ANBAI Article

The Association of National Board Accredited Institutions (ANBAI) was started in Bangalore in 2010. This was in response to the decision of the National Board of Examinations (NBE) to take over admissions to medical courses in India. Before this decision, teaching hospitals and medical institutions were able to admit students if they passed the entrance test for eligibility. The first national meeting of ANBAI was held in October 2010 at the Bangalore Baptist Hospital, where it was decided that having an Association of DNB (Diplomate of National Board) accredited Institutions would greatly help in addressing problems faced by teaching hospitals and students. The first ANBAI governing council meeting was held at Bangalore Baptist Hospital in December 2010, and ANBAI was formally registered at the Registrar of Societies in January 2011. 

Once ANBAI was formed, its first action was legally challenge the decision by NBE to take over control of admissions to medical courses in India, however the case was decided in favour of NBE and ANBAI was ordered by the court to pay a fine of one lakh rupees! Fortunately, that is now water under the bridge, and the relationship between the NBE and ANBAI today is characterized by collaboration and strength in teamwork for the benefit of the health sector in our country. The admission process by NBE is now looked up to as the gold standard in our country.

The turning point in the relationship was when the Indian Government introduced the National Commission for Human Resources for Health (NCHRH) Bill.

Buoyed by the success of their first joint endeavor, ANBAI and NBE have worked together on several projects with stellar results. Infact, NBE considers ANBAI as its ambassador, for communicating, implementing, interacting with all the accredited Institutions and faculty!!  ANBAI has facilitated a significant number of changes in the way the NBE has been improving postgraduate medical education.

The following points highlight some of these achievements. 

  • The number of examiners and inspectors from NBE hospitals have increased dramatically over the years. Now it has been decided that 50% of the examiners in the practical’s, will be from NBE Institutions. This will keep increasing till all the examiners will be from the NBE stream.   
  • Earlier reaccreditation assessment use to take place every 3 years. Now it has been increased to once in 5 years, decreasing the cost for the Institutions. 
  • Hospitals had been requesting for an increase in DNB tuition fees. With the active intervention of ANBAI, these have been increased from Rs. 50, 000/- per year earlier to the present Rs. 1, 00,000/- per year.  ANBAI was able to achieve this, while still keeping the DNB postgraduate courses the cheapest in the country. 
  • With constant feedback about poor examination results, ANBAI through discussions with NBE have been able to improve the exam result rates, by improving with standardized and objective assessments, without compromising the quality of the evaluation.  
  • ANBAI with its constant lobbying and discussions, has been able to get the Medical Council of India to grant equivalence for the degrees of the NBE, subject to certain criteria. In yet another achievement, the recently formed NMC, has also granted equivalence status to the NBE degrees. 
  • ANBAI engaging with MOHFW, NITI AYOG and PMO has enabled increase in the number of DNB seats, both for postgraduate medical education, as well as, the MBBS seats in the country, which is a boon for most of the private teaching Institutions.  
  • Based on the feedback back received from Institutions, the PG thesis approval can now be done by the individual hospital Ethics Committee itself. These Institutions no longer have to wait for third party approval. 
  • Most of the exam centers invariably were at Medical colleges. ANBAI’s repeated pleas with the NBE, has resulted in acceptance of NBE accredited Institutes to be considered as examination centres. Teaching faculty from these Institutes are also now actively considered to be examiners. 
  • It was well known that earlier failed candidates could appear for the repeat exam only one year later. ANBAI's interactions with the Executives of the NBE, has helped to bring it back to once every 6 months. 
  • Basic Sciences teaching was earlier mandated to be done by faculty from medical colleges. ANBAI has again helped change this impractical rule. Basic Sciences teaching can be now done by the Physicians and Surgeons in the same teaching Institute itself. This is a paradigm shift in the way Basic Sciences teaching can be done.    
  • In yet another point of synergy, the ANBAI conclaves are now being co-hosted by the National Board of Examination itself. 

 

NBE and ANBAI have initiated many projects for the betterment of DNB faculty and students. Both parties are contributing material for the Uniform eLearning Library, a game-changing resource for healthcare students and professionals who can access information at the click of a button.

Communication in Healthcare and Quality in Health are two crucial areas which do not have a place in the present medical curriculum. All NBE students are given books on Communication in Healthcare and the Handbook on Quality and Patient Safety promoted by ANBAI. The NBE faculty have been trained in healthcare communication. This is to be part of NBE PG curriculum from next year.

ANBAI is on the NBE-UNESCO Steering Committee on Teaching of Bioethics in PG Medical Education and on the Uniform Learning Resources Committee of the NBE.

