This medical college produces doctors, but has no patients

NEW DELHI: For four years, Medical Council of India (MCI) repeatedly flagged concerns about a private college in Madhya Pradesh but could not stop it from taking in three batches of students. One batch of 150 doctors is now in its final year of MBBS while another just appeared for second-year exams.The story of RKDF Medical College, which finally faced a Supreme Court crackdown in January, shows how blatantly such colleges exploit the legal process to stay in business. 68171945MCI and a Supreme Court-appointed inspection committee had noted “fictitious” patients in the teaching hospital, falsified medical records and “grossly inadequate” patient load. Although the SC has ordered that the third batch admitted in 2017-18 be shifted to other private colleges in MP, the 2014-15 and 2016-17 batches remain at RKDF college. It’s anyone’s guess just how many real patients these soon-to-be doctors have seen. It was business as usual at the college when TOI visited it around 11.30am on January 30. The dean, Dr S S Kushwaha, offered a tour of the college and hospital to show it had enough patients and required facilities. He also suggested a visit to the hostels to talk to students. However, TOI found an empty hospital with wards locked up, defunct operation theatres, no patients in the post operative ward or anywhere else, barring a handful in the OPD area. The OPD rooms had no doctors, and the blood bank was deserted too. How lawyers kept this college going for 4 years2014RKDF College set up in BhopalJune 2014Gets MCI permission for admissions in 2014-15February 2015MCI finds deficiencies, recommends withdrawal of permission. Centre asks MCI to review decision. MCI stands firm, also recommends barring admission for two yearsSeptember 2015SC orders another review on college’s plea. Centre reviews and reiterates decision. RKDF goes to Delhi HC against orderDecember 2015Delhi HC orders Centre to re-examine matter. Centre sticks to decisionMay 2016MP HC orders fresh inspection on RKDF pleaMay 2016SC appoints oversight committee (OC) to oversee MCIJuly 2016SC also orders fresh inspection when MCI challenges MP HC orderSeptember 2016SC asks OC to decide on admissions for 2016-17. OC gives approval on condition that college rectify deficiencies, submit compliance report to health ministry and give MCI a bank guarantee of Rs 2 crore. RKDF gets second batchJanuary 2017MCI again recommends barring admission for two years for breach of OC conditions. Centre accepts recommendationJuly 2017MP HC allows provisional admission of 150 students based on fresh inspectionAugust 2017SC upholds MP HC orderSeptember 2017College halts inspection. MCI report flags fake patients, empty wards, not enough surgeries or procedures, absence of faculty and residents. Fresh inspection done on college’s request. MCI asks for 2017-18 batch to be cancelled. Centre orders 2-year bar on intakeOctober 2017SC stays Centre’s order, allows admitted students to continueDecember 2017SC considers assessment report and cancels admission of 2017-18 batch. Committee with CBI officer and AIIMS doctors asked to conduct inquiryJuly 2018SC directs MP to accommodate RKDF’s 2017-18 batch in other private colleges for 2018-19January 2019SC fines RKDF Rs 5 crore for deceiving it. Orders fee refund to students plus Rs 1 lakh compensation to each. Dean to be prosecuted for false evidenceThe hostel visit didn’t materialise, ostensibly because students had left after the exams. When told no patients or students were around, Dr Kushwaha claimed patients mostly visited the hospital after 4.30pm. However, on a repeat visit the same evening, he admitted there were no patients, hence no point in repeating a tour of the hospital. An employee who played guide said the college has three “public relations officers” who bus in ‘patients’ from nearby villages before inspections. Dr Kushwaha said they had separate funds to get “clinical material” (read patients) for students. Incidentally, Dr Kushwaha was Madhya Pradesh’s director of medical education from January 2014 to the time he joined RKDF college as dean immediately after his retirement in 2015.Asked why teaching is allowed to continue at a college that the Supreme Court had found to have “indulged in large-scale malpractices” to comply with the minimum standards for admitting students, officials in the Madhya Pradesh Directorate of Medical Education said it was up to Medical Council of India or the courts to shut it down.