P.G. Medical Education Regulations, 2000
MEDICAL COUNCIL OF INDIA SALIENT FEATURES OF
POSTGRADUATE MEDICAL EDUCATION REGULATIONS, 2000
(Amendments incorporated in pdf)
- Short title and commencement:-
- These regulations may be called “The Postgraduate Medical Education Regulations 2000.
- They shall come into force on the date of their publication in the Official Gazette.
- GENERAL CONDITIONS TO BE OBSERVED BY POSTGRADUATE TEACHING INSTITUTIONS:
- Postgraduate Medical Education in broad specialities shall be of three years duration in the case of degree course and two years in the case of Diploma course after MBBS and in the case of super specialities the duration shall be of three years after MD/MS with the exceptions wherever indicated.
- Postgraduate curriculum shall be competency based.
- Learning in postgraduate programme shall be essentially autonomous and self directed.
- A combination of both formative and summative assessment is vital for the successful completion of the PG programme.
- A modular approach to the course curriculum is essential for achieving a systematic exposure to the various sub-specialities concerned with a discipline.
- The training of PG students shall involve learning experience ‘derived from’ or ‘targeted to’ the needs of the community. It shall, therefore, be necessary to expose the students to community based activities.
- GOALS AND GENERAL OBJECTIVES OF POSTGRADUATE MEDICAL EDUCATION PROGRAMME TO BE OBSERVED BY
POSTGRADUATE TEACHING INSTITUTION.
The goal of postgraduate medical education shall be to produce competent specialists and/or Medical teachers.
- who shall recognize the health needs of the community, and carry out professional obligations ethically and in keeping with the objectives of the national health policy
- who shall have mastered most of the competencies, pertaining to the speciality, that are required to be practiced at the secondary and the tertiary levels of the health care delivery system;
- who shall be aware of the contemporary advance and developments in the discipline concerned;
- who shall have acquired a spirit of scientific inquiry and is oriented to the principles of research methodology and epidemiology; and
- who shall have acquired the basic skills in teaching of the medical and paramedical professionals;
3.2 GENERAL OBJECTIVES OF POST-GRADUATE TRAINING EXPECTED FROM STUDENTS AT THE END OF POST-GRADUATE TRAINING
At the end of the postgraduate training in the discipline concerned the student shall be able to;
- Recognize the importance to the concerned speciality in the context of the health needs of the community and the national priorities in the health section.
- Practice the speciality concerned ethically and in step with the principles of primary health care.
- Demonstrate sufficient understanding of the basic sciences relevant to the concerned speciality.
- Identify social, economic, environmental, biological and emotional determinants of health in a given case, and take them into account while planning therapeutic, rehabilitative, preventive and primitive measure/strategies.
- Diagnose and manage majority of the conditions in the speciality concerned on the basis of clinical assessment, and appropriately selected and conducted investigations.
- Plan and advise measures for the prevention and rehabilitation of patients suffering from disease and disability related to the speciality.
- Demonstrate skills in documentation of individual case details as well as morbidity and mortality rate relevant to the assigned situation.
- Demonstrate empathy and humane approach towards patients and their families and exhibit interpersonal behaviour in accordance with the societal norms and expectations.
- Play the assigned role in the implementation of national health programme, effectively and responsibly.
- Organize and supervise the chosen/assigned health care services demonstrating adequate managerial skills in the clinic/hospital or the field situation.
- Develop skills as a self-directed learner, recognize continuing education needs; select and use appropriate learning resources.
- Demonstrate competence in basic concepts of research methodology and epidemiology, and be able to critically analyze relevant published research literature.
- Develop skills in using educational methods and techniques as applicable to the teaching of medical/nursing students, general physicians and paramedical health workers.
- Function as an effective leader of a health team engaged in health care, research or training.
- STATEMENT OF THE COMPETENCIES :
Keeping in view the general objectives of postgraduate training, each discipline shall aim at development of specific competencies which shall be defined and spelt out in clear terms. Each department shall produce a statement and bring it to the notice of the trainees in the beginning of the programme so that he or she can direct the efforts towards the attainment of these competencies.
