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Health education has evolved into health promotion. Health education is any combination of learning experiences designed to facilitate voluntary actions conducive to health. Health promotion is the combination of educational and environmental supports for actions and conditions of living conducive to health, thereby including health education. four other main developments are relevant: the need for planning (the PRECEDE–PROCEED model), the importance of evaluation, the use of social and behavioral science theories in the development of health promotion interventions (the Intervention Mapping process). Finally, recent developments in information technology (e.g., computer tailoring) and their effect on health promotion are presented.

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The Health Education Research and Rehabilitation Council of India

भारतीय स्वास्थ्य शिक्षा अनुसंधान एवं पुर्नवास परिषद् ऑफ इंडिया, (a central council for health, rehabilitation, education and paramedical services.).

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Utilizing and Interpreting Nutrition Data in Research

The Harvard T.H. Chan School of Public Health has had active research and educational programs in India since the 1960s. However, the Mumbai-based India Research Center, an office of Harvard Global Research Support Centre India, is designed to broaden and coordinate the School’s existing collaborations and create new relationships with organizations and agencies across India.  The ultimate goal is to improve health in India and around the world through the strategic goals of research, training, and knowledge translation and communication.

Center researchers are engaged in a number of diverse projects , developing cases for the School’s DrPH program, convening workshops and symposiums on important public health topics, and designing a national communication strategy on mental health for the Indian ministry of health and family welfare, among many others.

We invite you to explore the India Research Center website and learn about our projects and collaborators.

Improving Health in India

As the world’s second-most-populous country and one of its fastest-growing economies, India faces both unique challenges and unprecedented opportunities in the sphere of public health.

For more than a decade, India has experienced record-breaking economic growth that has been accompanied by significant reductions in poverty. According to the World Bank, infant mortality in India fell from 66 to 38 per 1,000 live births from 2000 to 2015. Life expectancy at birth has increased from 63 to 68 years, and the maternal mortality ratio has fallen from 374 to 174 per 100,000 live births over the same period.

India also has dynamic pharmaceutical and biotechnology industries; world-class scientists, including a burgeoning clinical trials industry; and leading hospitals that attract foreign patients and treat its better-off citizens.

Yet Indian government and public health officials agree that the country also faces persistent and daunting public health challenges, particularly for the poor. These include child undernutrition and low birth weights that often lead to premature death or lifelong health problems; high rates of neonatal and maternal mortality; growth in noncommunicable diseases such as obesity, diabetes, and tobacco use, leading to cancer and other diseases; and high rates of road traffic accidents that result in injuries and deaths.

As the Indian government strives to provide comprehensive health coverage for all, the country’s rapidly developing health system remains an area of concern. There are disparities in health and health care systems between poorer and richer states and underfunded health care systems that in many cases are inefficiently run and underregulated. New government-financed health insurance programs are increasing coverage, but insurance remains limited.

Public and private health systems are placing huge demands on the country’s capacity to train exceptional health leaders and professionals. Rising to meet these challenges, the people of India have an opportunity to have a major influence on their own future health and on the future of public health and medical efforts globally.

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The Harvard T.H. Chan School of Public Health is collaborating with partners across India to address those challenges. Together, the School and its partners are introducing educational innovations to India to expand skills training, degree programs, and leadership development at new schools and institutes of public health. We seek to leverage the School’s resources to help strengthen public health training and build capacity across the health sector in India.

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Prof. Monika Arora is a public health scientist working in the area of Non-Communicable Disease (NCD) prevention and control and adolescent health. She is the Vice President (Research and Health Promotion) at the Public Health Foundation of India (PHFI). She is the President of the NCD Alliance (2023-25), was the founding Chairperson of the South East Asia NCD Alliance (2020-23), and a Founding GB member of the Healthy India Alliance. She coordinates a multi-disciplinary research team at PHFI. She Chairs the Research Management Committee of PHFI and is also a Member Secretary of the External Research Advisory Council of PHFI.

