New Delhi: The Indian Chest Society on Thursday called upon the National Medical Commission to reinstate the department of respiratory medicine in the MBBS curriculum. The move would ensure that future medical graduates are well-equipped to address the respiratory health challenges facing India, the group, representing more than 6,000 respiratory medicine specialists across the country, said.
The appeal came amid the sharp rise in the Air Quality Index (AQI), shooting up to 1,000 in several regions.
The severe pollution is leading to a marked increase in respiratory and cardiovascular illnesses, disproportionately affecting vulnerable groups such as children and the elderly, the group said.
Dr Arun Madan, Professor and Head of the Department of Respiratory Medicine at Delhi’s Hindurao Medical College, emphasised the critical role that medical college hospitals have played for decades as hubs for advanced respiratory care and training.
He expressed concerns over the NMC’s decision to remove Respiratory Medicine departments from MBBS medical college hospitals.
The move was formalised under the ‘Guidelines for Undergraduate Courses under Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses and Assessment and Rating Regulations, 2023’ (UGMSR 2023 Guidelines).
“This decision … threatens to undermine the nation’s capacity to manage respiratory health effectively,” Madan said.
Dr GC Khilnani, former head of the department of pulmonology and sleep medicine at the AIIMS-Delhi, said India is among the most polluted nations globally, with over 99 per cent of its population exposed to PM2.5 levels exceeding WHO safety guidelines.
Such high pollution may exacerbate respiratory and cardiovascular diseases, Dr Khilani, currently the Director of the Department of Respiratory Medicine at Delhi’s PSRI Hospital, and Chairman of the Indian Chest Society (North Zone) said.
He said removal of respiratory medicine as a dedicated department among MBBS programmes has far-reaching implications.
“Without structured training led by respiratory specialists, medical students will miss critical learning experiences, which could hinder their ability to diagnose and treat respiratory diseases effectively,” he said.
He argued that general practitioners and non-specialists may be unable to provide specialised care required by respiratory patients, leading to poorer health outcomes.
Medical colleges are instrumental in executing programmes such as the National Tuberculosis Elimination Programme, he said, “Removing respiratory medicine from the curriculum may hinder medical colleges’ ability to support these programmes, compromising efforts to control TB and other respiratory diseases.”
Dr Manoj Goel, Principal Director and Head of the Department of Pulmonary Medicine at Fortis Medical Research Institute, Gurugram, said adopting clean technologies in industries, expanding renewable energy use, improving urban planning for energy-efficient cities, and implementing advanced waste management practices may alleviate pollution’s impact.
According to the World Health Organization, achieving even the first interim air quality target could prevent 300,000 deaths annually.
Dr Rakesh Chawla, Chairman of the Department of Respiratory Medicine, Critical Care and Sleep Medicine at Saroj Superspeciality Hospital and Jaipur Golden Hospital, Delhi, also underscored the critical role of respiratory medicine departments in medical colleges.
Their removal jeopardises patient care, particularly for tuberculosis, chronic obstructive pulmonary disease , and pollution-related illnesses, and undermines India’s TB elimination goals, and Dr Chawala, who is also the Vice President of the Indian Chest Society, said.
“The absence of these departments limits comprehensive care and diminishes hospitals’ capacity to meet broader community health needs. Additionally, the NMC’s decision has raised governance concerns, as it lacked transparency and bypassed necessary parliamentary approval,” he said.
“NMC says this has been done to reduce burden on MBBS students. This is a ridiculous argument when we need more primary physicians to deal with rising respiratory diseases,” he added.
Dr Aditya Chawla, a consultant in the Department of Respiratory Medicine, Critical Care and Sleep Disorders at Jaipur Golden Hospital and Saroj Super Specialty Hospital, said the NMC’s decision disregards the current and projected healthcare needs of the Indian population.
Respiratory medicine has traditionally been an essential part of MBBS education in India.
Under the Undergraduate Medical Education Board (UGMEB) 2020 curriculum, departments such as respiratory medicine, physical medicine and rehabilitation (PMR), and emergency medicine were considered integral specialties.
“However, the exclusion of these departments … contradicts this previous recognition, which is troubling given the high burden of respiratory diseases in India. India has the highest global proportion of multidrug resistant TB in the world in 2023 (as per global TB report 2024),” he said.
