Medical Education Commission

The Medical Education Commission (MEC), or Chikitsa Shiksha Aayog (चिकित्सा शिक्षा आयोग), Sanothimi, Bhaktapur, is Nepal's central body for overseeing medical education. MEC plays a vital role in maintaining standards and ensuring fairness in the country's healthcare education system. Established through the National Medical Education Act 2075, the Commission upholds every Nepali citizen's fundamental right to good health by carefully managing and improving the quality of medical education across the country.

The Start and Legal Basis

The Medical Education Commission is based on Nepal's constitution, which states that health is a fundamental right for everyone in Nepal. This right means everyone should have access to essential healthcare and fair access to health services, including emergency treatment. The government is responsible for ensuring these rights are real, including investing in public health and managing the health sector to improve access to and quality health services.

Medical education is key to making these health goals achievable. Therefore, the Nepali government established the Medical Education Commission. The main goals of the MEC are to put more state money into medical education, make sure education programs match what Nepal needs for healthcare, and simplify the rules and management of medical education organizations. MEC is in charge of organizing how medical education institutions are set up and run, making sure they are high quality, professional, accountable, and fair in terms of location and access for students from all backgrounds, especially those who have been excluded.

The National Medical Education Act 2075, which became law on February 22, 2019, provides the legal structure for the MEC. This law officially created the Medical Education Commission and clearly defined its role, giving it the power to supervise and direct medical education in Nepal.

Roles, Responsibilities, and Authority

Article 6 of the National Medical Education Act of 2075 details the roles, responsibilities, and authority of the Medical Education Commission. The Commission has significant power to regulate and improve medical education standards throughout Nepal. Its diverse duties include making policies, setting standards, managing accreditations, and overseeing institutions.

(A) Creating National Policy: MEC's role includes deciding the main national policy guiding medical education. This means setting the overall plan for medical education in Nepal, ensuring it supports national health aims, and adapting it to meet changing healthcare needs.

(B) Setting Policy and Standards for Medical Education: The MEC is tasked with developing policies and standards for all levels and types of medical education, applicable at the national and local levels. This involves defining the benchmarks for what should be taught, faculty qualifications, facilities, and overall quality control in medical education institutions throughout Nepal.

(C) Common Entrance Test Policy: MEC's key responsibility is to decide the policy and rules for running the Common Entrance Test. This test is a standard way to ensure fair entry into medical programs nationwide and the just and open selection of future healthcare professionals.

(D) Accreditation Policy and Criteria: MEC has the power to set the policy, basis, and rules for accreditation of medical education institutions. Accreditation is an important way to check quality, ensuring that institutions meet set standards and offer good education. This involves carefully checking institutions against established benchmarks and criteria.

(E) Policy for Academic Growth and Research: The Commission sets academic growth and research policies in medical education. This includes encouraging research in medical institutions, setting guidelines for academic progress, and promoting new ideas in medical education delivery.

(F) Giving Instructions to Educational Bodies: MEC is authorized to give necessary instructions to universities, institutes, and councils about medical education. This allows the Commission to guide educational bodies to follow its policies and standards, consistently applying rules across the sector.

(G) Accreditation Standards for the National Board of Medical Specialties: MEC is responsible for approving accreditation standards for the National Board of Medical Specialties (NBS). This is important for maintaining high standards in specialized medical areas and ensuring the quality of specialist doctors trained in Nepal.

(H) Policy and Criteria for Letters of Intent and Affiliation: MEC is responsible for setting policies and criteria for granting letters of intent and affiliation and terminating affiliations with medical education institutions. This regulatory control allows MEC to manage the creation of new institutions, oversee their connection with universities, and act against institutions that don't meet standards.

(I) Awarding Titles to Physicians: The Commission can award titles to physicians who successfully pass exams conducted by the National Board of Medical Specialties. This formal recognition confirms the skills of specialist physicians and ensures that only qualified professionals are given specialist titles.

(J) Approving Annual Budget: MEC is responsible for approving its annual budget and the necessary staff positions. This administrative function ensures the Commission's financial stability and effectiveness.

(K) Planning Locations for Educational Institutions: The MEC is tasked with approving the locations of educational institutions. This involves strategically deciding where to locate them across Nepal, ensuring a fair geographical distribution, and addressing gaps in access to medical education in different regions.

(L) Other Assigned Tasks: MEC is also required to perform other tasks as assigned, allowing it to be flexible and address new needs and challenges in medical education as directed by relevant authorities.