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The Training Division at PHFI focuses on implementing various capacity building initiatives that aim to upgrade the knowledge, skills and core competencies of Healthcare Professionals since the year 2010. Various initiatives have been formalized and implemented for healthcare professionals from diverse backgrounds in the areas of chronic conditions, palliative care, healthcare quality, health program management, health technology, occupational health and evaluation & monitoring of health programs.

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About Health Promotion Division (HPD)

The Health Promotion Division at the Public Health Foundation of India (PHFI) aims to nurture interdisciplinary health promotion research, programming and practice and focuses on promoting multi-sectoral coordination. The Division adopts a settings based approach to design health communication, health literacy, and community outreach activities that mainstream health promotion policy and practice. The Division works on designing theory-based interventions to develop healthy settings in diverse contexts and generates evidence to support effective messaging, programming and policy development. The Division brings together approaches ranging from health education, advocacy, community empowerment, legislative reforms, fiscal policy change to organizational change and strengthening health services to address social inequalities in health.

The Division undertakes rigorous evaluation of outcomes and processes to assess impact of these health promotion interventions on population health and wellbeing. Research on impact of programmes in influencing health of individuals and population is a core activity undertaken at the Health Promotion Division. Represented by multi-disciplinary team of Epidemiologists, public health experts, clinicians, behavioral scientists, nutritionists, qualitative researchers and heath communication experts.

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Sex selection in pregnancy.

Dr. Sutapa B. Neogi (Principal Investigator), IIPH-Delhi (Relevance to MDG 3A and 5A)

Objective: Sex selection is a major social concern in India. The use of indigenous medicines purportedly influencing the probability of having a son is reported to be a common practice... Read More

Programme for Improving Mental Health CarE (PRIME)

Dr. Rahul Shidhaye (Principal Investigator), CCCI, PHFI

Objective: The Programme for Improving Mental Health CarE (PRIME) was launched in 2011 to generate evidence on the implementation and scaling up of... Read More

mHealthcare

Dr. Ajay Vamadevan (Project Coordinator), CCCI, PHFI

Objective: The rising burden of chronic diseases, and their co-morbidity are a major challenge for the Indian health system, requiring life-long therapy. Innovative approaches such as task-shifting/sharing... Read More

Diabetic Retinopathy

Prof. GVS Murthy (Principal Investigator), Director, IIPH-Hyderabad

Objective: Of the projected 69 million people with diabetes in India, 6 million people are estimated to have sight threatening Diabetic Retinopathy (DR). This is an important and avoidable cause of blindness... Read More

Global burden of Disease

Dr. Lalit Dandona (Principal Investigator), PHFI

Objective: While programmes for disease prevention and control as well as health promotion are underway in many countries, often, they are historically and politically shaped, rather than reflecting... Read More

India’s tobacco-related fiscal policies

Dr. Sakthivel Selvaraj (Principal Investigator), PHFI

Objective: India has a complex tobacco tax structure; there has been a growing interest from state governments to increase taxes on tobacco products as a measure to curtail consumption, although the impact of the same on revenue and consumption was unexplored... Read More

Yoga-CaRe trial

Prof. Prabhakaran D (Principal Investigator), CCCI, PHFI

Objective: Many of the ancient traditions of India such as Yoga can be an answer to the spiralling health care costs and can be used innovatively to address the emerging epidemic of chronic diseases in India... Read More

Yoga for Tobacco Cessation

Dr. Bidyut Sarkar (Principal Investigator), PHFI

Objective: To evaluate, if a brief community outreach intervention (a single session advice of 15 min to stop tobacco use combined with training in yogic breathing exercise) delivered by health workers to promote tobacco cessation in India... Read More

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The current state of public health education in India: A scoping review

Affiliations.

