The scientists’ community having qualifications of

Medical M.Sc postgraduate degree

appeals to you for your help

AGAINST THE
INJUSTICE
METED BY
THE
NATIONAL
MEDICAL
COMMISSION

A humble submission by the

National M.Sc Medical Teachers’
Association® (NMMTA)
Delhi

www.medicalmsc.org
THE BACKGROUND

 MBBS course is divided into non-clinical and

clinical subjects.
 The non-clinical subjects are divided into pre-
clinical and para-clinical parts.
 Pre-clinical parts include Anatomy, Physiology
& Biochemistry in the first year.
 Para-clinical parts include Pharmacology,
Microbiology & Pathology in the second year.
 During the early years of medical education,
few doctors took up postgraduation in non-
clinical disciplines resulting in a serious
shortage of teachers.
 M.Sc courses were started in medical
colleges in these non-clinical disciplines; only
a few doctors pursued them.
 Mudaliar Committee (1959) recommended
offering M.Sc courses (except Pathology) to
the life-sciences graduates in order to fill this
void.
 THE BACKGROUND

 M.Sc courses in the non-clinical disciplines

were included in the first schedule of Indian
Medical Council Act (1956).
 Medical Council of India (MCI) accorded
permission to medical colleges to start these
M.Sc courses.
 Once science graduates having B.Sc
qualifications started pursuing these
courses, MCI silently stopped regulating them
& courses vanished from the Schedule-1.
 Medical colleges continued to offer these
courses as “Medical M.Sc” and the degrees
were awarded under the Faculty of Medicine.
 Although abandoned by the MCI, these
courses are recognized by the UGC.
 At one stage nearly 100 medical colleges ran
these courses; now around 35 colleges do.
THE MEDICAL M.SC COURSES

 Medical M.Sc courses were modelled along

MD postgraduate course with similar
curriculum and syllabus.
 Both MD & Medical M.Sc courses are
conducted by the medical colleges using the
same infrastructure & faculty.
 Conduct, including teaching and examination
of the students are similar.
 The qualifying degree for MD course is MBBS
whereas qualifying degrees for Medical M.Sc
courses are B.Sc (life sciences), MBBS, BDS
etc.
 The first year of Medical M.Sc course
includes compulsory study of human
Anatomy, Physiology & Biochemistry just as
first year MBBS students do.
 Like MBBS & MD courses, Medical M.Sc
degree is awarded by the Health Universities.
CAREER OPPORTUNITIES

 The Medical M.Sc courses were offered to life

& allied science graduates with the sole
intention of creating teachers for MBBS
training.
 The first choice of career is a teaching role in
medical/dental colleges.
 Although MCI stopped regulating M.Sc
courses, they are recognized for the purpose
to appointing the scientists as teachers in
the five non-clinical disciplines.
 Until the 1998 amendment of the MCI’s TEQ
guidelines, scientists could be promoted to
the post of Professors & HODs based on their
M.Sc degree and experience.
 Ph.D was made mandatory for the scientist
(also called non-medical teachers) for
positions above Assistant Professor following
1998 amendment.
CAREER OPPORTUNITIES

 MCI collects information of every faculty in

the colleges under its ambit and maintains a
database of teachers.
 Despite this, it has no information on the
number of “non-medical” teachers working in
various medical colleges.
 Our estimate suggests around 13% of all
teachers in the five non-clinical specialties in
Indian medical colleges are scientists (non-
medical).
 Despite being in thousands (~7,000),
scientists never had any representation or
say in the regulatory body (MCI or NMC).
 Apart from teaching jobs, career
opportunities include consultants in
diagnostic labs or research scientists.
 The non-clinical doctors have lobbied hard to
deny us all roles in teaching and diagnostics.
CURRENT CRISIS