(M) Modifying Plans and Rules: The Commission can modify action plans, proposals, directives, or rules submitted by the Directorate and the Board and then submit these to the Commission for approval. This ensures the Commission can adapt and respond to changing situations and feedback from those implementing the policies.

(N) Recommending Letters of Intent: MEC is responsible for making recommendations to the Commission for letters of intent as per the Act, based on what the relevant Directorate suggests. This multi-step approval process makes the decision-making about new medical institutions more thorough.

(O) Implementing Policies and Programs: MEC is responsible for implementing its policies and programs approved by the Commission through the relevant Directorate and board. This ensures that policies are effectively implemented into real actions and programs.

(P) Ending Affiliations: As per the Act, MEC can send a letter to the relevant university to end an educational institution's affiliation. This power allows MEC to act against institutions that violate regulations or standards.

(Q) Working with National and International Bodies: MEC must cooperate and coordinate with national and international organizations involved in medical education. This teamwork helps share knowledge, adopt best practices, and align with global standards in medical education.

(R) Creating Location Plans for Institutions: MEC is responsible for creating plans for the locations of educational institutions. This planning role helps ensure medical education facilities are distributed strategically, meeting geographical needs and promoting fair access.

(S) Recommending Student Numbers and Fees: The Commission is tasked with making recommendations to the Commission about the number of students placed in educational institutions, tuition fees, and related matters. This role directly affects who can access medical education and its affordability, aiming for fair and open fee structures.

(T) Other Assigned Tasks: Similar to point (L), MEC is also responsible for doing other tasks as assigned, allowing it to adapt and handle unexpected needs in the medical education field.

Organizational Structure

To effectively carry out its wide-ranging responsibilities, the Medical Education Commission is structured to include representatives from various important sectors within Nepal's health and education systems, as detailed in Article 5 of the National Medical Education Act, 2075. This diverse group ensures that different viewpoints are considered and that decisions are made in an inclusive way within the Commission.

The Commission's leadership is headed by:

(A) Prime Minister: As the Chairman of the Medical Education Commission, the Prime Minister offers high-level political support and strategic direction to the Commission's work.

The leadership also includes Co-chairs:

(B) Minister of Education: As co-chair, the Education Minister contributes knowledge of educational policy and management to the Commission's discussions.

(C) Minister for Health: Also a Co-chair, the Health Minister provides important insights into the nation's health needs and ensures medical education aligns with public health priorities.

Supporting the leadership is a Vice President:

(D) A Physician Appointed by the Government: Appointed by the government, this Vice President, a physician recognized for their significant contributions to medicine, brings clinical and professional experience to the Commission's leadership.

The Commission includes a broad and representative membership featuring key individuals from different sectors:

(E) Member, National Planning Commission (Education and Health Watch): Representation from the National Planning Commission ensures that planning for medical education is part of broader national development plans and that health and education aspects are considered together.

(F) Three University Vice-Chancellors: Including three Vice-Chancellors from universities offering medical education programs will bring academic leadership and institutional perspectives to the Commission's discussions and decision-making.

(G) Secretary of Education: The Education Secretary's membership ensures smooth coordination between MEC and the Ministry of Education, making policy implementation and administration easier.

(H) Secretary of Health: Similarly, the Health Secretary's presence ensures strong connections with the Ministry of Health and helps integrate public health goals into medical education planning.

(I) Chairman, University Grants Commission: The Chairman of the University Grants Commission oversees higher education funding and brings expertise in university-level education and funding to the Commission.

(J) Vice President, Council for Technical Education and Vocational Training: Having representation from the Council for Technical Education and Vocational Training (CTEVT) ensures medical education is coordinated with technical and vocational training within healthcare.

(K) President, Ayurveda Medical Council: The President of the Ayurveda Medical Council brings knowledge of traditional medicine and helps integrate Ayurveda education into the wider medical education system.

(L) Chairman, Nepal Health Research Council: The Chairman of the Nepal Health Research Council contributes expertise in health research and promotes using evidence in medical education and healthcare practices.

(M) Chairman, Nepal Nursing Council: The Chairman of the Nepal Nursing Council ensures nursing education is represented and included in the overall medical education system.

(N) Chairman, Nepal Council of Health Practitioners: The Chairman of the Nepal Council of Health Practitioners provides a broader view of healthcare professionals and ensures coordination among different groups.