• 1 Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States.
• 2 Foundation of Healthcare Technologies Society, New Delhi, India.
• 3 Division of Non Communicable Diseases, Indian Council of Medical Research, New Delhi, India.
• PMID: 36504927
• PMCID: PMC9727389
• DOI: 10.3389/fpubh.2022.970617

With the creation of public health management cadre in the state, district, and block levels of India, there is a need for a comprehensive, synergistic education system to ensure efficient public health across the country. This scoping review, therefore, aims to examine the characteristics of public health education programs available in India's varied geographical and regional contexts. It examines 16 program-related descriptors across public health Doctoral, Masters, Bachelors, Post-graduate Diploma, and Diploma education programs offered. Data was retrieved through institutional websites. Results of our analysis showed 84 unique institutions in 20 states and 3 UTs currently offering 116 public health programs across India's 28 states and 8 UTs. Private and public institutes were 65% ( n = 75) and 35% ( n = 41) respectfully. The majority of universities mainly provided Masters of Public Health ( n = 73, 63%) programs followed by Postgraduate Diploma (PGD) and Diploma ( n = 17, 15%), BPHSc ( n = 14, 12%), and Ph.D. ( n = 12, 10%). The majority of Ph.D. programs in public health are offered in Maharashtra, Karnataka, and Haryana, while Masters in Public Health programs are offered highest in Karnataka, Bachelors in Public Health programs in Rajasthan, Post Graduate Diploma in Public Health program in Delhi, and Tamil Nadu had the most number of Diploma in Public Health programs. Thirty-one percent ( n = 36) of the public health programs are offered across the south, 28% ( n = 32) across the north, and 22% ( n = 26) across the west Analyzed descriptors provide comprehensive information on program characteristics, mainly admission, format, and tuition fee. The review offers five suggestions to improve collaborative public health education and prepare a workforce with the skills, knowledge, and expertise to respond to the twentyfirst century's public health threats and challenges in India.

Keywords: BPH/BPHSc; India; MPH; Ph.D.; Postgraduate Diploma; public health; public health education; public health management cadre.

Copyright © 2022 Joshi, Bhatt, Gupta, Grover, Saggu and Malik.

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Facets of India's Economy and Her Society Volume II pp 149–180 Cite as

Education and Health Services in India: A Brief Overview

• Raghbendra Jha 2  
• First Online: 21 March 2018

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Strong growth in the health and education sectors is essential for sustained long-term growth in India. This chapter looks at India’s demographic transition and educational attainments, reviewing expenditure in the sector and then outlining some indicators of the country’s educational achievements. The challenges faced by the education sector and essential reforms are discussed. There is also an overview of key aspects of India’s health sector, looking at the challenges it faces and suggesting some policy reforms.

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The estimated contribution of human capital to per capita GDP growth is sizable in view of the fact that average per capita GDP growth in India over the period 1951–52 to 2012–13 has been 5.0% (computed from RBI data).

The middle-income trap is a situation in which a country’s per capita income reaches middle-income levels (according to the World Bank classification) but does not progress to high-income levels.

For a review of India’s education system and its history see Dutta ( 2008 ) http://jacobenfield.com/dossier/IndianEducationSystem_HystoricalAnalysis_Dutta_Barry_Bull.pdf (Accessed 1 June 2017).

A caveat needs to be added here. India’s demographic dividend is also associated with a deteriorating gender balance—a problem that is only going to get worse with higher education and incomes (Chaudhri and Jha 2013 ).

For a summary of the Kothari Committee Report see http://www.yourarticlelibrary.com/education/kothari-education-commission-1964-66/76816/ (Accessed 1 June 2017).

A major step in the direction of creating a uniform regulator for education in India was enacted in 2017. See http://economictimes.indiatimes.com/industry/services/education/modi-government-to-replace-ugc-aicte-with-one-higher-education-regulator/articleshow/59008312.cms . This will lead to uniformity in standards across the country.

For an overview of needed education reforms in India, see Cheney et al. ( 2015 ).

For an analysis of needed reforms in the private sector’s provision of education, see Ghosh https://www.oecd.org/edu/ceri/Shobha%20Mishra%20Ghosh%20FICCI%20Presentation%20for%20OECD%20Seminar.pdf (Accessed 5 June 2017).

Some of this even occurs through deception. See, the effort to conceal facts about the disputed Babri-Masjid Ram-Janmabhoomi site in http://www.dailymail.co.uk/indiahome/indianews/article-3412538/The-Leftist-historians-distort-India-s-past-guilty-academic-dishonesty-hypocrisy.html (Accessed 5 June 2017).

