June 30, 2010

Health ministry panel to examine Dental Council decisions

Not a single new dental college has been given permission to start undergraduate dental course this year. Around 45 new colleges, 95% of which were private, had applied to the Dental Council of India (DCI) seeking permission to start new admissions. But the applications of all of them were rejected on grounds that they did not have enough faculty to run a dental college or enough clinical matter to teach students on. On the other hand, the registration of nearly 42 dental colleges, which are already running for the past few years, have also not been renewed.

The Union health ministry has now set up a four-member technical committee — director general of health services Dr R K Srivastava, Dr Naseem Shah and Dr O P Kharbanda from the department of dentistry at AIIMS and Dr Ashok Autreja from PGI Chandigarh — which will see whether these colleges really lacked infrastructure and faculty.

The committee is undertaking "personal hearing" with all these colleges and will give its report to the ministry on Saturday. If some colleges show merit, their application will be sent back to the DCI for a relook. "Since the applications of so many colleges were rejected, the ministry decided to set up a committee to look into the matter," said a ministry official.

Speaking to TOI, DCI chief Dr Anul Kohli said, "Most of the colleges were rejected for failing to comply with the rules regarding faculty and clinical matter under the Dentistry Act. However, the last date for considering an application is July 15 till which time a college can make changes and get a clearance. As of now, not a single new college has been given permission to start courses."

According to Dr Kohli, India does not require new dental colleges. "There is hardly any employment opportunity for dentists in India. We must not open new dental colleges anymore but accreditate the old ones under three categories — doing well, can improve and bad. Colleges coming under the last category should be shut down."

At present, India has 290 dental colleges with 22,000 seats. Of these, 88% are private and 12% are run by the government. According to the Council's senior members, dental education has become a lucrative business that is diluting quality dental education in India. "There is a serious dearth of visiting faculty. It has become a lucrative business to start a new dental college. This clearly explains the sudden increase in the number of dental colleges applying for permission to DCI," Dr Kohli said.

The Council has now made it mandatory for professors teaching in UG level to stay in the same college for at least one year while those teaching the PG level must do so for three years. It has also made continuing medical education or CME mandatory for 20 hours a year and 100 hours for 5 years.

Link: Original Article

Many Indians lack access to essential medicines: Report

India has the largest number of people (649 million) having no access to essential medicines, according to World Medicine Report (2004) of World Health Organization. The report also reveals that 77% of health expenses in rural areas and 70% in urban areas are on medicines alone. In a year, out-of-pocket medical costs alone push 2.2% of population below the poverty line, the report suggests.

According to S Srinivasan of Vadodara (Gujarat), who has been involved in issues related to medicine for over three decades and who has established LOCOST that manufactures essential drugs, the proportion of private expenditure on health in India is one of the highest in the world (84%) as compared to just 16% public expenditure. The total expenditure on medicines is in excess of Rs 30,000 crore, meaning Rs 1,500 for each family in the country, he said.

The UNDP Task Force on access to essential medicines report says that about 65% of Indians lack access to essential medicines. But 50-60% of the people are not able to get all the medicines, he explained. A World Bank document, using National Sample Survey data, concludes that more than 40% of those hospitalized in India borrow money or sell assets to meet the expenses.

Srinivasan will share his work on issues related to drug pricing and will deliver a talk on `Medicine prices: Why so high?' at a programme organized by Dharwad-based Drug Action Forum at Karnataka Vidyavardhaka Sangha at 5.30 pm on Friday.

Link: Original Article

June 25, 2010

Doctors from 11 states to get marks for rural stint

In a unique initiative, government has decided that fresh medical graduates from 11 north eastern and northern states would get additional marks in the All India Post Graduate Medical Entrance Examination if they serve in rural areas of their states.

The states include Assam, Manipur, Nagaland, Arunachal Pradesh, Meghalaya, Tripura, Mizoram, Sikkim, Uttaranchal, Himachal Pradesh and Jammu and Kashmir. “I belong to Jammu and Kashmir, which is akin to the northeast. We have the same militancy, insurgency, problems of aloofness, inaccessibility, hills and difficult terrain,” Union health minister Ghulam Nabi Azad said.

“The 11 states have been clubbed and given them the special concession. Doctors interested in post graduation can get 10% extra marks in the national PG test if they work for one year in the most inaccessible and difficult area of their state,” he said. Those working for two years would get additional 20 per cent marks and 30 per cent for those serving three years.

Link: Original Article

June 24, 2010

States want medical education brought under NCHER

Cutting across the political spectrum, education ministers of various states on Saturday said that medical education should be brought within the ambit of the proposed National Commission for Higher Education and Research (NCHER).

Though many states pointed out problems with certain provisions of the Higher Education and Research Bill that creates NCHER, the general tone in the one-day meeting of the Central Advisory Board of Education was supportive of the idea of an apex regulatory body for higher education. With the health ministry resisting taking away of medical education from the purview of the now-defunct Medical Council of India, and HRD ministry also treading cautiously, it is likely that the final call on medical education will be taken by the PM.

