Hello Friends.
This is one more good article regarding the fraud which was happening in MCI.
This has appeared recently in THE WEEK magazine. I hope you will like it.
In bad shape: The gynaecology ward at the hospital of Santosh Medical College in Ghaziabad / Photo: Arvind Jain
The inside story of how some private medical and dental colleges thrive on ill-gotten permits. Here the faculty is dubious, facilities almost nil, and beggars pose as patients
By Gunjan Sharma
The pathologist goofs up your blood test; the dentist drills the wrong tooth; the physician diagnoses your seasonal cough as tuberculosis! What could make you burst into peals of laughter as scenes from Rowan Atkinson’s Mr Bean would undoubtedly be unwelcome in real life. Yet it could happen to you and me at the hands of a neighbourhood pathologist, dentist or physician if the specialist is a product of one of those dubious private medical or dental colleges operating on ill-gotten permits.
Every year about 20,000 doctors and an equal number of dentists pass out from over 400 private medical and dental colleges across the country. The only criterion for admission to most of these institutes is the student’s paying capacity. An MBBS seat is on sale for Rs 30 lakh to Rs 50 lakh; an MD (doctorate of medicine) or MS (master of surgery)
for Rs 70 lakh to Rs 2 crore. The seats for bachelor of dental surgery and master of dental surgery courses in private dental colleges are priced between Rs 15 lakh and Rs 50 lakh. Though most of these colleges lack even the basic infrastructure to qualify as a medical or dental college, they have been doling out degrees, thanks to the corruption in the now dissolved Medical Council of India and other regulatory bodies.
Santosh Medical College in Ghaziabad is one such institution. THE WEEK found that its 750-bed hospital was a shambles. The gynaecology wards with dingy and dimly-lit corridors were deserted. The window glasses were broken, there were cobwebs in toilets, and the mattresses were tattered.
In the pathology lab, the autoclave, a device used for sterilising medical instruments, seemed to be out of use. Shards of broken test tubes lay scattered on the slab. Some wards had a handful of patients.
Posing as a patient, I asked some students if I could get a blood test done at the college’s path lab. They dissuaded me. “You cannot trust the results here, better get it done somewhere else,” said a student. The college produces 100 medicine graduates and an equal number of dental graduates, and hands out 67 postgraduate degrees and diplomas in 17 medical and dental specialities every year. “Teachers take no initiative as far as academics are concerned,” complained a student. When contacted for views, vice-chancellor D.K. Arora said he was not authorised to comment and would call later.
At Maharishi Markandeshwar University (MMU), Mullana, Haryana, most of the rooms in its ‘750-bed’ hospital had proper labels—ICU, ICCU, PICU, cardiopulmonary lab. But conspicuous by their absence were the patients! Most wards, covered with silk curtains and locked from the outside, were empty.
The outpatient department of the university’s MM College of Dental Sciences & Research was vacant, too. A conversation with the students was revealing. “We draft the people in the nearby villages as patients,” said a BDS student. “It is mandatory for us to see a certain number of patients in our third and fourth years.”
Not that the regulatory bodies have been unaware of the rot in these colleges. According to the minutes of the January 4, 2010, meeting of Dental Council of India’s executive committee, students at the National Dental College and Hospital, Dera Bassi, Punjab, were treating patients without rubber dams (thin rubber films used to isolate the tooth under treatment) and power suction (used to suck out blood and saliva during a procedure). They weren’t trained in processing and sterilising instruments. All this when the college runs an MDS programme (nine seats in different specialities).
Despite the lack of faculty and clinical infrastructure, the MCI and DCI have allowed many medical and dental colleges to increase the number of seats. The minutes of the MCI executive committee meeting dated April 24, 2006, indicate that the claims of MM Institute of Medical Sciences & Research about 13 of its faculty members were not acceptable to the inspectors. Some were found to be working at other places, some did not have adequate experience, and some others didn’t even have an MBBS degree!