Even the contributions of great congressmen, for example, Vallbhbhai Patel and Subhash Chandra Bose, who had differences with Nehru during the Freedom Struggle have been ignored. Not to speak of the contribution of those who adopted violence as a method to attain Independence for the country.

This spills over into a wide array of issues including, for example, respect for and the use of the ancient Indian language of Sanskrit, see Malhotra ( 2016 ).

A number of suggestions have been made in this regard . Hindi is already understood by almost 80% of the population and spoken by a large section society. Many Indian languages (including Hindi) have several words in common with Sanskrit and, hence, with each other. A useful linguistic exercise would be to use this commonality to develop a Sanskrit-based hybrid language.

Indians may constitute one-quarter of the world’s labour force by 2020.

As a result of some of the problems with the education sector in India, as much as 2.83% of the tertiary-educated population migrated in 1990. This rose to 4.33% in 2000 . (World Bank, World Development Indicators data).

See https://www.oecd.org/edu/ceri/Shobha%20Mishra%20Ghosh%20FICCI%20Presentation%20for%20OECD%20Seminar.pdf (Accessed 7 June 2017).

According to the Finance Ministry’s Indian Public Finance Statistics 2015–16 the tax/GDP ratio in India was 17.15%, consisting of 5.76% in direct taxes and 11.38% in indirect taxes. This tax/GDP ratio was about 4% of GDP lower than countries with per capita GDP (in Purchasing Power Parity (PPP) terms) similar to India’s.

For more on the inequality of health outcomes across regions, castes and gender see Sen ( 2014 ).

See Jha ( 2014 ) for an elaboration on this point.

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Arndt-Corden Department of Economics, Australian National University, Acton, Australia

Raghbendra Jha

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Jha, R. (2018). Education and Health Services in India: A Brief Overview. In: Facets of India's Economy and Her Society Volume II. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-349-95342-4_6

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• v.14(5); 2022 May

Medical Education and Research in India: A Teacher’s Perspective

Venkataramana kandi.

1 Clinical Microbiology, Prathima Institute of Medical Sciences, Karimnagar, IND

Medical education is a systematic process wherein interested and eligible individuals are trained to become physicians/surgeons. It is assumed that a person who completes the Bachelor of Science and Bachelor of Medicine (MBBS) degree will be competent enough to perform the duties of a physician of first contact. However, it is not the case with graduates from India. Most MBBS graduates prefer to pursue a postgraduate degree and become unavailable to people or governments. The doctor-to-patient ratio in India (1:1,655) does not currently satisfy the World Health Organization’s prescribed ratio (1:1,000). The Government of India, therefore, has been taking initiatives to increase the number of MBBS graduates. Moreover, there are several doubts over the quality of medical education and the competency of medical students. In addition, the National Medical Commission, the epic body that regulates the medical education and practice in India, has recently been conducting medical education technology workshops to improve teachers and has devised a new curriculum to elevate the standards of medical education in India. This editorial attempts to provide readers with the current status of medical education and research in India.

The Indian medical education system has recently seen a makeover in the form of a change in the curriculum. This change may have become inevitable due to growing concerns, both within the country and globally, over the low standards and quality of MBBS graduates. It has been widely accepted that medical students graduating from Indian institutions are not competent enough to practice. This is evident by the requirement for medical graduates from India to clear the United States Medical Licensing Examination (USMLE) to practice in the United States. Therefore, the National Medical Commission (NMC), previously known as the Medical Council of India (MCI), has come forward with a vision to revamp medical education in India. The main motto of this initiative by the NMC is to ensure that Indian medical graduates (IMG) are competent enough to function as community physicians of first contact [ 1 ]. This decision by the Government of India (GOI) was taken after considering the high disease burden among people, as well as the huge disparities in the status of medical institutions/establishments/facilities/services within different geographical regions of the country. Moreover, the NMC has made it mandatory for all medical teachers to undergo a training program on medical education technology (MET). The NMC regularly conducts basic and advanced workshops/courses for all medical teachers in the country. However, the NMC appears to have ignored the most significant aspect that could potentially contribute to the success of a teacher/learner in medical education. The attitudes of both the teachers and learners significantly influence the learning outcomes, thereby affecting the competency of medical graduates. Carefully designed faculty development programs may contribute to medical teachers’ professionalism, management, and leadership abilities that further enable students to become competent physicians [ 2 ].