Despite overwhelming support of the states to the idea of NCHER, HRD minister Kapil Sibal maintained that his ministry is yet to form its own opinion on the matter. ‘‘Right now the bill belongs to the task force,’’ Sibal said. A clearer picture will emerge after a month since states have been asked to give their detailed views on NCHER in the next four weeks.

The HRD ministry might seek PM’s intervention at the time of finalizing the Cabinet note on NCHER. The Higher Education and Research Bill, proposing the setting up of NCHER, has been prepared by the task force constituted by the HRD ministry and brings medical education within the ambit of NCHER.

Members of the task force — M K Bhan, secretary, department of biotechnology, legal expert N R Madhava Menon and social scientist Mrinal Miri — defended the provision of the bill and clarified that the autonomy of states in higher education is not being taken away. They explained that NCHER will promote the autonomy of universities by devolving powers.

Link: Original Article

Health journals form over 40% foreign publications in India

India seems to be a health conscious nation as far as reading about the subject is concerned with health magazines forming the chunk of foreign journals or periodicals published from the country.

A large number of 154 facsimile editions of foreign journals on health are published from the country out of the total 373 since doors were opened for such publications in 2003, according to Government data.

The publications range from subjects on neurology to cancer to cardiology and even 'medical grapevine' which talks about the latest news from the world of medicine.
The journals also include those on homoeopathy and psychiatry.
However, the trend seems to be declining over the years with no health magazine among the 18 approved for publication last year.

This year, till now, only three magazines, including 'Fortune India', have been given approval.
An yearly break-up shows that the maximum number of 72 approvals for foreign journals were given in 2006 and the least number of five in 2003.

The government has in 2009 allowed a 100 per cent FDI in the publication of facsimile editions of foreign newspapers. Via the same notification, the Government notified 26 per cent of FDI in the Indian editions of foreign newspapers and current affair magazines.

India had originally changed the law in 2003, allowing foreign groups full ownership of non-news publications.

Link: Original Article

June 23, 2010

Education board for bringing medicine, law under regulator

The Central Advisory Board of Education (CABE) Saturday backed the inclusion of all fields, including medicine and law, under the proposed apex regulator for higher education in the country, despite resistance from the health and law ministries, official sources said.

A meeting of CABE, the highest advisory body on education, was held in the national capital and the recommendation to include all fields was made by the task force, which formulated the draft bill on the creation of the National Commission for Higher Education and Research (NCHER) - an overarching body which will oversee higher education.

'The CABE has confirmed the task force's recommendation of including medicine and law. All states in principle agreed to the structure of the draft,' a source in the human resource development (HRD) ministry said.

'There was no resistance in general on inclusion of medical or law education,' he said.

HRD Minister Kabil Sibal said: 'It is the recommendation of the task force...a final decision has to be taken by the government when the bill is submitted.'

The NCHER has been proposed to cover all streams of higher education. Medical and law education are out of the ambit of HRD ministry. The NCHER bill, however, proposes to include these streams in its ambit.

'It has become imperative that a holistic view of higher education is taken because of the increasingly converging nature of disciplines at the frontiers of emerging knowledge,' a statement submitted to CABE by the task force said.

Agriculture, being a state subject, has not been brought under the ambit of the HRD ministry but the task force has recommended the central government to consult states and take 'appropriate legal measures to bring agriculture within the ambit of NCHER'.

Following CABE's deliberations, the bill now awaits recommendations from some states. Once these recommendations are submitted, the task force will finalise the draft for government approval.

Link: Original Article

Education Minister for common engineering, medical entrance tests

Critical about holding of multiple entrance exams for admission into higher educational institutions, Union HRD Minister Kapil Sibal has pitched for uniform entrance test.

To start with, the CBSE, a premier school education board under the HRD Ministry, will merge the All India Engineering Entrance Exam and All India Pre-Medical Test, Sibal said.

The merger of AIEEE and AIPMT will help students immensely. While Physics and Chemistry will be common for both, the medical students can answer only the Biology paper and the engineering students can answer the Mathematics paper.

Addressing the Education Ministers' Conference, he said his Ministry was presently debating whether it is possible to have one common exam after class XII that will test general awareness and aptitude.

The universities will give weightage to the Class-XII marks and entrance marks of students while giving admission.

For entrance to institutions, class XII marks and this test could be the criteria. The marks of different Boards could be equalised through a mathematical formula for weightage.

This will give an opportunity to children from economically weaker sections who are not able to avail of coaching and get through the current system of entrance exams.

Sibal underlined that this was just being debated at present, as the current system is being seen as unfair for the poor and the under privileged.

"We are trying to prepare a system under which students will not have to appear in exam after exam," he said.

The Council of Boards of School Education (COBSE) has already prepared a common curriculum in science and mathematics. He said the state boards should adopt the curriculum which would help in holding a common entrance test

Link: Original Article

June 22, 2010

Doctors serve rural areas mainly due to geographical affinities, says survey

Preferential admission to higher education after serving in a rural place also the reason

A medical practitioner's decision to join service in rural and remote areas is widely influenced by geographical affinities and familial associations. Preferential admission to higher education after serving in a rural place was also cited as a reason though by few doctors.

