National Knowledge Commission Report to the Nation 2009: Baseline

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the MCI with no attempt to upgrade or evaluatestudents or courses.Quality: There is lack of consistent and regulatedstandards in medical education with many of thecolleges having questionable training capacities and noaccreditation system. Medical graduates are often notassessed for clinical skills in accordance with nationaland international standards. There is lack of appropriateregulation and that further compounds the problem.State governments can grant license to practice generalspecialty, sub-specialty or super-specialty medicine withno assessment of clinical skills. With roughly 26000graduates passing out from MBBS every year and only11-12 thousand postgraduate seats, about 14-15 thousandgraduates get into medical practice with theoreticalknowledge but no application of knowledge. MCI hasneither the power nor the infrastructure to continuouslymonitor and standards. Major reforms at each levelare needed in order to elevate the present condition ofmedical education in India to international standards.Curriculum: The graduate course is 4½ years withassessments in the 1 st year and 2 nd year and 2½ years later,by internal and external examiners assessing theoreticalknowledge acquired. Skill assessment is limited to acase discussion. Internship is of 1 year duration with nofaculty supervision or system of assessment. The graduateacquires unsupervised clinical skills after leaving medicalschool and before entering general practice. Only aboutfive thousand can get a postgraduate seat and then gothrough a graded clinical responsibility. It is thereforenot surprising that a series of studies conducted byAIIMS and a consortium of 16 medical colleges duringFigure 31: Growth of AYUSH colleges in India460440420431 4314444003803603743883403202000-01 2001-02 2002-03 2003-04 2004-05Source: Medical Council of IndiaFigure 32: State wise distribution of medical colleges (2005)MaharashtraKarnatakaAndhra PradeshTamil NaduKeralaUttar PradeshGujaratWest BengalRajasthanMadhya PradeshBiharPunjabDelhiJammu & KashmirOrissaJharkhandHaryanaAssamUttaranchalHimachal PradeshChhattisgarhTripuraGoa0 5 10 15 20 25 30 35 40 45Source: Medical Council of India196 National Knowledge Commission
1989-1995 concluded that our medical graduates lackclinical skills. As a follow up to these studies, WHOSEARO conducted a study General Practice in India,Nepal & Sri Lanka- a status report (1998) which found themedical care delivered by a sample of general practitionersto be of questionable quality.Funding: The Central Budget allocation for healthwhich includes medical education has declined from1.3 per cent of the GDP in 1999 to about 0.9 percent today. As a percentage share of the Total CentralBudget, it has been stagnant at 1.3 per cent, while inthe states, it has declined from 7 per cent to 5.5 per cent(National Health Policy 2002). The results from theNational Health Account (NHA) for the year 2001-02showed that total health expenditure in the country wasRs. 1,05,734 crore, accounting for 4.6 per cent of itsGDP. Out of this, public health expenditure constitutedRs. 21,439 crore (0.94 per cent), private healthexpenditure constituted Rs. 81,810 crore (3.58 per cent)and external support Rs. 2,485 crore (0.11 per cent).In nominal terms, the per capita public healthexpenditure increased from Rs. 89 in 1993-94 toRs. 214 in 2003-04, which in real terms is Rs. 122.Given these statistics, it is no surprise that the reachand quality of public health services has been below thedesirable standard.Health Services and Medical Personnel: While Indiahas seen considerable improvements in health standardsin the last six decades, problems of access to qualityhealthcare and shortages of skilled medical personnelstill persist. As per 2007 figures, India had 6.9 lakhregistered allopathic doctors, 7.2 lakh AYUSH doctors,15 lakh nurses and 6.8 lakh pharmacists. While theabsolute number is not very low for a developingcountry, the numbers prove inadequate in view ofIndia’s large population.Figure 33: Growth of per capital health expenditure by Centre and StatesNominalReal2502001501005001993-94 1994-95 1995-96 1996-97 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-03 2003-04Figure 34: Number of doctors per 1000 populationGreeceItalyFranceGermanyAustraliaUSUKJapanIndia0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5Source: Journal of Royal Society of Medicine Vol. 99, June 2006Report to the Nation197
Page 1: Annexure I: BaselineReport to the N
Page 8 and 9: years and 15-17 years were 13.8 per
Page 11 and 12: Formal vocational training and broa
Page 13 and 14: 4. Impact: Of the trained candidate
Page 15 and 16: Figure 16: Growth of student enrolm
Page 17 and 18: Figure 18: Sector-wise plan & non-p
Page 19 and 20: More Talented Studentsin Maths and
Page 21 and 22: Figure 23: State-wise enrolment in
Page 23 and 24: Figure 26: Total enrolment in lawPe
Page 25: Figure 29: Growth in medical colleg
Page 29 and 30: Figure 37: Regional distribution of
Page 31 and 32: Figure 40: Growth in engineering in
Page 33 and 34: Open and Distance EducationIntroduc
Page 35 and 36: correspondence courses must be made
Page 37 and 38: Figure 47: State-wise distribution
Page 39 and 40: Figure 53: Applications filed by In
Page 41 and 42: Figure 57: Resident patent filings
Page 43 and 44: Figure 60: Overall and potential en
Page 45 and 46: AgricultureIntroductionAgriculture
Page 47 and 48: Table 19: Global extension practice

National Knowledge Commission Report to the Nation 2009: Baseline

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