National Medical Commission mandates strict scrutiny of ‘fake patients’ before sanctioning new medical colleges or enhancing seats

The NMC has released the Medical Assessment and Rating Board (MARB) guidelines for evaluation of medical college/institutions 2024.
| Photo Credit: K MURALI KUMAR

The National Medical Commission (NMC) has ordered strict scrutiny of “fake patients” shown by the managements during physical assessment/inspection before sanctioning of new medical colleges or allowing increase in the number of Under Graduate (UG) and Post Graduate (PG) medical seats.

NMC has invited applications for establishment of new medical colleges intending to offer undergraduate course and increase in the number of PG and UG seats for the academic year 2025-2026. It has released the Medical Assessment and Rating Board (MARB) guidelines for evaluation of medical college/institutions 2024

What the guidelines say

In the MARB guidelines, the NMC has stressed the need to curb the practice of showing “fake patients” in the medical colleges. For the purpose of training students, a certain minimum clinical exposure of patients has been defined in the Minimum Standards of Requirements (MSR) criteria of UG and PG Board in the form of bed occupancy requirements etc.

However, it has been observed that some medical institution/colleges show fake patients (persons who do not require any treatment at all or in-patient treatment) to fulfil the requirement of bed occupancy, investigation, etc. The guidelines say that if the assessor notices this and makes a remark, “it will be considered as indulgence of institution in ‘fake patient practice’ which will be considered as a serious violation and it will invite punishment as per MARB rules,” reads the guideline.

Therefore, NMC has instructed all the assessors that observation as to whether a large number of patients were admitted on the day of assessment or the previous day is a must.

Further, it said that it should be examined whether such recently or previously admitted patients have no minor or insignificant ailments/problems which can be treated on Outpatient (OPD) basis with oral medications.

Patients who are admitted without any evidence of investigations like X-ray, blood tests etc., (before or after admission) or treatment which is generally done for admitted patients like intravenous fluid, injections, catheterisation, giving medicines etc should be noted. It should be observed whether in paediatric ward, “most of the admitted children were playful and joyous without any significant problem.”

From the same family?

Further, it stated that the observation of assessor/s on whether multiple patients from the same family were admitted and whether patients were admitted in large numbers through preventive health check-ups/camps is also a must.

The NMC’s guidelines also stressed that the attendance of the faculty and other staff should be reviewed from time to time. “The required number of faculties as mentioned in MSR guidelines of respective boards (UG or PG) should be available throughout the year and for any given period of time. As it is a minimum requirement document, no relaxation will be permitted except in special circumstances in the larger interest by following due procedures,” it added.

Will abide by rules

Speaking to The Hindu, Dr. B.L. Sujatha Rathod, Director of the Directorate of Medical Education, said that NMC is the regulatory authority and the State is the implementing authority. “Whatever the regulations are, it will be examined and put into action,” she said.