Editorial. Baseless curbs on southern States opening medical colleges

The National Medical Commission’s (NMC’s) recent move that effectively prevents the southern States from opening new medical colleges or adding more MBBS seats in the existing institutions appears to be an irrational one. In an extraordinary gazette notification issued on August 16, the NMC, a statutory body, unveiled new guidelines that cap the number of MBBS seats in existing government and private medical colleges. The guidelines also introduce the ratio of 100 MBBS seats for every 10 lakh population in each State and Union Territory.

“Applications for establishing new undergraduate medical education colleges shall be allowed for 50/100/150 seats…After Annual Year 2023-24, Letter of Permission for starting new medical colleges shall be issued only for annual intake capacity of 50/100/150 seats, provided that medical college shall follow the ratio of 100 MBBS seats for 10 lakh population in the States/Union Territory,” the notification read. The guidelines restrict the States as no medical or dental college can be established or their capacity increased without prior approval of the Centre. The reality is that the southern States already exceed the limit set by the NMC. Tamil Nadu, for instance, has 11,600 seats for a projected population of 7.64 crore as of 2021, which is 4,000 more than the 7,600 seats the State should have according to the new NMC guidelines.

The NMC move is perplexing in a country that faces a paucity of doctors. If the reason for the guideline is concern over quality of education due to mushrooming of colleges, the right course would be to inspect these colleges more frequently and disqualify those that are lacking in standards. Restricting the number of seats defeats the overall objective of improving the ratio of doctors to the population. Besides curbing the rights of States to provide healthcare and education, the NMC move has also underlined the tensions between the more developed southern States against the laggard North. The sentiment gaining ground is that the South is being penalised for offering better education and health facilities. It makes little sense to restrict the number of medical graduates when inter-State movement of medical professionals is common.  NMC as a regulator of medical institutions must instead focus on its mandate of checking malpractices in the funding and running of medical colleges and hospitals. There is much to do here, even in the southern States. Its predecessor, Medical Council of India, failed miserably here. But curbing supply of doctors makes for bad policy and economics.

The issue is likely to become a heated one, as Tamil Nadu and Karnataka governments plan to open a medical college in each district. The Karnataka Minister for Medical Education has criticised the NMC order, which is unlikely to survive legal scrutiny.

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