“The Medical Council of India (MCI) should act as a facilitator to enhance the quality of medical education and health services rather than a regulator with a stick says Dr Vivek A Saoji, Dean and Principal, Bharati Vidyapeeth University Medical College.
There have been a lot of discussions happening on the issue of poor Government control over the accreditation process of medical colleges. What are your thoughts on this. How do you think the situation can be improved?
Regarding poor government control over the accreditation process of medical colleges I feel that there should be no government control over the accreditation process and it should be done independently by an autonomous body. Let me explain, at present the Medical Council of India inspects the medical colleges and recommends to the government to grant permission to start a medical college or increase its capacity. The Medical Council of India is a regulatory body or the body which governs the medical education in the country. This however is not an accreditation in real sense, which to me is a process of self uation and improvement in the overall quality and ensuring that the systems are in place. Medical Council of India is not directly responsible for quality control; it only ensures that minimum standards are fulfilled.
At present the only accrediting agency in the country is the National Assessment and Accreditation Council (NAAC) which is an autonomous body of the UGC. NAAC accreditaties all the colleges and universities but the accreditation in voluntary and not many medical colleges has undergone the process. Some of my suggestions to improve the situation are to ensure quality of medical education accreditation should be made mandatory to all medical colleges and health science universities. It however has to be done by an autonomous body and should be free of government control There should be a separate body to accrediate medical colleges and health science universities.
Since accreditation is not mandatory many colleges may not volunteer for it so there should be some incentives for accredited institutes. There should be a separate list or directory of accreditated colleges so that the students are able to choose the best and lastly the parameters for accreditation should be realistic and comparable to the international standards so even if our students want to go abroad they should not face any difficulty.
What strategies you have adopted in your college to keep up the curriculum updated as per present day requirement?
We do curriculum review and updation in every three years. The updation is based on the feed backs received from the faculty and students, current practices followed internationally i.e. evidence based and perceived needs of the students and society to deliver appropriate healthcare. However we have to follow the guidelines prescribed by the Medical Council of India.
In our college, we are using information technology for effective delivery of the curriculum. We do regular needs assessment, seek feedback from the students & faculty & based on that make necessary changes, our emphasis is on self directed & lifelong learning, we do hope to make the difference but it is a long drawn process & we are still far from ideal.
In doing so, what are the challenges you have faced and how have you overcome those challenges?
The biggest challenge in bringing about a change is convincing the faculty. It is the willingness of the faculty to adopt change which is most important.For that we conduct regular faculty development workshops. It has helped us a lot. Now not only are the faculties aware about new development but are ready to implement them. Secondly, resources may be a challenge. We have to work with limited budgets and limited recourses, here we priorities the needs and use the available funds in a judicious manner. Thirdly the students, sometimes they may not accept the change and they may not want to come out of their comfort zone. This again is overcome by conducting foundation courses and counseling the students.
The Indian hospitals are under manned and we face challenges of lack of skilled medical and para medical staffs in the country. To combat the problem what are the steps a medical college can take? What are your suggestions?
As far as healthcare manpower is concerned we are definitely undermanned. Our doctor population ratio is very poor, but more important is that it is skewed. In urban areas there is a problem of plenty while in rural areas it is grossly inadequate. We no doubt need additional skilled healthcare man power, but again more important is to create the environment in rural area where a doctor would go and work. So even if we double or triple our capacities to produce doctors but if they do not go in rural areas the purpose is defected. So I very strongly feel that it should not be looked up in isolation and just create the additional manpower but to look at the issue in holistic manner. We also have to ensure the quality of healthcare manpower that we are creating, as in many places it is of subordinate quality.
A balance between numbers and quality has to be achieved. Then only we will be able to serve the underserved rural population and not just by increasing number of doctors
A balance between numbers and quality has to be achieved. Then only we will be able to serve the underserved rural population and not just by increasing number of doctors.I completely agree with you that directly we are short in supply & secondly the quality is not assured. As said earlier we have to balance between the two.
Accreditation is one way to ensure quality. Now most important is we have to use technology both for training of manpower as well as for delivery of healthcare.Use of telemedicine, use of mobile phones, social media for rapid communication, and training of local people can help solve the problems of delivery, so also for training use of simulation, self learning modules etc. will bring in uniformity. More paramedical staff and giving responsibility to them about health education to masses, (providing clean drinking water, toilet training,immunisation, assisted deliveries, malnutrition etc) can dramatically improve the healthcare scenario; practicing preventive health also may help solve the problems to some extent. I strongly feel that simple measures and looking at healthcare delivery from a holistic perspective can address these issues.
How do you think Medical Council of India is acting on improving the scenario?
Medical Council of India is doing its bit, but it is mainly bogged down in granting permission & giving recognitions.It has to have a quality assurance cell. It has to recognise good colleges, categories them and help them reach the next level. At present all of them are put in same category. Moreover at times there is conflict of interest between the Medical Council of India with government and it leads to policy paralysis. Some good initiatives by the Medical Council of India has not seen the light of the day. In last few years Medical Council of India has been riddled in controversies. It should also gain the confidence of not only doctors but the public in general.It should act as a facilitator to enhance the quality of medical education & health services rather than a regulator with a tick. In last few years it has done a lot of good work but more needs to be done and then we all have to strengthen the Medical Council of India.