According to a qualitative research on ‘Factors Influencing Decisions of Doctors to Serve in Rural and Remote Areas of Chhattisgarh State,' doctors' decision to remain in rural and remote areas over periods of time were driven by a combinations of factors, including geographical affinities, personal values of service, professional interests and ambitions, strong relationships with colleagues and in the case of contractual doctors, the anticipation of obtaining a regular position.

Working conditions evoke a mix of responses among doctors, some revelling in the experience and finding opportunities in the challenge of adversity, and others confronting an eroding knowledge base and decline in professional confidence and capabilities, said the survey. It was conducted by the Public Health Foundation of India, the National Health Systems Resource Centre and the State Health Resource Centre, Chhattisgarh.

Many respondents, particularly contractually employed practitioners, perceived that their presence in their respective locations was not of their free will.

They were simply assigned there by the government's placement process. Some respondents even touched upon the alleged role of nepotism and, in some instances, active corruption in the allocation of postings, suggesting that remote and less-preferred locations were assigned to those who did not have personal or pecuniary influence to bear on authorities.

On the other hand, a number of practitioners had also actively sought to work in the area of their present locations. Geographical and ethnic affinities were cited by a majority of practitioners as a reason for serving in a remote area.

MOTIVATING FACTOR

Values of service and the importance of a social return from government-funded medical education were also cited by a few doctors, as a motivating factor for joining a position in a rural or backward area.

A few respondents indicated that they had joined government jobs in rural areas due to policies linking conduct of rural service with eligibility for or preferential admission to postgraduate degree course.

Link: Original Article

Robots to be employed in UK hospitals

If you see an army of hi-tech robots all over the NHS hospital, don't be surprised. For the first time in the UK, the state-of-the-art-technology is being used to carry out various activities.

The robots will be used for transporting clinical waste and dirty linen, delivering food and dispensing drugs.

Ahead of the opening in August, the robots are being tested at the 300 million pounds Forth Valley Royal Hospital in Larbert, Stirlingshire.

The robots will operate along a dedicated network of tunnels beneath the hospital. The human staff will use a hand held personal digital assistant (PDA) system to call the robots.

The robot will then move towards the lift, collect or deliver its item and return to the lift.

This technology will work with the help of sensors, which will direct the functions.lspeth Campbell, spokesperson of NHS Forth Valley, said the new system would help in preventing infections.

"Staff is very pleased. It is exciting to be the first in the UK to do this." the Sun quoted Campbell as saying.

"We know they work well in other hospitals elsewhere in the world. While it is new, we aren't nervous because we know it is a system that works well," Campbell added.

Link: Original Article

June 21, 2010

Over 170 quacks in TamilNadu State arrested

Following up on a High Court order issued earlier this year, the Tamil Nadu police, on Thursday night, launched a State-wide crackdown on those practising allopathy without a formal degree in medicine. Over 170 persons were arrested.

The court, in its order, had instructed the Indian Medical Association to furnish the names of persons practising medicine without a valid licence. The association had provided a list of 2,000 such persons throughout Tamil Nadu on June 2 to the Health department, the State DGP and the ADGP and the Chennai City Police Commissioner.

According to the Additional Director General of Police (Law and Order) K. Radhakrishnan, more than 170 persons posing as ‘qualified medical practitioners' and practising allopathy were arrested across the State. “There are two kinds of quacks: those having no degree and those holding some degree or certificate in Siddha or homeopathy [but practising allopathy]. In the southern districts alone, 75 persons were taken into custody till Friday evening. The numbers are set to increase as more arrests are likely on Friday night,” he said.

In Chennai, Commissioner of Police T. Rajendran said special teams formed to apprehend quacks arrested four persons in Tiruvottiyur. Personnel of St. Thomas Mount police district arrested nine quacks on Friday morning. V. Varadharaju, Deputy Commissioner, St. Thomas Mount, said raids were conducted in the jurisdiction of Tambaram, Shankar Nagar, Pallavaram and Pazhavanthangal police stations.

Principal Secretary, Health, V.K. Subburaj, said the raids would continue throughout the State. Information had been sent to all District Collectors to come down on quackery. As prescribed in the IMA and Tamil Nadu Medical Council's Code of Ethics, all registered practitioners are mandated to display their registration information prominently in their clinics or hospitals.

IMA Secretary T.N. Ravisankar said the association hopes that the drive would be conducted at periodic intervals to prevent quacks from endangering the lives of patients. The IMA members would update the government constantly with information about the whereabouts of quacks. He reiterated the demand for an Anti-quackery Act to bring a permanent solution to the problem and wanted punitive action made more severe.

Link: Original Article

IMA to hold rally against Central medical Bill

The Indian Medical Association (IMA) is not only opposed to the dissolution of the Medical Council of India (MCI) but also to the Clinical Establishment Bill and the three-year rural medicine course being considered by the Ministry of Health and Family Welfare.

According to IMA president Dr G Samaram, these issues were discussed at the Central Working Committee (CWC) meeting of the association held early this month in Mehsana district. Nearly 200 members from across the country had attended the meeting.

“The IMA has sought permission for a rally and dharna at Jantar Mantar in Delhi next month. It is against the Clinical Establishment Bill passed by the Union Cabinet because the clauses of the bill show inclusion of more bureaucracy,” said Dr Samaram.

