The Dr K Kasturirangan-chaired committee recently submitted a Draft National Educational Policy (NEP) to the Ministry of Human Resource Development in May, 2019 (1). It has been thirty-three years since the last comprehensive education policy of 1986. Naturally, this Draft Policy has been long awaited and involves many complex issues (as evidenced by the controversy already created around the “imposition of Hindi”). This editorial seeks to examine only slices of the NEP that deal with higher education, and to foreground some on-the-ground challenges to meaningful implementation, especially more easily overlooked topics such as medical ethics.
Despite many details that have to be worked out, it is clear to all stakeholders that higher education has to be looked at more thoughtfully. The headline news is always that of the lack of Indian universities in international rankings. Hence the effort to rank universities, such as that of the National Institute Ranking Framework (NIRF) is right in principle. People might rightfully dispute specific rankings but there is no doubt that some accountability in the system is overdue provided it is done in a respectful way, and is intended to help institutions improve.
But rankings are only the last outcome. What is needed is the infrastructure to help those rankings grow robust. There are many aspects to this such as pedagogy, customised and differentiated student learning, equity, internal governance of the universities and so on. But the chief duty of universities is research with a strong public-benefit mandate. The way to test research is mainly through publications, and it is publication in journals that is the nub of the issue.
The natural extension of governmental interest after the initial ranking frame is that of encouraging publication in respectable journals. This is where the true mettle of the government will be tested in the future—will it be able to help grow and fund an ecosystem of India-relevant, high quality publications in journals that also in time win international respect? The experience thus far has not been encouraging—regulators that came up with poorly designed Academic Performance Indicators are now trying to douse the fire lit by themselves. It is, however, gratifying that there is appreciation, at least now, of the serious threat to the Indian research ecology from low quality and predatory journals (2). The solution, as indicated earlier, is to focus on growing a high-quality research ecology. But it must first be accepted that this takes time and patience, and cannot be driven by random target numbers that regulators (and consequently, university administrators) regularly inflict on academics. Far from taking a punitive stance, it should be admitted that the failure to nurture a research ecology is primarily the failure of an enabling governmental and funding body, rather than that of individual professors. This point has already been ably articulated in an earlier editorial jointly published in IJME and other biomedical journals: “Around the world, as in many fields in our country, employees are assessed using the so-called “subjective” criteria, with sufficient reliability. Setting up such systems – though admittedly hard – is not impossible. These will surely take time, effort and commitment to set up. But if we unquestioningly accept the simplistic tools such as publication count, we will never move to a higher plane. Hence, as a profession, we need to initiate debate for moving towards better systems of assessing quality. Such an assessment system would necessarily mean a multi-pronged evaluation – by peers, students as well as administrators” (3).
The reason that it is easier to get published abroad is that many of the journals are self-evidently focused on issues of the Global North with only a token presence in issues relevant to India or the Global South. This is most obvious in cases of expensive science journals where the possibilities of commercialisation are high. In contrast, in issues that impact more Indians (either directly in terms of healthcare, or indirectly in terms of cultural knowledge) there are very few creditable sites of publication. The reasons are multi-fold. On the one hand, global indexing services are insufficiently sensitised to the types of research relevant to India (research that has great social and cultural impact, but may have lower commercial value or immediate relevance to the normative centre of knowledge ie Euro-America). In large fields of knowledge such as history, medical ethics, literature and so on, there are only the barest handful of, say, Scopus-indexed journals (one mentions Scopus as the UGC has been referring to it directly). Scholars have noted that dealing with a heavy hand in nascent fields stifles innovation: “The field of medical humanities is, as it is, poorly developed in India and such norms for the assessment of performance will further hamper its progress” (4). In the last year, there have been many controversies with regard to the high pricing of these journals, and large public university systems such as that of the University of California have withdrawn from negotiations (5) India too needs to take a strong stance, at least on issues of clear universal relevance such as public health and ethics—we need to learn to take genuine intellectual ownership of the shape, pace, direction and substance of what is uniquely relevant to India, and take charge of our journey out of widespread and avoidable morbidity and excessive commercial distortion.
On the other hand, the response in India should not be, as it has typically been, a blind, reflex “research-nationalism” that simply lists and de-lists, without credible explanation, journals on governmental indexes. Rather, one should learn from the best practices of global indexing agencies how to develop credible tools for collaboration, searchability, feedback, real time tracking and so on. These should then be used to give more significance to India-relevant research even as it manages high levels of rigour. As it stands, there is, for example, no clearly stated document laying out first principles in medical ethics in Indian healthcare. The government must initiate the conversation as only it can provide legal teeth, as well as funds, regulatory rules of access to health information for Indian citizens and so on. It must not be forgotten that the point of a journal is to serve the public interest and individual innovation—while what happens in practice is that the rigid norms of a journal distort innovative, meaningful thinking, eg: “We submitted an original article which was accepted only as a brief report. We agreed because it was the highest impact factor journal in the subject category in India” (6). Of course, this is also part of the larger question of how circulars—which have such massive consequences for tens of thousands of professionals—are simply issued with little sense of the rationale or explication of the decision-making process.
