Medical Council of India is corrupt, says health ministerBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4762 (Published 22 July 2014) Cite this as: BMJ 2014;349:g4762
All rapid responses
Congrats! Truth unveiled for the first time. The regulatory bodies are more corrupt than the doctors. Further it's an observation that, even the best medical colleges run by state or central govt. have faced derecognition by MCI, and on the other hand, even the worst medical college in private sector have never been derecognised, instead got more and more seats!
Statement by Dr Harshwardhan is not going to solve the problem. The medicine practice needs to be streamlined, and regulated like NHS in UK. Leaving to individuals , allowing private practice, infusing more and more RMPs and PMPs, just for the sake of health statistics, allowing phenomenal growth of unregulated nursing home sector, allowing anyone to advise any sophisticated investigation, are but smaller list of deadly problems faced by medicine in India.It should be noted that, a sizable number of brain scans(CT scan and MRI) is ordered by RMPs and MBBS level practicing physicians. Diagnostic centers encourage it for business, and beneficiary is always.....! In a country like India, with a large population, lack of proper education, health can't be sold to private players.Govt. has to shoulder it by strengthening it's own institutions, and all free health care schemes needs to be routed through it's colleges. And knee-jerk response to media report or to supreme court judgement on malpractices is not going to help.There is no paucity of such judgements in India, hardly matter to anyone.The actions can only cure this menace, no words, no statements, no supreme court directions or media report is capable of solving it.
Competing interests: No competing interests
The comments made by the newly elected Bharatiya Janata Party (BJP) leader, Dr. Harsh Vardhan, who was recently appointed as the central health minister of India that Medical Council of India (MCI), highest medical regulatory body in the country, is “corrupt” is an undeniable fact which is known today even to most ordinary people living in the country. What is unique in the instant case is that never before a political leader dared to take on a hot topic like “healthcare corruption” so bluntly and so soon after coming to power. No doubt that doctors who are presently occupying MCI and running India’s medical education and healthcare delivery system would not accept these scathing comments with a smiling face. But Indian health minister should be applauded at least for showing the courage about the status of MCI through this candid submission.
Wide-spread corruption that has long-plagued medical education and practice of medicine in India came to limelight in 2010 after then MCI president, Dr. Ketan Desai, was caught red-handed by the highest law-enforcing agency in the country (CBI) while taking bribe from a private medical college allegedly in exchange of granting permission to start new medical courses. This brought great ignominy and shame for the millions of hard-working and caring doctors of Indian origin practicing around the globe as it was reported in top international medical journals [1,2]. In fact, under immense public pressure, then Indian UPA government led by the national Congress party was compelled to dissolve MCI and discharged more than 100 MCI members on the ground that the corruption involving Dr. Desai was too deep and wide-spread to fix just by removing Dr. Desai or a few other people.
For the next more than four years, MCI was run by a handful of eminent doctors (“Board of Governors”) selected by the government by passing new law through “Indian Medical Council Amendment Ordinance”. But full body MCI was re-established last December under the same UPA government and same health minister from Congress party, Mr. Gulam Nabi Azad. Unfortunately, the newly constituted MCI is nothing more than old wine in a new bottle. Many of the members of the previous MCI that was disbanded on ground of wide-spread corruption have returned to the new MCI, most of them “nominated” by the state or central government. It is incredible that the same doctor-members who were removed from MCI by the government on ground of alleged corruption were re-nominated by the same government after four years. Perhaps even more shockingly, Dr. Desai himself has been chosen again as a member of the new MCI from Gujarat while he is free on bail and still waiting for the criminal trial on serious charges of bribery and corruption . The reason for a “corrupt” MCI writ large on every document in possession of the health ministry – it is the dirty open secret of Indian medicine.
No wonder that the new health minister has dubbed MCI as a “corrupt” body because old wine in a new bottle is still “old” wine. While health minister’s frank submission about corruption in MCI is a positive sign for many “good” Indian doctors and hapless patients of India, one has to wait and see that the new health minister just not talks the talk but he also walks the walk by taking meaningful corrective measures to cleanse MCI and curb healthcare corruption. Unfortunately, more than one billion people in India are used to see frequent boisterous claims against corruption by unscrupulous political leaders in India with no remedial measure to fix the problem. Corruption has riddled throughFor the sake of humanity, we all hope that the present health minister and new BJP government in India will be an exception.