He further said the IMA recommends that the rural medicine courses should be of four years, instead of three and half years.

“The rural masses should also get quality professionals for their treatment,” he said, adding: “Why should a rural medicine course cannot be similar to the urban course? Instead of running two separate courses for urban and rural masses, the number of seats in MBBS courses should be increased.”

IMA Gujarat chapter president Dr Jitendra Patel said the CWC meeting has unanimously resolved to oppose the dissolution of the MCI by an ordinance dated May 15. “Representatives from IMA, Gujarat will also participate in the Delhi rally,” he said.

According to an IMA press release, “a perusal of the provisions of the Indian Medical Council Act, 1956, would categorically bring out that the Government of India has substantial and reasonable control on the affairs of MCI. In terms of section III of the Act, the government is required to constitute MCI”.

The White Paper developed by the IMA CWC committee has condemned the dissolution of MCI as arbitrary exercise of power.

It demands reconstitution of the MCI as per provisions, restoration of the council’s independence, and retaining of the MCI in its present character and form.
Link: Original Article

I-T dept to earn over Rs 600 cr from tax on hospital payments

Tax authorities can now raise an additional Rs 600 crore or more after a Bombay High Court order that held that third party administrators (TPA)—companies that liaise between insurers and hospitals to facilitate cashless treatment for policyholders—are required to deduct taxes while making payment to hospitals.

The High Court order issued in May 2010 was on a writ petition filed by Dedicated Health Care Services. This is the latest in a series of litigations between TPAs and the Income-tax (I-T) department. The Karnataka High Court too had held, in the case of Medi Assist, that TPAs are required to withhold taxes while making payments to hospitals. The Bombay High Court order however set aside a CBDT circular stipulating penalty on TPAs for non-deduction of taxes.

Speaking to ET, Dr Nayan Shah, a director, Paramount Health Services said that TPAs have been depositing tax, deducted at source, with the I-T department under protest ever since the circular was issued. The association of TPAs had also decided to file a special leave petition in the Supreme Court.

Although it is an administrative hassle for the insurance industry, the tax deduction at source will not hit buyers of health insurance. According to Sanjay Datta, head of customer service, health and accident at ICICI Lombard, it will bring more of the unorganised healthcare service providers into the tax net. The money reimbursed every year to hospitals—for cashless service to policyholders—amounts to Rs 4,000 crore annually. Of this, 60% is facilitated by TPAs who make the payment out of float funds that are parked with them by non-life insurance companies. In return for their services, the TPAs receive a 5% commission from insurance companies on the health insurance premium. The I-T authorities claim that TPAs have to deduct tax at the rate of 10% at source before making payments to hospitals.

The I-T department, Mumbai had carried out surveys last year on six TPAs and raised tax demands ranging from Rs three crore to Rs 69 crore. The survey had revealed that none of them had deducted tax (TDS) while making payments to the hospitals, from the fund made available to the patients by the insurance companies. The I-T authorities therefore issued demand notices under section 194 (J) of the Income-tax Act which deals with payment for professional services.

The Karnataka High Court had observed that since it is the TPA which is the authority in making payments to hospitals, it is obligated to deduct TDS. The High Court had also observed that the critical factor in deciding this issue is the fact that the agreement for paying to the hospitals is between the TPA and the hospital.

Link: Original Article

Village stint to help doctors in PG Entrance: Health Minister

Health Minister Ghulam Nabi Azad Saturday said the government is planning to give academic incentives to medical graduates who serve in villages before opting for post-graduate courses.

Medical graduates who serve in rural areas will be given additional marks which will help them while applying for post-graduate courses, he said.

'Students will get extra marks in the National Entrance Exam (NEE) for the post-graduate medical courses if they have served in rural areas,' Azad said after inaugurating an organ transplant unit at a hospital in Gurgaon.

'If the person practices for one year in a rural area he will get 10 percent extra marks, for serving two years, it will be 20 percent and for three years, 30 percent,' he said.

The proposal for making practice in rural areas compulsory for medical students was mooted in 2006 by then health minister Anbumani Ramadoss. The proposal however met widespread protest from the student and medical fraternity.

Pointing to the ministry's fresh stand on the issue, Azad said that keeping in mind the opposition to the earlier proposal the government will now give incentivise to medical students aiming for post-graduate courses for serving in rural areas instead of forcing them to do so.

'Most of the doctors are unwilling to work in rural areas, such incentives are necessary,' Azad said.

'Fifty percent seats in the post graduate diploma courses will be reserved for students who serve in rural areas for three consecutive years,' he said.

The announcement comes at a time when the government is formulating a separate course for training doctors for rural areas.

A three-year bachelor of rural medicine and surgery course proposed by the ministry aims at giving basic health training to doctors who will have a licence to serve only in rural areas.

Spelling out government's initiatives for increasing the number of doctors in the country, Azad said that the number of seats in medical colleges will also be increased.

'We will be increasing the post-graduation seats by more than 10,000 in the coming time,' he said.

The government has approved an additional 3,700 MBBS seats in government medical colleges, besides setting in motion a process to increase the number of MBBS graduates within the next five years.

Talking about the number of medical colleges in the country, Azad said new colleges will be established in states which have been backward in this area.