The irregularities at Santosh Medical College and Padmashree Dr D.Y. Patil College, Pune, had figured in a writ petition filed in 2001 in Delhi High Court challenging the appointment of Dr Ketan Desai as MCI president, and seeking directions for the Centre to reconstitute the council. The petitioner, Dr Harish Bhalla, pointed out that Santosh Medical College had been denied permission to operate and its MBBS degree derecognised in October 2000, for want of adequate clinical material, infrastructure and teaching staff. The MCI’s inspectors commented that its patients, teachers and instruments were fake. The college was found deficient again in January 2001. Everything, however, turned out to be in order in April, and permission for admission of a new batch of students was granted along with recognition to its MBBS degree. The petition also mentioned that Pune’s Dr D.Y. Patil College had 3 per cent bed occupancy in June 2000 when it got permission to admit another batch of students. Rules stipulate 80 per cent occupancy to admit a new batch.
There has been a pattern to refusing and then granting permission. The inspectors first find fault with the institution; a few months later an all-clear report is given after another inspection. “Inspection reports of these colleges were being manipulated by MCI officials,” said an MCI official. “The first inspection report ‘truthfully’ shows the reality of the college; the inadequacies are reported and rectified as soon as money changes hands.”
Dr Usha Mohandas, former dean of V.S. Dental College in Bangalore, who has inspected dental colleges for the DCI, said that her reports had been misused to extract money from colleges. “Within weeks after I send my reports, another inspector would go and report that the inadequacies I had mentioned had been rectified,” she said.
Often inspections are a farce. At a private medical college in south India, an inspection starts with a visit to the Tirupati temple. The college management then offers the inspector prasad, which may turn out to be a laptop, wads of currency notes, gold or precious stones. Some offer free holiday trips for the inspectors and their families.
On the day of inspection, it is not uncommon to see beggars and rickshaw pullers posing as patients, and students and cafeteria waiters playing doctors. In 2005, the Andhra Pradesh Junior Doctors Association carried out a sting operation in some private colleges in the state. The footage shows how Kamineni Institute of Medical Sciences and Bhaskar Medical College brought bus-loads of labourers to pose as patients. Undergraduate students and some outsiders played doctors, nurses and paramedical staff at the time of inspection. “It was a sample study,” said Dr B.Y. Praveen Kumar, former president of JUDA. “There are around 30 private medical and dental colleges in Andhra and all of them severely lack faculty and patients. These colleges manage recognition and annual renewal by bribing regulatory bodies. In fact, many government colleges were denied recognition to promote these colleges. The century-old, well-recognised Osmania University’s MD (medicine) degree was derecognised, while five-year-old Kamineni was granted 10 MD medicine seats.”
Some institutes also forge certificates of doctors without their knowledge to create faculty. THE WEEK is in possession of letters by some doctors whose certificates have been forged by private medical colleges to present them as faculty. Dr Suresh Appasamy’s degree—he did his MBBS from Dr MGR Medical University, Chennai—was fabricated by a private medical institute. “It was shocking when I received a letter from the MCI wanting explanation for the forged degree some person produced before an MCI inspector in Mahavir Institute of Medical Sciences in Vikarabad. I tried to contact the institute on the phone numbers given on some documents sent by the MCI, but nobody picked up the phone,” said Appasamy over phone from the US, where he has been working for the past four years.
Dr Xavier Rajesh Packianathan alleged that a college claimed he was on its faculty while he was working as a radiologist in the US. The college had produced forged certificates in his name, with someone else’s photograph on them. In yet another case, a person was paraded as Dr M. Nagaraja Rao at Santhiram Medical College, Nandyal, Andhra Pradesh during an MCI inspection in June 2008. A Central Vigilance Commission inquiry revealed that the real Dr M. Nagaraja Rao had died in 2006.
Dr Quamruzzaman, a doctor from West Champaran, Bihar, wrote to the MCI that all his original documents, including his medical degree, were forcefully taken by the police, who demanded Rs 10,000 to return the documents. When he approached MCI officials, including Desai, he was asked to pay Rs 150,000 for a fresh registration document. (THE WEEK has copies of the letters sent by all the above mentioned doctors to the MCI.)
There is no dearth of fake faculty who lend their names to these colleges for a ‘fee’, and appear only for inspections. Clever inspectors can catch them. “These faculty members won’t even know where the toilet is,” said Usha Mohandas. “Once at a dental college, I met a person claiming to be principal at 9 a.m. and another person claiming to be principal at 9.30 a.m.”