 Over the last few years more doctors have

been pursuing MD in non-clinical subjects.
 This has resulted in increased competition
for jobs in teaching and diagnostic sector as
both MD and Medical M.Sc holders qualify.
 For unknown reasons, MCI had reduced the
student-teacher ratio in medical colleges,
thereby making the competition fierce.
 Irked by the competition by the non-doctors,
incessant lobbying was initiated to oust the
scientists from all these roles.
 The MCI, which is naturally a body of the
doctors and for the doctors, took side of its
own community and side-lined the scientists.
 Through its official circular, it advised
medical colleges to hire scientists only in the
absence of a suitable medical candidate.
CURRENT CRISIS

 The scientists’ community is getting fewer

opportunities due to this bias on the part of
MCI.
 Under pressure from the community of non-
clinical doctors, MCI in 2018 proposed to
halve and halt the appointment of non-
medical teachers.
 As per MCI guidelines, up to 30% of faculty in
the Anatomy, Physiology, Pharmacology and
Microbiology and up to 50% in Biochemistry
can be scientists (non-medical).
 Due to intensive protest from our association,
this proposal was shelved.
 When NMC replaced the MCI, it adopted the
MCI guidelines retaining the same
percentage of non-medical teachers, but
sought feedback from the stakeholders.
CURRENT CRISIS

 The non-clinical doctors, who outnumber

scientists (1:7) lobbied hard to exclude the
scientists.
 Stakeholders were given one week’s time to
send their feedback.
 Bowing to the lobby, NMC amended its
guidelines reducing the permissible
percentage of non-medical teachers to 15%
in Anatomy, Physiology & Biochemistry and
0% in Pharmacology and Microbiology.
 In just one week’s time NMC went through
thousands of representations, which is quite
unlikely. We believe that this exercise was an
eye-wash.
 By implementing this through a gazetted
notification, it has create an atmosphere of
fear, despair, gloom and anger in the
scientists’ community.
CURRENT CRISIS

 NMC insists that the new guidelines would be

applicable only to the new medical colleges
that would start 2021-22 academic course.
 It also insists that the non-medical faculty
already in employment in recognized colleges
or in various stages of recognition will not be
affected.
 From our experience we know that medical
colleges tend to interpret and implement
guidelines as per their whims, fancies or
conveniences.
 There are already reports of terminations of
non-medical teachers in colleges where
these guidelines don’t apply.
 These apart, the NMC guidelines have made
it impossible for the scientists to seek new
teaching jobs in both old and new colleges.
CURRENT CRISIS

 NMC has advised that new appointments,

whether for new or old colleges shall be
based on its new amended guidelines.
 A non-medical teacher will now be forced to
remain in the same medical college and all
opportunities to shift jobs are closed.
 Therefore, once removed from job or forced
to resign, there are absolutely no job avenues
left.
 Being forced to remain in the same job, the
employers now have the liberty to abuse
them, deny them promotions, salary
increments, examinership roles etc.
 Also, the new guidelines would apply to an
old medical college if it seeks to increase
student admission. In such a case, colleges
would terminate existing non-medical
teachers or won’t regularize the current
teachers serving in probationary period.
CURRENT CRISIS

 While those with qualifications in Anatomy,

Physiology and Biochemistry have at least
15% chance, those in Pharmacology and
Microbiology have zero chances.
 The threat of job loss, humiliations, abuses,
harassments, insults and denials of various
opportunities are real.
 Many non-medical teachers are now in their
middle-ages; many have financial
commitments such as children education,
housing loans, children marriage etc.
 At this stage, it is impossible to change the
field of career, having spent years to decades
in this profession.
 There are 3,000-4,000 students currently
pursuing Medical M.Sc courses in various
medical colleges. Their career stands
destroyed even before it begins.
WHY NMC CHANGED THE GUIDELINES?