'Eighty percent of the medical colleges and 85 percent of nursing and paramedic institutes are in southern and western India. It is time that we laid emphasis on northern and eastern states,' he said.

The government plans to set up six new medical colleges and 270 nursing schools in next three to four years.

'Because of space constraints in urban areas, we have rationalized (the size of minimum required) land for building a medical college from 25 acre to 20 acre in cities and towns and 10 acre in metros,' the minister added.

Link: Original Article

Task forces unable to decide on medical education

Given the complexities of bringing in medical education under the National Commission on Higher Education and Research (NCHER) — an overarching regulatory body — as against the National Council on Human Resource for Health (NCHRH), the task forces of the two proposed bodies on Thursday broadly decided to explore the possibility of allowing both the institutions to come up, but to have some linkages with each other.

The members of the two task forces who met here felt there was a “cultural disconnect” between the two draft Bills with the NCHER Bill striving to make the universities and research institutions highly autonomous while the NCHRH Bill was based on far too many “government controls” on medical institutions and hospitals. Instead of trying to force uneasy compatibility, the members sort of agreed that both the bodies could be created through two legislations as announced by President Pratibha Patil in her speech to the joint session of Parliament, and then find some possible connection.

The task force on NCHRH, set up by the Ministry of Health and Family Welfare, might also go in for a fresh relook at the draft to make the institutions more autonomous.

According to a member, the two task forces recognised the need for a multi-disciplinary approach to higher education with specific needs of medical education to be addressed, as also the need for setting up a technical monitoring body. It was suggested that some members could be common to both the bodies and they could serve as a link between the two streams of education.

The NCHER task force will now take its draft to the Central Advisory Board of Education (CABE) on June 18 and 19. If approved, it will then be submitted to the government and the final call will be taken by the Prime Minister.

The NCHER proposes to bring under its purview all streams of higher education and research including medical and legal. However, this is being resisted by the Ministries of Health and Family Welfare and the Law. Agriculture is also sought to be brought under the domain of the NCHER but since it is a State subject, it would require a constitutional amendment to bring it in the Concurrent List.

The issue was also raised at the Parliamentary Standing Committee of the Ministry of Health and Family Welfare where the members said medical education was linked to the health system and could not be extracted. They also said that the proposed NCHER was a highly centralised body and health and education being in the Concurrent List could not be handed over to it.

Link: Original Article

June 17, 2010

Human resource, health ministries mull common council members

As the tug of war between the ministries of human resource development and health on medical education continues, a middle path by having common members in both proposed councils is being contemplated by the two.

'If we have two boards, we can have common members. It will serve the purpose,' said an official present in the meeting between Health Secretary Sujatha Rao and Human Resource Development Secretary Vibha Puri Das Thursday to discuss the issue.

While the HRD ministry continues to pitch for inclusion of health education under the ambit of the proposed National Commission of Higher Education and Research (NCHER), the health ministry remains adamant on creation of a separate National Council of Human Resource in Health (NCHRH).

The meeting was inconclusive as both stuck to their respective stand. 'No conclusion was reached,' the official said.

Rao reiterated that the NCHRH was proposed in the president's speech to the joint session of parliament last year and the health ministry is already at an advanced stage in formulation of the bill.

'Medical education can not be separated from health ministry as it is attached to hospitals,' the official said.

The decision on the draft NCHER bill will be taken in the meeting of Central Advisory Board on Education (CABE) scheduled June 18-19

Link: Original Article

Call to validate and standardise traditional medicines

The study of indigenous systems of medicine should be integrated with the curriculum of modern medicine to strengthen and preserve traditional healing wisdom, J. R. Krishnamoorthy, CEO, Dr. JRK's Siddha Research and Pharmaceuticals, said on Thursday.

Delivering the First Government College of Integrated Medicine (GCIM) Alumni Endowment Oration hosted by Sri Ramachandra University (SRU), Dr. Krishnamoorthy said alongside familiarising allopathy students with Indian systems of medicine (ISM), students of traditional systems including Ayurveda, Siddha and Unani systems needed to be oriented with modern medicine.

Dr. Krishnamoorthy said the prevention approach of Siddha (“Unave Marundhu” or food is medicine) was deep-rooted in dietary habits and was increasingly relevant in an era of lifestyle diseases.

He pointed out that though ISM formulations enjoyed a distinct identity in the global markets, India's share of trade in this segment was only $ 1 billion whereas China's share in the $ 62 billion industry was around $ 19 billion.

Stressing the need for ISM practitioners to overcome stigma following the sensationalisation of sporadic reports on toxic effects of herbo-mineral formulations, Dr. Krishnamoorthy also felt that part of the purge had to come from within the fraternity as a few ISM physicians sought to profit from misleading claims.

Earlier, inaugurating a national workshop on analytical techniques in the standardisation of Siddha drugs, V. M. Katoch, Secretary, Department of Health Research, and Director General of ICMR, called for extending the technology platforms available for modern medicine to indigenous systems of medicine as well.

Pointing out that public faith in indigenous medicines had been built over thousands of years, Mr. Katoch called for application of technology to standardise and validate traditional knowledge.

