Quality Of Medical Education

Source: The Hitavada      Date: 11 Jun 2018 11:57:14


 

 

 

 

 

 

 

 


By Adv. R.S. Agrawal


According to the court, fixing minimum standards which have to be fulfilled for the purpose of enabling medical college to seek fresh inspection would not be contrary to the scheme of Section 10-A. In fact, Regulation 8(3)(1) provides that an opportunity shall be given to the medical college to rectify the defects. But the proviso contemplates that certain minimum standards are to be satisfied.

 


IN THE judgement of the case -Medical Council of India (MCI) v. Vedantaa Institute of Academic Excellence Pvt. Ltd. and Others, delivered on June 1, 2018, Justice L. Nageswara Rao and Justice Mohan M. Shantanagoudar, at the Supreme Court, have held that medical education must be taken very seriously and when an expert body certifies that the facilities in a medical college are inadequate, it is not for the courts to interfere with the assessment of the MCI, except for very cogent jurisdictional reasons such as mala fides of the inspection team, ex facie perversity in the inspection, jurisdictional error on the part of the MCI etc.


The court had expressed similar opinion in its judgement of the case - MCI v. Kalinga Institute of Medical Sciences (KIMS) and Others - (2016) 11 SCC 530 para 24.
Vedantaa Institute of Academic Excellence and its Institute of Medical Sciences have filed a writ petition in the Bombay HC seeking direction to the appellant-MCI to send its Experts’ team for the purpose of verifying the compliance of the deficiencies pointed out earlier. They had also prayed for a direction to the MCI to forward its recommendation to the Central Government before April 30, 2018.These institutions had also sought a further direction to the respondent - Union of India to consider the grant of permission of renewal on the basis of the recommendations received from the MCI. The HC allowed the writ petition and directed the MCI to inspect the concerned medical college and submit a report to the Union of India before April 30, 2018. Aggrieved thereby the appellant-MCI had filed this appeal.


The HC allowed the writ petition mainly on two grounds. According to the HC, Regulation 8(3)(1) proviso (a) of the Establishment of Medical College Regulations is not applicable to the case of the respondents.The other point which found favour with the HC is the manner in which the inspection was conducted. The HC held that the inspection conducted by the MCI Team was not fair.Senior Counsel Vikas Singh, appearing for the appellant submitted that findings recorded by the HC that Regulation 8(3)(1) is not applicable to the respondent-college as it had sought for first renewal is clearly erroneous. He urged that the HC lost sight of the first proviso to Regulation 8(3)(1). The Counsel contended that there is no ambiguity in the language of the first proviso to Regulation 8(3)(1), which covers colleges up to the second renewal. According to the said regulation, institutions having deficiency of teaching faculty and/or residents more than 30 pc and /or bed occupancy less than 50 pc will not be considered for renewal of permission for that academic year.


In view of the large scale deficiencies found in the inspection conducted on September 25 and 26, 2017, the counsel submitted that there is no question of an opportunity being given to the respondent-college to rectify the deficiencies. He also urged that the inspection was done strictly in accordance with the Assessors’ Guide issued by the MCI.He pointed out that the general instructions issued to the Assessors clearly shows that it was mandatory to verify the attendance sheet of every department (completed before 11 AM) signed by the faculty present on the day of assessment and duly counter-signed by the Head of Department.


According to the Assessors’ Guide the institutions should be asked to submit daily average clinical data for the last 12 months and clinical data of the first day of assessment.
In respect of verification of teaching faculty and resident doctors, the Assessors’ Guide provides for checking of faculty attendance before 11 AM on the first day of assessment. Only faculty/residents, who signed the attendance sheet before 11 AM are to be verified. No verification should be done for the faculty/residents coming after 11 AM.The senior counsel took the court through the inspection notes to submit that the inspection done by the assessment team cannot be found fault with. He also cited the Supreme Court’s decision in the case - MCI v. Kalinga Institute to state that the report of the experts should not be interfered with by the apex court.


The Additional Solicitor General, Maninder Singh submitted on behalf of the Union of India, that the proviso to Regulation 8(3)(1) was inserted with a view to ensure that institutions, which do not satisfy minimum infrastructure and faculty norms cannot be given an opportunity to rectify their defects .According to him, the standards fixed by the MCI are bare minimum and have to be strictly complied with to ensure the basic minimum standards of medical education.He struck a note of caution to state that any leniency shown by this court in providing an opportunity to such institutions to rectify the defects will have a cascading defect in the succeeding years and would result in colleges continuing to function with deficiencies as well as producing half baked and poor quality doctors.


According to the court, fixing minimum standards which have to be fulfilled for the purpose of enabling medical college to seek fresh inspection would not be contrary to the scheme of Section 10-A. In fact, Regulation 8(3)(1) provides that an opportunity shall be given to the medical college to rectify the defects. But the proviso contemplates that certain minimum standards are to be satisfied.
After perusing the material on record, the court stated that the conclusion reached by the Bombay High Court regarding the manner in which inspection was conducted, was also not correct. Bed occupancy at 45.30 pc on random verification was the claim of respondent - Vedantaa Institutions. However, the inspection report shows that out of required minimum of 300 patients only 3 were available at 10 AM on September 26, 2017. The submission relating to the cyclone being the reason for the number of patients being less is not acceptable.


The court expressed agreement with the submission made on behalf of the appellant - MCI that the Resident Doctors are required to be in the hospital at all points of time.
In view of the large scale deficiencies found in the inspection report of September 25, 2017 and September 26, 2017 and in view of Regulation 8(3)(1)(a), the respondent-institutions are not entitled to claim another inspection.The Supreme Court has set aside the judgement of the HC and allowed the MCI’s appeal.