Medical qualification nomenclature in India: Need to review and update

India has the highest number of medical colleges in the world. The National Medical Commission of India (NMC) plays a critical role in ensuring the quality of education for all graduate and postgraduate educational programmes. Indian healthcare professionals not only work in the country but also abroad. The Indian medical diaspora has earned laurels in foreign lands for their work ethic, professional commitment and expertise. As the world’s most populous country with a sound educational basis, India has been and will continue to be a source of skilled professionals, including doctors and paramedical healthcare professionals.¹ Therefore, medical educational policies ought to be robust and aligned with current evidence-based, international consensus-based and established protocols.

One of the intriguing areas of concern is the nomenclature of educational qualifications, which seems archaic and outdated. I have the following observations that seem to be out of sync with modern educational reality.

1. The educational programmes (generally referred to as programmes in short) are mentioned as courses by several medical educational institutions. The United Nations Educational, Scientific and Cultural Organization defines an educational programme as a ‘coherent set or sequence of educational activities designed and organized to achieve pre-determined learning objectives or accomplish a specific set of educational tasks over a sustained period’. The components of an educational programme are multi-layered and sequentially arranged and are called courses, modules, units or subjects.² Although both the University Grants Commission (UGC) and the National Accreditation and Assessment Council (NAAC) in recent years have made these terms abundantly clear, universities, colleges and other stakeholders continue to use the misnomers.

2. The graduate programmes are called undergraduate courses. First, it is not a course but a programme, and second, it is not an undergraduate programme as the student is not taking this programme during graduation but for doing graduation.

3. The postgraduate medical qualifications are mired in a multiplicity of names: MD, MS, MCPS, FCPS, PhD, DNB, DM and MCh. Thankfully, NMC abolished all postgraduate diplomas in medical education in 2021. The National Education Policy 2020 has laid out the exit point and the qualifications to be awarded in a graduate programme. There would be four exit points in a degree programme: award of certificate for an exit after 1 year, diploma for exit after 2 years, degree after 3 years and degree with honours after 4 years. If it is applied to the medical programmes too, this will further complicate the qualification names.

The American Board of Medical Specialties has a clearly laid out qualification nomenclature system for its medical professionals.³ The muddied water of qualification names in India needs to be cleared, especially for the comprehension of the international academic community. All basic medical sciences programmes could be labelled as MD/PhD. All clinical specialties could be called level I residency programmes, and all super-specialty programmes could be named level II residency programmes. The residency programmes could be called as Indian Board of Medical Specialities Residency Programmes. The naming of surgical residency programmes as Master of Surgery creates confusion in international academia as it equates the qualification with a master’s programme and not a doctorate. Similarly, the name of the super-specialty programme of medical specialties is DM. However, all surgery super-specialty programmes are called MCh.

I suggest the following measures to streamline the medical qualification names in India.

1. The NMC can formulate an advisory body to draft a medical education nomenclature policy. This body can consist of NMC officials and medical educationists. Representatives from NAAC, UGC, Ministry of Human Resource Development, Ministry of Education, and State Health Universities.

2. The nomenclature has to be uniform across the country, well-defined, and comply with the national and international educational qualification framework, such as credit hours and competency framework. Educational guidelines that have international consensus and are evidence-based must be considered.

3. The revised nomenclature must be applied prospectively, and equivalence of existing qualification names with the revised names must be prepared.

4. The revised names could be introduced similar to major countries, which are realistic, prudent, practical and pragmatic.

There is a need to revise the nomenclature of medical qualifications in India, assign qualification names to appropriate frameworks, align them with international trends, and provide greater clarity for domestic and international audiences. Although the task seems humongous, some action is required to replace old names. The least that can be done is changing the names of MS and MCh and renaming these qualifications that truly represent their programmatic and professional value and not merely equated irrationally as master programmes.