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The tyranny of the Medical Council of India's new (2019) MBBS curriculum: Abolition of the academic discipline of family physicians and general practitioners from the medical education system of India

After 21 years, a new MBBS curriculum has been released by the Medical Council of India (MCI), titled “Competency-based UG Curriculum for the Indian Medical Graduates.” This curriculum is to be rolled out from August 2019 across India. The curriculum document runs through 890 pages in three volumes. Overall, 2939 competencies have been proposed to be acquired by trainee MBBS doctors. The parliament of India in one of its reports (2016) noted that the medical education system is designed in a way that the concept of family physicians has been ignored. Not to mention a formal introduction as discipline, the new MCI MBBS curriculum does not even mention the words “General Practice” or “Family Medicine” or “Family Physicians” throughout the voluminous document. The curriculum committee has also ignored the recommendations of National Health Policies (NHPs) of 2002 and 2017 of the Government of India (GOI). In practicality, it leaves the MBBS students in the road of no return of specialist and tertiary level hospitalist care. It deliberately deprives thousands of medical graduates an invaluable autonomous career in community setting as practicing family doctors. Simultaneously, this new curriculum drafting exposes a treacherous hierarchical monopoly of hospital based specialists doctors over generalist community based primary care physicians within the healthcare delivery system of India. Keeping out family physicians and general practitioners from the health system means a free flow of patients from community to expensive tertiary care facilities in the absence of any structured referral system. Family medicine and general practice are independent medical disciplines/specialties across world. The curriculum neither meets the national public health aspirations nor the GOI policies on medical education. If implemented, it will be disastrous to the healthcare delivery system and public good in general. The new MBBS curriculum deserves to be outright rejected for the inherent fallacies.