Feedback to national medical commission regarding aadhar-enabled biometric attendance system at medical colleges in India

ABSTRACT

Teachers are the backbone of any country, the pillars upon which all aspirations and dreams converge, if we paraphrase 11^th President of India, Dr A P J Abdul Kalam,. A teacher of a Medical college has immense potential to shape the foundation and basic wisdom/ technical skills of a young student and resident. So, teachers’ absence makes the learners bereft of these gifts- making them vulnerable to construct poor reasoning and judging clinical scenarios inappropriately: deriving incorrect or false interpretation from a given case presentation. For this reason, when the National Medical Commission (NMC) comes up and pushes for an idea ensuring physical presence of workforce at their respective workplaces, everyone should welcome the move. Nevertheless, like every fixture the virtual solution has its unique challenges, requiring nuances for proper assessment, demands reasoned and detailed dissection of actual ground -level situation; hence, I want the regulatory body to tweak the attendance -system to make it suitable for diverse atmosphere, varying working -conditions and rapidly -changing environment. Such formulation should have two- way communication channels between man (and woman) power as well as their regulators. Only then fine -tuning may be expected to be achieved to derive the maximum benefit while reducing chances of error/ omission/ glitch/ incompleteness and fault.

“On #DoctorsDay, I express my deepest gratitude to the entire doctor community. Even amid the most unprecedented times, doctors have exemplified highest degree of courage, selflessness and resilience. Their dedication goes beyond healing; it gives our society hope and strength.” – Narendra Modi, Prime Minister of India; July 1, 2023, on Doctors’ Day.[1]

The National Medical Commission, on behalf of the Government of India, regulates medical education around the length and breadth of India at its 706 Medical Colleges.[2] As health is State matter, usually it is managed and regulated by the State yet policy formulation on important matters is the domain of the Center. While implementation and required resource allocation are made at the level of State bureaucracy, the Union Government directs equality over the nation. Recently, the NMC directed all the Medical Colleges under its control to implement the Aadhar-Enabled Biometric Attendance System (AEBAS),[3] as a result the order is under scrutiny and debate in academic circles and beyond. The NMC controls and keeps an eye on my Medical University too.[4] Due to the expansion of avenues of medical education in a decade or so,[5] already the sector has been reeling under faculty shortage.[6] Therefore, to resolve the challenge of ghost faculty,[7] wilful/deliberate absence/private practice the NMC has come prepared with innovative ideas.

All of us agree in principle with the idea and support its good intentions. When the physical absence of teachers at their workplaces is a rampant trend, students and residents do not have mentors and teachers at their educational institutions; all the modern-day technology should be used to its full extent to ensure their presence at designated places. Nevertheless, the biometric system the way NMC has brought posed several questions for an average teacher and resident which need to be addressed simultaneously. Although the website of the NMC has a feedback link,[8] several issues are not acknowledged in that virtual space. Hence, I am using this medium and mode to channel our concerns and posers to our regulator in the hope and belief that the matter reaches appropriate authorities so that someone lends an ear to it.

A circular dated October 18, 2022, is available on the website of the NMC from its administrative section. It has a Subject: Guidelines for implementation of Aadhar Enabled Biometric Attendance System in Medical Colleges.[9] The circular has a heading therein, “Guidelines for Aadhar Enabled Biometric Attendance System (AEBAS) in Medical Colleges.” What is the meaning of the Guideline, NMC should explain. Are the Guidelines mandatory to be followed, is not clear. Point number 4 states, “Medical Colleges should notify the office timing and circulate such timing to all the faculties/staff for strict adherence. It is expected that all faculties/other staff should follow the office timings/staff duties allotted to them.”

Nevertheless, the NMC also directs these medical colleges to have a minimum number of indoor beds and a minimum occupancy rate to get recognition and maintain it.[10] Its point B.3.1 specifies a minimum bed strength needed to be present in lieu of which the teaching institution may lose its recognition. What picture emerges when we connect the dots is that every medical college needs to run its indoor department while its faculty, residents, and other service -providers are on fixed duty timings which NMC has been regulating for a while. Hence, poser is that who looks after these patients outside the fixed duty hours. In the unit system usually, each patient is admitted under the care of a team consisting of a unit head, a faculty member, and one resident so in the evening/night after exiting (as per NMC guidelines) who attends them remains a mystery. This is an ideal scenario and many times only one faculty member is present at the bedside due to various reasons.

NMC should issue such guidelines as well. If a patient admitted with a diagnosis of heart attack (myocardial infarction) develops chest pain outside the fixed duty hours as specified by the NMC, who should visit at the bedside, needs to be clarified. If a pregnant woman develops seizures (a common complication as a result of pregnancy-induced-hypertension) in the night when a faculty member is asked to go back after finishing her duty hours and marking her movement as per the rules; whether she should be consulted at all, is a poser whose answers we have been looking for several months now.

The purpose of indoor wards is to monitor patients, ICU (intensive care unit) and CCU (critical/coronary Care unit) is intensive monitoring and the emergency ward/department is to provide round-the-clock medical care service to patients. Public hospitals are a last resort for poor patients whereas many times medicolegal cases are brought by law-enforcement officers in an inebriated/injured state under the influence of narcotics/poisons or road-traffic accidents. If these patients need to be attended to as per NMC’s guidelines during duty hours in the daytime, what will happen afterward, we don’t know. Hence, these guidelines are apparently incomplete. During a budget session of parliament a few weeks ago, an opposition Member of Parliament raised the matter at the highest level.[11]

Point number 10 of the Guidelines states, “Any breach of the cyber security/hacking of the online attendance monitoring system in any medical college should be brought to the notice of the NMC immediately.” Hence, apparently NMC is aware of the cyber threats which we are increasingly facing in the digital era. But who is responsible for the safekeeping of the data − local medical colleges, NMC, device makers/internet service providers; or all, should be clarified.

Now we have the Digital Data Protection Act in place.[12] The Act penalizes one who indulges in (personal) data theft. But who should an aggrieved faculty member approach when her data gets stolen remains unclear in the Guidelines. UIDAI (Unique Identification Authority of India) provides a feature of masked Aadhar to its data depositors.[13] Whether some safety features like these have been put in place here as well, NMC should inform in its communications to allay the concerns of staff members of medical colleges. While directing teachers to deliver their classes is a laudable objective of NMC, protecting data privacy is also a right of citizens. Regulators should take note of the risks and build up some protection/firewall around.

The guidelines put several restrictions in the name of improving the working culture at medical colleges, but rules should not become a tool of harassment for someone who has been doing her duties honestly. If NMC has not been able to earn her trust and respect, it should introspect. Although NMC mentions the rules as Guidelines − which suggest it to be directive only − Medical Colleges have been making it clear that a faculty member not registering herself on the platform will stop getting her salary soon. NMC should also clarify whether one can opt out of the Guidelines. Putting a noose around fugitives is a laudable objective when it comes to education but one who is present in the hospital premises attending her duties earnestly should not be forced to run from pillar to post to get her just dues from the exchequer.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.