The current scenario

Most medical teachers, especially those who participate in the teaching of students in their I MBBS and II MBBS may be considered accidental teachers. Although this is not usually considered a topic for discussion, it must be noted that the first two years of the MBBS course function as a foundation for students. During this period, students learn basic subjects, including anatomy, physiology, biochemistry, pathology, microbiology, and pharmacology. Basic and comprehensive knowledge of these subjects is considered extremely useful to understand the clinical subjects that the students pursue from the third year of the MBBS course. However, in practice, disinterested teachers are misguiding students to learn the subjects from an examination point of view rather than emphasizing the importance of the role played by pre and para-clinical subjects for the rest of their future in the medical profession (clinical relevance and integrated approach). The scenario may be the same with teachers who opt for less familiar clinical degrees after having compromised on their specialization of interest. Unfortunately, specializations gain familiarity based on the expected earnings they can get during the practice and not particularly about the interest/skills they have concerning the subject/specialization.

The NMC and GOI’s decision to improve the doctor-to-patient ratio has indirectly affected the teacher-to-student ratio. With increased numbers of medical institutions being permitted and more in the pipeline, there is a continuous movement of faculty resulting in transient deficiencies of faculty that directly affects the quality of curriculum delivery despite the improvement/change in the curriculum, as envisaged by the NMC recently. Further, the NMC and the GOI must consider the numbers of MBBS and MD (Doctor of Medicine) graduates who move out of the country for livelihood and other reasons. Interestingly, not many medical graduates were available who volunteered during the initial days of the coronavirus disease 2019 (COVID-19) pandemic. Therefore, public and private healthcare facilities were forced to work with medical students (house surgeons/interns/final MBBS students) and fresh MBBS graduates. The main reason is that MD graduates belonging to the pre and para-clinical subjects, sparing a few, lose their connectivity to medicine and lack the confidence to examine patients. This aspect needs serious consideration by the GOI, NMC, local governments, as well as the doctors themselves, who should make efforts to provide their services by running evening community clinics.

Admission for entry into the MBBS course is currently carried out based on reservations following the caste system that is prevalent in India. A significant percentage of seats are filled based on the student’s capability to pay fees, and some are accommodated to the non-resident Indian (NRI) category. Similarly, the admission of students is based on a competitive multiple-choice-based examination that does not evaluate students’ interests and attitudes and merely evaluates their theoretical knowledge. These are the main reasons for the deteriorating quality of medical graduates in India. Conversely, the deterioration in quality comes from the fact that the concepts that were described in the medical education workshops are not pursued by the majority of faculty members across medical colleges in India. Compared to the olden days, currently, teachers are not spending enough time with students and patients, especially in the clinical departments.

Medical teachers

Teachers appointed in medical institutes are required to have an MD degree in the respective subjects. However, the NMC has allowed the appointment of non-medical teachers (teachers without an MBBS degree) for up to 30% (50% in biochemistry) in both pre and para-clinical subjects excluding the department of pathology [ 3 ]. This was mainly due to the lack of qualified MD teachers available for the job. Recently, the change in the medical education curriculum with more emphasis on competency and competency-based medical education (CBME) has forced the NMC to reconsider the appointment of non-medical teachers. Therefore, NMC has decided to reduce the number of non-medical teachers in the anatomy, physiology, and biochemistry departments, and stop the recruitment of such teachers to the microbiology and pharmacology departments. The decision of the NMC regarding non-medical teachers was long pending with complaints about such teachers emerging over the years both from students as well as teachers with MD degrees. The major reason for the NMC’s decision to minimize and remove non-medical teachers is because the GOI and the NMC have already given a green signal/approval for admission into several MD courses in these departments. On the contrary, many MBBS graduates who fail to pursue a clinical MD/MS degree have been opting for non-clinical (pre and para-clinical) MD subject specialization courses. However, this decision by the NMC had some drawbacks. The major one is the lack of interest among MBBS graduates admitted in the concerned subject of specialization. After joining the courses, these students face difficulties in completing the course at the designated time. Moreover, the mandatory dissertation required for them to complete the course is not done with the required/desired technical and ethical standards.

