Heal thyself

Heal thyself

The regulator of medical education is itself in need of regulation. The ongoing spate of scandals show that nothing has been learned since the arrest of Medical Council of India (MCI) chairman Ketan Desai in 2010 for barefaced corruption. The latest is the arrest of a former high court judge and his associates, for agreeing to help an under-equipped college make the grade in court. Days earlier, a colonel of the Army Medical Corps was arrested for passing on sensitive information about inspections to a medical college in Puducherry.

Apart from the unchecked spate of education scams, the volume of litigation that the MCI faces concerning issues of policy, admission and examination suggest that the regulator is neither in command nor perceived to be so. While it has rightly imposed a uniform benchmark for admissions at the undergraduate and postgraduate levels, different syllabi set by states and the diverse languages they are taught in tilt the playing field. The suicide of Anitha. S, a Dalit aspirant from Tamil Nadu, forcefully drew national attention to this problem earlier this month. Besides, while the MCI is standardising entrance tests, it is spectacularly failing to assure uniform, quality education for entrants who qualify. The implications for the health of the nation are sobering, and the lucrative promise that India holds as a destination for medical tourism and education stands compromised.

In terms of the growth of medical colleges, India is the world leader, and a transparent accreditation process guided by checks and balances conferring credibility should have been the priority. Examination reform could have followed. The National Medical Commission Bill of 2016, which proposes to trifurcate the functions of the MCI to reduce opportunities for corruption, may prove to be cosmetic. It would eventually leave the monopoly in accreditation intact, and opacity would remain a problem. If even the Planning Commission could be summarily decommissioned, there is no credible argument against euthanasia for the MCI, or a similar body under another name. However, it would be silly to throw out the baby with the bathwater, since handing over the regulation of medical education to professionals instead of administrators established a progressive principle. However, corruption has stood in the way of an efficient technocracy, and only functional reform can strike at the root. The intersection of private enterprise and medical education and practice is laden with incentives for corruption. The scarcity of seats and their marked-up price tag incentivise brutally quick recovery, the marketing of pharmaceuticals and equipment exert unhealthy influences, and the inspection of teaching hospitals is a scandal, with doctors and even patients being “rented” for the day. Merely replacing the MCI will not suffice. Its successor must be armed with rules-based transparency to prevent rent-seeking.