S. P. Thyagarajan, Pro Chancellor (research), SRU, called for measures to validate and standardise traditional medicines that would help increase India's share in the global market for indigenous medicines.

It is estimated that 80 per cent of the world population used traditional medicines at some point of time and in a country like the US, the annual expenditure on traditional medicines had increased from $ 27 billion in 1997 to $ 40 billion in 2005, he said.

Link: Original Article

Number of medical seats declines in Karnataka

The number of medical seats in Karnataka this year has fallen by around 400, a direct result of the dissolution of the Medical Council of India (MCI) and the consequent move to re-inspect colleges that were granted approval in April this year.

Recognition granted to no less than five medical colleges in the State have been withdrawn and the student intake of KIMS, Hubli, has been reduced from 150 to 100. The list includes three government colleges (in Bidar, Shimoga and Raichur) and the S.S. Institute of Medical Science and Research, all of which were granted permission during inspection by the now-dissolved MCI inspection teams. Approvals, for admission or intake, given to 85 colleges across the country have been repealed and inspections are already under way, a member of the freshly-constituted MCI governing body told The Hindu.

Seats on offer

A total of 1,339 medical seats and 763 dental seats will be on offer on Thursday. The list on offer is further impoverished by the fact that two “deemed-to-be” universities, Yenepoya Medical College and K.S. Hegde Medical College in Mangalore, have pulled out of the CET admission process. They have refused to admit students under the subsidised government quota. Further, the Government has also decided to not admit students to the Ambedkar Medical College (AMC) in Bangalore, which has been denied permission to admit for over five years now. The AMC case is in court.

Top officials in the Directorate of Medical Education said the “last-minute” order caught them unawares as the seat matrix had been prepared. “It will affect students and the seats may re-enter in the casual vacancy round, but students will have to bear the brunt,” an official said. The inspection team, which visited these colleges in April, had approved all these colleges. But now re-inspection orders have been sent.

This move will further complicate the admission process for medical seat aspirants, which, given the paucity of seats, is already a tight-rope walk.

Being forced to opt for seats out of an incomplete seat matrix, many of them will find that the private college admission process conducted by COMED-K will clash with their second round of admission in July. “This will further complicate matters both for COMED-K and for us. Students too will find it difficult to make a ‘correct choice' and may prefer to wait for the second round,” a Karnataka Examinations Authority official said.

Meanwhile, the Directorate of Medical Education has written to the Union Government apprising them of the situation and seeking clarity on the issue by the second round, sources said. Inspections in the government colleges will begin on June 11. The new inspection team comprises academics from the All-India Institute of Medical Sciences, Christian Medical College, Vellore, St. John's National Academy of Health Sciences in Bangalore and JIPMER in Puducherry.

Link: Original Article

June 10, 2010

New MCI board to reassess all previous clearances

The six-member governing body of Medical Council of India (MCI) has decided to reassess all permissions granted to 79 medical colleges by the earlier regime regarding recognition of the institutes, starting new courses or increasing seats in existing ones.

A special team of 43 assessors, chosen from seven top central government medical institutes -- many of whom are well-known professors -- has been put together to inspect these medical colleges, wanting to either start an MBBS course or having applied for re-recognition of their MBBS degree.

The permanent inspectors who till now did the job for MCI have stepped down.

The governing body has finalised guidelines for the assessors to carry out inspections of colleges. A baseline datasheet has also been sent to all medical colleges which will have to be filled by the colleges and sent to the governing body.

MCI, which was established 76 years ago, was dissolved last month and replaced by a six-member panel after the CBI on April 22 arrested the then MCI president Dr Ketan Desai for taking a bribe of Rs 2 crore to grant recognition to a medical college in Punjab though it did not meet MCI standards.

The new governing panel is headed by Dr S K Sarin and includes Prof Ranjit Roy Chowdhary, Dr Sita Naik, Dr Gautam Sen, Dr Devi Shetty and Dr R L Salhan.

The new governing body has been authorised by the health ministry to both inspect and garnt recognition to medical colleges for the next one year under Section 10A of the MCI Act 1956.

Till now, it was the sole duty of MCI to inspect medical colleges for adequate infrastructure, equipment and faculty. Based on this inspection report, MCI recommended to the ministry whether to grant the college recognition or not.

But for the next year, the ministry will not be responsible for recognising colleges. It will be the sole responsibility of the six-member panel to both inspect and recognise all new medical colleges or old ones wanting re-recognition.

Dr Sarin said, "We will finish our task of assessing, approving or disapproving of new colleges and renewal of permission for colleges already approved for undergraduate courses well before the July 15 deadline. The same time will also be needed to go through all applications for the 14,897 postgraduate seats."

He added, "The 43 assessors were randomly chosen and through computer generated random numbering assigned the duty of inspecting colleges. They will submit their assessment reports by June 16. We will then evaluate individual files before reaching our decision."

Earlier, health secretary K Sujatha Rao said, "This committee is not in an advisory role but will actively look to run MCI, including issuing licences and permissions, conducting inspections and regulating medical education, for a maximum of one year. They will also suggest how to reform MCI which will help in preparing the bill which we plan to introduce in the monsoon session of Parliament."

