New Delhi: The Indian Medical Association (IMA) opposes the new norms notified by the National Medical Commission (NMC) for the appointment of faculty members to medical colleges.

The NMC regulates medical education and the medical practice of doctors.

Speaking to The Wire, IMA president Dr Dilip Bhanushali said: “We oppose all these provisions. They are unacceptable.”

Bhanushali said they have sought an appointment with NMC's head to express their reservations with the hope that the regulator would reconsider the new norms. He said the IMA is hoping to meet the NMC's newly appointed head, Dr Abhijat Sheth, soon.

Bhanushali alleged that these norms would dilute medical education – something that faculty members who are currently working at the All India Institute of Medical Sciences (AIIMS) in Delhi have also pointed to.

The revised NMC norms say senior consultants (doctors treating patients) with three years of teaching experience in government medical colleges are eligible for the post of professor – the seniormost post in the medical teaching hierarchy.

Usually, as a senior AIIMS faculty member said, it would take around seven to ten years for an assistant professor – the entry-level post – to become a professor via the ‘assessment promotion scheme’.

“One would be recruited as assistant professor and then climb up the ladder to become associate professor, additional professor and finally professor,” he said. The AIIMS faculty member preferred anonymity because he is not authorised to speak to the media.

The Union Public Service Commission (UPSC) also recruits professors. But that route too requires a total teaching experience of six to eight years.

Now, the NMC has brought the bar down to three years of teaching experience – whether in recruitment through the UPSC or through the route of promotions.

“This is the most worrying part – the dilution by a huge margin of the eligibility criteria for becoming a professor,” the AIIMS faculty member said. Roughly speaking, one would become a professor only after the age of 40, but now this would be advanced, he added.

Change in norms for assistant and associate professors

The norms have been changed for the appointment of assistant professors and associate professors.

According to the new provisions, doctors – who are specialists in various disciplines of medicine and have practiced for ten years – can be appointed as associate professors even if they do not have any teaching background.

Earlier, one could become an associate professor only if they had prior teaching experience in a medical college. That provision has been done away with.

The associate professor is the second-most senior post in the hierarchy of faculty members.

As far as the appointment of assistant professors is concerned, the new NMC norms say that a clinician can become an assistant professor if they have two years of experience of treating patients. The norms specifically say that one can become an assistant professor without any senior residency experience.

As per earlier norms, one year of senior residency was necessary to become an assistant professor.

Senior residents are those who have completed their post-graduate courses in medicine. Following this, they work in specialised departments for further training.

Thus, the norms for the appointment of assistant professors and associate professors have also been watered down.

The NMC has added the qualification that specialists (treating clinicians) who are to be appointed as associate professors and assistant professors – without any teaching experience or senior residency, as the case may be – must have completed a ‘basic course in biomedical research’ (BCBR).

A BCBR is a course that equips medical teachers and PG students with a better knowledge of conducting research.

It has nothing to do with any training in teaching.

The AIIMS faculty member pointed out: “If one learns research methods only and has no training for teaching, how can s/he become a faculty member?”

He also said that teachers in medical colleges immerse themselves in their role by participating in various seminars and student presentations and contributing to publications. “What would the NMC do to ensure that all of those who are appointed as teachers, only on the basis of clinical experience, will have this bent of mind?” he asked.

Outgoing NMC chief Dr B. Gangadhar, under whose leadership the new norms came into place earlier this month, told The Wire that a module would be put in place for those clinicians who become medical teachers without any prior teaching experience.

However, no thought has been given to the specifics of the module yet.

“India's healthcare system is undergoing significant transformation, with the [Union] government announcing a vision to add 75,000 new medical seats over the next five years,” the NMC said in its press release, justifying the new norms.

“However, a critical bottleneck has been the availability of qualified faculty required to initiate or expand medical programs,” it added.

Gangadhar also said that the NMC thought it would not be wise to not exploit the clinical experience of doctors. As far as the lack of teaching experience is concerned, he said, it could be compensated for by the experience that doctors gain during their practice.

Dr Amarinder Singh Malhi, chief patron of the United Doctors' Front, contested this claim. “Medical teaching is a trinity of three things: research, education and [treating] patients. One can't be compensated [for] by the other,” he said.

The “dilution of teaching standards may produce more doctors, but it may compromise the quality of education,” he added.

Malhi suggested that if the new NMC provisions were to be implemented, then a strong regulatory oversight should have been put in place to ensure that the doctors without any teaching experience, who are recruited as faculty members, keep performing satisfactorily.

The new provisions are silent on this, he said.

MSc/PhD faculty

One of the biggest points of contention regarding the NMC's new regulations is that they allow MScs and PhDs in non-medical fields to be appointed as faculty members in pharmacology and microbiology departments. Earlier, this provision existed only for anatomy, physiology and biochemistry departments.

If doing so was okay for those three departments, why could it not be implemented in pharmacology and microbiology departments as well, asked outgoing NMC chief Gangadhar.

However, anatomy, physiology and biochemistry are preclinical subjects. Anatomy is the study of the human body, physiology is the study of the human body's functions, and biochemistry deals with the body's chemical processes.

But pharmacology, on the other hand, is not a preclinical but a para-clinical subject. The latter are the ones that bridge the gap between preclinical and clinical subjects. Clinical subjects form the basic core of medical practice and include departments like medicine, surgery and gynaecology.

Pharmacology deals with the basic principles of drugs and how they work on the human body. This is the subject that deciphers the pathway of a drug that deals with a disease. Clinical departments greatly rely on pharmacologists to understand which medicine works for a particular disorder.

The IMA president said that allowing a non-medical person to teach paraclinical subjects is a huge mistake.

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