- COMPONENTS OF THE POSTGRADUATE CURRICULUM :
The major components of the Postgraduate curriculum shall be :
- Theoretical knowledge
- Practical and clinical skills
- Thesis skills.
- Attitudes including communication skills.
- Training in research methodology.
- STARTING OF POSTGRADUATE MEDICAL COURSES AND THEIR RECOGNITION.
- An institution intending to start a Postgraduate Medical Education course or to increase the admission capacity shall obtain permission of the Central Government under Section 10A of the Act.
- The institution shall apply for recognition of the Postgraduate medical qualification to the Central Government through the affiliating university.
- NOMENCLATURE OF POSTGRADUATE COURSES.
The nomenclature of postgraduate medical courses shall be as provided in the Schedule annexed to these Regulation : Provided that in the case of postgraduate medical degree and diploma courses instituted prior to the commencement of these Regulations with the approval of the Medical Council of India and which have not been included in these regulations, the institutions concerned shall continue such course till the students admitted complete the said courses.
- The institutions recognised by the Medical Council of India for running Postgraduate courses prior to the commencement of the Indian Medical Council (Amendment) Act,1993 and those medical colleges recognised for running Bachelor of Medicine and Bachelor of Surgery (MBBS) course or institutions established by the Central Government for the purpose of imparting postgraduate medical education shall be eligible for starting any postgraduate degree or diploma and higher specialty course.(1A). The Central Government shall exempt any such existing/proposed non-teaching institutions or specialist institution or autonomous body owned and managed by the Central Government/State Government from fulfilling the prescribed provision of having an undergraduate teaching facility, and allow starting Postgraduate medical course.
- The maximum number of students for a postgraduate medical course, who can be registered in any recognised department, for training for the award of postgraduate degree or diploma by the affiliating university, shall be determined by the facilities available in the department in terms of infrastructure, teaching staff and clinical teaching material.
- Every student, selected for admission to postgraduate medical course in any of the medical institutions in the country, shall possess recognised MBBS degree or equivalent qualification and should have obtained permanent Registration with the Medical Council of India, or any of the State Medical Councils or should obtain the same within on month from the date of his admission, failing which the admission of the candidate shall be cancelled;
Provided that in the case of a foreign national, the Medical Council of India may, on payment of the prescribed fee for registration, grant temporary Registration for the duration of the postgraduate training restricted to the medical college/institution to which he is admitted for the time being exclusively for postgraduate studies; Provided further that temporary registration to such foreign national shall be subject to the condition 5that such person is duly registered as medical practitioner in his own country from which he has obtained his basic medical qualification and that his degree is recognised by the corresponding Medical Council or concerned authority.
- The students undergoing postgraduate courses shall be exposed to the following :
- Basics of statistics to understand and critically evaluate published research paper.
- Few lectures or other type of exposure to human behavior studies.
- Basic understanding of pharmaco-economics.
- Introduction to the non-linear mathematics.
- SELECTION OF POSTGRADUATE STUDENTS.
- Students for Postgraduate medical courses shall be selected strictly on the basis of their academic merit.
- For determining the academic merit, the university/institution may adopt any one of the following procedures both for degree and diploma courses :-
- On the basis of merit as determined by the competitive test conducted by the State Government or by the competent authority appointed by the State Government or by the university/group of universities in the same state; or
- On the basis of merit as determined by a centralized competitive test held at the national level; or
- On the basis of the individual cumulative performance at the first, second and their MBBS examination, if such examination have been passed from the same university; or
- Combination of (i) and (iii):
Provided that wherever entrance test for Postgraduate admission is held by the State Government or a university or any other authorized examining body, the minimum percentage of marks for eligibility for admission to postgraduate medical courses shall be fifty per cent for general category candidates and 40 per cent for the candidate belonging to Scheduled Castes, Scheduled Tribes and Other Backward classes. Provided further that in non-Governmental institutions fifty percent of the total seats shall be filled by the competent authority and the remaining fifty per cent by the management of the institution on the basis of merit.
