NMC drops full-time teachers’ share, student stipend from medical college ranking criteria

Two years after it prepared a draft framework for the accreditation and ranking of medical colleges in collaboration with the Quality Control of India (QCI), the National Medical Commission (NMC) has come up with another outline for evaluating them.

While the new version largely draws from the earlier ranking framework published two years ago, it has left out some of the key parameters previously proposed for assessing medical colleges. It no longer includes the proportion of full-time or regular teachers to the overall faculty requirement as one of the parameters. Another yardstick, financial entitlements including stipends given to interns and residents, has been nixed. Publication in top quartile research journals has also been dropped from the list of criteria.

Unlike general and technical education institutes, which are periodically evaluated and graded by the National Accreditation and Assessment Council (NAAC) and National Board of Accreditation (NBA), respectively, there's no comparable mechanism for assessing medical colleges. Assessment under the National Institutional Ranking Framework (NIRF) is also flawed.

To fill this void, NMC’s Medical Assessment and Rating Board (MARB) had in July 2023 signed an agreement with QCI to assess medical colleges with the stated objectives of ensuring delivery of quality education, promoting excellence in medical education and fostering continuous improvement in medical colleges. This resulted in the first draft framework for the accreditation and ranking of the institutes regulated by MARB.

Interestingly, the new proposed framework, released for public feedback on Saturday, makes no mention of the preceding document.

Medical College Ranking: Fewer parameters

While the regulator has retained the 11 broad evaluation categories suggested by QCI, it has removed or merged several of the minute parameters, added a few new ones and modified others.

This has brought down the overall count of parameters from 92 – 20 qualitative and 72 quantitative – to 78 (26 qualitative and 52 quantitative). The relative weightage assigned to some of the broad categories has also been changed, with a more even distribution of scores across the board.

The parameters and the changes in weightage are as given below.

Medical College Ranking: Criteria and changing weightage

While the ‘human resource and teaching learning process’ broad criterion continues to have the highest allocated score of 160, the number of parameters under the head has been reduced from 13 to 11. Two parameters – “Programme wise Number of Full Time/Regular Faculty vis-à-vis Total Faculty required” and “No. of resource persons from the relevant fields invited as Guest/Visiting Faculty for Lectures in last 2 Years” – have been dropped.

The document, though, retains another quantitative criterion, “Programme wise number of recruited Faculty Staff vis-à-vis Regulatory specifications”. This mentions in passing that all teachers must work full-time but without making the proportion of regular appointees an independent assessment factor.

NMC keeps NEET, drops stipend

Under the “Students’ Admission & Attainment of Competence” broad category, a quantitative parameter “Provisions of Financial entitlements (Remunerated Posts/Stipendiary Positions) created by college” has been omitted. The document, however, persists with other parameters under the criteria, including the NEET scores of incoming students and graduates, students’ performance in the exit exams (the National Exit Test is yet to be launched) and the number of graduates pursuing higher education.

The yardsticks to measure “Research Output and Impact” have also been tweaked. While the earlier document had provided for calculating the cumulative citation scores in only Q1 and Q2 (the top 50%) research publications, the new draft considers citations in all the indexed journals. It, however, assigns only half the score for citations in the bottom 50% Q3 and Q4 journals compared to the top ones.

A parameter that specifically demanded high quartile (Q1) publications by the college staff and students has been done away with. On the other hand, a differential scoring system based on the journal quality has been introduced as part of another criterion for evaluating research output.

Among the additions, NMC suggests a department-wise analysis and review of students’ performance in formative and internal assessments and subsequent corrective actions taken by the college.

NMC’s ranking framework ‘old wine in new bottle’

The experts have called the new draft framework a case of “old wine in a new bottle”.

“NMC, in collaboration with QCI, had previously drafted a framework for accreditation and ranking of medical colleges under its purview. That 106-page document has now merely expanded into a 190-page version with similar content. Such recurring documents from the NMC — often withdrawn, reissued, or updated with corrigenda — are not uncommon and have contributed to a loss of interest among faculty,” said Dr Satendra Singh, director professor at University College of Medical Science and Guru Teg Bahadur Hospital at New Delhi.

Singh criticised the two drafts for considering a larger swathe of research publications, instead of only those carried by the journals indexed in MEDLINE and PubMed. “This omission only perpetuates the unethical culture of predatory journals, many of which are indexed in poor-quality databases but not in MEDLINE,” he said.

The educator also lamented the poor emphasis on diversity and inclusivity in the evaluation benchmarks. “Although the framework includes anti-ragging and POSH (Prevention of Sexual Harassment) guideline scores, it makes no mention of parameters related to diversity, equity, inclusion, or disability accessibility. This was also a key shortcoming of the NIRF rankings, which awarded top positions to institutions that remain largely inaccessible to persons with disabilities,” he said.

Singh also criticised the “narrow, checkbox-oriented” assessment methods such as geo-tagging photographs of seminars and conferences and live video feeds. He highlights that there is little encouragement for other innovative community engagement efforts beyond what’s prescribed in the medical curricula.

J Swamidass, a Puducherry-based activist with United Doctors Front (UDF), also advocated inclusion of other parameters, especially those pertaining to work-life balance as well as physical and mental well-being and safety of trainee doctors. He suggested additional criteria, including students’ mental health, dropouts due to ragging, heavy workload, long duty hours and paucity of leave; vacant faculty positions; stipend payments to trainees; and the number of students undergoing psychiatric counselling.