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.

News Source: The Hindu