- PERIOD OF TRAINING
The period of training for the award of various postgraduate degrees or diplomas shall be as follows:
- Doctor of Medicine (M.D.) / Master of Surgery (M.S.)
The period of training for obtaining these degrees shall be three completed years including the period of examination. Provided that in the case of students having a recognised two year postgraduate diploma course in the same subject, the period of training, including the period of examination, shall be two year.
- Doctor of Medicine (D.M.) / Master Chirurgiae (M.Ch.)
The period of training for obtaining these degrees shall be three completed year (including the examination period) after obtaining M.D./M.S. degrees, or equivalent recognised qualification in the required subject; Provided that where an institution on the date of commencement for these Regulation, is imparting five year training in Neurology and Neuro-Surgery, such institution shall continue to have five year training course.
The period of training for obtaining a postgraduate Diploma shall be two completed years including the examination period.
Migration/transfer of postgraduate student from one medical college or institution to another.
Migration/transfer of students undergoing any postgraduate course – degree /diploma shall not be permitted by any university or any authority.
The examinations shall be organised on the basis of grading or marking system to evaluate and certify candidate’s level of knowledge, skill and competence at the end of the training and obtaining a minimum of 50% marks in theory as well as practical separately shall be mandatory for passing the whole examination. The examination for M.S., M.D., D.M., M.Ch., shall be held at the end of 3 academic years (six academic terms) and for diploma at the end of 2 academic years (four academic terms). The academic terms shall mean six months training period. For other details please refer to Regulations.
- Doctor of Medicine (M.D.) / Master of Surgery (M.S.)
- Departmental training Facilities:-
A department having an independent academic entity of a teaching institution, consisting of one or more units, each having the prescribed minimum strength of faculty, staff and beds shall be recognised for Post Graduate training.
11.1 Staff – Faculty
- A clinical department or its unit training candidates for broad or super specialities, shall have a minimum of three full time faculty members belonging to the concerned disciplines of whom one shall be a Professor, one Associate Professor/ Reader/ and one Astt. Professor/ Lecturer, possessing the qualification and experience prescribed by the Medical Council of India;Provided that the second or subsequent additional unit may be headed by an Associate professor. Of these faculty members only those who possess a total of eight years teaching experience, out of which at least five years teaching experience as Assistant Professor/Lecturer gained after obtaining Post Graduate degree, shall be recognised as Post Graduate teachers.
- In each department, training candidates for super specialities, there shall be a minimum of three faculty members with requisite Post Graduate qualification and experience – One Professor, One Associate Professor / Reader and one Assistant Professor / Lecturer, with atleast two of them holding the degree of D.M./M.Ch. in the concerned discipline. Of these faculty members only those who possess eight years teaching experience out of which at least five years teaching experience as Assistant Professor / Lecturer gained after obtaining the higher speciality degree shall be recognised as Post Graduate teachers; Provided that in the case of super speciality courses which are being newly instituted relaxation of qualification and experience of Post Graduate teachers may be granted by the Medical Council of India for sufficient cause.
- In addition to the faculty staff, the strength of Residents / Registrars / Tutors / Demonstrators, as well as technical and other para medical staff shall be as per the staff strength prescribed for 50 or 100 or 150 students in the “Minimum Requirements for 50/100/150 MBBS Admissions Annually Regulations.’
11.2 Minimum requirements for a Post Graduate institution :
- An institution conducting both undergraduate and Post Graduate teaching shall satisfy the minimum requirement for undergraduate training as prescribed by the Medical Council of India and shall also fulfil additional requirements for Post Graduate training depending on the type of work being carried out in the department. The extra staff required to be provided in various departments shall be as given in Appendix-I.
- A Department imparting only Post Graduate training shall:-
(i) Provide facilities consistent with the all round training including training in basic medical science and other departments related to the subject of training as recommended by the Medical Council of India.
