Now, NEET exam, 1-year internship must for physiotherapy: Allied health sciences get major revamp

NEW DELHI: Physiotherapy graduates in the country can now attach a ‘Dr’ to their names, but with a ‘PT’ suffix to distinguish themselves from medical graduates and PhDs. Also, admission to physiotherapy courses will be mandatorily through the National Eligibility-cum-Entrance Test (NEET UG). The students will also be required to undergo a year-long internship following their graduation – like in MBBS – extending the duration of the course from the usual four and a half years to five years.

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These are among the changes that a new competency-based curricula for physiotherapy and nine other allied health science disciplines aim to bring. They were released by the ministry of health and family welfare (MoHFW) and the National Commission for Allied and Healthcare Professions (NCAHP) this week.

Emphasising practical skills and holistic development of students, the new curricula introduce a slew of reforms in the eligibility criteria, course structure and assessment system, aimed at bringing uniformity in paramedical education around the country. NCAHP plans to enforce the standardised programmes nationwide from the 2026-27 academic year.

The use of ‘Dr’ honorific by physiotherapists has been a contentious issue. The Indian Medical Association (IMA) has staunchly opposed the practice, arguing that only the persons practicing modern system of medicine or AYUSH should be deemed doctors and allowed to use ‘Dr’. On the other hand, the Indian Association of Physiotherapists (IAP) has argued that IMA isn’t the relevant body to access the statutes of physiotherapists.

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Allied Health Sciences: Standardised syllabus, quality

The new syllabus handbooks, released on Wednesday, seek to revise the model curricula prepared by MohFW in 2015-16 and 2017 for seven allied healthcare professions (AHP). These are:

• Physiotherapy
• Optometry
• Dialysis therapy
• Health information management
• Medical radiology and imaging technology
• Radiotherapy technology
• Operation theatre technology

Syllabi for three additional allied health science courses - applied psychology and behavioural sciences, physician associate, and nutrition and dietetics - have also been published, in what the commission terms as the “first phase” of curriculum rollout. As many as 56 allied health professions spanning 10 broad healthcare areas are within NCAHP’s ambit.

In addition to the course structure and contents, the documents also prescribe minimum basic standards related to the faculty, infrastructure and clinical facilities for running paramedical courses. They also chart out the career progression pathways in clinical, academic and research domains.

Prasad VG, an NCAHP member and programme co-ordinator at Amrita Centre for Allied Health Sciences at Kochi, told Careers360 that syllabi are the progression of an effort by MoHFW since 2011 to grant recognition to various paramedical professions and issue licenses to the practitioners. This will help enhance the nationwide healthcare delivery system, he said.

“The emphasis of the syllabi is on standardisation and quality improvement. Currently, there are no national standards of curricula, faculty and infrastructure. Some of the state paramedical councils and universities have defined certain standards but there are variations,” he added.

The new competency-based curricula for allied science courses are built around nine learning goals. These are:

• Clinical care
• Communication
• Membership of a multidisciplinary health team
• Ethics and accountability at all levels
• Commitment to professional excellence
• Leadership and mentorship
• Social accountability and responsibility
• Scientific attitude and scholarship
• Lifelong learning

A key feature of the syllabi is exposing students to clinical practices alongside basic science education during the early years - “vertical integration” - as well as using the concepts of basic sciences through the course - the horizontal integration.

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“This new curriculum has been structured in a way such that it facilitates horizontal and vertical integration between disciplines; and bridges the gaps between both theory and practice, and between hospital-based practice and community practice. The amount of time devoted to basic and laboratory sciences (integrated with their clinical relevance) would be the maximum in the first year, progressively decreasing in the second through the final years of the training, making clinical exposure and learning more dominant,” reads the curriculum document.

According to Prasad, mandatory internship is the most important aspect of the new curricula. He also points out that the undergraduate course for physician associates, who assist doctors in providing care to patients, has a community medicine component in each semester to ensure that the students are connected to the real-world situations. Their clinical training will start with observation and progress to engagement.

Allied science admissions: NEET, national exams

The new norms stipulate that admissions to physiotherapy, optometry, nutrition and dietetics, and dialysis technology and therapy programmes be on the basis of the candidates’ performance in NEET.