1. Mudur G. Medical Council of India calls for president elect of WMA to be denied post. BMJ 2010; 341: c5825.
2. Chatterjee P. Trouble at the Medical Council of India. Lancet 2010; 375: 1679.
3. Pasha S. The spectre of Desai: Ketan Desai, tainted ex-president of MCI, returns to haunt the regulatory body. 2013. http://indiatoday.intoday.in/story/ketan-desai-medical-council-of-india-...
Competing interests: Author is the founding-president of "People for Better Treatment" (PBT), a registered non-government organization dedicated toward removing healthcare corruption and medical negligence in India (WWW.PBTINDIA.COM).
I read your news item ‘Medical Council of India is corrupt, says health minister’ with great interest. With more than twenty-five years of teaching experience in both Government and private medical colleges, I am not surprised by the news item.
During my long association with medical education, I have seen the standard of medical education deteriorating. Getting a job in a medical college as a faculty member was like a dream come true in my time, as there was neither the culture of corporate hospital nor private medical colleges. Things have now changed. Having joined the medical college, it is still a secondary job for majority of the faculties. The primary concern is private practice. The devotion and dedication of teaching is somewhat lacking. The MCI inspection for any college is like an event management. It has opened up many job opportunities for people who arrange everything from faculties to furniture. Even today the Honourable health minister, Dr. Harshvardhan, has given a statement in Times of India, Delhi edition, regarding ‘racket’ of docs-lab nexus. Doctors as well as the common man are aware of the prevailing corruption not only in MCI but also in other fields of health care sector. It is time that the ‘aware’ government make stringent laws to heal the health services.
Competing interests: No competing interests
Medical Council of India (MCI) has been facing a number of allegations about the way it works for the past several years. A number of lobbies within and outside the medical fraternity have been trying to control the way it works. These lobbies include private medical colleges, pharmaceutical companies, bureaucracy and professional organisations.
While it cannot be denied that India needs more Medical Colleges to optimise the doctor patient ratio but mushrooming of these institutions has diluted the quality of medical education. The lobby of these private colleges, which includes a number of well-connected politicians uses its influence to force MCI to relax or modify norms of admission, hospital bed requirements, requirement of faculty and even annual inspections. A large number of Medical Colleges with dismal infrastructure manage to get permission not only to admit students but also increase their intake.
The doctor-pharma industry nexus continues to flourish despite stringent rules. This is on blatant display during annual conferences and even on weekend meets organised by pharma industry in almost every major city in posh hotels where liquor and food are up for grabs.
Mr. Harsh Vardhan who himself is a doctor is aware of all the ills that plague the MCI or medical fraternity in India. The working of MCI needs to be made more transparent and the hush-hush way of working deserves to be dispensed with. He has to initiate a dialogue with all the stakeholders to identify the issues and way these may be dealt with. The least he can do is to appoint men with impeccable track record as office bearers of MCI.
Competing interests: No competing interests
Ensuring patient safety is an essential requirement for clinical trials. This aspect has been neglected in most of the clinical trials conducted in developing countries such as India. Even in the developed countries like US also, as reported by McCarthy M (1), failure by the researchers to stick to their stated plans, to protect the safety of trial participants, and to maintain good records, have been cited as common reasons for warning letters issued by the US Food and Drug Administration (FDA) to clinical investigators.
Shetty UC (2) reviewed the content of 84 first warning letters issued by the United States Food and Drug Administration (USFDA) following site visits to 46 trial sponsors, 20 lead researchers, and 18 institutional review boards, which assess and monitor safety, between 2005 and 2012. They have found that the most common concern raised among clinical trial sponsors was a failure to monitor progress according to the stated schedule (58 per cent), followed by a failure to obtain the agreement of the principal investigator (35 per cent).
Under such circumstances, what could be done to ensure patient safety during clinical trials ? The Government of India has notified some changes in the context of clinical trials in India (3). Notification of the Government of India provides provision for compensation to the client in case injury or death resulting from participation in the clinical trial in the following ways: (i) free management as long as required in case of injury occurring to the clinical trial subject, (ii) financial compensation as per order of the Licensing Authority to the subject if injury, to the nominee in case of death of the subject, (iii) bear medical management expenses by the sponsor of the clinical trial. Compensation in case of injury or death related to the trial should be granted because of the following reasons:
(a) adverse effect of investigational product(s);
(b) any clinical trial procedures involved in the study;
(c) violation of the approved protocol, scientific misconduct or negligence by the sponsor or his representative or the investigator;
(d) failure of investigational product to provide intended therapeutic effect;
(e) use of placebo in a placebo-controlled trial;
(f) adverse effects due to concomitant medication excluding standard care, necessitated as part of approved protocol;
(g) injury to the child in-utero because of the participation of parent in clinical trial.
