The Tuesday Interview | ‘The NExT will set a uniform standard for all doctors coming into service’

The National Medical Commission (NMC) empowers all the states to adopt a uniform operating procedure to hear cases related to medical negligence. Dr B N Gangadhar who recently took charge as the NMC chairman has a long list of tasks lined up ahead of him. In an interview with DH’s Udbhavi Balakrishna, he explains his objectives, as the chairman of NMC, to strengthen the quality of medical education and healthcare services in India. 

Excerpts: 

We recently reported that there are at least 25 cases of medical negligence pending in Bengaluru since 2015. What will you be doing to ensure greater transparency and swifter delivery of justice?

All medical negligence cases will have to be heard by the State Medical Council (SMC). Currently, doctors can appeal to the NMC if they have any grievances after the SMC’s verdict. We have empowered all the states to adopt a uniform operating procedure to hear these cases. More importantly, we have trained experts in different specialities to give their opinions to the SMCs. This type of human resource training or orientation is, perhaps, the first such endeavour. 

Several medical colleges and healthcare facilities are running with sub-par infrastructure. In your tenure, how do you plan to address this lacuna?

Many colleges have been doing very well, but there are areas for improvement. According to the NMC Act, medical colleges must declare an annual report on different parameters. This year, we have collected the data online. Based on their declarations and the data we have collected, we have given them feedback. We will be reviewing these conditions more often; it is a continuous process to sensitise them. But this is not an act only to police them. This is being done in the hope that the colleges that we trust will, in return, give us truthful data.

During local inspections, many institutions are given clearances but are later flagged to be sub-par by the NMC. How do you plan to deal with this?

It is true, there may have been such cases. This year, we have eliminated the process of physical inspections by close to 90%. We have only sent inspectors to new colleges. Additionally, we are ensuring patient authentication occurs using the Ayushman Bharat Health Account (ABHA) number. This is to give us more authentic data, and not done to keep an eye on these hospitals. It will also be helpful nationally in terms of collecting health statistics; it will help us assess the clinical material in the college, so we can advise them to use their resources better.

Are there any plans to include an NMC representative in these local inspections?

That is a very good idea to consider, but currently we have very few NMC staff. People who are going on these inspections are going on the behalf of the NMC itself. Let’s see how we can do this. If there are good ideas that are proposed to improve our operations, we will augment them with our techniques.

What are some of the immediate challenges before you?

We must conduct the National Exit Text (NExT). This will bring a major change in the way human resources are allowed into the community. The logistics of this examination need to be developed with suitable consultation from appropriate stakeholders. The examination will set a uniform standard for all the doctors coming into healthcare service.

How can the NMC improve the health and safety of doctors in India?

The NMC is concerned about the safety of all doctors. As part of our training, some skills that can help mitigate conflicts between patients and the doctor are being provided. The NMC has constituted a national-level committee to look into doctors’ mental health issues, particularly suicide among both undergraduate and postgraduate trainees. There are almost 10,00,000 trainees at any point in time.

The committee has met several times, and has interacted with several stakeholders by visiting different medical institutions. Its recommendations have far-reaching impacts on student well-being, some of which are already in place. For example, the students get a faculty mentor who will handhold them throughout their course on concerns related to both academic and extra-academic matters. This is called the mentor-mentee programme. Many colleges have already started this, and the feedback has been encouraging. Students are also introduced to yoga in their foundation course. This can empower them to manage stress better. Training in the attitude, ethics, and communication (AETCOM) module improves their skills, which can also foster wellness.

What are your focus points to tackle gaps in India’s healthcare services?

The focus this year is to increase teacher availability in all the medical colleges. Colleges may ensure that the faculty are given adequate incentives to join them. Our idea is also to ensure that more doctors and postgraduates are produced. We will continuously assess how to increase the number of postgraduates, and strengthen the quality of medical education in the country.