V.S. Dental College appointed two professors who lived just 20 minutes from the college. Every time there was an inspection they would come running. They joined the faculty on the understanding that they would visit the institution just three mornings a week. “Many teachers including me raised it before the management, and the DCI, but with no result! The result was that I got thrown out of the dean’s chair on false allegations,” said Mohandas. “Most private colleges have maximum 20 per cent staff presence on an average day.”
Some colleges even manipulate examinations. Flouting rules, Dr D.Y. Patil College, Navi Mumbai, scheduled practicals for MDS examination twice—first on June 11 and 12, and then on June 15 and 16—last year. One candidate who appeared in the examination had not figured in the original list of candidates sent to the examiner. (Copies of the original list of candidates, the exminer's letter and the letter mentioning the dates of the examination are with THE WEEK.)
“I found many irregularities in the examination system when I visited the college,” said Mohandas. “This year 10 students have taken exams in conservative dentistry, while the college has recognition for five seats only.” College principal Vivek P. Soni’s cell phone was switched off and the response to dialling director, postgraduate studies, S.S. Rankhambe’s cell number was a blank. The landline numbers of the college given on the web site were not functional.
Most of the 160 private medical colleges have flourished with the blessings of Desai, who is now in judicial custody for allegedly taking a bribe of Rs 2 crore from Gian Sagar Medical College, Patiala, for renewal of recognition. Desai had been first arrested by the CBI in 2001 on corruption charges, but he was given a clean chit.
Though he was not in office till 2009, he seemed to be in control. Sources in the MCI alleged that then secretary Dr A.R.N. Setalvad and acting president Dr P.C. Kesavankutty Nair were in cahoots with Desai. Most of the executive committee members and inspectors toed Desai’s line. “Desai gave the impression of being close to powerful politicians across party lines and even CBI officials,” said Dr B.C. Chaparwal, vice-president of MCI from 1995 to 2001 and member till 2006.
Initially the Union ministry of health and family welfare refused to take action against the MCI after Desai’s arrest. On May 4, Health Minister Ghulam Nabi Azad said in the Rajya Sabha that there was no provision in the Indian Medical Council Act to take action against the president and its functionaries. In a letter to the Prime Minister, Chaparwal, criticised the minister’s statement: “The Central government has all the powers to take action provided in the Indian Medical Council Act under section 3, 31 and 32.”
Sushma Swaraj as Union health minister was in the process of drafting a bill to amend the Indian Medical Council Act when the general election was announced and the BJP lost power. “We need people with strong vision, integrity, and an understanding of the medical system,” said Dr Harsh Vardhan, former health minister of Delhi. “Thankfully, this government finally dissolved the MCI. But still a lot has to be cleaned up. Desai has obliged almost every person in the Indian Medical Council as well as Indian Medical Association. The two bodies have strong political connections.”
The MCI has been replaced by a six-member panel of eminent doctors, but the Dental Council of India and other regulatory bodies remain intact even though a health ministry task force last year suggested these be scrapped, since, according to the task force report, “many of these councils, besides being far too unwieldy, have attracted criticism for their functioning from health workers, administrators and the media. They have also drawn judicial censure”.
In its initial years medical education in India was considered one of the best. “Such high were the standards that for 20 years Britain’s National Health Service was dependent on Indian doctors. But the level of medical education deteriorated with time,” said Dr Ranjit Roy Choudhary, former director, National Institute of Immunology, who is on the new panel. In his article in Beyond Degrees, a compilation of articles by eminent people, Choudhary states the MCI’s lack of transparency as a reason for deterioration.
Many medicine men blame Desai for the sinking system. “Forget about the specialised care, doctors at tertiary care institutes associated with medical colleges are not even able to deal with the routine care of patients,” said Dr Amod Gupta, head of ophthalmology at the Postgraduate Institute of Medical Education & Research, Chandigarh. “How are they going to train the students and what are these students going to do in their life? We need good teachers at every medical institute. A student passing out of PGI Chandigarh or any other reputable institute needs 10-12 years of specialised practice to become a good teacher.”
Clearly, not a case of quick remedies.
This is one more good article regarding the fraud which was happening in MCI.
This has appeared recently in THE WEEK magazine. I hope you will like it.
