[Answered] What are various challenges and issues faced by medical education in India? In light of this critically examine the provisions of National Medical Bill, 2019.

Medical colleges in India fail to provide the much needed healthcare for its 1.2 billion population. Medical education in India is not upto the mark and need reforms. Fixing the problems in the medical industry is crucial to the health and well-being of a country.

Issues and Challenges of medical education in India:

1. Poor doctor-patient ratio: India has one government doctor for over 11,000 patients. Though India has the highest number of medical colleges as a nation, the small graduating class strengths of 100-150 students create a major problem for a population of this size. Less than 8% of the total students get a chance to continue further studies.
2. Rote learning than clinical skills: In the system of evaluating doctors followed in India, anyone who is able to memorise a large amount of information can become a doctor. The fundamental exam pattern has remained the same, banking on rote learning techniques, while the humanitarian criterion is not taken into account. Doctors are evaluated according to the answers they give in MCQ questions. These tests are more for memorising skills rather than knowledge. Thus, their clinical skills are not tested till they start practicing.
3. Outdated syllabus and teaching style: Regular breakthroughs take place in the medical field everyday, but the medical studies syllabus in India is not updated. New domains of medical science are barely touched upon. Students study in a teacher-centric pattern, which doesn’t employ technology as much as foreign countries.
4. Lack of skilled teachers: Teachers for medical institutes are selected based on their degrees and not their clinical experience. This reduce the effectiveness of the knowledge they can impart to the students. Moreover, no teaching training is provided and teaching innovations are also lacking.
5. Poor medical research: MBBS students specialise in certain fields to be able to get a job and thus, research is neglected. Colleges must take the responsibility of enhancing research in medical education.
6. Corruption in medical education: The Medical Council of India (MCI), is surrounded with controversy and faces bribery and corruption allegations. The MCI regulations has certain loopholes which that led to accreditation of colleges which even lack proper facilities or infrastructure.

Significance of National Medical Bill, 2019:

To tackle various issues and problems in medical education government has introduced National Medical Bill 2019. Bill seek to improve medical education in following ways:

1. Bill seek to regulate medical education and practice in India leading to better medical standards.
2. It focus on the issue Corruption in medical education through transparent appointment to the medical commission.
3. Bill would help in reducing shortage of medical professionals by giving license to community health providers.
4. It ensure ethical standards in the medical practice through Ethics board.
5. It will rationalise fees in private medical colleges thereby making medical education more affordable.
6. In India, the MCI has so far been operating independently. This gap can be bridged by the NMC.
7. By introducing qualifying exams like NEET and NEXT, NMC can instil uniformity in the standard of competence and skills.
8. NMC would encourage and incentivise innovation and promote research by laying down rules that make research a prerequisite in medical colleges.

Some flaws in the Bill:

1. The NMC will consist of 25 members, of which at least 15 (60%) are medical practitioners. To reduce the monopoly of doctors, it should include diverse stakeholders such as public health experts, social scientists, health economists, and health related non-government organisations.
2. Disputes related to ethics and misconduct in medical practice may require judicial expertise.
3. The Bill does not specify a time period for the NMC to decide on an appeal.
4. The Bill introduces a National Exit Test for students graduating from medical institutions to obtain the licence to practice as a medical professional. But Bill does not specify the validity period of this licence to practice.
5. The extensive discretionary powers that the Bill provides to government reduce the accountability of NMC and make it virtually an advisory body.
6. The capping of the fees of 50% of seats in private medical colleges is dubbed to be anti-poor, as the remaining 50% of seats which is called the management quota, will witness a high rise in fees. This can deny admission to poor students on 50% seats.

Indian medical education has many issues which need to be tackled. Many doctors has neither the skills nor the knowledge to handle the primary care and infectious diseases. While NMC can help in improving the medical education and practice in the country, the government must thoroughly focus on addressing much other issues too like lower public expenditure in health sector etc.