Continuing Medical/ Dental Education- Do the statutory bodies have jurisdiction?

 

The simple answer is NO! In my opinion any public notice to the effect by statutory bodies is probably ill- advised or a wrong understanding of the Dentist Act 1948 and the Regulations made by it as per 20 (1). It certainly must be ratified or challenged in a Court of Law.

Let me explain. Continuing Education is an absolutely necessity not only in health care but also in all professional arenas. I completed my post graduate training in 1986, nearly 40 years ago. What I learnt at college is not what I practice today. It has qualitatively and quantitatively evolved over the last 4 decades to keep pace with innovation, new skill sets and advanced technology. I am sure this is the experience of all professionals.

How did we acquire new skills? Obviously, by attending courses and workshops meant to upskill and adapt to newer methods. Continuing education also helps us fill in the gaps during training and produce better doctors. This is a boon to the public in accessing uniformly better and safer healthcare.

Recently more than one State Dental Council has issued a public notice prohibiting the conduct of continuing education by individuals or associations without taking prior permission of the Dental Council. This public notice is ostensibly based on the Code of Ethics regulation 2014 which was further amended to include CDE points as a mandatory requirement. The amended clause also provides direction to clarify the qualifications for the CDE provider. Let me quote the relevant provision of the gazette notified regulation no which came into effect in 2018.

Section 2 (b) defines a service provider to include all DCI /MCI recognized institutions having dental departments, government bodies and Armed Forces. Professional bodies such as Professional Associations and National Specialty Associations will need to apply to the DCI/ State Dental Councils for award of CDE points for meeting and conferences held under their aegis and this approval will be valid for a period of 5 years, subject to review.

The CDE points as per 6 (1) of the same regulation also says that there should a CDE credit system in India and each and every dentist shall inform the State Dental Council from time to time otherwise (SIC), it would amount to violation of the provisions of the ‘Revised (Code of Ethics) regulations 2014

For reasons best known to the DCI and State Councils the central theme of mandatory CDE points were never carried out in the last 7 years. In the absence of CDE requirements, where does the issue of the qualification for the provider arise?

Does this not mean that the regulation (DE-226-2017) is not implementable or was abandoned for the last 8 years? The old system of non –formal workshops and lectures can and should be continued in the interest of knowledge acquisition and continuing education.

Even if valid, a regulatory body can lay guidelines for acquisition of CDE points to fulfil regulatory requirements on those who wish to renew registration. The statutory body cannot prevent one qualified registered practitioner teaching another qualified registered practitioner any skill or technique or emerging treatment modality. Therefore, it is clearly outside the jurisdiction of the statutory bodies if no CDE points given or degree/ diploma is awarded.  The Dentist Act (the document of maximum reliance) only talks about recognized qualification. In fact, The Code of Ethics 3.2 encourages learning with the exhortation that “They should try continuously to improve medical knowledge and skills and should make available to their patients and colleagues the benefits of their professional attainments. and in fact encourages dentists to update their knowledge”. Implantology, for example, is not a recognized stand alone specialty. Dental surgeons became implantologists by learning it from the pioneers. Today it is a robust branch of dentistry, practiced by dental graduates, although it was not taught in dental colleges.  If the knowledge provider is spending time and resources on training, it is justified that they charge a cost towards imparting knowledge or skill.

In the final analysis it must be remembered that the Dentist Act of 1948 (with amendments) is to be relied upon if there is a conflict between the Act and regulations made by it. The Dentist Act  of 1948 and all amendments thereafter only refers to regulating registered qualifications like BDS, Dental Mechanics and Dental Hygeinists. If the Dental Council did in fact want to address the issue of non- registrable qualification it could have been done when amendments were instituted in 1992, 1993, 2016 and 2019. The issue was never addressed.

I sincerely hope that the National Dental Commission will address these issues more reasonably and allow flow of knowledge in the best interest of the profession and the public rather than drag these issues in court.

Caveat: the author George Paul has no vested interest in the matter as he does not conduct any courses or training.