(ii) have as many autopsies, biopsies and cytopsies as possible for teaching purposes; and
(iii) make available facilities of ancillary department for coordination of Training.
11.3 Bed Strength in Clinical Departments:-
A department to be recognised for training of Post Graduate students, shall have not less than 60 (Sixty) beds each of General Medicine, General Surgery, Obstetrics and Gynecology, 30 (thirty) beds each for others incase of M.D/M.S. and diploma and 20 (twenty) beds each in case of D.M./M.Ch
Explaination: – A unit shall consist of 30 beds for MD/MS and 20 beds for DM/M.Ch. respectively.
11.4 Out – patient departments :-There shall be adequate space and sufficient number of examination cubicles available in the out – patient Department. Besides the general outpatient services, Speciality Clinics shall also be available for the training of post-graduate students in the relevant broad and super speciality; To determine the number of students who may be admitted for training, outpatient attendance, work turnover and ambulatory care also have to be taken into consideration.
11.5 Laboratory Facilities:- The institution shall have adequate laboratory facilities for the training of the Post Graduate students, and such laboratories shall provide all the investigative facilities required and shall be regularly updated keeping in view the advancement of knowledge and technology and research requirements, and for training of students in non-clinical departments, proper and contemporary laboratory facilities shall be made available.
11.6 Equipment:- The department shall have adequate number of all equipments including the latest ones necessary for training and as may be prescribed by the Council for each speciality from time to time.
- Number of Post Graduate Students to be admitted.
- The ratio of recognised Post Graduate teacher to number of students to be admitted for the degree and diploma courses shall be 1:1 each for degree and diploma courses in each unit per year, to the extent that in no circumstances more than two students for degree and one for Diploma shall be registered in a unit in one academic year.
- In case the institution is having only Post Graduate diploma courses in any subject then it shall have a unit of 30 beds with three full time teachers. The ratio of number of students and recognised Post Graduate teachers shall be 1:1 and in no circumstances more than three students can be admitted in a unit per year.
- The requirement of units and beds shall not apply in the case of Post Graduate degree or diploma courses in Basic and para-clinical departments. The ratio of recognised Post Graduate teacher to students shall, however be maintained at 1:1 both at degree as well as diploma level.
- The number of students to be admitted in case of Post Graduate degree (Super speciality) courses shall be one student per year per recognised Post Graduate teacher in a department having a minimum of three faculty members (one Professor, one Associate Professor/Reader & one Asstt. Professor/Lecturer) and twenty beds. If the number of Post Graduate teachers in the unit is more than one then the number of students may be increased proportionately but not more than two in a unit per year in any circumstances. For this purpose one student should associate with one Post Graduate teacher:
Provided that no Post Graduate seats left unfilled in an academic year, shall be carried forward to the next or subsequent academic years, being from 1st January to 31st December of any calendar year.
- TRAINING PROGRAMME
- The training given with due care to the Post Graduate students in the recognised institutions for the award of various Post Graduate medical degrees / diplomas shall determine the expertise of the specialist and / or medical teachers produced as a result of the educational programme during the period of stay in the institution.
- All candidates joining the Post Graduate training programme shall work as full time residents during the period of training, attending not less than 80% (Eighty percent) of the training during each calendar year, and given full time responsibility, assignments and participation in all facets of the educational process.
- The Post Graduate students of the institutions which are located in various States / Union Territories shall be paid remuneration at par with the remuneration being paid to the Post Graduate students of State Government medical institutions / Central Government Medical Institutions, in the State/Union Territory in which the institution is located. Similar procedure shall be followed in the matter of grant of leave to Post Graduate students.
- Every institution undertaking Post Graduate training programme shall set up an Academic cell or a curriculum committee, under the chairmanship of a senior faculty member, which shall work out the details of the training programme in each speciality in consultation with other department faculty staff and also coordinate and monitor the implementation of these training Programmes.
