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For the use of Members of Parliament NOT FOR PUBLICATION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not for publication.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

Cabinet Committee on Economic Affairs, PIB Release dated 07.02.2018. URL: http://pib.nic.in/newsite/PrintRelease.aspx?relid=176333

Rajya Sabha Unstarred Question No. 3635 dated

Lok Sabha Unstarred Question No. 1300 dated 09.02.2018

Rajya Sabha Unstarred Question No. 2032 dated 13.03.2018

Rajya Sabha Unstarred Question No. 2820 dated 20.03.2018

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

Health%20and%20Family%20Welfare/92.pdf)

Annexure-I

Annexure-II

Annexure-III

Annexure-IV

Annexure-V Number of Doctors Registered with State Medical Councils / Medical Council of India

as on 31st December, 2017

Sr. Name of the Medical Council Number of Doctors

1. Andhra Pradesh Medical Council 86129

2. Arunachal Pradesh Medical Council 840

3. Assam Medical Council 22532

4. Bihar Medical Council 40043

5. Chattisgarh Medical Council 6915

6. Delhi Medical Council 16176

7. Goa Medical Council 3367

8. Gujarat Medical Council 53954

9. Haryana Dental & Medical Council 5717

10. Himachal Pradesh Medical Council 2849

11. Jammu & Kashmir 14326

12. Jharkhand Medical Council 5093

13. Karnataka Medical Council 104794

14. Madhya Pradesh Medical Council 34347

15. Maharashtra Medical Council 153513

16. Medical Council of India 52666

17. Nagaland Medical Council 801

18. Orissa Council of Medical Registration 21681

19. Punjab Medical Council 44682

20. Rajasthan Medical Council 40559

21. Sikkim Medical Council 893

22. Tamil Nadu Medical Council 126399

23. Travancore Medical Council 55251

24. Uttar Pradesh Medical Council 71480

25. Uttrakhand Medical Council 7060

26. West Bengal Medical Council 66974

27. Tripura Medical Council 0

28. Telangana Medical Council 2354

Total 10,41,395

*The other State / UTs do not have their own Medical Registration Council.

Hence, their workers get registration with the Councils of other neighbouring States.