Why NMC derecognised CPS Mumbai courses and then restored recognition

NEW DELHI: On August 30, the National Medical Commission (NMC) reversed an earlier decision to discontinue all courses offered by the College of Physicians and Surgeons in Mumbai. CPS Mumbai is over a century old but changes in regulation of medical education left its future and the status of its courses uncertain. Consequently, the beleaguered institution is a full year behind in admissions, still taking in students for the 2023-24 batch while the rest have moved on to 2024-25.

Through a notice dated August 16, the Post Graduate Medical Education Board (PGMEB) of NMC discontinued courses offered at CPS. The board found the college’s response to a show cause notice, in which it stated that it considered itself an examination body with authority to grant medical qualifications, misleading.

However, within 15 days, NMC withdrew its CPS courses discontinuation notice, forced by a Bombay High Court order dated August 22, 2024. “In the meeting of the PGME Board dated July 16, 2024, the decision taken is only in the form of a recommendation and not a final decision, which is only empowered to be taken by the NMC,” the court said while directing the the NMC to rectify the declaration on its website.

Dr Ajay D Sambre, president, of CPS Mumbai, in a statement, said: “CPS welcomes this decision by NMC and with this decision, all negative remarks and speculations will stop. With this order, not only CPS but the entire alumni of CPS and the future students have received justice.”

Since 2009, CPS Mumbai has been facing actions from state and central medical education regulatory bodies. Despite this, admissions have continued along with the court cases.

NMC’s actions and Maharashtra government’s flip-flops on recognition had hit the admission cycle at CPS 2022-23 and it could not fill any of its 1,100 seats in Maharashtra. “But in 2022-23, we had admissions in other states apart from Maharashtra,” said CPS Mumbai’s statement. “NMC action has affected the CPS admissions for the year 2023-24. We agree that there are uncertainties among the students after receiving the notice from NMC, but students are awaiting admission in CPS despite the legalities and we appreciate the student's efforts to get enrolled at CPS.”

The CPS courses admission process for 2023-24 is still ongoing and on the basis of NEET PG 2023 scores.

The NEET-PG 2024 was conducted on August 11 this year and results were announced on August 23. The merit list for 50% all India quota (AIQ) seats was released on September 4 at natboard.edu.in and nbe.edu.in. The NEET PG 2024 counselling schedule is out and registration is from September 20.

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CPS Courses: What is CPS Mumbai and what does it teach?

Established in 1912, CPS is a medical institution by the definition of the erstwhile IMC Act 1956 or as per section 2(i) of NMC Act 2019 and had been established as an “examining body” by the colonial Indian Government in 1912.

CPS offers postgraduate medical education as well as fellowship and diploma courses.

The qualifications granted by CPS Mumbai allow the practitioner to register themselves as specialists upon completing a two-year diploma or three-year fellowship and passing a prescribed exit examination. It also grants PG diplomas and fellowships in Rajasthan, Odisha, Karnataka, Gujarat and in Dadra and Nagar Haveli.

The CPS courses offer an alternative to MBBS graduates seeking postgraduate studies, apart from the traditional MD and MS programmes and the Diplomate of the National Board (DNB) courses provided by the National Board of Examinations in Medical Sciences (NBEMS).

CPS Courses Recognition and Derecognition: Under MCI and NMC

Started on the lines of the Royal College of Surgeons of England in 1912, CPS has been in the limelight since the Medical Council of India (MCI) removed its recognition in 2009.

Through notifications dated December 2, 2009 and February 3, 2010, the central government de-recognised the qualifications issued by CPS Mumbai by deleting these qualifications from the first schedule of the Indian Medical Council Act, 1956 (IMC Act, 1956).

However, the Maharashtra Medical Council (MMC) granted state-level recognition to CPS in the same year.

Through a government resolution in July 2015, the Maharashtra public health department allowed the CPS to start the following nine diploma courses .