 It is believed that now there are more doctors

with MD qualifications in the non-clinical
specialities. We disagree with this!
 While there has been 26-45% increase in PG
seats in the non-clinical subjects, 40-50% of
these seats remain vacant.
 The curriculum of MBBS course is no longer
compartmentalized as before; it is more
integrated now.
 Since the new curriculum of Competency
Based Medical Education has horizontal and
vertical integration with other non-clinical
and clinical disciplines, a doctor is more
suitable to teach.
 The non-medical teachers don’t have patient
exposure, therefore are not qualified to teach
medical students.
 We believe that these arguments, though
sound appealing, aren’t entirely accurate.
NMC IS WRONG FOR THE FOLLOWING

 It is assumed that only those with MBBS/MD

are good teachers and all scientists are bad.
This is a myth. There are good and bad
teachers with either qualification. In fact,
many scientists are excellent teachers. These
guidelines will deprive medical students of
potentially good scientists teachers.
 All teachers, whether medical or non-medical,
have undergone the mandatory MCI-
monitored curriculum implementation
support programme for the implementation
of CBME.
 The integration component is only 20%. It
should not be assumed that MBBS student
will start practicing from the third year
onwards. The first two years of MBBS are
non-clinical; they get to learn about all the
ailments in the clinical subjects anyway.
NMC IS WRONG FOR THE FOLLOWING

 It is wrong to assume that the quality of

medical education would not be met due to
the presence of one or two scientist teachers
in each department. ≥70% of teachers in the
non-clinical subjects are anyway doctors.
They can always compensate for what a
scientist teacher lacks.
 The NMC must invest some efforts to train
the scientist teacher. The scientist teacher
can always consult the clinical teacher for
inputs, learn, and teach. After all, the
scientist has studied the same thing that the
medical teacher has learned in the MD
curriculum. Basic MBBS education is
undeniably useful, but the teachers from
either background teach mainly on the basis
of their postgraduate curriculum.
NMC IS WRONG FOR THE FOLLOWING

 It is assumed that the newly established

colleges will get medical faculties. The
shortage of medical teachers (including in
non-clinical subjects) are very much real even
now.
 In several instances, the positions are going
vacant despite several rounds of placement
advertisements and interviews. This is more
so in rural, remote, under-developed or hilly
areas, where most doctors don't want to go.
 The students will be deprived of teachers in
such colleges. Currently, in these scenarios,
the scientist teachers are carrying the most
burden.
 It is assumed that by selectively applying new
rules to the new colleges, the quality of
medical education will improve by ousting all
scientist teachers.
NMC IS WRONG FOR THE FOLLOWING

 The new CBME curriculum will be applicable

to all the medical colleges, both old and new.
In fact, the number of students admitting to
the MBBS course will be much higher in the
current 542 medical colleges.
 The existing scientist teachers will continue
in the established colleges for another
decade or two until all the scientists are
eventually flushed out of the system. The
benefit of limiting scientists in the new
colleges is therefore negligible.
 It is assumed that the medical teachers will
be able to handle academics (teaching &
practical demonstrations) and diagnostic
laboratories all by themselves. In many
colleges they are doing it, but in many other
colleges, it is the scientists who are jointly or
primarily doing this.
NMC IS WRONG FOR THE FOLLOWING

 Not only these, the scientists are also

contributing to the growth of scientific
knowledge through research and
publications. The contributions of the
scientists must not be belittled.
 Medical teachers are forced to undertake a
course in Research Methodology, whereas
the Ph.D. scientists have already gone
through it in their Ph.D. curriculum. Such
scientist teachers are better suited to be PG
research guides.
 It is assumed that by purging the scientists
from medical teaching, the standards of
education can be raised. The 30% of non-
medical teachers can't be held liable for poor
quality of medical education whereas the
remainder 70% of medical teachers absolve
themselves of all responsibilities.
NMC IS WRONG FOR THE FOLLOWING