In contrast to a Ph.D. degree, wherein the pursuant does research work for at least three years to become eligible for the award of the degree, MD graduates work as part-time teachers (tutor/junior resident/senior resident) and are able to complete the course within three years. All universities in India come under the aegis of the Union Grants Commission (UGC). However, medical institutions and medical universities function under the umbrella of the NMC. The UGC mandates that Ph.D. students publish at least two original research articles in reputed journals and present at least one abstract in a national/international conference to become eligible to be awarded the degree. This is in complete contrast to the MD degree, wherein the students only undertake research work for a maximum period of one year, and it is not mandatory to publish/present papers in journals/conferences. Moreover, the period during the MD study is considered a teaching experience in the position of resident/tutor/demonstrator. Therefore, MD degree holders become eligible for appointments as assistant professors after the study period. This points to the fact that an MD degree must not necessarily be considered a research degree. The UGC has a mechanism wherein the Ph.D. thesis and postgraduate dissertations submitted by the students are deposited in a repository (Shodhganga) and are carefully screened for plagiarism before they are approved/accepted. The Information and Library Network Centre (INFLIBNET) is an autonomous interuniversity center of the UGC [ 4 ]. However, even today, this practice is not followed by medical universities. Therefore, MD dissertations are generally not as standard as Ph.D. theses. Medical Universities, in the future, should consider screening all MD dissertation submissions for potential plagiarism and make the dissertations available in the public domain (similar repository as the INFLIBNET). Several institutions do not support the financial aspects of the MD dissertation, and this limitation could be the reason why the students are unable to pursue real research and finally end up writing dissertations without even working on the topic. This situation can be improved by active vigilance by the NMC and at the institutional level regarding the MD dissertations and their standards. Given the above observations, the matter of equivalence of an MD degree with a Ph.D. degree appears to be questionable. However, medical universities in India and autonomous research institutes funded by the GOI are accepting/recognizing MD degree holders as Ph.D. guides. Such practices should be re-evaluated by higher education bodies/councils because it affects the standards of Ph.D. holders and their future in research activities.

Medical research

Medical teachers who were not properly trained in research end up being not interested in pursuing research after obtaining their degrees. This probably was the main reason why the NMC was particular about the research publications requirement for promotions. However, medical teachers find it difficult to do even these mandatory research publications. This is majorly attributed to the lack of financial and logistic support from the public and private administrations. The lack of proper research orientation among medical teachers appears to have significantly impacted the research inclination of students. Moreover, medical institutions have not been supportive of the research activities of both the faculty and students. The GOI, under the Indian Council for Medical Research, has been implementing limited numbers of short-term studentship (STS) research fellowships (two-month duration) for medical students [ 5 ]. Despite this initiative, many more interested students will remain unbenefited. This issue may be addressed by the institution by devising a mechanism wherein research-oriented faculty may be roped into a group (research wing) that mainly functions to facilitate interested students to pursue research work under able faculty members. Because research work involves financial implications, medical institutions must create a fund (crowdfunding, donations, corpus, others) that potentially serves this purpose.

The criteria for promotion that requires a medical teacher to have published at least two papers in an indexed journal also appear to be responsible for the deterioration of research standards among medical teachers and institutions. This decision by the NMC was instrumental in the emergence of several predatory journals that claim to have been indexed by the agencies recognized/prescribed by the NMC. However, the NMC realized and changed its decision and excluded the Index Copernicus as the desired indexing agency that was responsible for the emergence of pay-to-publish journals. Interestingly, the NMC recently added the Indian Citation Index to the list of desired indexing agencies along with others that are already present, including PubMed, Scopus, DOAJ, and EMBASE, among others. Given unethical research and publication practices, the NMC may choose to accept literature reviews as an acceptable type of article in consideration for promotions. This will enable faculty members to pursue research and get increasingly acquainted with current trends with extremely limited resources and encourage within-country and foreign collaborations.