One of the strengths of this current Draft Policy has been the appreciation of the need for a more liberal education, and its strong relevance in improving even professional education—medical ethics is an ideal site for this marriage, for every arts discipline (history, literature, anthropology etc) is increasingly studying medical knowledge, and disciplines like medical humanities and medical sociology are among the fast-growing and most exciting subfields within the Arts. Thus, tiers of expertise can be created for a field like medical ethics at a symbiotic level for both journals as well as university departments, and the idea should be to grow and nurture an appropriate syllabus (including norms of training, delivery and evaluation) in all healthcare related universities or departments. Medical ethics (and science more broadly) must see themselves as integral to a liberal education.
One must understand that developing this policy and research ecology is not something that can be done in a hurried, punitive manner. It will take sustained work over at least a generation to really build a publication (and concomitant indexing) system. A plan must be seeded now—to identify the disciplines, build up core and sub-committees, and help disseminate research topics, methodologies, training modules. This is a long-term play, and the government must treat it with the patience, respect, and autonomy that such a quest deserves.
On the key question of appointments to these varied committees, the ideal profile would be that of someone who, having done high-quality research in their early career, chose to move into administration in their forties or so—thus having first-hand knowledge of research, administration, and,ideally, sufficient exposure to international structures. Unfortunately, the norm in India has been that research lies in the hands of academics who have made a career in administration rather than research. Of late, in what seems tokenism, there is the handful of famous international names, but if one has little experience of institutions in India, this is unhelpful. Equally, entrenched and well-connected Indian administrator-bureaucrats, not having credible international reputations, are also misfits.
The right mix in the team is vital as there is no getting away from the hard work of constituting many committees and drafting details of tasks and outcomes—simply setting targets with little sense of requirements (physical, work-load relief, language issues) on the ground will only be a continuation of the previous decades. The agenda and evaluations should be set by a credible peer-network consisting of faculty from various fields—a peer systemof respected specialists and mentors is vastly preferable to the current inspectorate system as it alone can give specialised advice that the non-specialist bureaucrat cannot, especially if what is being talked about is cutting-edge research, or research in complex fields like publication ethics. There should also be a credible, easily available spokesperson who will regularly communicate with the media and interested citizen groups on an ongoing basis, and in the spirit of conversation—this needs to replace the current system where fiats are sent by ministries to senior university officials telling them to organise this or that event (this is the case even if the theme of the “event” is beneficial—such as the environment, yoga, secularism etc).
Researchers must instead be allowed to concentrate on their primary work: as it stands, very few universities can afford the fees that international journals (or bouquets of journals) demand, and thus the overwhelming majority of universities, especially in countries like India, have no chance of doing cutting-edge work as they are unaware of the latest iteration of research in their sub-field (7). This is a stark exclusion. Indeed, universities can often fund multiple deserving students for the price of some of these journals. The government needs to take a strong stand on journal availability and sensitised pricing, and create a national access, at least for those fields that are clearly citizen-facing such as public health and medical ethics (the term ‘medical ethics’ is not mentioned in the Draft report, and there is no substantive discussion on the interrelation of ethics and healthcare). There must be insistence on a non-profit status for journals in such vital fields, and payment may be linked to capacity to pay—better endowed universities may be required to pay more, or cross-subsidise.
However, finance may well be the easier issue as itis a matter of regulation and allocation. The deeper issue will be the executive ability required for a continual dissemination of the best practices of research writing, the use of qualitative and quantitative techniques, and the necessity to always think from a public-benefit viewpoint. Indeed, among the major obstacles to quality research in India are the ill-conceived targets and checklists that university officials (often in line with higher bodies) demand. There is thus a need to educate administrative officers that research is different in different fields, and that high quality research papers in multi-dimensional and fine-grained areas such as medical ethics may require longer gestation periods, and may not score high impact factors or the h-index; but are nevertheless integral to any idea of social beneficence. “The Stanford University chemist Zare believes that the h-index is a poor measure in judging researchers early in their career, and it is more a trailing, rather than a leading, indicator of professional success” (8)
Documents such as the Draft Education Policy tend to be overly normative. The proof of the pudding is in the eating, or rather, the proof of the research would be in energised researchers and excited students, and in ethically enriched communities who see clear signs, after a long, dark tunnel, of the mitigation of centuries of historical and social exclusion in healthcare. This exclusion has lost us several decades in public-spirited, meaningfully-evaluated research, and must give way to a hopeful new chapter that will determine the outcomes for the coming decades.