January 31, 2011

Health Ministry has the last word on CET

Ending the confusion over common entrance tests for graduate and postgraduate courses in medicine, the Centre on Wednesday said the Health Ministry would have the last word in the matter and since the two notifications issued by the Medical Council of India had been declared “invalid” by the Ministry, these should be considered withdrawn.

Rejecting the contention that the MCI Board of Governors was “overstepping” its brief, sources in the Ministry told The Hindu that it was probably “innocence and ignorance of the official processes” on the part of the Council that made it issue the notifications and refuse to withdraw them.

In case the Centre at any point in future decided to hold such a test, the notifications could be revived, the sources explained.

Karunanidhi's protest

Meanwhile, Tamil Nadu Chief Minister M. Karunanidhi has written to Union Health Minister Ghulam Nabi Azad seeking a review of the CET proposal. Earlier also, he opposed the proposal and even spoke to Prime Minister Manmohan Singh, following which the notifications were put on hold. The Chief Minister said he was writing to Mr. Azad to register his protest.

The MCI notifications would mean a single entrance examination for MBBS and MD courses offered by all 271 medical colleges — 138 run by government and 133 under private management.

The issue will be discussed at next week's meeting of the State Health Ministers and Secretaries convened by Mr. Azad. An attempt would be made to take the States on board as medical education is on the Concurrent List and nothing could be done without their consent, the sources said.


Officials in the Ministry said the MCI notifications resulted in confusion among students as many States had already started the process of entrance examinations for MBBS admissions, as had many private colleges and deemed universities. The entrance examinations are held soon after the Class XII Board examinations are over across the country. In any case, the officials explained, private colleges, minority institutions and deemed universities could not be legally bound to be part of the National Eligibility-cum-Entrance Test (NEET) for graduate and postgraduate medical courses through a regulation. This would need an Act of Parliament, as there were issues of domicile in several States and reservation in all others.

The way out

Many States were already surrendering 50 per cent of their postgraduate seats to the Central pool and would be unwilling to give up the remaining seats also. The only way out would be to arrive at a “give and take” formula, the sources said.

While the Ministry itself is supporting the idea of a CET to reduce the burden on students who, at present, write as many as 17 entrance tests, it wants to go ahead, taking along all the States and stakeholders to ensure that there is no litigation which would stall the entire process for years.

Link: Original Article

US health insurance giants vie for cashless service in India

American health insurance giants Aetna and United Healthcare are in the race to provide cashless service under health insurance in India. The two companies are among nine that have been shortlisted by government-owned general insurers which control close to 80% of the cashless mediclaim market.

The health giants are among the 24 that have responded to a request for joint venture proposals by the General Insurers Public Sector Association (GIPSA) that represents four of the largest health insurers —New India Assurance, National Insurance, Oriental Insurance and United India Insurance. These state-owned companies plan to float a captive third-party administrator (TPA) for managed healthcare services. GIPSA is seeking a partner that will provide technical support in networking and negotiating with healthcare providers. The other companies shortlisted include Patni Computers and French Coris International , which provides claims management services . Cambridge Solutions and Lason, two BPO firms which are keen on diversifying into healthcare, are in the list. Among the existing TPAs, emeditek and Medi Assist have been shortlisted.

Speaking to TOI, G Srinivasan , chairman, United India Insurance who also heads GIPSA, said that he expected a decision to be taken on a partner in two months. The four companies have taken an in-principal approval from their boards to set up a TPA firm. He said that the objective of setting up a captive was to bring down losses in health insurance.

"When there are many TPAs we are not able to bargain better rates from healthcare providers. We hope to get lower prices for policyholders and also expand the reach of cashless claims service," said Srinivasan . Last year, GIPSA took a tough stance on managing claims by drawing up a list of maximum charges it would pay under various heads. TPAs were asked to create a preferred provider network which would include only those hospitals that adhered to the tariff. This stance affected thousands of policyholders as most of the tertiary care hospitals refused. Since then, things have changed. "In Delhi, most of the large hospitals have joined the network, including Batra, Gangaram, Saint Stephens. We are waiting for the corporate chains of Apollo, Max and Fortis," said Pawan Bhalla, MD, Raksha TPA. In Mumbai of the five large tertiary care Hospitals Jaslok is agreed to have joined.

