For over a year, Indian chest and respiratory medicine specialists, including pulmonologists, have been in conflict with the National Medical Commission (NMC) over its sudden decision to remove Respiratory Medicine from the MBBS curriculum. After several appeals to the regulatory authorities went unheard, the Indian Chest Society (ICS), which represents chest and respiratory specialists across India, has filed a plea before the Bombay High Court, seeking reinstatement of the department. The case is set for further hearing on September 25, 2024.
The controversy began when the Undergraduate Medical Education Board (UGMEB of the NMC removed three departments—Physical Medicine and Rehabilitation (PMR), Respiratory Medicine, and Emergency Medicine—from the mandatory list for undergraduate medical admissions. The NMC’s decision also excluded Respiratory Medicine from the Competency-Based Medical Education (CBME) guidelines. The rationale provided was to ease the burden on MBBS students, with General Medicine expected to cover Respiratory Medicine topics. However, this move met with strong opposition from chest specialists, who pointed to the rising burden of respiratory diseases in India and the need for dedicated training in this field.
Dr. Raja Dhar, Director and Head of Pulmonology at CMRI Hospital in Kolkata, and Secretary of the Indian Chest Society, emphasized the critical need for respiratory medicine education in India. Diseases like Chronic Obstructive Pulmonary Disease (COPD), lower respiratory tract infections, pneumonia, tuberculosis, and lung cancer are among the leading causes of death in both India and globally. Dr. Dhar pointed out that over 100 million people in India suffer from asthma and COPD alone, with the country contributing significantly to global COPD deaths. He also highlighted India’s high burden of air pollution, which exacerbates respiratory illnesses, and the growing threat of tuberculosis, despite government goals to eliminate the disease by 2025.
Given this immense burden, respiratory specialists argue that removing the subject from the MBBS curriculum devalues its importance and compromises the quality of future doctors' training. Dr. Dhar stated that it is crucial to sensitize MBBS students to the significance of respiratory diseases, as general physicians may not fully grasp the complexities involved.
The Indian Chest Society had previously written to several government dignitaries, including then Union Health Minister Mansukh Mandaviya and Minister for Road Transport and Highways, Nitin Gadkari, urging the reinstatement of Respiratory Medicine. Despite Gadkari’s support, the NMC reiterated its stance that General Medicine could cover respiratory topics and that post-graduate specialization was available for interested students.
Pulmonologists like Dr. Neel Thakkar, based in Vadodara, have also initiated online petitions, gathering public support to reverse the NMC’s decision. Dr. Thakkar argued that removing Respiratory Medicine from undergraduate education could lead to poor management of common respiratory illnesses like TB, COPD, and pneumonia, potentially increasing preventable deaths by up to 30%.
With their concerns still unaddressed, the ICS, along with the Indian Society of Physical Medicine and Rehabilitation, has approached the Bombay High Court, demanding that the NMC follow its own regulations, which previously mandated a separate Respiratory Medicine department in all MBBS-approved medical institutions. The case remains ongoing, with respiratory specialists hoping for a favorable outcome to safeguard the future of healthcare in India.
(Input from various sources)
(Rehash/Ankur Deka/MSM)