ANBAI has contributed to the effort to introduce NBE post-graduation programs into district hospitals in Karnataka. So far, 9 Government District hospitals have been accredited in Karnataka with 80 seats. Due to ANBAI's continuous support and encouragement, 10 more Taluk and District hospitals have applied for recognition as NBE teaching Institution!  ANBAI has facilitated this in many States of the country now.

NBE had a long period without a Governing Board to conduct its activities. ANBAI had written to the Government of India, and Niti Ayog drawing attention and resolving this issue.

In the last six years, ANBAI has initiated and supported many programs to improve the landscape of the healthcare sector.

There was a separate recommendation from ANBAI that the National Board of Examination becomes a Postgraduate Board, in the newly formed NMC, and that this body was not to be dissolved. NBE will remain separate from the NMC

ANBAI supported the empowerment of nurses and clinical autonomy for nurse Practioners in midwifery. ANBAI also submitted suggestions for the Allied and Healthcare Professional’s Central Council Bill, many of which have been accepted, including representation of ANBAI in the Governing Body.

ANBAI is also part of the consultation on private sector participation, in expansion of Medical Education, called by Ministry of Health & Family Welfare on the direction of the PMO.

ANBAI is a member of several alliances and is represented on various Boards that deal with issues affecting the health sector. It has participated in numerous national conclaves and consultations.

ANBAI is a member of the National Steering Committee to review legal and ethical perspectives of healthcare in India. 

ANBAI celebrates the Teachers day at the National level and distinguished teachers are honored in recognition of their contribution towards Medical Teaching. Also such regional level functions are also similarly arranged and teachers honored.

ANBAI was also instrumental in creating the DNB alumni cell to look into the welfare of NBE degree holders.

ANBAI along with AHPI was also responsible for ensuring the legislation on banning smoking in public places.  

ANBAI is represented on the Task Force for Policy on Public Health, Govt. of Karnataka. 

After the introduction of entry-level standards by the National Accreditation Board for Hospitals and Healthcare Organisations (NABH), ANBAI has been promoting entry-level accreditation, especially among small healthcare Organisations, through the Consortium of Accredited Healthcare Organisations (CAHO). It works closely on various issues with the Association of Healthcare Providers, India (AHPI) including efforts to recover illegal deductions from UTI for their member hospitals, increasing procedure rates payable under CGHS scheme, for campaigning for logical and transparent pricing, focusing on patient safety, participating in the “Save the Doctor” campaign to equalize the number of under-graduate and post-graduate seats, and negotiating with the government on bonuses and minimum wages in the healthcare sector. 

In Karnataka, AHPI and ANBAI were instrumental in reducing the electricity tariff for hospitals, removing the luxury tax on hospitals, recovering pending payments for member hospitals from ESIS, and protesting relations to violence against hospital staff. 

In a major achievement, ANBAI has been facilitating annual and biannual interaction of the various accredited DNB Institutions, with officials of the NBE. One session is at the AGM of ANBAI. This has now been extended to State Level meetings also. Karnataka has had two such half-day sessions with the President and Executive Director of the NBE, in the last 1 year. 

Today, ANBAI is a network connecting every NBE teaching hospital in India, with several State chapters across the country: Delhi, Tamil Nadu, Andhra Pradesh & Telangana, Karnataka, Kerala, Maharashtra, and West Bengal including the North-Eastern states. Its head office, originally in Bangalore, is in the process of moving to Delhi. The governing council of ANBAI meets annually to plan the strategy and activities of the next year.  ANBAI also conducts annual conferences, bringing together the community of those who work in medical education and providing a platform for them to share their successes and best practices. 

ANBAI also recommended the invitation of NBE onto the NABH Board

The proposal for a Uniform Learning Resource through the National Medical Library has been sent to the NBE, Niti Ayog, and the Ministry of Health and Family Welfare.   

ANBAI also has sent a proposal for Basic Sciences webinar to facilitate easier teaching of Basic Sciences in the DNB course. We await approval from the National Board.

ANBAI has been at the forefront of a game changing exercise – the abolishment of several exams for students to pursue their postgraduate career. Part of the efforts of the ANBAI has paid off in NMC announcing just one single exit exam to facilitate easier entry into postgraduate courses.  

ANBAI is grateful to all its member hospitals and partners, especially the NBE. The former President of the NBE, Dr. Srinath Reddy, the current President, Dr. Abhijat Sheth and Vice-President & Executive Director, Dr. Rashmikant Dave and their team, have provided invaluable guidance and advice to ANBAI. We look forward to continuing partnership with our fellow Associations and with the Government, to strengthen the quality of post-graduate Medical Education in India.

Reviewed on: 19/08/2019