The Great Divide in Postgraduate Medical Recognition: Why Some Specialists Are Left in the Cold

Imagine training for years, dedicating your life to learning, and still being told you're not qualified enough depending solely on where you stand on the map of India. This is not fiction. It’s the confusing reality faced by thousands of medical professionals who complete their postgraduate education from one of India’s oldest medical institutions, the College of Physicians and Surgeons (CPS), Mumbai.

Despite being more than a century old, CPS and its postgraduate diplomas continue to stand at the crossroads of recognition. What should have been a straightforward academic path has become a puzzle with different pieces missing in different states.

Let's dive into the real reason behind the ongoing battle for recognition, the legislative loopholes, and the emotional and professional toll it takes on practitioners.

Founded in 1912, the College of Physicians and Surgeons in Mumbai was established with the noble aim of training doctors beyond their MBBS degree. Over the years, it began offering two- and three-year diploma and fellowship programs in fields like gynecology, pediatrics, pathology, and more.

These courses have helped plug the specialist shortage in many regions. In rural belts, CPS-trained doctors are often the only specialists available. However, the same qualifications are valid in some states and completely invalid in others.

This fragmented acceptance raises a crucial question: Are these qualifications flawed or is the system itself broken?

While states like Maharashtra, Gujarat, Rajasthan, West Bengal, and a few Union Territories allow CPS-qualified doctors to practice, others have withdrawn recognition or never granted it at all.

The answer lies in state-level medical legislation. Some states recognize CPS diplomas under their local laws, while others rely strictly on the list of recognized qualifications published by the National Medical Commission (NMC) India’s apex medical regulator.

This patchwork of rules means that a CPS-trained pediatrician in Mumbai might be respected as a specialist but the moment they move to Delhi or Karnataka, their qualification could be considered unofficial.

This burning issue recently found its way to the floor of the Indian Parliament. A Member of Parliament questioned the government on why CPS diplomas are treated differently across states, and whether the Centre had any plans to bring uniformity.

In response, the Union Minister of State for Health, Smt. Anupriya Patel, clarified that only those medical qualifications listed under the NMC Act are nationally recognized. She also said that institutions offering unlisted courses must seek NMC's approval before launching new programs.

But the reply did more than just quote the law, it highlighted a deep-rooted policy paralysis that has been neglecting thousands of medical professionals caught in limbo.

While Maharashtra was once a stronghold for CPS recognition, things began to shift in recent years. The Maharashtra Medical Council (MMC), after conducting inspections, reported severe deficiencies in several CPS-affiliated institutes. Based on these findings, the state derecognized 26 CPS diplomas and fellowships, halting new admissions.

CPS challenged this decision in the High Court, hoping for relief. However, the court upheld the derecognition, citing the need for regulatory compliance and standardization. The ruling closed the doors on new admissions for 2024-2025, affecting hundreds of aspiring postgraduates.

This move by Maharashtra sent shockwaves across the medical community because if the birthplace of CPS no longer stands by it, what does that say about its future?

The NMC’s stance hasn’t been vocal, but its actions speak louder. The Postgraduate Medical Education Board (PGMEB) of NMC recently recommended withdrawing popular CPS courses like DGO (Gynecology), DCH (Pediatrics), and DPB (Pathology and Bacteriology). These courses once filled critical specialist gaps in secondary care hospitals.

Additionally, the National Board of Examinations (NBE) has refused to absorb CPS courses under its umbrella effectively denying them mainstream acceptance. Without the backing of either NMC or NBE, these diplomas are fast becoming paper qualifications with no professional currency.

Thousands of doctors across India now hold diplomas that are invalid in key states. Their options? Either remain in the few states where CPS is still recognized or pursue further degrees from recognized institutions, which isn’t always financially or logistically possible.

Some private hospitals and diagnostic labs are also reluctant to hire CPS-qualified specialists, fearing legal backlash or insurance complications. For patients, this means losing access to otherwise qualified doctors. And for doctors, it’s a direct hit to their careers and dignity.

Can Uniformity Be Achieved?Yes, but not without political will, regulatory clarity, and genuine dialogue between states and the Centre.

Here’s what needs to happen:

1. Transparent Audit of CPS Programs: Rather than blanket bans, a transparent inspection of each course and affiliated institute can separate the credible from the questionable.

2. Upgradation of Curriculum: CPS must evolve its teaching standards to match national and international benchmarks.

3. One Nation, One Recognition Policy: The Centre must work with states to end the regional disparity in medical qualification recognition.

4. Reform Through Collaboration: CPS, NMC, and state medical councils should sit at the same table with one goal: standardization without exclusion.

The debate around CPS recognition is not just about degrees. It’s about trust in the medical education system. It’s about the promise made to thousands of medical graduates that their hard work will be valued equally regardless of where they practice.

If we continue to stay silent, we risk building a healthcare system riddled with confusion, inconsistency, and avoidable shortage of specialists. For a country as diverse and populous as India, can we really afford that?

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