“The students studying there have not complained or gone to court. How can we take any action?” said an official while agreeing that students passing out as doctors without be treating genuine patients and getting proper training was a concern. large68173017 67767232How lies and lawyers keep shady colleges in businessMadhya Pradesh's RKDF college is shown on the MCI website as affiliated to the state-run Barkatullah University, though Kushwaha said they were not affiliated anymore. Asked if their affiliation had been withdrawn after the SC order, he said that was not possible as they are affiliated to Sarvepalli Radhakrishnan University, a private university owned by the RKDF Group, which runs a veritable education empire in Madhya Pradesh, including colleges of nursing, pharmacy, dental science, homoeopathy and Ayurveda.What that suggests is for the RKDF Group, and Dr Kushwaha, the crores in SC-imposed fines or being labelled by the apex court as a fraudulent institution is no more than a pause. The business of education rolls on without any full stops.Madhya Pradesh’s RKDF Medical College would have been shut down in its first year itself but for the lies and lawyers it employed. Shady medical colleges across the country follow this playbook. In MP alone, four private colleges have been debarred from admissions in the past few years, but not before lengthy litigation. large68180685 Every time MCI gives an adverse assessment report based on a college’s deficient facilities, the college moves court claiming the inspection was faulty and biased. Courts often order re-inspection and/or allow admissions on the assurance that the deficiencies would be removed.For example, in November 2016, the Supreme Court-appointed oversight committee (OC) allowed the four MP colleges to enrol students although MCI’s inspection teams had repeatedly found glaring deficiencies. The OC gave conditional approval for admissions without physical verification.Lack of patients is a common problem at private colleges. Many fill up their hospitals with hired “patients” before inspections. Yet, all four colleges got their “essentiality certificates” from the MP government confirming they own and manage 300-bed hospitals, which is the eligibility condition to get 150 seats. The state also undertook the responsibility to adjust their students in other colleges if “the applicant (college management) fails to create infrastructure for the medical college as per MCI norms and fresh admissions are stopped by the central government.” As a result it had to accommodate about 600 students of the deficient colleges in government colleges and other private colleges. Colleges using fake faculty and patients and challenging MCI's assessment reports in court is a common malpractice everywhere from Madhya Pradesh to Uttar Pradesh, Karnataka, Telangana, Kerala and Tamil Nadu. College managements have repeatedly charged the MCI with being selective in refusing permission, often overlooking similar deficiencies found in its inspections. With a parliamentary panel and the Supreme Court on more than one occasion expressing shock at the council's functioning, these charges cannot be dismissed outright. In Bhopal, TOI found most private colleges were located well outside the city and depended heavily on empanelment in government schemes to have a barely sufficient number of patients. A former employee of the now closed Advanced Medical College said the hospital used to send buses to nearby villages to get patients.Last August, Mahavir Institute of Medical Sciences in Telangana was pulled up by the SC for “the fraud played by the college in projecting healthy persons as patients in their hospital for the purpose of showing compliance of minimum standards.” medium68171345While granting relief to private colleges, courts have sometimes questioned MCI’s rationale for being lenient towards government medical colleges that lack infrastructure. The difference, MCI says, is mainly the availability of patients. Responding in a case filed by the students of two closed private medical colleges in MP — Advanced Medical College, Bhopal, and Modern Medical College, Indore — MCI said, “in private medical colleges... the clinical material is not as abundant as that in the government medical colleges... The government medical colleges... have abundant clinical material/inflow of patients, which is the most crucial aspect of the teaching and training of medical students.” Also, while private colleges can simply shut shop leaving students in the lurch, government colleges can’t and don’t.boxcontentBarred Colleges: What the MCI foundOperation theatre register shows procedures but equipment for doing those not presentInspection refused, hospital shut down due to death in trustee family or poor patient load blamed on local festivalThree patients admitted in orthopaedic ward had abdominal pain and chest painBed occupancy was 33 out of 300 beds. Next day, patients weren't found in wardsTwo patients were told to fake a corneal abrasion70% of in-patients admitted a day before inspection. Over 70% faculty recently appointedPatients said were brought in three buses from home, yet bed occupancy was 91 out of 280 bedsHospital said doctors were summoned to police station. Police confirm no such summons were issuedPatients in surgical wards had no inpatient case sheet, OPD papers or any belongings Beds had no mattresses and bedsheets. Patient details not entered in ward registerNo ventilators or monitors in Intesnsive care unit, Pediatric intensive care unitWards had no oxygen pipeline or cylinders