving the bill.

Govt axe on 82 UG and many PG medical seats

By Sanjiv Dube
In a blunt decision on May 31 the Union government barred 82 existing medical colleges from admitting students to their MBBS seats in the academic session 2018-19, thereby blocking at least 10,430 of the estimated 64,000 UG seats available in the country.

The decision was taken following recommendations by the Medical Council of India (MCI) which cited "deficiencies" in these medical colleges in the matter of infrastructure, faculty and number of patients.

Seventy of these 82 medical colleges denied permission to admit students are private colleges. The affected government colleges are in Uttar Pradesh (4), Bihar (3), Jharkhand (2), Chhattisgarh (1), Karnataka (1) and Kerala (1).

A cursory glance at the list of disapproved colleges would show that most of these private colleges -- and even government colleges -- were relatively new and were situated in small towns where faculty and infrastructure is difficult to maintain.

Take the case of a new government college Vardhman Institute of Medical Sciences, Nalanda, Bihar. Nalanda is 80 kilometres away from Patna and its physically tough to commute 80 Kms daily to reach the medical college with the kind of poor roads that the state has.

Take the case of another newly opened government medical college --- Rajkiya Medical College, Jalaun, Uttar Pradesh. Jalaun is located amidst the core of notorious Jamuna-Chambal ravines and is far away from Kanpur-Jhansi national highway. No medical expert would dare to stay there come what may.

While most of disapproved private medical colleges are located in cities and are still deficient, largely because of their owners willful neglect, the government medical colleges -- fund starved as they are -- are established by public heath policy and in small towns where finding and retaining faculty is an impossible task.

The Ministry of Health and Family Welfare also rejected proposals to approve 68 new medical colleges which would have added 9,000 MBBS seats for the 2018-19 academic session.

The Union cabinet had in February approved plans to set up 24 new government-funded medical colleges by 2021-22, in addition to 58 medical colleges that were to be established and attached to district hospitals by 2019.

But the rejection of approvals for 68 new colleges, 31 of them government institutions, have raised the question how the government would find faculty for the planned new colleges.

Among the 68 rejected proposals for new medical colleges, 37 are from private institutions.

The health ministry has also rejected proposals from nine medical colleges - four government and five private - to increase their MBBS seats by 50 to 100 each.

Axe on PG/Super speciality courses

The ministry has also axed a number of proposals from 31 postgraduate colleges and super speciality medical institutes for the academic session 2018-19 following adverse recommendations of the MCI.

Incidentally the disapproved colleges include Christian Medical College, Vellore which ranked third in the NAAC assessed India Ranking 2018 for Medical stream. Similarly King George's Medical College University, Lucknow which ranked fifth in the India Ranking 2018 had to suffer the most.

Christian Medical College, Vellore had applied for M.Ch (Reproductive Medicine & Surgery), D.M (Nephrology) and D.M (Pediatrics Neurology) which were rejected. Similarly King George's Medical College University, Lucknow had applied for M.Ch (Plastic & Reconstructive Surgery), M.Ch (Neurosurgery), D.M (Critical care Medicine), M.Ch (Urology) and M.Ch (Cardio Vascular & Thoracic Surgery) and all claims were rejected.

SC to rule on quota for govt docs in PG courses

By Rajiv Shukla
The Supreme Court will soon rule on whether in-service doctors can be allowed benefit of seat reservation in post-graduate degree courses by the state government.

The Supreme Court had in Dr. Sandeep s/o Sadashivrao Kansurkar vs Union of India and others delivered on 27 October 2015 specifically said that there cannot be any kind of reservation in PG admissions except as stipulated in the MCI regulations.

On April 17 a five judge bench presided over by Chief Justice Deepak Misra reserved the order after hearing the arguments against the denial of reservation benefits to in-serve candidates wishing to pursue PG degree medical courses.

Many states have reserved 50 per cents seats in PG medical courses for medical officers in government services despite clear bar by the Medical Council of India (MCI) regulations.

The five-judge constituion bench hearing the Aadhar case acknowledged the importance of the matter and heard the counsel for the petitioners.

A batch of petitions by Tamil Nadu Medical Officers Association and doctors from Kerala, Maharashtra and Haryana challenged the validity of the Post Graduate Medical Education Regulations 2000 framed by the MCI.

