‘Medical education needs ground-breaking reforms’: IMA students’ network head

NEW DELHI: Indian Medical Association-Medical Students Network (IMA-MSN) deals with queries and concerns of around 33,000 medical students across India. During an interview, Indian Medical Association-Medical Students Network (IMA-MSN) chairman Shalabh Gupta spoke about medical education in India, unstructured regulations, student suicides, NExT exam and more. Edited excerpts below.

Q. It is believed that medical students – both PG and UG – are bearing the brunt of an overburdened healthcare system in India. What are your views?

A. Healthcare is overburdened in India because it’s given less priority. Most of the time people struggle to get their treatment done at hospitals because of low finances. Secondly, the government has to be proactive in increasing the financial budget as currently, India is spending less than 2% of its GDP on healthcare, while in Brazil, Russia, China, and South Africa (the other BRICS countries), they have a healthcare budget of about 10% of GDP. Our health system will be overburdened until we invest in health. There will be a shortage of doctors, healthcare workers, especially in rural areas. This is exactly what we saw during Covid times.

For undergraduate (UG) and postgraduate (PG) students, there should be a structured medical education system which can govern the entire country without any confusion. At present, medical education is undergoing a lot of changes. Once the government takes care of the shortage of doctors, many things will fall into place.

Q. In case of National Eligibility cum Entrance Test (NEET), there is a rise in suicides among medical aspirants preparing for the exam. What should be done?

A. Peer-pressure during the coaching period is leading to suicides. Parents should not push their children to pursue MBBS or dentistry. Students are burdened with the family’s expectations. This peer-pressure must be reduced.

Next, coaching centres , which have become “industries”, must arrange special sessions for students. More sensitisation about the issue is important. The problem becomes worse due to high competition. New medical colleges are now being developed. I am sure this will ease the competition with an increase in the number of seats.

Q. Over 1,200 medical students dropped out in the last five years. Why do mental health issues remain unaddressed?

A. Medicine is a long career. Previously, there were no mentor-mentee programmes. But now mentorship programmes have been introduced which help students gel with the system. We also must have a suicide prevention programme at the national level. Ground-breaking reforms are needed in medical education where this should be a part of the curriculum.

Also, we are going to start an initiative with IMA and Junior Doctors Network (JDN).

We have already started a helpline but it will start functioning in a structured manner soon. Every month we are carrying out suicide prevention programmes online. There is a dedicated number where they can call and seek help.

Further, to spread awareness, we are organising a National Youth Summit on June 8-9, 2024.

Q. The National Exit Test (NExT) exam has been on hold for the last two years. The health ministry is examining the preparedness of states and medical colleges. What are your views?

A. I don’t know what was the hurry and the reason behind introducing the NExT. We are following a European standard. There is no harm, but we cannot just copy from some foreign country.

The authorities must inform during a specific year that they plan to start NExT from that session. But they cannot start the exam in the middle of the year. Now the curriculum has changed, third-year subjects have been shifted to the final year, overburdening students. Usually in all foreign medical courses, the focus is on the entire course. But in India, the focus is on final year only. In foreign countries, the duration of MBBS is six to seven years. Here we have four-and-a-half years.

Another problem is that NExT is combined with the medical licensing exam. If someone doesn’t clear the NExT exam, they cannot apply for a doctor’s licence. Without a licence, a MBBS student is as good as a 12th pass.

Q. What are your views on the government’s plan to bring a policy on mixing Ayurveda with modern medical education?

A. It will be a disaster. Everyone should function in their own streams. What is the need for a mix? Why is this experiment done in India only? Modern medicine is evidence and precision-based. And Ayurveda is basically for prevention of diseases . The treatment has to be done through modern medicine only.

Q. What are your views on NMC’s Minimum Standard Regulations for Undergraduate guidelines?

A. These guidelines are unrealistic. So many standards have been put into place. The problem mainly comes in private colleges because there is a huge corpus of money that needs to be invested. In a medical college in a small district, where are you going to find the faculty?

Then, there are guidelines on the number of beds even in sections like the department of ophthalmology. Patients in such departments get operated and discharged in two hours. How can you have a bed occupancy of more than 80% in the eye department?

These days, surgeries are least invasive. So in the surgical departments, I feel the number of beds has to be reduced – like in ophthalmology and ENT departments. Further, there are mandates on the number of beds in a hospital. Every day a new regulation comes; there is no structured approach.

Q. There is still a shortage of teachers.

A. These minimum requirements have to be trimmed down. Secondly, we have to put more emphasis on creating teachers. If teachers are not paid well, they will not join medical colleges. Teachers are moving from one medical college to another due to low salaries. Authorities have to be flexible in determining minimum requirements of teachers.

The authorities should focus on the quality of medical students that are graduating. They should focus on the quality of education that they can provide rather than on creating multiple medical colleges. Otherwise, the situation will become similar to the likes of engineering, management and dental colleges, where they don’t have enough students to fill the seats.

Q. NMC has cleared the way for online inspection of medical colleges. What impact will there be?

A. As many new medical colleges are coming up, there is a need for resources to carry out physical inspections. Maybe, NMC has decided to do everything online. Like the biometrics of teachers, the data of students and other requirements can be seen online. So they are running a trial. Currently, NMC doesn’t have clarity on what to do and how to do it. Every day there is a new rule. However, if they stick to it, doing things online is a good idea.

Q. Despite the Central Information Commission asking NMC to disclose the assessment reports of medical colleges , it hasn’t. There’s little information in the public domain on medical colleges. How does this lack of transparency impact students ?

A. A uniform code of medical education has to be provided to all colleges. Once this is implemented, transparency will come automatically. A uniform policy is needed.

Already-admitted medical students don’t go into these intricacies. Students who are preparing for NEET or qualify NEET, it is not in their hands to choose the college, it depends on the ranking of the students. Further, until a student takes admission in a medical college, MSN is not involved. It’s for medical aspirants and not for medical college students or MSN. Further, ratings awarded by accreditation agencies help medical aspirants choose the college.

These are technical questions that need to be answered by the National Medical Commission. However, uniformity and transparency are important.