The National Medical Commission (NMC), through its Medical Assessment and Rating Board (MARB), has issued guidelines to address the malpractice of medical colleges admitting fake patients during inspections. These guidelines, outlined in the “Establishment of Medical Institutions, Assessment & Rating Regulations, 2023”, aim to ensure compliance with ethical practices and accurate assessments.

What Are Fake Patients?

Fake patients are individuals admitted to a hospital to falsely meet the bed occupancy or patient count requirements set by NMC. These individuals often do not require inpatient treatment and are admitted solely to pass inspections. This malpractice undermines the integrity of the medical education system.

NMC Guidelines to Identify Fake Patients

The assessors are trained to identify fake patients based on the following observations:

1. Sudden Surge in Admissions: A large number of patients were admitted on the day of inspection or the day before.
2. Insignificant Ailments: Patients with minor or no significant health issues that could be treated on an Outpatient (OPD) basis.
3. Lack of Medical Evidence: No records of investigations (like X-rays, blood tests, or other diagnostic procedures) or treatments like IV fluids, medicines, or injections.
4. Playful Pediatric Patients: In pediatric wards, children appear healthy and play without signs of illness.
5. Multiple Patients from the Same Family: Admission of several individuals from a single family.
6. Preventive Health Checkups: Large numbers of patients are admitted through health camps or preventive checkups.
7. Other Observations: Any other justifiable observations made by the assessor.

Assessors document these cases with IP numbers and reasons for marking them as fake patients.

Consequences of Indulging in Fake Patient Practices

Institutions found indulging in fake patient practices face serious penalties under Chapter 5 of the Establishment of Medical Institutions, Assessment & Rating Regulations, 2023:

• Warnings: Issuance of a warning with time for compliance or rectification.
• Monetary Penalty: A fine of up to INR 1 crore per violation.
• Application Suspension: Withholding processing of applications for new schemes or approvals.
• Reduction in Seats: Cutting the intake of students for subsequent academic years.
• Course Stoppage: Halting admissions to certain courses.
• Recognition Withdrawal: Recommending to NMC for withdrawal of recognition.
• Rating Suspension: Withholding or withdrawing the institution’s rating for up to five years.
• Immediate Action on Coercion: Any attempt to pressurize MARB or NMC will lead to the suspension of application processing.

Why This Matters

The NMC inspections ensure that medical institutions meet the required standards for training students, including minimum bed occupancy and clinical exposure as per MSR criteria. By addressing fake patient practices, NMC aims to maintain the integrity and quality of medical education in India.

Conclusion

The NMC guidelines highlight the importance of ethical practices during inspections and aim to prevent fraudulent activities like admitting fake patients. These measures protect the credibility of medical education and ensure that aspiring doctors receive genuine clinical exposure. Medical colleges need to comply with these guidelines to build a robust and transparent healthcare system.

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