The bench orally observed that there cannot be a merit list other than the Central (all-India) and the state lists.

All admissions to PG medical seats are through National Eligibility cum Entrance Test (NEET) under which 50 per cent seats are to be filled through all-India merit and 50 per cent through the state quota.

Pleading their case the counsel for the petitioners from Tamil Nadu said that allowing reservation to them would encourage doctors to work for the state service and in rural areas. On the other hand the counsel representing the Central government and the MCI said that the state have no legislative competence to reserve seats. "Deserving candidates would be replaced by in-service candidates. This is not permissible. This would lead to lowering of standards," the counsel for MCI pleaded.

The MCI counsel said that the first round of counselling has been completed and passing an interim order would jeopardise the scheme.

The matter reacherd the five-judge bench after a bench of Justices Kurian Joseph, Mohan M Shantanagoudar and Navin Sinha last week favoured consideration by a larger bench for passing an emergent interim order. The court had then said it wanted clarity on the distribution of powers between the Centre and the states.

PG courses to be must for all medical colleges

By Our Correspondent
All medical colleges in the country must have postgraduate courses within three years and the new ones within three years of receiving recognition to run undergraduate (UG) courses.

According to a set of amendments suggested by the Ministry of Health and Family Welfare the move is aimed at adding 10,000 more PG seats in next four years. The country presently has about 38,000 postgraduate seats for about 68,000 MBBS graduates who come out of medical college every year.

The amendments to be made to Post-graduate Medical Education Regulations 2000 say that the colleges that fail to do this will lose their recognition. 

The Regulations 2000 will apply to both private and government medical colleges. “There are several medical colleges running only undergraduate courses and wasting valuable resources. It is more prudent to make use of the existing infrastructure than invest in building expensive new colleges,” said a senior health ministry official on condition of anonymity.

According to the health ministry’s estimates, it costs up to ₹4 crore to create a seat in a new medical college, while it costs just about ₹1.2 crore to do so in an existing institute. Colleges will have to apply to start offering post- graduate programmes, following which the MCI will inspect them.

The colleges need to pass the inspection within three attempts to retain recognition. “This is to ensure colleges start PG courses. People have a knack for circumventing rules so we have ensured they have no option but to start PG courses,” the official added.

In an effort to increase seats, the ministry had revised the teacher-student ratio in government medical colleges in 2017, with the benefit now extending to private colleges also. The revised norms permit one professor to have three students under him and one associate professor to have two students, up from the 1:2 ratio for professors and their students, and 1:1 for associate professors.

“This will also give us more PG seats but colleges will have to apply for new seats. There will be proper inspection and the seats will increase for 2019-20 academic session,” the health ministry official said.

Experts welcomed the move but warned that monitoring the quality of doctors produced is equally imperative.

“Increasing PG seats is necessary because many students don’t take up medicine, thinking there is only a 50% chance of their doing PG. But the government must ensure that the quality of training is not compromised,” said Dr KK Talwar, former chairperson, MCI, and former director, Postgraduate Institute of Medical Education and Research, Chandigarh.

The revised norms permit one professor to have three students under him and one associate professor to have two students, up from the 1:2 ratio for professors and their students, and 1:1 for associate professors.

“This will also give us more PG seats but colleges will have to apply for new seats. There will be proper inspection and the seats will increase for 2019-20 academic session,” the health ministry official said.

Experts welcomed the move but warned that monitoring the quality of doctors produced is equally imperative.

“Increasing PG seats is necessary because many students don’t take up medicine, thinking there is only a 50% chance of their doing PG. But the government must ensure that the quality of training is not compromised,” said Dr KK Talwar, former chairperson, MCI, and former director, Postgraduate Institute of Medical Education and Research, Chandigarh.

NEET is back, SC bench scraps earlier judgement

By Rajiv Shukla
In a landmark move the Supreme Court of India on April 11, 2016 recalled its one of the most controversial judgements -- NEET case judgement -- and ordered that "the case be heard afresh".

The case, called National Eligibility-cum-Entrance Test (NEET) case was delivered on July 18, 2013 by the Chief Justice of India Altamas Kabir a dayAltamash Kabir before he was to retire, giving ample relief to private medical colleges. Some  private medical colleges had challenged the Medical Council of India and Dental Council of India regulations on admissions to medical and dental college -- and the relief allowed them to have their way in the matter of admissions.