In bad shape: The gynaecology ward at the hospital of Santosh Medical College in Ghaziabad / Photo: Arvind Jain
The inside story of how some private medical and dental colleges thrive on ill-gotten permits. Here the faculty is dubious, facilities almost nil, and beggars pose as patients
By Gunjan Sharma
The pathologist goofs up your blood test; the dentist drills the wrong tooth; the physician diagnoses your seasonal cough as tuberculosis! What could make you burst into peals of laughter as scenes from Rowan Atkinson’s Mr Bean would undoubtedly be unwelcome in real life. Yet it could happen to you and me at the hands of a neighbourhood pathologist, dentist or physician if the specialist is a product of one of those dubious private medical or dental colleges operating on ill-gotten permits.Every year about 20,000 doctors and an equal number of dentists pass out from over 400 private medical and dental colleges across the country. The only criterion for admission to most of these institutes is the student’s paying capacity. An MBBS seat is on sale for Rs 30 lakh to Rs 50 lakh; an MD (doctorate of medicine) or MS (master of surgery)
for Rs 70 lakh to Rs 2 crore. The seats for bachelor of dental surgery and master of dental surgery courses in private dental colleges are priced between Rs 15 lakh and Rs 50 lakh. Though most of these colleges lack even the basic infrastructure to qualify as a medical or dental college, they have been doling out degrees, thanks to the corruption in the now dissolved Medical Council of India and other regulatory bodies.
Santosh Medical College in Ghaziabad is one such institution. THE WEEK found that its 750-bed hospital was a shambles. The gynaecology wards with dingy and dimly-lit corridors were deserted. The window glasses were broken, there were cobwebs in toilets, and the mattresses were tattered.
In the pathology lab, the autoclave, a device used for sterilising medical instruments, seemed to be out of use. Shards of broken test tubes lay scattered on the slab. Some wards had a handful of patients.
Posing as a patient, I asked some students if I could get a blood test done at the college’s path lab. They dissuaded me. “You cannot trust the results here, better get it done somewhere else,” said a student. The college produces 100 medicine graduates and an equal number of dental graduates, and hands out 67 postgraduate degrees and diplomas in 17 medical and dental specialities every year. “Teachers take no initiative as far as academics are concerned,” complained a student. When contacted for views, vice-chancellor D.K. Arora said he was not authorised to comment and would call later.
At Maharishi Markandeshwar University (MMU), Mullana, Haryana, most of the rooms in its ‘750-bed’ hospital had proper labels—ICU, ICCU, PICU, cardiopulmonary lab. But conspicuous by their absence were the patients! Most wards, covered with silk curtains and locked from the outside, were empty.
The outpatient department of the university’s MM College of Dental Sciences & Research was vacant, too. A conversation with the students was revealing. “We draft the people in the nearby villages as patients,” said a BDS student. “It is mandatory for us to see a certain number of patients in our third and fourth years.”
Not that the regulatory bodies have been unaware of the rot in these colleges. According to the minutes of the January 4, 2010, meeting of Dental Council of India’s executive committee, students at the National Dental College and Hospital, Dera Bassi, Punjab, were treating patients without rubber dams (thin rubber films used to isolate the tooth under treatment) and power suction (used to suck out blood and saliva during a procedure). They weren’t trained in processing and sterilising instruments. All this when the college runs an MDS programme (nine seats in different specialities).
Despite the lack of faculty and clinical infrastructure, the MCI and DCI have allowed many medical and dental colleges to increase the number of seats. The minutes of the MCI executive committee meeting dated April 24, 2006, indicate that the claims of MM Institute of Medical Sciences & Research about 13 of its faculty members were not acceptable to the inspectors. Some were found to be working at other places, some did not have adequate experience, and some others didn’t even have an MBBS degree!
The irregularities at Santosh Medical College and Padmashree Dr D.Y. Patil College, Pune, had figured in a writ petition filed in 2001 in Delhi High Court challenging the appointment of Dr Ketan Desai as MCI president, and seeking directions for the Centre to reconstitute the council. The petitioner, Dr Harish Bhalla, pointed out that Santosh Medical College had been denied permission to operate and its MBBS degree derecognised in October 2000, for want of adequate clinical material, infrastructure and teaching staff. The MCI’s inspectors commented that its patients, teachers and instruments were fake. The college was found deficient again in January 2001. Everything, however, turned out to be in order in April, and permission for admission of a new batch of students was granted along with recognition to its MBBS degree. The petition also mentioned that Pune’s Dr D.Y. Patil College had 3 per cent bed occupancy in June 2000 when it got permission to admit another batch of students. Rules stipulate 80 per cent occupancy to admit a new batch.