In the case of dialysis technology, other entrance tests conducted by the universities and the states are also recognised. Separate national-level entrance tests have been proposed for undergraduate admissions in physician associate and medical radiology programmes. The students can enter the remaining courses simply through class 12 exam.

Except for physiotherapy and optometry, the course duration for most of the programmes continues to be four years, including a semester or a year of internship or clinical training.

BPT course details, duration change

The bachelor of physiotherapy (BPT) and bachelor of optometry (B.Optom) will both now span five years. The previous model curricula had recommended four-and-a-half and four-year durations for these courses, respectively. While a six month internship has been added to the former, the latter will get an additional regular academic year. The bachelor in dialysis therapy technology (BDTT) is also a four-year course now, up from three and a half years prescribed earlier.

While most of the courses will continue to follow the semester pattern of instruction and evaluation, the physiotherapy course scheme has been changed to the annual pattern.

The total number of credits for the four regular years of the programme has been increased from 288 to 334. In case of BOptom too, several new courses have been introduced thanks to the programme being extended for five years.

As in the previous model curricula, the revised syllabi advocate using of a variety of assessment tools such as objective structured clinical examination (OSCE), objective structured practical examination (OSPE), objective structured long examination record (OSLER), mini case evaluation exercise (CEX), case-based discussion (CBD), direct observation of procedures (DOPs), portfolio, multi-source feedback and patient satisfaction questionnaire alongside the traditional evaluation method.

In physiotherapy, internal assessment carries 20% weightage in each subject, with both internal and external evaluation scores divided across theory, practical and viva. The students are required to separately obtain at least 50% marks in each of theory and practical tests.

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Paramedical courses in medical colleges

The norms also mandate that the colleges for most of the paramedical courses should either be colocated with an existing medical college, or should have tie-ups with other hospitals in the vicinity to enable clinical exposure. In case of physiotherapy, standalone institutes must have a minimum 10 acres of land and 35,000 sqft built-up area, among other facilities.

The standards for running optometry courses demand a separate building and facilities for the college, even if the institute is attached to a medical college. A minimum exclusive built up area for of 26,675 sqft for an intake of 30 students per batch and 35,750 sqft for 60 students is a must.

The faculty student ratio for both BPT and BOptom will continue to be 1:10. The teachers are required to mandatorily undergo periodic faculty development programmes.

Experts have welcomed the changes in paramedical syllabi and the standardisation efforts.

“It’s a forward-looking curriculum, which covers the philosophy, background of the professional clinical progression pathway and continuum of education through PhD,” said Avinash Supe, former director of medical education in Maharashtra, currently working as professor emeritus at Seth GS Medical College, Mumbai, he said about the physiotherapy curriculum.

“Physiotherapists will no longer be seen as support staff but decision makers, researchers, educators and important health care professionals,” he added.

NCAHP has also underscored the need for enhanced awareness about the benefits of physiotherapy in early orthopedic, neurological and pediatric conditions, especially among the rural population.

The commission went on to recommend that five physiotherapists be posted in all the government primary health centers to screen school children, community centers and rural population, educate them about precautionary measures.

Supe, however, also highlighted some of the shortcomings of the handbooks, especially the lack of specifics. “While the assessment methods include new tools such as OSPE and DOPS, there are no details about them or how they will be aligned with the course content. The weightage for learning goals under Bloom’s Taxonomy [knowledge, comprehension, application, analysis, synthesis, and evaluation] are not spelt out well. The assessment doesn’t appear to be formative, as it still follows the terminal and prelim test pattern. The competency statements are not well-defined. There needs to be an alignment with the social accountability and structured delivery. The competency progression ladder as well as elective subjects are missing,” he said.

Prasad said that since the paramedical institutes have already begun the admission process for 2025-26, the new norms cannot be enforced until the next academic year.

“It will take some time to fulfill these requirements. Besides, NCAHP hasn’t started giving licenses to institutes. Though a few months ago, the commission has directed that no new paramedical education institute be set up. The existing colleges can't start new programmes or increase their intake,” he said.