Reforming Medical Education In India

The Centre for Studies of Plural Societies organized an online ‘Distinguished Lecture’ on “Reforming Medical Education in India” on 16th April 2022 at 4.00 PM (IST). The lecture was delivered by Prof. Furqan Qamar and chaired by Prof. Syed Ziaur Rahman.

About the speaker: Prof. Furqan Qamar is a professor of management at the Centre for Management Studies, Jamia Milia Islamia, New Delhi. Formerly, he served as the Secretary-General of the Association of Indian Universities. He also held the position of the vice-chancellor of the University of Rajasthan and the Central University of Himachal Pradesh; he served as the educational advisor in the Planning Commission of India.

About the chair: Prof. Syed Ziaur Rahman is a professor of pharmacology at Aligarh Muslim University and a permanent member of the Board of Trustees and Chair of the Advisory Council International Association of Medical Colleges. He has authored seven books, 12 chapters, and more than 190 research papers while editing 11 periodicals. Moreover, he is also the founder and treasurer of Ibn-e-Sina Academy of Medieval Medicine and Sciences, Aligarh.

Prof. Furqan Qamar commenced the talk by asserting that the interest in reforming medical education has grown since the war in Ukraine. He iterated that the capacity of the medical field is severely restrained in India. However, this does not mean that the number of medical colleges and their intake capacity has remained stagnant since independence. India had only about 28 medical colleges and in 2021-22, the number of medical colleges has gone up to 595. While in 1950-51, almost all medical colleges were under government domain with the idea of training people to serve the nation. During 1991-92 this started changing as high fee charges in medical education started making entry into the system. In today’s scenario of the above 600 colleges, almost half of them are private or in the private domain. The intake is deficient, with less than 100,000 students every year, half of which goes to the government and half to the private sector.

Prof. Qamar said that although there are limited seats, the demand for medical education is higher, with a large population wanting to pursue it. This demand has been proliferating with about 10-15% every year. Taking the example of 2021, Prof. Qamar points out that nearly 1.6 million students appeared in the undergraduate National Eligibility cum Entrance Test (NEET) examination, of which only 900,000 students qualified. The qualification requirements stated that if anyone scores above 50% marks or more, one has qualified and is eligible to pursue medical education. However, of these 900,000 students, only about 90,000 were admitted. Prof. Qamar explained how students go through various stages of the selection process. It is a tedious exercise through which few students remain dissatisfied and choose to re-attempt the examination failing which, some eventually select a different discipline, thereby giving up their dream of studying medical science.

Prof. Qamar pointed out that the World Health Organisation (WHO) suggests that a country must have at least one doctor per 1000 people. India claims to have crossed this limit and has one doctor per 834 patients. However, when examined by some researchers, the supporting documents of India are claimed to be bloated, and they estimate that the actual number of people in that registry is close to half what the Medical Council of India (MCI) claims to be. Therefore, there is a need to double this number. There is a need to expand the medical colleges and their intake capacity, which is a demanding task. The tricky part is not the construction of the college but the faculty. According to Prof. Qamar, every country in the world suffers from a shortage of qualified, trained, and specialized doctors, which makes expansion further difficult.

Lastly, Prof. Qamar spoke on the issue of students travelling abroad and those who are returning without completing the degree or after completing their education but unable to clear the Foreign Medical Graduate Examination (FMGE). The qualifying rate for this examination is very low, ranging from 6-16% every year. He said there is no specific data on how many of them have a medical degree but have not qualified the FMGE. He predicted this number to be very high. However, there are a few reasons that support the inability of the students to qualify for FMGE. An objective view shows the difference in pedagogy and curricula as the key reasons for failure. The clinical practice experience, claimed Prof. Qamar, depends on the wide variety of patients these trainee doctors have access to. Doctors from India and Egypt are considered good because of their experience in treating and dealing with various diseases due to the large population. Curing these patients makes the doctor more knowledgeable, which is difficult for a country with a lower population. Another critical part is the importance of forensics as a part of the curricula. Students often take the help of coaching institutes to upgrade themselves to qualify for this examination. According to Prof. Qamar, if these aspirants are identified, along with the number of students who could not qualify the FMGE, the existing medical colleges could start crash courses, enabling them to qualify FMGE. If followed through, they can be added to the existing pool of doctors. Medical education has been outstanding in one aspect; there has been continuous professional development across all branches of knowledge, unlike many other disciplines. Hence, bringing the above solution into practice would go a long way.

The lecture was followed by the question and answer session and the final remarks by the chair, Prof. Syed Ziaur Rahman. He emphasized that the government of India is trying its best to harmonize and standardize medical education with the standard of the foreign countries, for example, the competency-based medical education system, which will provide India with lifelong learners and leadership qualities and communicators. He further emphasized the need to reduce the cost of medical education. Prof. Rahman concluded that there needs to be openness, transparency, and efficiency in the medical field, and there must also be a check on the malpractices.

The report is prepared by Anirban Banerjee, the Research Intern at CSPS