Steps for ascertainment of the injury or death has been incorporated in the notification. It involves reporting of adverse effects, injury or death by the sponsor to the Chairman of the ethics committee who has granted ethical clearance to the trial, from the ethical committee to the Licensing Authority which will constitute an Expert Committee to look into the matter for appropriate compensation within a specified time frame.
Researchers have been critical about the provision of free treatment to the injured since there is no clear information on the nature of injury, whether related to the trial or not since injury can happen to anybody which may or may not be related to the effects of the clinical trial such as road traffic injury, murder etc. Shukla S (4) has raised the issue of negative impact on the pharmaceutical industry due to the changes in the regulatory requirements. However, the changes are necessary with clear information on the provisions of the notification for providing adequate safety and compensation to the participants of clinical trials.
Measures for patient safety should include formation of “reference groups” or “safety committees” to provide advice on the adequate course of action in situations that may develop during patient safety research (5). The committee may regularly monitor the trial through site visits, patient interaction, review of periodic patient information and reports by the investigators etc. In addition, if patients are hospitalized, a close monitoring and observation by dedicated nurses for the clinical trial could provide the much needed information on adverse effects of the drugs or intervention. The role of the trial subject and his/her close associates or relatives need to be emphasized. They should be educated and motivated to report any effect they have observed in their body during the participation in the study to the investigators so that appropriate safety measures can be undertaken.
1. McCarthy M. Failure to adhere to study plans is the most common
research error among US investigators. BMJ 2014;348:g4245
2. Shetty UC, Saiyed AA. Analysis of warning letters issued by the US Food and Drug
Administration to clinical investigators, institutional review boards and sponsors: a
retrospective study. J Med Ethics June 23, 2014. doi:10.1136/medethics-2013-101829
3. Notification of Government of India, Ministry of Health and Family Welfare (Department of Health). G.S.R. 53(E).The Gazette of India Extraordinary, part II-Section3-sub-section (i), New Delhi, 30th January, 2013. Available at
http://cdsco.nic.in/writereaddata/GSR%2053(E)%20dated%2030.01.2013.pdf (accessed 23.7.14)
4. Shukla S. India's amended trials regulations spark research exodus. The Lancet 2013;382:845. doi:10.1016/S0140-6736(13)61833-4 (Published Online: 05 September 2013).
5. World Health Organization. Ethical issues in patient safety research: interpreting existing guidance. Available at http://apps.who.int/iris/bitstream/10665/85371/1/9789241505475_eng.pdf. (Accessed on 23rd July 2014).
Mongjam Meghachandra Singh
Department of Community Medicine
Maulana Azad Medical College, New Delhi
School of Health Sciences,
Indira Gandhi National Open University, New Delhi
Competing interests: No competing interests
Establishing medical colleges with a standard hospital as stipulated by medical council of India is a challenging task for public or private sector to handle. Hospitals with a long history of serving the public could help initiate a proposal to run a medical college. Many forget that human resources are more important than the concrete structures that are built to fulfill the norms of MCI.
The outpatient strength, the quality of teaching staff and the vision of the institution form the founding principle for developing a good medical institute. The system which is run as a machinery with every year inspection to review or recommend the college to be of good standard is a real calling for the business acumen of the management and teaching skills of the college. Balancing both is the duty of MCI which guides and converts many a time ordinary institutes to institutions of excellence. Corruption is a common terminology in the dictionary of business endeavor including educational institutions run as well-oiled machinery,
With the growing population the need for doctors and hospitals grow exponentially. Therefore many private institutions with a business motive do crop up. The motive though may be like any other business incentive profit - yet it serves the cause of education. How this cause could be utilized and used lies with regulatory body like MCI. We cannot be Utopian in our outlook to brand any one or organization as corrupt in a world which runs on populism or religious or regional grounds.
Medical sectors is a very big money spinning business run by corporate sectors who with all their altruistic (autocratic sometimes) tendency serve humanity with a price to provide better health care and education.
Corruption is a habit with all of us in every walk of life. It is a difficult word to describe. We cannot root it out. We enjoy slogans like alcohol and smoking are injurious to health - labels pasted on alcohol and cigarettes. Yet the most profitable and thriving industries are breweries and tobacco companies.
MCI with all its frailties have so far helped to create laudable institutes of medical education. We need to salute them for their services rendered to promote the cause of medical education and public health in a world which is run by corrupt politicians and policies.
Competing interests: No competing interests