Existing TPAs have been up in arms against GIPSA's decision to have a captive firm. Their main concern was that such a firm would put them out of business. The association of TPAs had filed a complaint with the Competition Commission of India (CCI) that such a captive firm would create a monopoly. A decision by the CCI is expected next week. However, the initial antagonism appears to have worn off a bit considering that the health insurance market is growing at 35-40 % and most TPAs have their hands full managing the business. Also , there are indications that GIPSA may not hand over its entire health insurance business to the captive company to manage. "We have always said that we will not transfer 100% of health business from day one. We will start with a part of the business," said Srinivasan.

Link: Original Article

January 30, 2011

MCI, Health Ministry on war path

The Board of Governors of the Medical Council of India and the Union Health and Family Welfare Ministry seem to be heading for a showdown with the former refusing to withdraw the two notifications for holding common entrance tests for graduate and post-graduate courses in medicine.

The Ministry on Monday declared the notifications “invalid” and directed the MCI to withdraw them immediately as no mandatory approval was taken from the Ministry as required under Section 33 of the Indian Medical Council Act, 2010. However, the MCI Board, which held an emergency meeting on Tuesday, decided to go ahead with the two National Eligibility-cum-Entrance Tests (NEET) since these were issued on the Supreme Court directions and their withdrawal will amount to contempt of court. “The Common Entrance Tests (CET) will happen,” a Board member told The Hindu.

The Centre had asked the MCI to put “on the hold” the proposal following stiff opposition from several States, including Tamil Nadu, where no test is held for admission to the MBBS courses. Several private institutions and the Tamil Nadu government had moved the court against the NEET. Tamil Nadu Chief Minister K. Karunanidhi had even spoken to Prime Minister Manmohan Singh, expressing his displeasure over the MCI's move, following which the proposal was kept “in abeyance.”

The Supreme Court, in its order last month, said it would not come in the way of notifying the common entrance test or anyone moving the court against it. Soon after, the Ministry decided to hold a meeting of the State Health Ministers and secretaries in Hyderabad between January 11 and 13 to arrive at a wider consensus since health and education are State-subjects. This was conveyed to the MCI as well.

The meeting will be chaired by the Ministry. The MCI went ahead and issued the two notifications on December 21. Strangely, the Ministry officials were unaware of the notifications until it was reported in the newspapers on Monday after which they issued directive to the MCI asking them to withdraw them immediately.

The CET is aimed at reducing the stress on the students aspiring to join medicine who at present have to write 17 tests for admission to medical colleges. Under the NEET, students would have to write only one test and the selection would be done on the basis of merit with reservations as applicable to the States. Private colleges would also get some seats.

Link: Original Article

Ministry holds MCI orders on CET ‘invalid’

Taken aback by the Medical Council of India's notifications for holding common entrance tests to graduate and post- graduate courses, the Union Health and Family Welfare Ministry on Monday declared the two notifications “invalid” and directed the MCI to withdraw these with immediate effect.

The Ministry, in a letter to S.K. Sarin, chairman of the Board of Governors of the MCI, said the notifications were issued without prior approval as required under Section 33 of the Indian Medical Council Act, 2010.

The notifications were issued ahead of a meeting of State Health Ministers and secretaries, which was to discuss the matter for arriving at a consensus before taking the final call. The meeting, to be chaired by Union Health and Family Welfare Minister Ghulam Nabi Azad, was to take on board all shades of opinions on the matter of National Eligibility-cum-Entrance Test (NEET) for MBBS. However, no discussion on a common entrance test for PG courses was on the agenda for the meeting, scheduled from January 11 to 13, that would also take up the introduction of Bachelor in Rural Health Care course, among other things.

The common entrance test for MBBS had been opposed by many States, and Tamil Nadu Chief Minister K. Karunanidhi had even spoken to Prime Minister Manmohan Singh on it, following which the notification was put on the hold by the Health Ministry. Some private medical colleges and even the Tamil Nadu government had moved the Supreme Court. The court, in its last order, said it would not come in the way of notifying the common entrance test or anyone moving the court against it. Soon after, the Ministry decided to hold the meeting with the States and other stakeholders for a wider consensus. These instructions were passed to the MCI also to ensure that the notification on the MBBS entrance examination was put on hold.

