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Human Resources for Health
Published in: Human Resources for Health 1/2021

Open Access 01-12-2021 | Review

The impact of colonial-era policies on health workforce regulation in India: lessons for contemporary reform

Authors: Veena Sriram, Vikash R. Keshri, Kiran Kumbhar

Published in: Human Resources for Health | Issue 1/2021

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Abstract

Background

Regulation is a critical function in the governance of health workforces. In many countries, regulatory councils for health professionals guide the development and implementation of health workforce policy, but struggle to perform their responsibilities, particularly in low- and middle-income countries (LMICs). Few studies have analyzed the influence of colonialism on modern-day regulatory policy for health workforces in LMICs. Drawing on the example of regulatory policy from India, the goals of this paper is to uncover and highlight the colonial legacies of persistent challenges in medical education and practice within the country, and provide lessons for regulatory policy in India and other LMICs.

Main body

Drawing on peer-reviewed and gray literature, this paper explores the colonial origins of the regulation of medical education and practice in India. We describe three major aspects: (1) Evolution of the structure of the apex regulatory council for doctors—the Medical Council of India (MCI); (2) Reciprocity of medical qualifications between the MCI and the General Medical Council (GMC) in the UK following independence from Britain; (3) Regulatory imbalances between doctors and other cadres, and between biomedicine and Indian systems of medicine.

Conclusions

Challenges in medical education and professional regulation remain a major obstacle to improve the availability, retention and quality of health workers in India and many other LMICs. We conclude that the colonial origins of regulatory policy in India provide critical insight into contemporary debates regarding reform. From a policy perspective, we need to carefully interrogate why our existing policies are framed in particular ways, and consider whether that framing continues to suit our needs in the twenty-first century.
Footnotes
1
Cadre of hospital assistants with responsibilities including bandaging, stitching, injections, dressing of wounds and other tasks to assist surgeons and medical staff—https://​www.​nqr.​gov.​in/​sites/​default/​files/​QF%20​_​Dresser%20​_​MED206.​pdf
 
2
Indian medical gradates currently seeking to practice in the UK must undertake entrance examinations or complete training programs recognized by regulatory bodies in the UK—https://​www.​gmc-uk.​org/​registration-and-licensing/​join-the-register/​before-you-apply/​working-as-a-doctor-in-the-uk
 
3
In 2008 the Ministry of Health and Family Welfare amended the Indian Medical Council Act to recognize post-graduate medical qualifications from five foreign countries: Australia, Canada, New Zealand, U.K. and U.S.A. Notification accessed on 12 July 2021: https://​main.​mohfw.​gov.​in/​medicaleducation​counselling/​recognition-foreign-post-graduate-medical-qualification.".
 
4
"It is worth noting that the Medical Council of India was concerned with the regulation of standards only in the university-affiliated medical colleges, while the medical schools which granted the licentiates were under the control of provincial governments.".
 
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Metadata
Title
The impact of colonial-era policies on health workforce regulation in India: lessons for contemporary reform
Authors
Veena Sriram
Vikash R. Keshri
Kiran Kumbhar
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2021
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-021-00640-w

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