National Medical Commission Releases PGMER 2023 Regulations

January 8, 2024

GS Paper II Government Policies and Interventions

Context: The criticisms are faced by the recently notified Post-Graduate Medical Education Regulations, 2023 (PGMER 2023 Regulations) in India.

About the NMC PGMER 2023 Regulations or Post-Graduate Medical Education Regulations

Introduction of New Medical Courses: It introduced Six types of Postgraduate (PG) medical courses with varying durations, covering broad-specialty qualifications, super-specialty courses, diploma courses, and post-doctoral certificate courses.
Online Counseling: Common counseling for admission to PG medical courses in India will be conducted online by state or central counseling authorities, ensuring a merit-based selection process.
Compulsory Residential Rotation: The introduction of a compulsory residential rotation (District Residency Programme or DRP) of three months for MD or MS students in broad specialties in district hospitals, providing hands-on experience.
Reduce Approval Time: Medical colleges can now apply for permission to start PG medical courses one year after receiving approval for undergraduate courses.
Academic Cells: There is also the provision of the establishment of academic cells to monitor training programs and ensure their quality.
Smooth Operation: The existing NEET-PG examination will continue till the proposed National Exit Test (NExT) becomes operational for the purpose of PG admission.
Recognition to Medical College: Once a medical college is granted permission to start PG courses or seats, the course will be treated as recognized.
Strict Implementation: For better implementation of regulations, there is a provision of penalty clauses which include monetary penalty, reduction in the number of seats (admission capacity), or complete stoppage of admissions.
- Non-Compliance: It also outlines penalties for non-compliance, with medical institutions facing a fine of ₹1 crore per seat for breaching regulations. A two-year admission ban may be imposed for continued non-compliance.
Beneficial for Students: All post-graduate students will work as full-time resident doctors for “reasonable working hours” and will be provided “reasonable time for rest” in a day.
- They will be permitted a minimum of 20 days of casual leave per year and five days of academic per year.
  - However, earlier there was no written provision for leaves.
- Tracking of Progress: A dynamic e-log book will track postgraduate students’ progress, and will engage them in thesis-related research.

Need of the Post-Graduate Medical Education Regulations, 2023:

To foster quality, ethical practice, and inclusivity within the medical fraternity and to enhance the standards of education and practice nationwide.
To prohibit the migration of students from one medical institution to another.
To reserve seats in medical colleges for various categories will align with the prevailing laws in States/Union Territories.

PGMER 2023: Its Criticisms

Working Hours: The use of “reasonable time for rest” in a day is vague and limits the specific limits on working hours.
- Many times junior doctors work 72 to 96 hours without break, so there must be clarity on the working hours of the resident doctors.
Mental Health: The reforms are silent over the measures for mental health and burnout prevention.
Irregularity of Stipends: The ongoing issue of irregular stipends has not been addressed.
- PG students in private medical colleges contend that their stipends fall significantly short of those offered by government medical colleges (GMC).
Integration of Artificial Intelligence in the Curriculum: In new reforms, there is also a lack of guidelines for the integration of Artificial Intelligence in the curriculum.
Inclusivity Issues: The regulations offer a 5% reservation for doctors with disabilities but have been criticized for not incorporating the recommendations from “Doctors with Disabilities: Agents of Change.”
- Also, terms like ‘moderate’ dyslexia and the exclusion of mental illness and autism contradict existing laws and ignore Supreme Court directives (Vibhushita Sharma petition), indicating a lack of thorough inclusivity.