Other concerns

Despite several positive changes by the NMC, medical institutions are further plagued by the problems of ghost faculty, ghostwriters, and other malpractices related to examinations, research, dissertation work, and publications. The factors that potentially affect medical education and research in a medical institution are depicted in Figure ​ Figure1 1 .

Ghostwriter

Ghostwriters are anonymous persons who write manuscripts (that in this case are represented by research publications) for teachers who require them for promotions. A ghostwritten research article is used by a teacher to his/her credit by implanting his/her name on it and without mentioning the person who has written it. Moreover, ghostwritten articles are not necessarily written based on authentic data collected after conducting bench work. These amount to malicious practices under the recommendations by the Committee of Publication Ethics (COPE). Ghostwriters have been in full function helping several medical teachers to acquire research publications required for promotions. The problem with ghostwriting is that authors claim a work neither by doing nor by writing. Such literature that is written without actually working and available as published content in the public domain will adversely influence the scientific community and public health.

Ghost faculty

It has been a frequent occurrence in the past decade, wherein medical teachers representing more than one medical college appear before the NMC during inspections. However, NMC did identify this problem and punished several such medical faculties. There was also a problem of duplicate faculty wherein the certificates of a medical person were used to wrongly represent the faculty. Despite strict vigilance by the NMC, the newest trend is the ghost faculty. Medical colleges call upon qualified medical graduates during the inspection and show them as resident faculty members to the NMC. It is an open secret that is followed ubiquitously by several institutions throughout India. Interestingly, the faculty list shown by the institutes could range between 15 and 20 in each department during the inspection days. However, once the NMC inspection is completed, the actual faculty that works on the ground is considerably low in numbers (hardly 10). This significantly affects the faculty-to-student ratio. Assuming a college has 200 students, and the college shows 15 staff during the inspection, the actual number of teachers working on the ground will be less than 10. This results in overcrowding during practical demonstrations, and, for this reason, many students do not follow/understand the practical aspects. Moreover, with a smaller number of faculty members, teachers do not function in the manner that allows them to train each student adequately. Several practicing doctors and academically uninterested graduates are approached by the institutions. Due to the financial favors offered by institutions, medical graduates agree to be on the rolls of the college.

The ghost faculty who regularly present themselves to the NMC during the inspection do not even take a single theory/practical class. However, institutes promote them regularly based on the number of years of experience, despite the fact that the person has never attended the college in person, nor has he/she taken a single class. The ghost faculty issue emerges because there is a frequent increase in the number of medical colleges.

Admission requirements for entry into the MBBS course also require serious considerations. More than half of the admissions currently are carried out based on reservations based on the caste system that is prevalent in India. Although the remaining seats are considered open, a significant percentage are filled based on the student’s capability to pay fees, and some are accommodated as NRIs. This implies that the merit of students is grossly ignored, and admissions, therefore, in the current situation do not guarantee the entry of qualified students who are willing and motivated to pursue the course.

Currently, India has the highest number (>600) of medical colleges in country-wise statistics. However, the medical education quality and standards of medical graduates have been under the scrutiny of the GOI and the NMC. A mere change in the curriculum and faculty training does not necessarily guarantee standards. Increased vigilance, uniform salaries, peer evaluation of research publications used for promotions, support and encouragement for faculty pursuing research, continuing medical education in the form of workshops/seminars/symposiums/conferences, and extensive student feedback are mandatory to further strengthen the quality of medical education and improve the standards of medical graduates in India. Recently, the UGC has decided to appoint non-Ph.D. teachers in universities for utilizing their vast experience and expertise. It is, therefore, imperative that subject expertise matters much more than the degree a person holds.

Teachers are role models for students, and to nurture future generations in the right direction, it is more than essential to improve the attitudes and quality of teachers. Further, it is the institutes that teach the society and the country as a whole regarding how systematically one should function to achieve desirable results. Therefore, institutes must take responsibility for establishing the best educational environment.

In conclusion, it should be noted that addressing the deteriorating standards and quality of medical education requires a multifaceted approach. The implementation of the new curriculum for undergraduates and medical education technology workshops for faculty members does not guarantee an improvement in the quality. Dedication from admitted students, faculty, and institution administration is equally important.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.