 The fact that premier central medical

institutions such as AIIMS, JIPMER, PGI, etc
continue to employ scientist teachers without
any bias, is indicative that scientists are an
integral part of medical education.
 The same is the practice in developed
countries; 21% of teachers in US medical
colleges are scientists.
 In fact, 50-60% teachers in the non-clinical
disciplines in the top 10 medical institutions
of the West are scientists (non-medical).
 MCI has admitted in its letter No.MCI-
7(10)/2019.Legal/(18354)/183596 dated
21-01-2020 that intellectual cross-
fertilization with diverse intellectual steams is
vital for medical education. There is no need
to divert away from this wisdom.
 " ... a complete phasing out of faculty with M.Sc-Ph.D
from the teaching faculty after 3 years in the pre-
medical basic sciences (Anatomy, Physiology and
Biochemistry) would create a closed system. It would
preclude the intellectual cross-fertilization which
generates dynamism in teaching and research that
not only advances the growth of the subject but
intellectually stimulates the mind of the student, who
would then be able to think in innovative ways as to
how to understand and practice of medicine. So, there
is a great thrust from MCI and other bodies involved in
higher education to encourage research. Research
does not recognized intellectual boundaries. Many of
the advances in science have come from basic
sciences. Hence, there is a need to maintain this flow
of ideas and not completely stop the input of medical
faculty who are not medically qualified in the
preclinical subjects. We have to be very clear that the
idea of higher education (and definitely the medical
education is classified as higher education), should be
to encourage the entry of diverse intellectual streams
that feed into the medical sciences. India should not
be isolated from the trends in the rest of the world,
including even the developing world, let alone the
developed world, by cutting off the basic roots of the
medical sciences.“ -MCI
OUR APPEAL

 NMC must be advised to retain the previous

MCI ratio on the appointment of non-medical
teachers.
 In fact, there shouldn’t be any ratio at all. The
colleges must be free to appointment
teachers of either qualifications purely on
merit.
 The union health ministry must form a
council to regulate Medical M.Sc courses and
registers persons offering professional
services in the diagnostic sector.
 Government must formulate a policy on the
requirement of Medical M.Sc courses
keeping in mind their utility to the nation.
 Government must promote the appointment
of Medical M.Sc/Ph.D holders as scientists in
medical colleges to promote research.
OUR APPEAL
 Government must utilize the services of ICMR
in facilitating Ph.D courses for the thousands
of scientists working as teachers in medical
colleges.
 All colleges offering PG course must also
have Ph.D courses so that many scientist
teachers can pursue Ph.D.
 Colleges offering PG courses must be
stimulated to start research activities and
start post-doctoral research positions.
 Government must promote research by way
of grants and aids to medical colleges with a
rider to involve scientists.
 Government must focus more on the PG
courses in the clinical subjects. India needs
more doctors to attend to direct patient care.
Teaching & diagnostics can be supported by
scientists with medical M.Sc/Ph.D
qualifications as is the practice in the West.
FINAL WORDS

 When we write to the HRD ministry regarding

the conduct of Medical M.Sc courses, we are
redirected to the Health Ministry because the
courses are conducted in medical colleges.
When we write to the health ministry, we are
redirected to the MCI, which always washes
its hands off by claiming that it has nothing
to do with Medical M.Sc courses.
 In effect, there is a complete policy paralysis
and nobody has a clue about these courses
and their issues.
 We never had any representation in MCI and
none in NMC; therefore it becomes easier to
overlook our concerns. Govt must nominate
one of us in the NMC.
 We constitute a significant minority; our
interests and welfare must also be
addressed. We resent being treated as a
disposable commodity.
 In this COVID19 crisis, it is the scientists in
medical colleges who have taken the lead in
setting PCR laboratories; in many cases
scientists are jointly or solely running these
labs.
 For far too long it has always been the
doctors’ community that has received
attention and glory. It is time for the
policymakers in the government to uphold
the interests of other communities.
 While NMC is the regulating body, policies &
directions should come from the ministry.
The govt has some social responsibilities too;
it has to ensure that livelihood and
employment opportunities of scientists are
not snatched away.
 We implore you to help us in this regard.
With sincere regards

Dr. Sridhar Rao Mr. Arjun Maitra

President Gen. Secretary