Reforming the Medical Council of India
The recent editorials by Dr George Thomas and Dr Sunil K Pandya in the IJME with respect to the functioning of the Medical Council of India (MCI) force us to think about how reforms can be introduced inthe MCI (1, 2). Dr Pandya suggests that we would do well to learn a lesson from the General Medical Council (GMC) of the United Kingdom (UK). It is true that the MCI can learn from many aspects of the GMC reforms which were introduced in the 1980s, especially after the Bristol case1 and the Shipman affair2. One of the most notable reforms introduced by the GMC was greater representation of lay members in its fitness-to-practice committee (3). At the moment, there are equal numbers of medical and lay members in the GMC. This suggests that the public has an equally important role as do physicians in regulating clinicians in the UK. In contrast, in the MCI, there is not a single representative of the public among the total of 89 members under different categories. As for the GMC, of its 12 members, half (ie six) are from among the public.
In addition, the GMC implemented a long-standing proposal for the revalidation of licensed doctors in 2012 (4). Revalidation,usually required every five years, is the process by which practising doctors must demonstrate their fitness to practise. During their annual appraisal and revalidation, doctors have to provide feedback from patients as one of the supporting pieces of information on their practice. It can be argued that compared to the MCI, the GMC is more accountable to the general public and its proceedings are more transparent. If the MCI introduced reforms on the lines of the GMC, it would reduce the monopoly of doctors and it would be easier to take disciplinary action against clinicians in case of violations. Moreover, it would help in strengthening the relationship between the public and doctors.
In sum, by making decision-making more transparent, changing the balance of interests in the MCI, and empowering citizens, some real progress can be made in reforming the MCI.
The letter is the part of a Wellcome Trust Studentship (grant number: WT087867MA) awarded to Shashank Tiwari at the Institute for Science and Society, School of Sociology and Social Policy, University of Nottingham, Nottingham (UK). The Trust is not responsible for views expressed in this letter. The author is grateful to Paul Martin, Sujatha Raman and Pranav Desai for support and guidance.
Shashank S. Tiwari, ITT Labs, Birmingham, Alabama (USA) e-mail: [email protected]
1The Bristol case was related to deaths of 29 babies and young children at the Bristol Royal Infirmary who had received complex cardiac surgery from 1985 to 1995.
2The conviction of GP Harold Shipman for murdering several of his patients in 2000
- Thomas G. The Medical Council of India—change necessary, apprehension persist. Indian J Med Ethics.2013 Oct-Dec; 10(4): 216-17.
- Pandya SK. The Medical Council of India: need for a total overhaul. Indian J Med Ethics. 2014 April-June; 11(2):68-70.
- Stacey M. The General Medical Council and professional self-regulation. In: Gladstone D (editor). Regulating doctors. Institute for the Study of Civil Society, London. Great Britain: St Edmundsbury Press; 2000: 28-39.
- General Medical Council (GMC). An introduction to revalidation [Internet] [cited 2014 Dec 18]. Available from: http://www.gmc-uk.org/doctors/9627.asp