Ahmedabad: A new eligibility rule under the Pradhan Mantri Jan Arogya Yojana (PM-JAY) is quietly threatening to upend cancer care across Gujarat, by barring hundreds of experienced oncologists from treating the scheme’s patients.The revised recruitment and empanelment norms require oncology specialists to hold doctorate of medicine (DM), magister chirurgiae (MCh) or doctorate of national board (DrNB) qualifications. The rule effectively sidelines veteran doctors holding MD degrees, many of whom have specialized cancer care in the state.The issue is particularly acute in Ahmedabad, home to at least 250 oncologists. In private practice, MD-qualified specialists who have operated for decades are now ineligible for PM-JAY empanelment, restricting their ability to treat the most vulnerable patients.The impact is visible even in govt-aided institutions. An analysis of the 2023 NIRF ranking data for the Gujarat Cancer and Research Institute (GCRI), a govt-funded hospital which treats PM-JAY beneficiaries, reveals a heavy reliance on MD-qualified faculty members. Out of 93 faculty members listed, a significant majority, including those in senior leadership, hold MD degrees. The reliance on MD-qualified faculty members had already come under scrutiny last year. “A group of parents wrote to the Union health secretary and the National Medical Commission (NMC), questioning how doctors with only MD degrees in general medicine were teaching and guiding students in the DM medical oncology programme at GCRI,” said a senior official.Dr Kirti Patel, deputy director of GCRI, said, “When we were studying in the late 1970s, oncology training was very different. Doctors completed an MD and many treated cancer patients because specialized DM oncology courses did not exist then.” Now, the NMC has clarified that institutions failing to follow these new superspecialty norms will face scrutiny.The Ahmedabad Medical Association (AMA) has raised concerns regarding the rural healthcare vacuum this will create. Dr Jignesh Shah, chairman of AMA, said, “In smaller towns and non-metro areas, there is a severe shortage of DM-qualified oncologists, and a rigid application of recruitment norms will restrict access to cancer care”.He argues, “Basic cancer treatment, including chemotherapy, should be allowed under a structured and regulated framework. Trained MD physicians and radiation oncologists can handle uncomplicated cases, provided treatment is protocol-based, supported by tumour boards, and backed by clear referral systems for complications. Complex cases can be referred to DM specialists.” What is equally important, experts say, is increasing DM seats, creating fellowship programmes, and mandating standard treatment protocols and safety safeguards.“GCRI director Dr Shashank Pandya said he was not aware of the new rule. He said, “Surgeries are carried out by MCh-qualified doctors, and therefore surgical procedures under PM-JAY are not affected.” He also said the institute has not received any official communication from the state health department regarding the changes.