• Diploma in ophthalmic medicine and surgery (DOMS)
• Diploma in gynaecology and obstetrics (DGO)
• Diploma in child health (DCH)
• Diploma in pathology and bacteriology (DPB)
• Diploma in anaesthesia (DA)
• Diploma in psychiatry medicine (DPM)
• Diploma in tuberculosis diseases (DTD)
• Diploma in transfusion medicine (DTM)
• Diploma in tropical medicine & health (DTMH)

Through a notification dated October 17, 2017, the union ministry of health and family welfare (MoHFW) recognised all 39 PG diploma courses at CPS on the condition that admission will be based on the NEET PG score and qualifications will not be treated as medical qualification for teaching purposes.

Four months later and without citing reasons, the health ministry derecognised 36 out of 39 medical postgraduate diplomas granted by CPS by again deleting them from the first schedule of the IMC Act, 1956. This was announced by a notification published on January 22, 2018. The remaining three diploma courses were DGO, DCH and DPB.

Through the same notification, MoHFW inserted six fellowship courses in the first schedule of the IMC Act, 1956 and clarified that these qualifications shall not be treated as recognised medical qualifications for the purpose of teaching.

The courses were:

• Membership of College of Physicians and Surgeons, Mumbai (MCPS)
• Fellowship of the College of Physicians and Surgeons, Mumbai in Medicine (FCPS Med)
• Fellowship of the College of Physicians and Surgeons, Mumbai in Pathology (FCPS Path)
• Fellowship of the College of Physicians and Surgeons, Mumbai in Surgery (FCPS Surg )
• Fellowship of the College of Physicians and Surgeons, Mumbai in Dermatology FCPS Derm )
• Fellowship of the College of Physicians and Surgeons, Mumbai in Midwifery and Gynaecology (FCPS Mid & Gyn )
• Fellowship of the College of Physicians and Surgeons, Mumbai in Ophthalmology (FCPS Opth)

CPS Courses Admission: Shift to NEET PG, state counselling

On December 5, 2019, the ministry of health directed the Maharashtra government to conduct a centralised admission process for medical diploma and fellowship courses affiliated to CPS Mumbai on the basis of NEET PG scores. Since 2021-22, the directorate of medical education and research, Maharashtra, has been conducting admissions for CPS diploma and fellowship courses.

During 2022-23, after the admission process of PG medical courses was over, the state government had not yet started admissions for CPS courses. This forced the college to seek directions from the union government. The counselling for CPS course admissions typically starts after the counselling for other postgraduate medical courses, such as MD and MS.

The union government wrote back to CPS referring to an earlier letter from May, 2021, and reiterating that the state was responsible for admission counselling for CPS courses. Ultimately, DMER Maharashtra conducted admissions for 2022-23.

CPS Mumbai courses discontinuation and inspections

Major trouble for CPS began in January 2023 when the Maharashtra government wrote to the union government stating that the medical education and drugs department visited 120 hospitals for inspections and found two that were entirely closed, 74 that refused to subject themselves to inspection, and 44 with “severe deficiencies of infrastructure and faculty, violating NMC minimum standard requirements.”

“Admitting students in such institutes would be detrimental to the careers of those students in particular and for the health system in general,” the department wrote while seeking further guidance from the union government.

On January 23, 2023, the department had written to the CPS seeking course-wise details of seats in the institutes where CPS courses were offered; permission for running the CPS courses; agreements signed between CPS and private institutes regarding the fee structures; and list of recognised teachers by institute.

On January 31, 2023, CPS replied that it was collating that information and would respond in due course. The department wrote again on February 3, saying it hadn’t received the information. On February 6, 2023, CPS replied that it had already furnished details of seats and as CPS would be “functioning as an examining and affiliation body, it could not ‘recognise’ teaching institutions. There was no pact between CPS and any private institution regarding fees and that no question of requiring ‘permission’ was ever contemplated.” It also provided a list of recognised teachers to the department.

On March 14, 2023, apart from noting the deficiencies on inspection, the secretary of medical education and drugs department issued a show-cause notice to CPS asking for an explanation as to why the CPS courses should not be discontinued.