There has been a pattern to refusing and then granting permission. The inspectors first find fault with the institution; a few months later an all-clear report is given after another inspection. “Inspection reports of these colleges were being manipulated by MCI officials,” said an MCI official. “The first inspection report ‘truthfully’ shows the reality of the college; the inadequacies are reported and rectified as soon as money changes hands.”
Dr Usha Mohandas, former dean of V.S. Dental College in Bangalore, who has inspected dental colleges for the DCI, said that her reports had been misused to extract money from colleges. “Within weeks after I send my reports, another inspector would go and report that the inadequacies I had mentioned had been rectified,” she said.
Often inspections are a farce. At a private medical college in south India, an inspection starts with a visit to the Tirupati temple. The college management then offers the inspector prasad, which may turn out to be a laptop, wads of currency notes, gold or precious stones. Some offer free holiday trips for the inspectors and their families.
On the day of inspection, it is not uncommon to see beggars and rickshaw pullers posing as patients, and students and cafeteria waiters playing doctors. In 2005, the Andhra Pradesh Junior Doctors Association carried out a sting operation in some private colleges in the state. The footage shows how Kamineni Institute of Medical Sciences and Bhaskar Medical College brought bus-loads of labourers to pose as patients. Undergraduate students and some outsiders played doctors, nurses and paramedical staff at the time of inspection. “It was a sample study,” said Dr B.Y. Praveen Kumar, former president of JUDA. “There are around 30 private medical and dental colleges in Andhra and all of them severely lack faculty and patients. These colleges manage recognition and annual renewal by bribing regulatory bodies. In fact, many government colleges were denied recognition to promote these colleges. The century-old, well-recognised Osmania University’s MD (medicine) degree was derecognised, while five-year-old Kamineni was granted 10 MD medicine seats.”
Some institutes also forge certificates of doctors without their knowledge to create faculty. THE WEEK is in possession of letters by some doctors whose certificates have been forged by private medical colleges to present them as faculty. Dr Suresh Appasamy’s degree—he did his MBBS from Dr MGR Medical University, Chennai—was fabricated by a private medical institute. “It was shocking when I received a letter from the MCI wanting explanation for the forged degree some person produced before an MCI inspector in Mahavir Institute of Medical Sciences in Vikarabad. I tried to contact the institute on the phone numbers given on some documents sent by the MCI, but nobody picked up the phone,” said Appasamy over phone from the US, where he has been working for the past four years.
Dr Xavier Rajesh Packianathan alleged that a college claimed he was on its faculty while he was working as a radiologist in the US. The college had produced forged certificates in his name, with someone else’s photograph on them. In yet another case, a person was paraded as Dr M. Nagaraja Rao at Santhiram Medical College, Nandyal, Andhra Pradesh during an MCI inspection in June 2008. A Central Vigilance Commission inquiry revealed that the real Dr M. Nagaraja Rao had died in 2006.
Dr Quamruzzaman, a doctor from West Champaran, Bihar, wrote to the MCI that all his original documents, including his medical degree, were forcefully taken by the police, who demanded Rs 10,000 to return the documents. When he approached MCI officials, including Desai, he was asked to pay Rs 150,000 for a fresh registration document. (THE WEEK has copies of the letters sent by all the above mentioned doctors to the MCI.)
There is no dearth of fake faculty who lend their names to these colleges for a ‘fee’, and appear only for inspections. Clever inspectors can catch them. “These faculty members won’t even know where the toilet is,” said Usha Mohandas. “Once at a dental college, I met a person claiming to be principal at 9 a.m. and another person claiming to be principal at 9.30 a.m.”
V.S. Dental College appointed two professors who lived just 20 minutes from the college. Every time there was an inspection they would come running. They joined the faculty on the understanding that they would visit the institution just three mornings a week. “Many teachers including me raised it before the management, and the DCI, but with no result! The result was that I got thrown out of the dean’s chair on false allegations,” said Mohandas. “Most private colleges have maximum 20 per cent staff presence on an average day.”