Meanwhile, health minister Ghulam Nabi Azad has asked the new board of governors to ensure transparency in the process of granting recognition to medical colleges and to be beware of touts. He wrote to Dr Sarin recently, "The decisions to be taken by the board of governors should be free, fair and without fear."

Link: Original Article

June 09, 2010

Medical Council of India: Time for a transformation

The dissolution of the Medical Council of India (MCI) has led to debates on the circumstances involved and the alternatives available. The agency that was set up to regulate medical education and practice had failed on many fronts – despite good intentions. The last straw that led to its demise involved charges of massive corruption. It was an open secret for years. However, this is also a historic opportunity for change and to open a new era in medical education. It provides an opportunity to reappraise the regulatory systems involved.

The MCI was packed with medical professionals, many of them from for-profit medical colleges. This often resulted in narrow perspectives and conflicts of interest. Each specialty represented on the body pushed its own limited agenda, often missing the bigger picture of the health care needs. The woods were missed for the trees.

The new authority should be composed of diverse stakeholders. They should include patient advocacy groups, consumers of health care, social scientists and allied health experts, in addition to distinguished medical professionals from leading medical institutions. This will ensure that overall health and health care needs, rather than narrow professional interests, are the focus.

LACUNAE

Over the years, the MBBS course, set in tertiary care institutions which often deal with exotic and rare disorders, has not equipped students to deal with the health needs of local communities. The explosion in medical knowledge has resulted in the introduction of new specialties. But there has been a marked reduction in the time spent for training in each subject and for acquiring practical skills during internship. The focus of undergraduate education has shifted from training basic doctors to manage common diseases to learning medical theory. This pattern has made them less skilled and much less capable of managing basic conditions.

The new regulatory authority should aim to channel education to deliver relevant health care to the vast majority of India's people. Health care needs should be determined based on local and national statistics rather than on western data and priorities. The focus of medical education and the health care delivery system should be on universal coverage of basic health needs. The regulators should periodically monitor the national health scenario and adapt medical education to changing health needs.

The syllabi, curricula and methods of teaching of the undergraduate medical course should focus on competencies and skills to be mastered rather than on knowledge to be acquired. The basic doctor should be a competent generalist who also has the background to specialise.

TRIVIAL FACTORS

The MCI regulations and inspectors were more concerned about the dimensions of classrooms and other such relatively trivial factors than about, say, the quality of teaching. The requirements were so archaic that many good medical colleges found it difficult (and unnecessary) to meet them. For example, every department of physiology is required to have amphibian and mammalian laboratories, despite a government ban on experiments involving such beings. The shortage of teaching faculty and the proliferation of capitation-fee medical colleges meant that many institutions employed teachers whose only mandate was to show up for MCI inspections. The high density of medical colleges in certain areas also means there are fewer patients in the new colleges. This results in inadequate clinical training for students.

The new regulatory authority should provide a basic framework for medical education and should measure the success of medical institutions by their output, namely the quality of the teaching programmes and the doctors produced, rather than on physical infrastructure.

The marked variability among medical colleges and major lacunae and inadequacies in some of them in terms of teaching faculty, clinical exposure, training and evaluation, make for unacceptable variations in the quality of new doctors. The training and evaluation systems for medical courses should be standardised and should focus on skills and competencies to be mastered, rather than on knowledge retained. The new authority should set national competency requirements for basic physician training and establish norms for a streamlined system of quality assurance and certification.

INNOVATION STIFLED

The current guidelines include much minutiae and rigid regulations that stifle improvement and innovation. The specification of basic and broad minimum standards for processes will allow for innovation and release good medical colleges from oppressive stipulations. This will allow for the growth of different models of medical education that are best suited for a diverse and vast country like India.

The same office and set of officers of the MCI handled accreditation and regulatory functions; this diluted and weakened both processes. The new authority should consist of two independent divisions. One should accredit medical education and the other should oversee medical practice. Complete lack of self-regulation was evident in its previous avatar. It needs to be replaced by a watchdog with sufficient teeth to ensure and enforce minimal technical and ethical standards in medical practice. The crass commercialisation of medical education and unethical practice should be checked.

The MCI was a law unto itself. While medical professionals and their regulatory authorities have privileges, they should also be held accountable for standards of medical education. The regulatory authority should be answerable for health and health care delivery. The focus should be on equity and inclusiveness which are mandatory for a vast and diverse country like India.

FOR ENLIGHTENED REGULATION

Physicians have always promoted medical education and its reform as a means to increase professional status. Abraham Flexner, an American reformer of medical education at the beginning of the 20th century, promoted educational transformation as a public health measure. He argued that the business ethic that governed for-profit medical colleges was incompatible with the progressive academic values necessary for socially useful medical education. He emphasised that the exploitation of medical education was particularly inconsistent with the social aspects of medical practice. He reasoned that in modern life the medical profession is an organ differentiated by society for its highest purposes, not a business to be exploited. He maintained that the government was the proper instrument for regulating medical education, because social welfare is inextricably linked to the quality of a nation's physicians.

