For several years now, there has been a shortage of professors to teach anatomy at medical colleges across the country. Medical colleges have been struggling to fill these posts, and for new colleges or those up for re-accreditation, this has been even more of a cumbersome task.
To counter this shortage, the National Medical Commission (NMC), in its recent draft, ‘Teachers Eligibility Qualifications (TEQ) in Medical Institutions Regulations’, retained a two-year-old provision allowing non-medical graduates with MSc and PhD degrees to teach medical students anatomy, biochemistry, and physiology during a transitional period. This move however, has drawn criticism from doctors. Meanwhile, MSc graduates in these subjects have been demanding that they be reinstated into medical colleges, as was the practice some decades ago, and be given a 30% reservation in jobs.
Experts weighing in on the subject say that even as an increasing number of medical colleges have been opened in the country over the last decade or so, the shortage of professors for certain courses has risen, but is not, as yet, insurmountable.
The history of anatomy as a discipline
Sudha Seshayyan, former Vice-Chancellor of the Tamil Nadu Dr. MGR Medical University, and a retired anatomy professor from Madras Medical College, traced the history of anatomy as a discipline in the State. “Sometime in the late 1960s, there were many MBBS graduates who did not opt for teaching. These were rudimentary days in the development of medical colleges, and teaching was an art that perhaps did not appeal,” she recalls. Around this time, the University of Madras launched postgraduate programmes in five non-clinical disciplines as “a kind of via media” — a stopgap measure to fill in posts at medical colleges. The government converted some tutor demonstrator posts in these disciplines to non-medical posts to tide over the shortage of professors in medical colleges, for non-clinical subjects.
Soon, private institutions also began courses in these disciplines, and there was a flood of MSc graduates. As the job market stagnated, these courses were subsequently abandoned.
At the same time, medicine as a discipline continued to evolve, and MD programmes (postgraduate courses) were then developed. Medical colleges began offering MDs in non-clinical subjects such as anatomy, community medicine, biochemistry, physiology, forensic medicine and pharmacology.
Dr. Sudha recalls a time when Tamil Nadu had 10 MD Anatomy seats. While Madras Medical College continues to fill all the four seats it has, Madurai and Thanjavur medical colleges, which had two each, lagged. They ultimately reduced the number of seats to one each, while Government Stanley Medical College in Chennai continues to admit two students in anatomy each year.
One problem that arose with this, points out V. Kanakasabai, former Director of Medical Education of Tamil Nadu, was the difference these programmes gave birth to, between the students. Dr. Kanakasabai, who did an MD in pharmacology, said students with a BSc degree were admitted to these 2-year non-clinical programmes. After graduation, some of them went on to pursue a 3-year condensed MBBS course and then moved to mainstream medicine — but these doctors were then not appreciated by those who had completed the conventional MBBS course in 5.5 years.
However, despite this, medical colleges continued to expand their programmes and offered around 20 disciplines, of which 7 or 8 were non-clinical. Initially, candidates who did not want a transferable job took them. Women, and male doctors with family compulsions, opted for these ‘rare’ disciplines. These non-clinical specialists who did not interact with patients were given perks such as early promotions and a pay hike to equalise for their loss of practice as doctors. “I became the youngest dean in-charge of a medical college when I was just 36,” Dr. Kanakasabai recalls.
Today, the situation has reached what many consider a critical point, though even now medical education experts say it can be resolved: there is a rising number of MBBS and MD graduates in the country who are not placed in medical colleges and simultaneously, there are a significant number who have worked for decades, without being promoted to the post of professors, they say. Each department of a medical college must have an assistant professor, associate professor and a professor.
Who can teach anatomy?
Anatomy, points out J.A. Jayalal, former national president of the Indian Medical Association, is the basis for surgery. “It is not a great idea to have MSc graduates to teach anatomy as they do not have a knowledge of applied anatomy. They do not know the clinical application of anatomy like MBBS graduates do. MSc graduates may know the theory but do not see patients, and so, there is a huge difference,” he explains. This hype about getting in non-medical graduates to teach at medical colleges is mainly being made by MSc anatomy graduates, he says.
“A decade ago, the National Medical Commission (then the Medical Council of India) decided to reduce the number of faculty for ‘rare’ branches. Posts reserved for non-clinical faculty were slashed in half, from 30% to 15%. Had the existing staff then been distributed among medical colleges, this situation may not have arisen,” he notes.
The rise and rise of medical college numbers
Over the past several years a number of States including those in the north that had fewer colleges compared to the south, have begun increasing the number of their medical colleges. “There has been 200% increase in medical colleges, for instance, in Uttar Pradesh. It now has 27 colleges. Across India, we now have 832 anatomy seats in 720 colleges. Every year 832 candidates are graduating. However, most of these seats for non-clinical subjects are concentrated in the south. Many students in colleges in the north are unaware of these options. With a proper distribution of these seats, this shortage would not have arisen,” Dr. Jayalal says.
While doctors in community medicine, pharmacology and biochemistry may work in laboratories, those in anatomy, physiology and forensic medicine, can only teach or conduct research, making them less attractive options, and compounding the problem.
Could AI be a solution?
Dr. Jayalal believes the introduction of Artificial Intelligence (AI) and cluster teaching could work at present. There are several good teachers, he points out, and the NMC can organise it so that the students of several colleges can be taught in one go.
The other major problem of the lack of cadavers — a medical college with 150 students should have 15 cadavers — . is being overcome by private colleges via computer simulations. These and other updated, newer and innovative methods of teaching can be adopted, Dr. Jayalal says, adding that MBBS doctors too, could be roped in to teach subjects such as anatomy.
The way forward
Primarily, the shortage of faculty for anatomy and other non-clinical subjects has arisen due to a skewed distribution of seats, say experts. Every government medical college must mandatorily have seats for anatomy they point out: this will help increase the number of graduates even in parts of the country that are facing acute shortages, and these graduates then need to be posted in medical colleges. Time-bound promotions and making these options attractive such as with higher pay, and better leave options is also necessary, they say.
Dr. Jayalal rues that some colleges have 35 seats of surgery, but no anatomy seats. “Without anatomy there can be no surgery. The NMC should insist that if a college wants to offer surgery, then they should have a good anatomy department,” he emphasises.
Published – February 28, 2025 07:30 pm IST