Some colleges even manipulate examinations. Flouting rules, Dr D.Y. Patil College, Navi Mumbai, scheduled practicals for MDS examination twice—first on June 11 and 12, and then on June 15 and 16—last year. One candidate who appeared in the examination had not figured in the original list of candidates sent to the examiner. (Copies of the original list of candidates, the exminer's letter and the letter mentioning the dates of the examination are with THE WEEK.)
“I found many irregularities in the examination system when I visited the college,” said Mohandas. “This year 10 students have taken exams in conservative dentistry, while the college has recognition for five seats only.” College principal Vivek P. Soni’s cell phone was switched off and the response to dialling director, postgraduate studies, S.S. Rankhambe’s cell number was a blank. The landline numbers of the college given on the web site were not functional.
Most of the 160 private medical colleges have flourished with the blessings of Desai, who is now in judicial custody for allegedly taking a bribe of Rs 2 crore from Gian Sagar Medical College, Patiala, for renewal of recognition. Desai had been first arrested by the CBI in 2001 on corruption charges, but he was given a clean chit.
Though he was not in office till 2009, he seemed to be in control. Sources in the MCI alleged that then secretary Dr A.R.N. Setalvad and acting president Dr P.C. Kesavankutty Nair were in cahoots with Desai. Most of the executive committee members and inspectors toed Desai’s line. “Desai gave the impression of being close to powerful politicians across party lines and even CBI officials,” said Dr B.C. Chaparwal, vice-president of MCI from 1995 to 2001 and member till 2006.
Initially the Union ministry of health and family welfare refused to take action against the MCI after Desai’s arrest. On May 4, Health Minister Ghulam Nabi Azad said in the Rajya Sabha that there was no provision in the Indian Medical Council Act to take action against the president and its functionaries. In a letter to the Prime Minister, Chaparwal, criticised the minister’s statement: “The Central government has all the powers to take action provided in the Indian Medical Council Act under section 3, 31 and 32.”
Sushma Swaraj as Union health minister was in the process of drafting a bill to amend the Indian Medical Council Act when the general election was announced and the BJP lost power. “We need people with strong vision, integrity, and an understanding of the medical system,” said Dr Harsh Vardhan, former health minister of Delhi. “Thankfully, this government finally dissolved the MCI. But still a lot has to be cleaned up. Desai has obliged almost every person in the Indian Medical Council as well as Indian Medical Association. The two bodies have strong political connections.”
The MCI has been replaced by a six-member panel of eminent doctors, but the Dental Council of India and other regulatory bodies remain intact even though a health ministry task force last year suggested these be scrapped, since, according to the task force report, “many of these councils, besides being far too unwieldy, have attracted criticism for their functioning from health workers, administrators and the media. They have also drawn judicial censure”.
In its initial years medical education in India was considered one of the best. “Such high were the standards that for 20 years Britain’s National Health Service was dependent on Indian doctors. But the level of medical education deteriorated with time,” said Dr Ranjit Roy Choudhary, former director, National Institute of Immunology, who is on the new panel. In his article in Beyond Degrees, a compilation of articles by eminent people, Choudhary states the MCI’s lack of transparency as a reason for deterioration.
Many medicine men blame Desai for the sinking system. “Forget about the specialised care, doctors at tertiary care institutes associated with medical colleges are not even able to deal with the routine care of patients,” said Dr Amod Gupta, head of ophthalmology at the Postgraduate Institute of Medical Education & Research, Chandigarh. “How are they going to train the students and what are these students going to do in their life? We need good teachers at every medical institute. A student passing out of PGI Chandigarh or any other reputable institute needs 10-12 years of specialised practice to become a good teacher.”
Clearly, not a case of quick remedies.
Wrong to go for "uniform standards". Aim:" world class standards". National & State level bodies like MCI need 12 members, only 4 doctors.Rest: a nurse, a prof, a politician, a private equity fund manager, a banker, a med college Dean, two foreign observers, a bureaucrat etc. All should have equal status on the committee. A 5 man audit committee with 3 financial experts.Must have measurable numerical targets.
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