(O) Chairman, Nepal Pharmacy Council: The Chairman of the Nepal Pharmacy Council represents pharmacy education and its important role in healthcare.

(P) At Least Two Chairpersons from Medical Professional Organizations: To ensure professional views are included, at least two chairpersons from official medical professional organizations, including national bodies and at least one woman, are members of the Commission.

(Q) Chairperson of Private Educational Institutions Association: The Chairperson of the national association for private educational institution operators (excluding medical and dental) represents the private medical education sector.

(R) At Least Two Civil Society Figures: To bring in wider community views, at least two respected individuals from civil society, including a woman, are members of the Commission.

(S) Chairman, Nepal Medical Council: The Chairman of the Nepal Medical Council, the professional body for medical doctors, ensures medical education standards align with professional practice.

(T) Three Medical Education Experts: To provide specialized knowledge, three medical education experts, including at least two women, based on fairness of representation, are members of the Commission.

(U) President, Nepal Medical Association: The President of the Nepal Medical Association, the professional organization for doctors, represents the concerns of practicing physicians.

(V) Chairman of Private Medical and Dental Colleges Association: Representation from private medical and dental colleges is further strengthened by including the Chairman of their national association.

(W) Senior Commission Staff Member: A senior staff member of the Commission serves as the member secretary, ensuring smooth administration and operations.

Goals and Purpose

The creation of the Medical Education Commission shows a dedicated effort to address important needs and problems within Nepal's medical education system. Using the knowledge and ideas from reports by previous commissions, committees, and task forces aimed at improving medical education, MEC's fundamental duties are to:

• Increase Government Funding: The Commission is responsible for advocating for and securing more government funding for medical education. This financial support is crucial for improving facilities, increasing resources, and raising the overall standard of medical education institutions.

• Develop Education Relevant to National Needs: A key goal is developing medical education that meets Nepal's needs. This involves adjusting what is taught, the programs offered, and training methods to address the country's healthcare challenges and priorities, ensuring graduates are well-prepared to serve the Nepali population.

• Regulate Medical Education Effectively: The MEC coordinates and efficiently regulates medical education. This includes simplifying regulatory processes, consistently applying standards, and creating a clear and responsible regulatory system.

• Organize Institutions' Setup and Operation: MEC plays a key role in organizing the work related to setting up and running medical institutions. This involves overseeing the licensing, accreditation, and monitoring of medical colleges and other educational bodies, ensuring they meet quality levels and operate effectively.

• Maintain Quality, Professionalism, and Responsibility: A top goal is maintaining quality, professionalism, institutional responsibility, fair geographical distribution, and social justice in medical education. This wide-ranging goal includes ensuring high educational standards, promoting ethical behavior, encouraging institutions to be responsible, addressing geographical differences in access, and promoting social fairness within medical education.

• Ensure Fair Access: MEC is committed to ensuring fair access to medical education for all students, including those from disadvantaged backgrounds. This involves implementing policies and programs to support students from less privileged backgrounds, promote diversity in medical institutions, and create a more inclusive and fair educational environment.

The Act defines medical education as "education in all fields and levels related to health professions (Health Professional Education)." This wide definition highlights MEC's oversight of all types of healthcare professional training, covering different fields and levels of education.

Key Features

The Medical Education Commission ensures high-quality and consistent medical education across Nepal. A main tool for achieving this is the National Common Entrance Examination. The Directorate of Examination within MEC focuses on creating and running a strong examination system.

The Directorate focuses on conducting the common undergraduate entrance examination, followed by exams for postgraduate and specialist programs (like DM/MCh). The Features of the Common Entrance Examination are designed to improve fairness, openness, and merit in medical admissions:

• Nationwide Application: The national common entrance examination covers all educational institutions that offer medical/health professional courses. This unified approach removes the difficulty for students facing multiple entrance exams for the same programs and levels, making the admission process simpler and easier.

• Objective and Tech-Based: The exams use objective tests with a technology-based evaluation system, reducing human involvement and ensuring accurate and unbiased scoring. This method improves the reliability and fairness of the assessment process.

• Selection Based on Merit: Student selection is strictly based on merit. A computer matching system places students in their preferred choices based on their entrance exam scores. This ensures that the most qualified students are admitted to medical programs based on their academic performance.

• Applicable for National Board Specialty (NBS) Degree: The merit from the entrance exam also counts towards pursuing the National Board Specialty (NBS) degree, managed by MEC. This connection emphasizes the importance of the common entrance exam as a starting point for basic and specialized medical education.