- The training programmes shall be updated as and when required. The structured training programme shall be written up and strictly followed, to enable the examiners to determine the training undergone by the candidates and the Medical Council of India inspectors to assess the same at the time of inspection.
- Post Graduate students shall maintain a record (log) book of the work carried out by them and the training programme undergone during the period of training including details of surgical operations assisted or done independently by M.S./M.Ch. candidates.
- The record books shall be checked and assessed by the faculty members imparting the training.
- During the training for Degree / Diploma to be awarded in clinical disciplines, there shall be proper training in basic medical sciences related to the disciplines concerned; during the training for the degree to be awarded in basic medical sciences, there shall be training in applied aspects of the subject; and there shall be training in allied subjects related to the disciplines concerned. In all Post Graduate training programmes, both clinical and basic medical sciences, emphasis is to be laid on preventive and social aspects and emergency care facilities for autopsies, biopsies, cytopsies, endoscopic and imaging etc. also be made available for training purposes.
- The Post Graduate students shall be required to participate in the teaching and training programme of undergraduate students and interns.
- Training in Medical Audit, Management, Health Economics, Health Information System, basics of statistics, exposure to human behaviour studies, knowledge of pharmaco – economics and introduction to non- linar mathematics shall be imparted to the Post Graduate students.
- Implementation of the training programmes for the award of various Post Graduate degree and diplomas shall include the following:-
(a) Doctor of Medical (M.D.) / Master of surgery (M.S.)
(i) Basic Medical Sciences
Lectures, Seminars, Journal Clubs, Group Discussions, Participation in laboratory and experimental work, and involvement in research studies in the concerned speciality and exposure to the applied aspects of the subject relevant to clinical specialities.
(ii) Clinical disciplines
In service training, with the students being given graded responsibility in the management and treatment of patients entrusted to their care; participation in Seminars, Journal clubs, Group Discussions, Clinical Meetings, Grand rounds, and Clinico – Pathological Conferences; practical training in Diagnosis and medical and Surgical treatment; training in the Basic Medical Sciences, as well as in allied clinical specialitites.
(b) Doctor of Medicine (D.M.) / Magister Chirurgiae (M.Ch.)
The training programme shall be on the same pattern as for M.D. / M.S. in clinical disciplines; practical training including advanced Diagnostic, Therapeutic and Laboratory techniques, relevant to the subject of specialisation. For M.Ch. Candidates, there shall be participation in surgical operations.
In – service training, with students being given graded clinical responsibility; Lectures, Seminars, Journal Clubs, Group Discussions and participation in clinical and Clinico-Pathological Conferences, practical training to manage independently common problems in the speciality; and training in the Basic Medical Sciences.
The examinations shall be organised on the basis of grading or marking system to evaluate and certify candidates level of knowledge, skill and competence at the end of the training and obtaining a minimum of 50% marks in theory as well as practical separately shall be mandatory for passing the whole examination. The examination for M.S., M.D, M.Ch shall be held at the end of 3 academic years (six academic terms) and for diploma at the end of 2 academic years (four academic terms). The academic terms shall mean six months training period.
- All the Post Graduate Examiners shall be recognised Post Graduate Teachers holding recognised Post Graduate qualifications in the subject concerned.
- For all Post Graduate Examinations, the minimum number of Examiners shall be four, out of which at least two (50%) shall be External Examiners, who shall be invited from other recognised universities from outside the State. Two sets of internal examiners may be appointed one for M.D./M.S. and one for diploma.
- Under exceptional circumstances, examinations may be held with 3 (three) examiners provided two of them are external and Medical Council of India is intimated the justification of such action prior to publication of result for approval. Under no circumstances, result shall be published in such cases without the approval of Medical Council of India.
- In the event of there being more than one centre in one city, the external examiners at all the centres in that city shall be the same. Where there is more than one centre of examination, the University shall appoint a Supervisor to coordinate the examination on its behalf.
- The examining authorities may follow the guidelines regarding appointment of examiners given in Appendix-II.