With the recall of the judgement status quo ante has been restored and the MCI has been told to organise a combined all-India admission test for private and government medical colleges.

However, the MCI vice-chairman Dr C V Bhirmanandham has expressed his inability to hold the all-India test this year because of paucity of time and this may allow the private players to have their way this year as well.

Hearing the review petitions on April 11 the Constitution bench of the Supreme Court headed by Justice A R Dave and comprising Justices A K Sikri, R K Agrawal, A K Goel and R Banumathi recalled the judgment dated July 18, 2013 which had quashed NEET. It said the “majority verdict“ delivered by then Chief Justice Altamas Kabir did not consider an earlier SC judgment that was binding on the bench, nor had he consulted other members of his bench.

Incidentally Justice A R Dave, who headed the 5-judge Constitution bench that recalled the earlier order had given a dissenting verdict in the NEET case. In his April 11 order he specified that he was not consulted by the then CJI Altamas Kabir.

The April 11 order comes just a month before separate entrance tests are to be held for government and private medical colleges, putting lakhs of students in confusion. There are over 400 medical colleges in the country and lakhs of students sit for admission tests for over 52,000 MBBS seats. Since 2013, state governments and private colleges have conducted separate examinations for these.

Monday's order leaves Medical Council of India with the onerous task of conducting the NEET at a short notice as students have already filled in forms for several entrance tests.

Immediately after judgment reviving the NEET was pronounced in open court, stunned lawyers appearing for private colleges, pleaded that the SC clarify the consequences. The bench replied that “natural consequence“ was that NEET comes into force. It said the court would give a fresh hearing on constitutional validity of NEET but in the meantime, the exam will be restored. The lawyers then pleaded that the MCI's notification to bring NEET back be stayed till its validity was decided afresh and said that in 2013, too, an interim stay was given. The bench, however, rejected the plea saying the interim order was only for one academic session and it could not continue.

“After giving our thoughtful and due consideration, we are of the view that the judgment delivered in Christian Medical College needs reconsideration,“ the bench said.

Recalling earlier order the Constitution bench allowed review petitions by the Union government and the Medical Council of India (MCI) against the July 18, 2013, verdict and restored the NEET 2011 notification.

“The NEET regulations are restored and MCI can conduct the examinations pending the fresh judgement,” the order said.

According to the 2011 notification, the CBSE was to conduct the tests for admission to MBBS and BDS courses and the National Board of Examination for the PG programmes.

The 2013 verdict

The 2013 verdict had created a buzz in the apex court corridors as an advocate had posted the outcome on a social networking site in advance. However, Justice Kabir had reportedly said he was not aware of the leak of the judgment.

While Justice Vikramjit Sen (since retired) had shared the views and findings of Justice Kabir against the NEET, Justice Dave had in his dissenting verdict said that the three judges "had no discussion on the subject due to paucity of time". Justice Dave had stressed that this was not the normal practice.

Justice Dave had written in 2013 that “one of the main considerations of having one common entrance test conducted by the Medical Council of India is to check the malaise of money-making business in the admission process by selling their seats for crores, which has been going on for the last so many years in private colleges.”

The Christian Medical College, Vellore; the States of Andhra Pradesh and Tamil Nadu; several associations of private medical colleges; DD Medical College and DD Hospital, Tamil Nadu; and various private medical colleges had filed petitions in High Courts and obtained an interim stay on the applicability of the NEET on them. On the MCI’s petitions, these cases were transferred to the Supreme Court.

No quota in PG admissions, asserts SC

By Rajiv Shukla
On October 27, 2015 the Supreme Court directed the Union  government and all state government to ensure that super-speciality medical admissions are kept "unreserved, open and free" following complaints that some southern states were allowing only domiciled MBBS doctors to appear for PG medical entrance exams.

Delivering a 58-page judgment in Dr. Sandeep and others versus Union of India and others the bench of Justice Dipak Misra and Justice P.C. Pant said that there should be no reservation in post-graduate medical courses based on caste, religion, residence or any other criteria.