Sources in the Ministry told The Hindu that while it was in favour of a common entrance test and had “in principle” approved it, it was a sensitive issue and could not be decided without taking the States on board. Also, there was no agency which would hold an all-India test of such a magnitude.

The MCI issued the two notifications on December 21 saying the Ministry had approved both. One that amended the Regulations on Graduate Medical Education said the NEET would be the criterion for selection to the MBBS and the marks obtained in mathematics in Class XII would also be considered for admission.

“In order to be eligible for admission to MBBS course for a particular academic year, it shall be necessary for a candidate to obtain a minimum 50 per cent marks in each paper of NEET. However, in respect of candidates belonging to the Scheduled Castes, the Scheduled Tribes and the Other Backward Classes, the minimum percentage marks shall be 40 and in respect of candidates with locomotory disability of lower limbs, the percentage shall be 45.''

Single test

According to the second notification that amends Postgraduate Medical Education Regulations, 2000, there shall be a single NEET for admission to post-graduate courses, the overall superintendence, direction and control of which will vest with the MCI.

Three per cent seats of the annual sanctioned intake capacity will be reserved for candidates with locomotory disability of lower limbs.

For private institutions, the notification says 50 per cent of the total seats shall be filled by the State government and the remaining by the institutions or medical colleges concerned on the basis of a merit list.

Link: Original Article

Punjab National Bank to help doctors become entrepreneurs

Punjab National Bank (PNB) has decided to set up a dedicated desk at its subsidiary — PNB Investment Services — to provide end-to-end advisory solutions for doctors who aspire to become entrepreneurs and are keen to set up hospital network across the country.

“This desk at PNB Investment Services will act as a single-stop service provider and facilitate all requirements of doctors, including preparation of detailed project reports,” Mr K.R. Kamath, Chairman and Managing Director of the bank, said here.

While there is lot of interest among medical professionals to become entrepreneurs and set up hospitals or clinics, their awareness of the banking related procedures for raising finance are not up to the mark. They are being compelled to take the services of consultants for preparation of project reports and this comes at a high cost.

PNB Investment Services will now provide these services at a lower price, Mr Kamath said.

He also said that that PNB would look at coming up with a doorstep banking model suited for doctors. PNB is already into doorstep banking, but at the wholesale level.

“We will have to come up with a tailor-made model for doctors. This can be done within the overall framework provided by RBI for doorstep banking,” Mr Kamath told Business Line.

Link: Original Article

Australian Doctors Happy With Their Jobs

Most doctors in Australia are moderately or very satisfied with their jobs, according to an NHMRC-funded study published in the Medical Journal of Australia.

Dr Catherine Joyce, Senior Lecturer for the Department of Epidemiology and Preventative Medicine at Monash University, Melbourne, and co-authors from Monash and the University of Melbourne investigated whether levels of job satisfaction and determinants of satisfaction differ between Australian GPs, specialists, specialists-in-training and hospital non-specialists.

Dr Joyce said that most doctors were moderately or very satisfied with their jobs and there was no significant difference in job satisfaction between GPs, specialists and specialists-intraining. However, hospital non-specialists appeared to be less satisfied than GPs.

Specialists were most likely to be very satisfied (37.5 per cent), followed by GPs (32.7 per cent), specialists-in-training (21.4 per cent) and hospital non-specialists (16.9 per cent). Fewer than two per cent of doctors in each group were very dissatisfied, but 12 per cent of hospital non-specialists were moderately dissatisfied compared with 7-8 per cent for other doctors.

Doing on-call work and the number of hours worked per week were not statistically significant and did not differ across doctor types, although specialists doing on-call work were less likely to be satisfied than GPs doing on-call work.

Dr Joyce said that having a professional support network was strongly associated with job satisfaction, consistent with research showing that it was a key factor in retention for rural areas, and that graduates’ perceptions of professional support influenced their career choice.

