What is wrong with the MCI?

In the wake of the Medical Council of India’s (MCI) take on the promotion of faculty recently (1), it is clear that the faculty of medical institutions across the country are in a state of alarm. A situation in which the whole onus of research is put on the faculty is quite quirky when there is no consideration of the fact that most medical colleges in India do not have a system of intramural funding, apt infrastructure and a pertinent environment for carrying out good research.

Promotion means a hike in salary, reputation, self-esteem, etc., and people may very well ignore research ethics in favour of survival. Although continuous assessment of the academic achievements of faculty is one of the essentials of maintaining good standards of professional and ethical medical education, in the absence of intramural funding and infrastructure, using publications as a parameter for the same may have serious consequences. If publications are forced on the faculty, in the absence of any funding or research infrastructure, there will be few, if any, concerns about research ethics or integrity. One of the primary objectives of the MCI is “maintenance of uniform (not high) standards of medical education, both undergraduate and postgraduate” and publications are a logically disparate way to achieve the same, at least in nonstandard research environments (2). The policy undoubtedly has no implications for the maintenance of uniform standards of medical education.

In India, there is no legislation for research misconduct. Research infrastructure and funding are not essential criteria for the establishment of medical colleges in India (3). India has designated research institutes for funding and conducting health research (4). Most medical colleges in the country do not have research infrastructure or intramural funding for health research and most research is funded by external agencies. The need for research on a topic is evaluated by the funding agencies. The selection of a research project is governed by the need of the funding agency rather than the interest of the faculty. Therefore, before imposing superfluous rules that are not well thought out on the faculty, the MCI must lay down specific research-related minimum guidelines (if at all it is empowered to do so) for institutions as well, so that some responsibility is shared and meaningful research is carried out. We feel that rather than a healthy initiative for research, the current policy is more of a tyrannical decision that reflects the hypocrisy and ineptitude of the MCI as a national medical regulatory body.

The lack of clear objectivity in the policy document indicates that it is just a desperate attempt to appear professional in the global research scenario and in the process, transferring all the responsibility on to certain individuals so as to create a window of opportunity for shifting the blame whenever the need arises. The institutions and the state governments are totally absolved of their responsibility towards research (3). Looking at the flaws and casualness of the document and the MCI’s flippancy regarding a search for a logical and reasonable solution, it seems that the MCI has not succeeded in doing any “original research” on addressing the problem of research in the country. Medical faculty also happen to be doctors with an enormous workload in resource-poor countries like ours and promoting research in such a dictatorial manner will only gradually lead to the demise of medical practice in medical colleges (which are also tertiary care institutions).

The ingeniously percolated idea of perceiving of research as a tool for the advancement of an individual’s academic career, rather than a nationalist concept of doing research for the country, could be another reason for regulatory bodies to conveniently come up with such skewed policies. The MCI must take initiatives to instil, in individuals and institutions, the concepts of research integrity and to propagate research as a tool for the nation’s development rather than relentlessly trying to create a hostile and autocratic environment in an effort to unnecessarily compete with the West.

Submission of similar work: A letter to the editor of the Journal of Postgraduate Medicine Education and Research on somewhat similar lines is under review.