Academicians list out 'musts' in proposed government medical colleges

Raigad Guardian Minister Aditi Tatkare with district officials of Alibaug going through the blue print of proposed medical college in Usar village

Academicians have expressed their concerns about the strengthening of rural health infrastructure and the need to have a curriculum covering infectious diseases and pandemics while reacting to the Government Medical Colleges coming up in three districts of Maharashtra. They have also listed other requirements that should be focused on, in the colleges.

mid-day in ‘Konkan set to get its first government medical college' on Thursday had written about a 53-acres land being reserved for one of the medical colleges in Usar village, on the Alibag-Roha road, which will also have a 500-bed hospital. Approximately Rs 639 crore would be spent for construction of the medical college and hospitals building in next three years, from date of sanction.

Professor Emeritus Dr Vedprakash Mishra, National Head of the Academic Programme of Indian Programme UNESCO Chair in Bio-Ethics Haifa and member of the International Committee for Bioethics for Asia Pacific Region, said "The district has always been taken as a unit of development. As such, keeping its developmental perspective with reference to the mitigation of healthcare requirements including that of the rural population mandates opening of Government managed Medical Colleges there. The creation of a Government Medical College is not only an avenue for the purposes of having trained health manpower at an affordable cost, but also a nucleus to cater to healthcare services in a non-commercial manner."

Dr Vedprakash Mishra

"However, it is imperative that the required standards specially with reference to the requirement of faculty, need to be maintained. In the present scenario, a diligent plan needs to be carved out by the government before venturing into the exercise. I would like to place on record that through the Medical Council of India as chairman of its Academic Council, I had made a suggestion to the government of India, to work out a ‘Perspective Development Plan' for the geographic location of medical colleges in the country, keeping in mind ‘socio-economic parameters,' specially with reference to the mandate incorporated under Article 371(2) of the Constitution of India. The real solution to the problem across the country is that medical colleges can then be opened only in those geographic locations, subject to fulfilment of stipulated procedures depicted in the said perspective plan for every five years of development. As such, instead of exercising in the nature of ‘crossing the bridge when it comes,' a diligently thought of mechanism is most desirable," said Dr Mishra.

"With regard to COVID-19 pandemic care, structuring of the pandemic management should be put in the Undergraduate Curriculum so that it becomes an integral part of the teaching and training. I have already suggested to the government of India, to start a Postgraduate Speciality Course titled ‘MD (Epidemic Surveillance and Management)' which would fulfill the requirement of trained specialist manpower for this," Dr Mishra concluded.

Dr Ketan Vagholkar, professor of surgery at D Y Patil Medical College said, "The COVID-19 pandemic has served as an eye opener for health care authorities. The deficit in the health care infrastructure in tier 1 and tier 2 cities including talukas, tier 3 and rural setting was felt in this period. It was also observed that cities which had medical colleges and teaching hospitals, did much better. Therefore, opening of new medical colleges in the interiors of Maharashtra will serve to be a blessing in disguise for local population. This will provide basic health care, as well as secondary and tertiary health carry, cutting across all specialities."

Dr Vagholkar further added, "Specific focus is essential in two areas, namely infectious disease and maternal and child health. These two areas are found to be extremely weak in the rural sectors. Working in these teaching hospitals will provide excellent experience to both graduates and post-graduate doctors. It will also provide better understanding and grasp of the health care needs in rural India. Super added research which is possible in a teaching hospital will go a long way in improvising health care standards in rural settings as well. This will also provide excellent job opportunities to the local population. This will undoubtedly create a secure health care environment in rural settings. All talukas, all district headquarter cities should be evaluated for the need to develop medical education institutions. This will completely bridge the gap between Urban and Rural health care system."

Dr Subhash Hira, professor of Global Health at the University of Washington-Seattle, USA and health advisor to several UN, Indian and African health agencies said, "As of January 2020 count, the doctor-population ratio in India is 1:1456 against the WHO recommendation of 1:1000 population. There are 300-odd/549 medical colleges run by governments in India. This doctor-population ratio is skewed in favour of urban areas by a ratio of 4:1 in rural areas. The National Medical Commission established in September 2019 brought major reforms to simplify designs of medical colleges and attached hospitals to make these more rational and in tune with modern times. For example, NMC, instead of sticking to British Raj regulatory requirement of 30-60 acres land for medical college and hospital, has reduced this to minimum 10 acres layout, and permitted district hospitals to become teaching hospitals for new medical colleges. Moreover, minimum requirement of full-time teaching faculty has been eased to make it rational and have cost-effective staffing. Even part-time and visiting teachers are considered equally important to increase the quality of teaching and research."

Dr Subhash Hira

Dr Hira added, "The NMC will oversee the establishment of new district-level medical colleges, including 75 state-run colleges by 2024. I am glad to hear that Alibaug in Raigad district is likely to be the first among six district-level medical colleges in Maharashtra. Historically, modern medical education is less than 200 years old in India. It started in 1843 with the establishment of the Grant Medical College in Mumbai. The medical education and healthcare was initially regulated by Indian Medical Services during British Raj, post-independence, the Indian Medical Council established in the 1970s formulated the regulations. Now, the game-changing move has happened with NMC that will ‘modernize medical education and standards of health care' in India. Kudos!"

"Since March 2020, the COVID-19 pandemic and its associated needs for essential health workers have accelerated scaling up health and medical education in India. The reality that the 21st century is the ‘century of pandemics', it is important for governments to invest in quality education and services," added Dr. Hira. "A lot more needs to be done by NMC to streamline tuition fees charged by public and private sector institutions, service rules /remunerations /health insurance /personal barrier protection etc. Till then, pandemics will deter young generations to stay away from medical careers," concluded Dr. Hira.

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