Vidya Pandit (Lucknow)
King George’s Medical University, Lucknow: heaviest penalty
Medical education in Uttar Pradesh — India’s most populous state (215 million) — is a mess. For one, the entire state covering an area of 243,286 sq. km is served by 72,757 registered medical (allopathic) practitioners, a ratio of 1:3800 doctor per 100,000 population cf. the proportion of 1:1,000 recommended by WHO (World Health Organisation). Moreover, these qualified medical practitioners are clustered in UP’s major cities — Lucknow, Kanpur, Varanasi and Gorakhpur. Citizens in the sprawling state’s hinterland are obliged to make do with the services of ayurvedic, unani and self-styled medical practitioners.
On May 20, presumably to raise standards of the profession, the newly constituted National Medical Commission (NMC, estb.2020), which replaced the scandals-ridden Medical Council of India three years ago, imposed fines ranging from Rs.2-20 lakh for “irregularities” on several of UP’s 65 medical colleges. The irregularities included acts of commission and omission such as less than required faculty, inadequate equipment and poor infrastructure maintenance.
According to academics in Lucknow, the fines have been imposed to prompt medical colleges to clean up their act even as the state’s BJP government is expanding the capacity of medical colleges statewide. This year total capacity in medical colleges which is currently 3,828 seats is scheduled to be increased by 1,300 seats in 35 government medical colleges (cf. 30 in private sector). The minimum number of seats a licensed medical college is obliged to provide is 100 (the most common number). Some large colleges offer more seats with the largest number of 250 provided by Rajshree Medical Research Institute, Bareilly; Mayo Institute of Medical Sciences, Lucknow; Rama Medical College and Research Centre, Hapur among others. The number of seats available in the show-piece All India Institute of Medical Sciences, Gorakhpur — chief minister Yogi Adityanath’s constituency — is 225.
Although the popular belief is that private medical colleges cut corners and disregard rules, the highest penalty of Rs.20 lakh has been levied on the government-owned King George’s Medical University, Lucknow, widely regarded as one of the best countrywide. The medical college of Banaras Hindu University has been slapped with a Rs.12 lakh penalty. NMC has provided all errant colleges a time window of two months to set things right.
According to monitors of higher education in Lucknow, rules-breaking and scams are rife in medical education in UP. “While inspecting medical colleges, I have come across the very same patients in attached hospitals of two medical colleges. Teaching faculty is also shuffled between colleges to show minimum numbers when inspectors arrive. Even when a college is granted full recognition, half of the faculty is made up of visiting lecturers — all violations of minimum numbers prescribed by NMC,” says Shugar Lal, retired superintendent of a Lucknow hospital, and member of the former MCI task forces despatched to evaluate colleges prior to their being granted permission to introduce new courses.
According to Mridula Singh, director at the KNS Memorial Institute of Medical Sciences, Barabanki, a major problem of medical colleges in the state is recruitment of adequately qualified faculty. “Getting teachers is a huge challenge for all medical colleges in the state. Medical colleges are so badly managed that graduates immediately migrate to other states, if not abroad. Moreover, faculty in medical colleges require postgrad qualifications. But capacity in UP’s medical colleges for postgrad education is 3,521 seats, which is totally inadequate,” says Singh.
Academics and medical practitioners are skeptical about the Rs.2-20 lakh fines levied on medical colleges for infringement of NMC rules and regulations because they are a mere slap on the wrist. In private medical colleges, the tuition fee per student for the MBBS programme is between Rs.10-14 lakh per year. For them, penalties of Rs.2-5 lakh are small potatoes.
Therefore the general expectation is that the fines imposed by NMC will be paid with ritual grumbling. After that it will be business as usual.