Increase in seats must ensure quality and uniformity of medical education
With a view to increasing the number of medical seats in both undergraduate and postgraduate courses, the parliamentary standing committee has recommended an increase in the number of medical seats, highlighting that there is a huge gap between demand and supply. The committee on Health and Family Welfare in its 157th report ‘Quality of Medical Education in India’ presented in the Rajya Sabha noted that the current scenario pertaining to medical seats at both the undergraduate and postgraduate courses demands immediate attention.
“With an annual influx of approximately two million aspiring medical students at the UG level, and only 1/20 times available seats, the demand far exceeds the supply, similarly, the number of available seats at the PG level is far less than the demand,” the committee said in its report. Experts claim that an increase in the number of the MBBS and PG seats can meet the demand for healthcare professionals, but it is important to consider factors such as infrastructure, faculty availability, clinical training opportunities, and adherence to regulatory standards to maintain the quality of medical education.
The PPP model
The committee highlighted that the government’s existing scheme of establishing new medical colleges attached to district or referral hospitals can help meet the challenge of seat shortage. “While this scheme can potentially contribute to achieving the goal of increasing the number of seats, the government should consider establishing colleges under a public-private partnership model in addition to setting up new colleges in underserved areas,” says Dr B Unnikrishnan, dean, Kasturba Medical College (KMC), MAHE, Manipal. “Through this model, institutions have been able to combine the resources and expertise of both sectors, resulting in the creation of quality medical education and healthcare facilities,” he says. Statistics indicate there has been an increase in medical colleges and seats for well over a decade. For instance, there was an 82% rise in medical colleges from 387 before 2014 to 704 in 2023, an increase of 112% in MBBS seats from 51,348 before 2014 to 1,08,940 in 2023, and a 127% increase in PG seats from 31,185 before 2014 to 70,674 in 2023.
Bridging the gap
“While increasing the number of medical seats can help alleviate the gap between demand and supply, it is not a stand-alone solution since it also means we need more hospitals and qualified teachers,” says Prof Dr Somashekhar SP, chairman, Medical Advisory Board, Aster DM Healthcare – GGC & India.
The committee further called upon the need to streamline the admission process by implementing a standardised national entrance examination to improve fairness and transparency in seat allocation. “The panel’s suggestion aligns with the discussions about replacing the NEET exam with the National Exit Test (NExT) for MBBS graduates. This standardisation is intended to ensure that all medical graduates meet minimum common standards of education and training. While an official date for the NExT exam for MBBS students has not been announced, the exam could potentially be implemented from August 2025, replacing NEET PG and FMGE exams for admission to postgraduate courses,” Dr Somashekhar says.
The committee declared that as per the Minimum Standards Regulations (UG-MSR) issued on August 16, 2023, a college, whether new or old, may be considered for authorisation to expand the number of undergraduate seats up to a maximum of 250 in phases, provided the required infrastructure and teaching positions are in place. In the academic year 2024-2025, approval will be granted for an increase in MBBS seats by 50, 100, and 150 seats. The committee further said that many medical colleges have 200 and 250 seats, adding further that the ideal batch size for a faculty to impart teaching is 150. “While larger batch sizes of 200 or 250 seats can be manageable with the right resources, the ideal batch size for effective teaching and personalised attention is generally considered to be around 150 seats,” Dr Somashekhar adds.
Capping tuition fees
The committee further suggested providing incentives and regulatory support to private institutions willing to establish medical colleges which would lead to not just seat increase but bring in healthy competition. Dr Unnikrishnan explains that private institutions should be incentivised to offer competitive tuition fees and scholarships to attract a diverse range of students. “The government must implement policies that promote accountability and affordability in private medical education. This can include measures such as capping tuition fees and monitoring fee structures,” he says.
Virtual classes
The panel further recommended the need to leverage technology for distance learning and organise virtual classrooms to enable a sizeable number of students to access medical education without overburdening the physical infrastructure of medical colleges. “Virtual classrooms can simulate real-life scenarios, facilitate interactive discussions, and provide access to a wide range of educational resources, however, hands-on practical training and clinical experience, may be challenging to replicate fully in a virtual setting,” says Dr Unnikrishnan, advocating a blended approach that combines virtual classes with practical training in physical settings like hospitals and laboratories.
The committee also suggested the need to revisit the UG-MSR as a one size-fits-all criterion will not work for all the regions. “By tailoring guidelines to specific regions, it allows for a more targeted and effective allocation of resources, infrastructure, and faculty. This can help address geographic imbalances in the availability of medical seats and ensure that healthcare education is aligned with the specific needs of different regions. However, it is important to strike a balance between regional considerations and maintaining national standards to ensure the quality and uniformity of medical education across the country,” Dr Unnikrishnan adds.
link