• Required for Postgraduate Study Abroad: Students wanting to pursue postgraduate courses overseas must pass the entrance exam to receive an eligibility certificate from MEC. This step ensures that Nepali medical graduates seeking international education meet a basic quality level set by MEC.

Directorate for Planning, Coordination, and Academic Improvement

The Directorate of Planning, Coordination, and Academic Upgradation within MEC is crucial for shaping the strategic path of medical education in Nepal. This Directorate is responsible for:

• Creating National Health Professional Education Policy: The Directorate leads the development of the national health professional education policy, aligning it with national health goals and ensuring it responds to changing healthcare needs.

• Planning Yearly Programs: It plans the yearly programs of the Medical Education Commission, turning policy goals into practical action plans and projects.

• Estimating Healthcare Workforce Needs: The Directorate estimates national healthcare workforce needs, production, and use. This data-driven approach informs planning and ensures medical education output matches the country's healthcare workforce requirements.

• Coordination with Education and Government Bodies: The Directorate facilitates coordination between educational institutions and government bodies, ensuring smooth teamwork and alignment in medical education development. This includes managing letters of intent, fee structures, and college student seat allocations.

• Improving Academics for Better Quality: A key focus is on academic improvement to enhance quality, including efforts to improve teaching methods, add new programs, and promote research in medical education.

Tuition Fees, Seat Allocation, and Scholarships

The Medical Education Commission also addresses important aspects of access and affordability in medical education, particularly tuition fees, seat allocation, and scholarship opportunities.

Tuition Fees: The MEC broadly defines tuition fees as "admission, tuition, lab, library, community training, or examination fees" charged by educational institutions. This definition provides transparency about the costs of medical education. The Commission sets tuition fees based on factors like institutional running costs, inflation, location, and providing scholarships and free services. Tuition fees for undergraduate MBBS programs differ between institutions inside and outside the Kathmandu Valley. In contrast, fees for other programs are generally consistent.

Seat Allocation: MEC decides the number of seats in medical institutions based on criteria set by the Directorate. This process uses the iSelf-Appraisal Tool/YardstickYard Stick for institutions to provide their assessment data. Expert teams from the Commission then check and monitor the data. The seat allocation recommendation committee then prepares a report for final approval by the executive committee. Seat allocation considers factors like facilities, staff, and adherence to national and international standards.

Scholarship Opportunities: MEC manages scholarship programs to promote fair access to medical education. Students awarded scholarships are expected to meet certain responsibilities, including completing their studies in a set time and providing compulsory service in remote and accessible areas as assigned by the government. Not meeting these responsibilities can lead to penalties, including losing future scholarship eligibility and financial consequences. Scholarship applicants must submit documents like Nepali citizenship, proof of passing the entrance exam, and documents related to reserved categories. There are also procedures for managing scholarships received from abroad, ensuring they align with national priorities and are fairly distributed.

Curriculum Development

The Medical Education Commission is central to shaping the medical education curriculum in Nepal. It is responsible for creating a national curriculum format/blueprint and maintaining consistency and standards across the national curriculum. This ensures a standardized and high-quality curriculum in all medical education institutions, preparing graduates with the necessary knowledge and skills to meet Nepal's healthcare needs.

Conclusion

The Medical Education Commission (MEC) of Nepal is a crucial organization that shapes the future of medical education and healthcare in the country. Through its wide range of responsibilities, including policy-making, regulation, accreditation, and quality assurance, MEC is key to upholding the basic right to health and ensuring well-trained and caring healthcare professionals are produced. By promoting fairness through the Common Entrance Examination, regulating fees and seat allocation, and supporting scholarships, MEC improves access, fairness, and quality in Nepal's medical education system. As the main regulatory body, the Medical Education Commission continues to be essential in advancing medical education and strengthening the healthcare workforce to serve the changing needs of Nepal and its people.

Under Article 5 of the National Medical Education Act, 2075, the Medical Education Commission is constituted as follows.

Organizational Structure of the Medical Education Commission (MEC):

Contact Details:

Medical Education Commission (Chikitsa Shikshya Aayog)

Sanothimi, Bhaktapur, Nepal

Phone: +977-1-6639414, +977-1-6639415, +977-1-6638902, +977-9851318498

Email: [email protected]

Website: www.mec.gov.np