“Questions about whether job satisfaction influences doctors’ decisions about working hours, retention and mobility are central to examining patterns of access to health care, and require further research,” Dr Joyce said.

Source-The Medical Journal of Australia, a publication of the Australian Medical Association.

Link: Original Article

MCI suggests major reforms in undergraduate course

The Medical Council of India (MCI) has recommended major reforms in the undergraduate course in medicine by converting conventional education into a competency-based module to develop skilled doctors through early clinical exposure. It has also suggested doubling the intake of medical students to meet the healthcare needs of the country in the coming years.

Pointing out that the current undergraduate curriculum in medicine did not make an MBBS degree holder feel equipped with adequate skills and competence to take care of the common problems at the secondary and tertiary level, the Undergraduate Education Working Group has said this factor also prevents young doctors from going to practice in the rural and primary health centres. The goal of training is not focused on providing health care to the needy and the disadvantaged, the eight-member working group has said in its report.

Distance education

It recommends options for distance education towards a fellowship or diploma in areas such as diabetic care, HIV medicine, geriatric medicine, hospital infection control, hospital management, and inclusion of medical ethics, forensic medicine and hospital infection control in the regular curriculum.

According to the report, the current intake of medical colleges and the critical mass of doctors would have to be doubled if India had to achieve the world average doctor-population ratio of 1.5:1000 by 2031 as against the present 1:1700.

Taking into consideration the existing medical colleges in the country, it was felt that the current intake of medical colleges and the critical mass of doctors should be doubled to achieve this target.

At present, there are 330 medical colleges with an intake of approximately 35,000 and with the present intake the shortfall of doctors by 2031 is estimated at 9.54 lakh.

To offset this, the report has suggested increasing the intake in the medical colleges wherever there is adequate infrastructure of teachers, equipment and clinical load and to augment infrastructure in relation to clinical load by attaching established medical colleges to district-level hospitals or secondary hospitals run by government agencies; upgrading existing larger district hospitals and augmenting their infrastructure to become community medical colleges through private-public partnership or public-private partnership and starting new medical colleges and hospitals preferably in States and underserved areas with doctors and medical colleges.

Clinical training

Chaired by George Mathew, Principal of the Christian Medical College, Vellore, the group stressed the need for restructuring the MBBS course with a four-year course and six months elective with a one-year internship. Clinical training should be included from the first year itself.

The past curricular revisions have mostly added to the existing content without undertaking the exercise to remove what is obsolete and outdated. This exercise needs to be taken up in a detailed and extensive manner and make the curriculum as efficient as possible, the report has said. It has to be discipline-based curriculum and lack of integration between basic and laboratory science and clinical medicine should be addressed.

It goes on to add that each medical college should be linked to the local health system, including Community Health Centres, taluka hospitals and primary health care centres that can be used as training base for medical students.

The Working Group was set up in July last year to evolve a roadmap for medical education in India and to evolve a broad policy on the duration and curricular changes that could be adopted as future strategies to make medical education in India comparable to global standards.

Link: Original Article

Hundreds of herbal medicines to be banned in UK next year

As new European regulations come into force, hundreds of herbal medicines, except for a small number of popular products for 'mild' illness, will be banned from being sold in Britain next year.

With just four months to go before the ban is put in place, thousands of patients are set to lose access to herbal remedies that have been used in the UK for years, reports the Daily Mail.

From May 1 2011, traditional herbal products need to be licensed or prescribed by a registered herbal practitioner to comply with an EU directive. The directive was introduced due to rising concerns over adverse effects caused by many alternative medicines.

This means almost 2,500 qualified UK herbalists and Chinese medicine practitioners will lose the right to supply a wide range of herbal medicines, because they are not signed up to the statutory regulation scheme.

Herbal practitioners have said that the cost of obtaining licenses was beyond their means.

Many traditional medicines are made up of a number of herbs and the Alliance for Natural Health (ANH) estimates the cost of obtaining a license at 100,000 pounds per herb.

According to ANH, no Chinese or ayurvedic medicine has been licensed.

But herbal practitioners have warned that patients may end up buying potentially dangerous supplies from the black market.

Link: Original Article



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