The order came on a batch of petitions challenging the domicile policy followed by Andhra Pradesh and Telangana based on the Presidential order, namely, Andhra Pradesh Educational Institutions (Regulations and Admissions) order of 1974 promulgated under Article 371(D) of the Constitution which gave special privileges of education and employment to the local people of Andhra Pradesh.

The bench cited an earlier case - Dr Pradeep Jain versus the Union of India and others - in which the top court had held in 1984 that merit was the sole criterion when it came to super-speciality medical admissions. But till date, it said, the government has not framed any rules or guidelines to implement the directive.

"In the Dr Pradeep Jain case this court... observed that in super-specialities there should really be no reservation. This is... for improving the standard of higher education and thereby... the quality of available medical services...," Justice Misra, who wrote the judgment, observed.

"We hope and trust that the Government of India and the state governments shall seriously consider this aspect... without delay and appropriate guidelines shall be evolved by the Indian Medical Council so as to keep the super specialities... unreserved, open and free."

The petitioner doctors had complained that while in most of India they are allowed to appear in entrance exams of different states for courses like DM (Doctor of Medicine) and MCh (Master of Chirurgiae), Andhra Pradesh, Telangana and Tamil Nadu permitted only those domiciled in these states.

This, they said, means that while candidates domiciled in these states can sit for exams in other states, students from other states are barred from taking exams in these states.

The petitioners said this went against constitutional provisions like Articles 14 (equality before law) and 16 (equality of opportunity in public employment, education, etc.).

The court asked the Andhra and Telangana authorities to objectively assess the policy to see whether it does justice to the aspirations of students and approach the issue keeping national interest as paramount.

The petitions filed said how students from other States, namely, Maharashtra, Uttar Pradesh, Gujarat, Rajasthan, Delhi, Karnataka, Kerala, West Bengal, Bihar and Haryana, allow candidates from all over India to appear in the entrance examination.

It complained that States like Andhra Pradesh, Telangana and Tamil Nadu confine the eligibility only to the candidates having domicile in their respective States.

This judgment only deals with the two States of Andhra and Telangana. The bench observed that it would consider Tamil Nadu's case separately in a hearing scheduled for November 4, 2015.

Supreme Court defends MCI's PG admission rules

By Rajiv Shukla
On January 12, 2015 the Supreme Court upheld the Medical Council of India's (MCI) postgraduate admission regulations and quashed Kerala government's decision to reserve seats for doctors working in its hospitals and other departments.

The court said, in no uncertain terms, that the admissions to the postgraduate medical courses can be done only on the basis of merit of students appearing in the common entrance examination.

The apex court division bench comprising Justices T S Thakur and R Banumathi said that the Post Graduate Medical Education Regulations of the Medical Council of India, 2000 were binding and state governments could not make any rule in violation of the regulations.

The state, the apex court said, overstepped its jurisdiction by making a law earmarking 40% of total seats available to the state quota for its medical officers who were to get admission on the basis of their seniority, without appearing in the entrance examination.

Delivering its judgement in Sudhir N. & ors. versus State of Kerala & ors. on January 12 the bench said : "Regulation 9 (of MCI) is, in our opinion, a complete code by itself inasmuch as it prescribes the basis for determining the eligibility of the candidates including the method to be adopted for determining the inter se merit which remains the only basis for such admissions. To the performance in the entrance test can be added weightage on account of rural service rendered by the candidates in the manner and to the extent indicated," it said.

The court said the method, however, was given a go-by by the impugned legislation when it provided that in-service candidates seeking admission in the quota shall be granted such admission not on the basis of one of the methodologies but on the basis of seniority of such candidates.

"When the maximum marks to be obtained in the entrance test for admission to the institutions for higher education including higher medical education are fixed, the state cannot adversely affect the standards laid down by the Union government. It was held that it is for the MCI to determine reservation to be made for SC/ST and OBC candidates and lowering the qualifying marks in their favour," it said.

Upholding the order, the apex court, however, objected to the observation made by the High Court in which it said that seniority of in-service candidates should be considered while preparing merit list.

"A meritorious in-service candidate cannot be denied admission only because he has an eligible senior above him though lower in merit. It is now fairly well settled that merit and merit alone can be the basis of admission. Their merit cannot be overlooked only to promote seniority which has no place in the scheme of MCI regulations," it said.



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