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The introduction of NEXT may usher in a new era of reforms

  • There is reason to believe the NMC will put an end to the existing rigid regulation
  • The reason for introducing an exit test was to shift towards outcome-oriented regulation

Out of the past 19 years, the Medical Council of India (MCI) had to work under oversight mechanisms appointed by the Supreme Court for nine years, and was under supersession by two different governments for four years. There was no improvement in its functioning and medical colleges continued to suffer under the abject control of MCI. There was very little focus on curriculum reform, improving the quality of education and on reducing the cost of education.

Such was the disdain of MCI towards increasing the medical education infrastructure in the country that during a particular year, they refused to consider the applications of nearly 40 colleges merely on grounds of format errors in some of the documents submitted by them, leading to a loss of 4,000 seats. Even a policy directive from the government failed to persuade them to consider inspecting the infrastructure in these colleges, which entailed an investment of over 12,000 crore. An expert group set up by the government and later the Department Related Parliamentary Standing Committee of the Ministry of Health and Family Welfare analysed the ills plaguing MCI.

The introduction of National Exit Test (NEXT) will be a giant leap forward in medical education. The basic reason for introducing an exit test was to shift towards outcome- oriented regulation, instead of focusing on the process of teaching. This will enable the NMC to do away with repeated inspections of physical infrastructure in colleges. At present, students do not have any objective way of assessing the quality of teaching in various medical colleges and judging whether the fees charged is commensurate with the quality of education being imparted. NEXT will automatically bring out a ranking of medical colleges on the basis of their performance and will help students to choose colleges. After passing the final year exam, students had to appear for National Eligibility cum Entrance Test (NEET) PG to secure admission to postgraduate courses. This additional examination has been done away with and the result of NEXT or common final year exam will be used for admission to postgraduate courses as well. This will reduce the burden on students while they are undergoing internship after the final year exam and help them to improve their clinical skills.

There has been much debate about the exact modalities of NEXT and also about the provisions relating to Community Health Providers in the NMC Act. This discussion is premature at this point in time. Both these have to be implemented through regulations which will be drafted by the eminent persons in NMC after an assessment of the current infrastructure and widespread discussions with stakeholders. The Act makes prior publication of regulations mandatory and details of the consultation procedure would be outlined in the rules to be framed by the government of India.

It stands to reason that the expert doctors who become part of the NMC would carefully and wisely frame regulations for conducting common examinations, common counselling, fee regulation and the necessary qualifications required for community health practitioners. There is no reason to harbour apprehensions about decisions to be taken by them even before the NMC is set up. All of the members would be eminent people, with an overwhelming majority of doctors and representatives of state governments. They will have the comfort of uninterrupted four-year tenure and will be able to perform without fear or favour. There is every reason to believe that they will put an end to the rigid regulation exhibited by their predecessors, ensure rapid growth and usher in a new era of reforms in the medical education sector.

Arun Singhal is additional secretary, ministry of health and family welfare. The views expressed are personal.

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