CPS diploma row: Fate of 20,000 plus specialist doctors in limbo

The future of more than 20,000 specialist doctors working in nine states including Karnataka is in jeopardy for the last two months following the publication of new registration rules for doctors by the National Medical Commission as the post-graduate speciality courses completed by these MBBS doctors are not recognised by the NMC.

They took courses from the College of Physicians and Surgeons, an accreditation body that has been in existence since 1912 and offers post-graduate diploma courses in several disciplines.

The CPS courses (around 1600 seats) provide a third route to medical students for post-graduate studies besides the MD/MS courses (64,000) and the Diplomate of the National Board (2700) offered by the National Board of Examinations in Medical Sciences.

In May, the NMC notified rules to create a national register of doctors but kept it open only to those whose qualifications are recognised pan-India.

This, in effect, prevents 20,000 plus CPS diploma holders – many of them are practising - to register themselves as specialists since such courses are recognised in a handful of states.

Besides Karnataka, other big states recognising the courses include Maharashtra, Gujarat, Odisha, Madhya Pradesh, Rajasthan and Chhattisgarh.

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“The careers and futures of dedicated doctors hang in the balance,” Nitish Kumar, a Pune-based radiologist who did his speciality training from one of the CPS-affiliated institutions, told DH.

While some of the CPS courses were recognised as medical qualifications under the Indian Medical Council Act, 1956; in recent years there were doubts about the quality of many such courses. In addition, there were allegations of corruption in the admission process.

In 2017, the Union Health Ministry came out with a gazette notification recognising 39 courses offered by the CPS. But a year later, the ministry published another notification derecognising 36 of the 39 courses without offering any explanation.

The NMC currently approves only three CPS diplomas in paediatrics, gynaecology and pathology, but the apex medical regulator has proposed to withdraw recognition to these three also from the next academic year.

"With its excellent reputation, the CPS provided an alternative avenue for those seeking higher training and not getting admission in normal NMC (earlier MCI) recognised colleges due to various reasons including reservations," commented Gautam Sen, professor emeritus in surgery at Grant Medical College, University of Mumbai.

Though the Union Health Ministry, Maharashtra government, NMC and state medical education departments hold back and forth talks since 2017 to decide on the fate of the CPS courses, the impasse continues.

The ministry formed one more expert panel earlier this year to look into the issues, though a 2018 committee recommended that the courses would be “extremely useful” to deliver healthcare services in community health centres and district hospitals where specialists are in short supply.

The rural health statistics for 2021-22 flagged an 83 per cent shortfall of surgeons and an overall 79 per cent shortfall of other specialists in community health centres.

"The NMC should use the CPS to produce excellent modern Family Medicine practitioners. This will be an ideal demonstration project for NMC," said Sen, who was one of the six members of the first board of governors for the Medical Council of India when the council was suspended by the Union government.