While the question of amending the Act for periodical renewal of registration remained pending with the Central Government, (as also with the state govts., regarding the MR Acts), the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, approved by the Central Government, was notified in the Gazette of India, dated 6th April, 2002. Its Rule 1. 2. 3, mentioned above, required of a Physician to participate in CME programmes for at least 30 hours every five years (note that these rules stipulate 30 hours of CME for 5 years, as against the 30 credit hours/5 years suggested by the Amal Dutta Committee and 150 credit hours/5 years suggested by the MCI in 1997). Having failed for 6 years (1996-2002) to convince the law makers to amend the IMC Act regarding renewals, the MCI immediately acted on the new regulations. The meeting of the Executive Committee of MCI, held on Sep 9, 2002, observed the following:
“Since the provisions of Regulation No. 1.2.3. (see above) have become mandatory, it has become necessary for the Council to consider the whole matter and issue necessary guidelines in regard to its implementation. The Executive Committee considered and approved the proposed Scheme for Continuing Medical Education for implementing the provisions of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 as approved by the Ethical Committee…and…the committee decided that the same be placed before the next General Body meeting of the Council for consideration.”
Accordingly, these proposals were placed before the 123rd General Body meeting of the MCI held on Nov 21, 2002 and were ratified. [Medical Council of India. 123rd Session: Minutes of the meeting held on 20th/21st Nov.,02. No.MCI-6(2)/2002-Med./ Available at http://www.mciindia.org/meetings/GB/2002/Ming%2020-21%20Nov02.pdf.]
It is thus clear that, having failed to convince the Parliament and all state legislatures to amend the IMC/MR Acts, the MCI decided to give up the proposal of renewals and went ahead to enforce CME Accreditation under the shelter of Code of Medical Ethics.
The excerpts of the minutes of that meeting, given here below, unravel the so called Scheme for Continuing Medical Education for implementing the provisions of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 and in the process, raise many more questions.
“With the coming into force of the new Ethics Regulations, it has become necessary to accredit identified organizations so that the certificates of attendance at CME issued by them can be taken as valid for the purpose of fulfilling the requirements of the new Regulations.
The following organizations are considered for authorization to conduct CME programmes and issue certificates of attendance. The authorization may be done by the State Medical Council, where the organization is situated or by the Medical Council of India in respect of All India Organizations.
- All recognized Medical Colleges (with full fledged Medical Education Units who will organize CME programmes).
- Indian Medical Association or the State Chapters of the Indian Medical Association.
- National Academy of Medical Sciences.
- Specialists Associations (only National level Associations or their State Chapters).
- All recognized Postgraduate Medical Institutions.
- Central Govt. and State Govts. Hospitals (including Districts Hospitals) and training centres in health field including Ministry of Health and FW, Defence, Railways & Open University Systems(IGNOU).
- National Board of Examinations (this was added on the recommendations of the 123rd Session of the General Body of MCI, mentioned above)
Modalities for accreditation
All State level organizations conducting CME Programmes should approach the State Medical Council concerned for accrediting these organizations for issue certificate of attendance in CME programmes conducted by them. Medical Colleges, Postgraduate Institutions and National level Organizations should approach the Medical Council of India for such accreditation.
Accreditation shall be for a period of one year at a time subject to renewal for a further period or curtailing or canceling the accreditation for valid reasons.”
As per the above Scheme, the Organizations conducting CME Programmes are to be accredited and not every CME Programme. Further, accreditation of national level organizations are not under the purview of the state medical councils. And, accreditation, once given, is for at least one year. This scheme also says nothing about accreditation fees, TA/DA, inspector hospitality etc.
If the above Scheme stands, why is the Karnataka Medical Council insisting on inspection and accreditation of each and every CME Programme? If national level organizations such as IMA, API etc., as well as medical colleges and post graduate institutions are to be accredited by the MCI for conducting CME Programmes, why is KMC insisting on inspection of each and every programme conducted by these organizations? Why is the KMC charging accreditation fees, TA/DA, local hospitality etc., for the inspectors when no such provisions have been made in the above mentioned Scheme of the MCI?
The Scheme of MCI envisages creation of a separate section under MCI/state councils for maintaining the register of CME Credits:
Having initiated the grand idea of CME accreditation, the executive committee meeting of Sep 9, 2002, set out to create separate sections within MCI/state medical councils to maintain the records of CME Programmes conducted by thousands of branches of various medical organizations and of the credit hours earned by thousands of medical professionals.
Registers to be maintained by the Medical Councils.
“Every State Medical Council/Medical Council of India shall maintain a register (computer data based) showing the names of accredited organizations conducting CME programmes indicating the year for which the accreditation is valid and the names of registered medical practitioners with their registration No., Council with which registered, number of credit hours of CME attended by them (indicating the date/month/year} for the purpose of record so as to ensure that each medical practitioner fulfills the criteria of attending 30 credit hours in a period of 5 years.
“The Executive Committee also approved the recommendations of the Ethical Committee that keeping in view large volume of work to be handled by the Council in regard to approval of organizations conducting the CME course, keeping record of CME programmes attended each year by registered medical practitioners and coordinating with State Medical Councils etc., a separate section may be created for the purpose.“
It has been 12 years since, but where are the separate sections for reporting the CME hours? Where and how should one report the credits earned via books written, articles published etc.? If such sections are yet to be fully created in the medical councils of all the states, why are a handful of states in a great hurry to insist on CME accreditation, and why are they being linked with renewals when such a clause is non-existing in the IMC Act?
And the letter from MCI Secretary dated August 28, 2009, say sit all about the CME accreditation!