- Number of candidates
The maximum number of candidates to be examined in Clinical / practical and Oral on any day shall not exceed eight for M.D./M.S. degree, eight for diploma and three for D.M./M/Ch examinations.
- Number of examinations
The university shall conduct not more than two examinations in a year, for any subject, with an interval of not less than 4 and not more than 6 months between the two examinations.
- Doctor of Medicine (M.D.)/Master of Surgery (M.S.)
M.D./M.S. examinations, in any subject shall consist of Thesis, Theory Papers, and clinical/Practical and Oral examinations.
Every candidate shall carry out work on an assigned research project under the guidance of a recognised Post Graduate Teacher, the result of which shall be written up and submitted in the form of a Thesis. Work for writing the Thesis is aimed at contributing to the development of a spirit of enquiry, besides exposing the candidate to the techniques of research, critical analysis, acquaintance with the latest advances in medical science and the manner of identifying and consulting available literature. Thesis shall be submitted at least six months before the theoretical and clinical / practical examination. The thesis shall be examined by a minimum of three examiners; one internal and two external examiners, who shall not be the examiners for Theory and Clinical; and on the acceptance of the thesis by two examiners, the candidate shall appear for the final examination.
- There shall be four theory papers.
- Out of these one shall be of Basic Medical Sciences and one shall be of recent advances.
- The theory examinations shall be held sufficiently earlier than the Clinical and Practical examination, so that the answer books can be assessed and evaluated before the start of the Clinical/Practical and Oral examination.
Provided that after five years from the commencement of these regulations, there shall be one theory paper of ‘multiple choice questions’; unless any institution wants to have such paper earlier.
- Clinical / Practical and Oral
- Clinical examination for the subjects in Clinical Sciences shall be conducted to test the knowledge and competence of the candidates for undertaking independent work as a specialist/Teacher, for which candidates shall examine a minimum one long case and two short cases.
- Practical examination for the subjects in Basic Medical Sciences shall be conducted to test the knowledge and competence of the candidates for making valid and relevant observations based on the experimental/Laboratory studies and his ability to perform such studies as are relevant to his subject.
- The Oral examination shall be thorough and shall aim at assessing the candidate knowledge and competence about the subject, investigative procedures, therapeutic technique and other aspects of the speciality, which form a part of the examination.
A candidate shall secure not less than 50% marks in each head of passing which shall include (1) Theory, (2) Practical including clinical and viva voce examination.
ii. Doctor of Medicine (D.M.)/Magister of Chirurgiae (M,Ch.)
There shall be four theory papers, one paper out of these shall be on Basic Medical Sciences, and another paper on Recent Advances. The theory examination will be held sufficiently earlier than the Clinical and Practical examination, so that the answer books can be assessed and evaluated before the start of the clinical/Practical and Oral examination.
- Clinical / Practical and Oral
Practical examination shall consist of carrying out special investigative techniques for Diagnosis and Therapy. M.Ch candidates shall also be examined in surgical procedures. Oral examination shall be comprehensive to test the candidate’s overall knowledge of the subject. A candidate shall secure not less than 50% marks in each head of passing which shall include (1) Theory (2) Practical including clinical and viva voce examination.
iii. Post Graduate DiplomaDiploma examination in any subject shall consist of Theory, Clinical and Oral.
There shall be three theory papers. One paper out of these shall be on Basic Medical Sciences. The examination shall be held sufficiently earlier than the clinical examination, so that the answer books can be assessed before the start of the clinical examination.
- Clinical and Oral
Clinical examination for the subject in clinical Science shall be conducted to test /aimed at assessing the knowledge and competence of the candidate for undertaking independent work as a Specialist / Teacher for which a candidate shall examine a minimum of one long case and two short cases.
The oral examination shall be thorough and shall aim at assessing the candidate’s knowledge and competence about the subject, investigative procedures, therapeutic technique and other aspects of the speciality, which shall from a part of the examination.
The candidate shall secure not less than 50% marks in each head of passing which shall include (1) Theory (2) Practical including clinical and viva voce examinations.