What to do with B.Sc community health course? how to stop this illegal encroachment?

When the parliament backed democratic govt want to establish one alternate cadre of health professionals through BSc in Community Health, in order to tackle the menace of doctors unwilling to serve in rural areas(as per MOH,Only 26% of doctors in India reside in rural areas, serving 72% of India's population), is there any organization  capable to stop this? 

IMA members across the country facing this question.

its a challenge thrown out by MOH & MCI  to the IMA. 

what could be done?

Recap:

MOH, wants the MCI stamp on the degree -BSc in Community Health, a unique training programme aimed at the basic health care needs of its target population, so that it was universally recognized

So,MCI has been obliged and framed the syllabus&curriculum.

MCI board chairman Dr K K Talwar said in September-2012, that this special cadre of health workers will be trained mainly in district hospitals, be placed in sub-centres or primary health centres and will be taught "some module of clinical work". This means this cadre can actually diagnose and treat basic medical cases, get involved in immunization programmes and administer extended first aid."We intend to introduce the course from April next year(2013). This cadre will also refer patients according to their condition to other centres. We have also prepared the syllabus of the course. 

Number of social service organizations,public health groups supporting this course and cited that some thing is better than nothing. common man in rural areas will be benefited in a way,that  the first aid,primary care and public health measures can be delivered at their door steps.

Evolution of BSc in Community Health course:

In 2010, experts in medical education and public health and in 2011, the Planning Commission and its expert group gave their approval to the three-and-a-half-year long BRMS degree and in 2012 the MCI has endorsed BRMS under the new name BSc in Community Health. The decisions to accept and implement the course are now with State governments.

precautionary measures proposed by the MOH:

These B.Sc graduates cannot affix the prefix “Dr.” to their names. The candidates are locally recruited to serve government health institutions under a service bond. They will have a clear career progression path as “health officers” up to the district level. The course is designed to produce health workers who will be an effective link between basic health workers and the doctor at the PHC or community health centre (CHC). They will be taught to treat minor ailments, help in delivery and administer first aid; but most importantly, when and where to refer a pateint promptly, in case of complications. They will be used for implementation of national programmes also.

IMA’s fears,assumptions and objections:

Will they not be tempted into private practice? Won’t they not migrate to urban areas and compete with MBBS doctors? Who will monitor this? Will they be required to take government jobs in rural areas as a condition of admission? Who will control/ensure the quality of their education?

 The move reverses a historic decision taken by Sir J.W. Bhore, chairman of India’s first health survey and development committee in 1952, to abolish the Licentiate in Medical Practice (LMP) and establish a single medical qualification, a university degree MBBS, as the requirement to become a doctor.

• This move is against the IMC Act.
• IMA has strong presumption,that the MOH will made MCI to open a parallel register for these community health graduates and in the course of time,they will rub their shoulders with main stream medical graduates.
• where is the need to introduce this type of course,when thousands of un /under employed 4  year trained nurses in our country?
• MPH /MHA are managerial or administrative courses.   But,here this B.Sc course is clinical course. how can we count that this B.Sc course is UG course for the  existing PG courses(MPH&MHA) ?
• IMA strongly senses,that MOH&MCI gradually marginalizing the main stream MBBS graduates from primary care.
• IMA fears,that  in the course of time,  MBBS graduate's role will be  shrinked to none as   Secondary and tertiary care are dominated by PG doctors.
• Then,what is the Meaning and justification to study MBBS?
• IMA has equal  concern for the rural people and for the medical fraternity. IMA  showed  number of viable and cost effective alternatives to the govt's short sighted policy and to this course.
• IMA  appraised and submitted its strong objections and various methods to improve rural health care - in a memorandum to all concerned authorities- PM,PRESIDENT of India,Health minister and leaders of various political parties.
• due to vehement and unstinting fight by the IMA in judiciary, MCI back tracked with BRHC course and changed the course's name and stipulated few   precautionary measures 

Chhattisgarh launched  a cadre of rural medical assistants (RMA) a decade ago and in 2012, 1,233 RMAs were posted in PHCs and health sub centres. Assam has already replicated this model.

 Six colleges began training RMAS from 2002 — about 150 of them every year. The MCI did not agree to the project, and the Indian Medical Association (IMA) even challenged it in court, but the course and certification survived with a change of name. The graduates got a diploma, not a degree, in modern and holistic medicine even though the course was similar in content to the MBBS programme.

The proponents of this course citing one study which states that  the prescription ability of RMAs to be on a par or better than that of medical graduates at the PHC level in relation to commonly prevalent diseases based on five clinical case management scenarios on pneumonia, malaria, preeclampsia, diabetes and diarrhoea and one referral case (TB). The study is available online at http://nhsrcindia.org/

Action to be taken: Fight for justice.Fight for stringent  implementation of IMC act- in judiciary of respective high courts of various states where ever this course is started.