Geographic, cultural, social, and economic diversity characterise India's States. Many regions are economically backward. The new regulatory authority will have to consider the scarcity of medical and health resources, the inequity in their distribution and the inefficiency in their utilisation. The small number of physicians now serving disadvantaged communities result in poor health care delivery and poor health indices. The increased requirements and competition for entry into the medical course and the long years of study required to become a physician have promoted “professional elitism” and have inhibited those who are economically underprivileged from pursuing careers in medicine. The issues related to inequity will need to be addressed as part of long-term planning of human resources.

TASKS

The new regulatory authority should lay down, implement and monitor standards for its diverse functions. It should promote high standards of medical education, maintain up-to-date registers of qualified doctors, foster good medical practices and be a watchdog to deal firmly and fairly with doctors whose fitness to practise is in doubt.

The authority will need the support of all those involved in medical education and in commissioning and delivering health care services. This will be a challenge for India with its large population with largely unmet health needs and variable access to health care. Nevertheless, it is a challenge that must be met. This is a great opportunity to ensure that medical education and training successfully equip doctors with basic skills and competencies to practise and for the life-long learning process that they require to keep up with advances in medical science and health care delivery.

(Professors George Mathew, M.S. Seshadri and K.S. Jacob are on the faculty of the Christian Medical College, Vellore. Many other faculty members contributed to a debate on this subject from which points emerged.)

Link: Original Article

Health Minister writes to MCI board, wants it to be fair and transparent

Union Health and Family Welfare Minister Ghulam Nabi Azad has asked the board of governors of the Medical Council of India (MCI) to be absolutely transparent, and fair and free in their decisions.

In a letter addressed to S.K. Sarin, the chairperson of the board, the Minister assured the MCI of all help from the Ministry and said that instructions had been issued to officials not to interfere in the functioning of the MCI.

Mr. Azad drew the attention of the board to touts, being used by the managements of some institutions to get clearance for the colleges by illegal means. He said these touts collect money from interested institutions in the name of the government, office-bearers and MCI members, thereby bringing a bad name to everyone.

“As such, I would like you to caution the members of the newly constituted board of governors that they have to be vigilant and keep their eyes open since their every step is being watched by the entire country with high expectations,” the letter said.

Recalling the circumstances under which the Indian Medical Council (Amendment) Ordinance, 2010, was promulgated on May 15, the Minister said after due deliberations, the Central government appointed the board of governors to exercise the powers and perform the functions of the Council. The selection of members was done keeping in view eminence, integrity and their standing in the field of medicine.

“The above ordinance has given additional responsibility to the board of governors to grant permission for establishment of new medical colleges, opening the new or higher course of study and increase in admission capacity in any course of study referred to in Section 10 (A) in the Indian Medical Council Act, 1956.”

The general council of the MCI was superseded on May 15, when the Centre promulgated the ordinance following the arrest of the MCI president Ketan Desai by the Central Bureau of Investigation on charges of corruption.

Link: Original Article

June 04, 2010

Indigenous H1N1 vaccine launched

India on Thursday got its first vaccine for H1N1 flu, almost an year after the deadly virus-caused flu was declared a pandemic by the World Health Organisation (WHO). Health Minister Ghulam Nabi Azad launched the vaccine, which he said was the first vaccine developed in independent India.

The vaccine, developed by Gujarat based medicine giant Cadilla Healthcare, will provide immunity from the H1N1 strain of virus, which is a mutation of the swine flu virus.

"We had no experience in production of vaccines, but we managed to make it on time," Azad said.
Cadilla's chairman and managing director Pankaj Patel was the first to take the vaccine followed by Azad.

The vaccine will provide immunity to H1N1 for one year.
"The vaccine has not been tested for very long time period, but it must provide immunity for one year," Patel said, adding the virus changes its strain every year. "So anyhow, another shot of vaccine will be needed after a year."

Besides Cadilla Healthcare, the Serum Institute of India, Bharat Biotech and Panacea Biotech were granted research aid for developing an indigenous vaccine for the virus which claimed more than 1,500 lives in last one year in the country.

The vaccine developed by the Serum Institute is likely to hit the market by the end of this month, while Bharat Biotech and Panacea are likely to launch their vaccine by July and August respectively.

Link: Original Article

June 03, 2010

RIM in pact with Maestros, launches mobile ECG

With an aim to increase its market share in India, BlackBerry-maker Research In Motion (RIM) on Thursday entered into a pact with medical equipment-maker Maestros Mediline Systems (Maestros) to launch health care solutions in India by introducing mobile electrocardiogram eUNO R 10 application in its handsets.

The tie-up would enable doctors to monitor the heart performance of their patients at any time using BlackBerry smartphones powered by teleservices provider Vodafone.

“Mobile technologies are playing an important role in the healthcare industry and we hope this tie-up with Maestro would be the next game changer in the healthcare sector over the next few years,” RIM’s Managing Director (India), Frenny Bawa, told reporters at the launch of the mobile ECG.

The tie-up is likely to boost the sales of Blackberry over the next few months.

Currently, the technology has been adopted by city-based Nanavati Hospital, where its cardiologists will have access to the patient’s ECG reports on their BlackBerry handsets, thus helping them respond quickly with a diagnosis and prescribe appropriate medication.

Gradually the service will be rolled out in various other hospitals across the country.

Link: Original Article

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