CPS Mumbai: Court case in the Bombay High Court

CPS challenged the show-cause notice in the Bombay High Court. Armed with the Maharashtra government letter on irregularities in CPS courses, the union health ministry formed an eight-member committee in April 2023, to look into the matter related to "recognition of CPS courses" and "continued admission to these courses".

The same month, NMC suggested that the central government de-recognise CPS courses as the institution does not come under the monitoring control of the commission.

“PGMEB recommends that the three diploma courses: diploma in pathology and bacteriology, diploma in child health and diploma in gynaecology and obstetrics, for which equivalence has been given by the ministry of health and family welfare by a letter dated April 30, 2021, should be withdrawn from next year,” says NMC’s letter to health ministry, dated April 13, 2023.

“In the said letter, NMC has only suggested to MoHFW withdrawing the equivalence for course DPB, DCH and DGO. CPS has been trying for a long time to get academic equivalence for continuing further education. It does not mean that NMC has not recommended derecognition of courses,” said CPS deputy registrar Dr Naresh Alreja in a clarification posted on CPS Mumbai’s official YouTube channel. He added that the college has been requesting MoHFW to bring CPS within the control of NMC.

On April 25, 2023, Bombay High Court rejected CPS’ petition challenging Maharashtra government’s show-cause notice. A few months later, in July, Maharashtra government derecognised all CPS courses after MBBS.

However, litigation on the subject continued. In reply to a petition filed by the CPS which contended that 10 courses which were recognised by the National Medical Commission Act 2019 cannot be de-recognised by the state government, the state in December 2023 told the Bombay HC it would review its July 2023 decision.

In March, 2024, the state medical education department allowed 10 courses to resume after a newly-appointed CPS committee met the state medical education secretary. These 10 include MCPS, FCPS (Med), FCPS (Path), FCPS (Surgery), FCPS (Derm), FCPS (Mid and Gyn), FCPS (Opty), DGO, DPB and DCH.

“The restoration of recognition to these CPS courses opens doors to a new collaboration between CPS Mumbai, the Government of Maharashtra, and the Maharashtra Medical Council. It underscores a shared objective to refine medical education and healthcare quality for the populace,” said Dr Ajay D Sambre, president of CPS.

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CPS courses: NMC actions, delayed admissions

The de-recognition of CPS courses followed by restoration of 10 courses by Maharashtra government and NMC’s notices have impacted the admission process.

In its July 5, 2024, letter to the ministry, NMC suggested a stop to admissions in all PG medical courses run by CPS Mumbai, within and without Maharashtra. Following this, NMC declared that the admission counselling planned by the state government for 2023-24 breached the Supreme Court’s 2016 order which banned admissions after the last date of joining set by the NMC.

The last date of joining PG medical courses for the academic year 2023-24 was November 30, 2023.

According to CPS officials, counselling for their fellowship and diploma courses starts after admissions for MD, MS and NBEMS diploma courses. Due to delays, counselling scheduled after November 2023 for 2023-24 academic year started on June 26, 2024.

The DMER Maharashtra started online registration for NEET-PG CPS admission 2023-24 on July 9, 2024 and is yet to announce its first merit list.

“This admission process is subject to the outcome of various court cases and directions received from the Government of India,” the department said in its CPS admission 2023-24 notice issued on June 26.

In July 2024, PGMEB had served a show-cause notice to CPS Mumbai for not following the regulatory provisions of the NMC and erstwhile Medical Council of India (MCI). CPS Mumbai replied that it considers itself an examination board like the National Board of Examination in Medical Sciences (NBEMS) which has authority to give medical qualification.

“The board found this as a misguiding statement and observed that the NBEMS is a government organisation included in the Schedule of NMC Act 2019,” an NMC notice dated August 16 said. In the same notice, NMC announced its decision to discontinue all the courses running under the umbrella of CPS Mumbai with immediate effect.

However, it has withdrawn the August 16 notice in compliance with the Bombay HC verdict.

State medical education secretary Dinesh Waghmare told the Times of India that the department will follow the union ministry's directives and added that the 10 courses were recognised by NMC.

Dr Vijay Oza, president of PGMEB, NMC, declined to comment saying, “the matter is subjudice”.