The National Medical Commission (NMC) has been questioned by the Nagpur bench of the Bombay High Court regarding the rationale behind eliminating the Respiratory Medicine Department from the MBBS curriculum. The plea challenging this decision was filed by the Indian Chest Society (ICS). The High Court bench, comprising Justice Bharti Dangre and Justice Abhay Mantri, has sought a detailed explanation from the NMC, emphasizing the potential consequences of such a decision.
During the proceedings, the argument was presented that the removal of Respiratory Medicine as a subject would lead to the unavailability of teaching staff for this course in over 706 medical colleges across India. This would consequently affect healthcare facilities and the quality of treatment available to ordinary citizens. The panel of judges pointed out that the absence of a specialized department would significantly impact the level of care provided to patients, especially those with respiratory conditions.
Last year, the Undergraduate Medical Education Board (UGMEB) of the NMC had eliminated three departments—Physical Medicine and Rehabilitation (PMR), Respiratory Medicine, and Emergency Medicine—from the list of mandatory departments required for a medical college to be approved for undergraduate admissions. The provision for a separate Respiratory Medicine Department has also been omitted from the newly released Competency-Based Medical Education 2024 guidelines.
Despite efforts by respiratory medicine specialists to appeal the decision through various authorities, no satisfactory resolution was reached. Consequently, the ICS chose to pursue a legal remedy by filing a Public Interest Litigation (PIL) before the Bombay High Court. In addition to ICS, the Indian Association of Physical Medicine and Rehabilitation has also joined as a petitioner in the case.
During a previous hearing, the petitioners’ counsel argued that the UGMEB is required to operate in compliance with the Act of 2019 and is subject to the regulations established by the NMC, as per Section 16(2) of the Act. Additionally, it was highlighted that under Section 57 of the 2019 Act, the NMC is empowered to frame regulations. Accordingly, on October 28, 2020, the NMC identified 24 departments—including those of Respiratory Medicine, PMR, and Emergency Medicine—that must be established by medical institutions approved for MBBS admissions.
According to a media report by The Hitavada, during a recent hearing of the case, the Apex Medical Commission informed the High Court bench that the removed subjects would now be included as part of General Medicine. However, the Court questioned the appropriateness of eliminating Respiratory Medicine as a distinct course and stressed the importance of specialized departments during the COVID-19 pandemic. The High Court also questioned the justification for including such a crucial subject under the broader umbrella of General Medicine. The NMC has been directed to provide a reasoned explanation for its decision within three weeks, while the petitioner associations have been instructed to submit their replies.
The counsel for the petitioners responded to NMC’s argument by stating that the inclusion of Respiratory Medicine in General Medicine would negatively affect the availability of specialized doctors for critical medical conditions. Furthermore, it was argued that the NMC’s decision would deprive medical students of important training, which would, in turn, have adverse consequences for patient care across the country.
“Mr. Rahul Bhangde, learned counsel appearing for respondents nos. 2 and 3, has sought an extension of three weeks to file a reply. The High Court expects the affidavit to be submitted within the specified period, as undertaken,” stated the bench. The petitioners were also granted the liberty to file their rejoinder within two weeks thereafter, with the matter scheduled to be taken up again on November 19, 2024.
Speaking to Medical Dialogues on the issue, Dr. Neel Thakkar, a Vadodara-based pulmonologist and member of the ICS, expressed concerns over the potential consequences of this decision. He noted that the removal of Respiratory Medicine from the MBBS curriculum could have significant repercussions not only on medical education but also on public health. “Without a dedicated department and the absence of specialized training, numerous lives may be lost. The spread of conditions like drug-resistant Tuberculosis (TB) and Chronic Obstructive Pulmonary Disease (COPD) could escalate, and the country’s preparedness for another pandemic could be compromised. These pressing questions need answers,” Dr. Thakkar remarked.
The High Court’s inquiry highlights the critical importance of specialized medical training in Respiratory Medicine, which has played a vital role during the recent pandemic. As the debate continues, both healthcare professionals and the public eagerly await NMC’s response regarding the future of specialized respiratory care in medical education.
Official notice: https://pdf_upload/bombay-hc-respiratory-medicine- 255599.pdf
(Input from various sources)
(Rehash/Ankur Deka)