Zoram Medical College: Why Mizoram wants centre to take over its only medical college

NEW DELHI: In 2018, Mizoram got its first state medical college. Five years later, it tried to offload it onto the centre. The chief minister, Lalduhoma of the Zoram People’s Movement, who assumed office in December 2023, requested the union government to convert Zoram Medical College into an Institute of National Importance (INI).

The college has been facing both funding and faculty shortages. “We wanted the centre to take care of the management of the medical college as we are facing a crunch in resources and a shortage of funds and faculty,” said Dr John Zohmingthanga, director, Zoram Medical College. However, the union government did not agree.

Typically, transferring the ownership of medical colleges has wider implications than just a change in the source of funding. State-run and governed medical colleges admit students from within the state to 85% of the seats, surrendering the remaining 15% to the “all-India quota” (AIQ) for which students from all over the country are eligible. But in a centrally-run institution, such as the All India Institute of Medical Sciences (AIIMS) Delhi, all seats belong to the AIQ.

In national institutions set in northeastern states, the seat distribution pattern is different. The North East Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS) in Shillong, Meghalaya, is a central institution but caters mainly to the northeastern states – 85% of its seats are distributed among Meghalaya, Nagaland, and northeastern states as a whole, including Sikkim.

Similarly, 85% of MBBS seats at Regional Institute of Medical Sciences (RIMS), Imphal – also a central institution – are earmarked for northeastern states. Even while expanding access to students from the northeastern states, institutions do not earmark all non-AIQ seats to a single state.

Zoram Medical College: A rocky start

Zoram Medical College started out as Mizoram Institute of Medical Education & Research (MIMER) and was established in August 2018 by Pu Lalthanhawla, then chief minister from the Congress Party. It was originally conceived as a major, autonomous medical college and research institution on the pattern of AIIMS, NEIGRIHMS or the RIMS.

Short of resources within the state, Mizoram brought in Dr Lallukhum Fimate, serving in Manipur at the time, as the first director and to help set it up. Fimate had been director of RIMS Imphal from 2002 to 2010, and wanted to develop ZMC – then, still MIMER – along similar lines. “I went to Mizoram at the request of the government to help them set up the medical college,” said Fimate.“I aimed to make MIMER an autonomous institute similar to AIIMS or RIMS.”

But almost nothing went according to plan. “However, when the constitution and by-laws [of the new institute] were prepared, implementing an autonomous system faced resistance from the finance department.”

That was not all. Upon landing in Aizawl – the college is 16 km from the state capital – Fimate found himself in charge of a medical college that had “zero faculty”, “no proper infrastructure” and untrained nursing staff.

The plans and clearance for ZMC (then MIMER) was on the basis of a central government scheme that sought to upgrade district or referral hospitals into medical colleges. Funding for the scheme’s projects is shared between the state and the union government – the centre provides 90% of the funds in the case of northeastern states.

In the case of ZMC, there was no state referral hospital to serve as the foundation for the medical college. Construction was delayed and deviated from the original plans. When it was ultimately set up, it was a small, 50-bed hospital instead of the planned 300-bed one.

The construction work for the state referral hospital, which would serve as the foundation of ZMC, faced delays and deviations from the original plan. “The Mizo National Front government came to power then,” said Fimate. Over time, efforts were made to expand the hospital and make it a 150-bed hospital.

The Mizo National Front came to power in December 2018 and its leader, Zoramthanga, became chief minister. In April 2019, the council of ministers decided to rename the fledgling hospital to Zoram Medical College – after the CM. It was strongly criticised, both for the decision to name it after a living person and also for dropping “research” from the name.

Essentially, the neutral “Mizoram Institute of Medical Education and Research” was judged to be weightier than “Zoram Medical College”.

Also readJamia Hamdard VC: Pharmacy education is in demand, clinical trials key area that needs to be tapped

ZMC students, teachers

At present, the college offers an MBBS programme with 100 seats. The first batch of students graduated last year. It occupies 300 acres on the outskirts of Aizawl, is affiliated to Mizoram University and the hospital has finally grown into a 500-bed one. Still, it is far from faring well. Acute fund crunch has made basic functions, such as maintenance of equipment, difficult.

A teacher, who asked not to be named, said that equipment in the intensive care unit (ICU) and operation theatre (OT) are very sensitive and require regular servicing. But the college is struggling to pay even for the annual maintenance contracts. “I, too, feel that we will be able to progress even more if the medical college is taken over by the centre. In medical colleges, for educational purposes, we need advanced equipment, and purchasing such advanced equipment is very difficult. We only have the necessities, but not what is needed to upgrade the skills,” they said.

A final-year student of Zoram Medical College, asking not to be named, agreed. “For most of us, we find it suitable that the college should go to the centre. Then only the state will develop as a whole,” he said. Most Mizoram employees are already non tax-paying and the state is reliant on central funds, they pointed out.

MBBS seat loss

It is the possibility of the loss of seats to the locals that is giving those, who otherwise support a transfer, pause.

“In Mizoram, around 80% of the inhabitants are purely Mizos, which is not the case with other northeastern states. Regarding the seat matrix, if it were to be handed over to the central government and the number of seats lessened for the state, we do not have a clear opinion on whether we want this to happen or not,” said the student.

An MA student at Mizoram University and a member of National Students’ Union of India (NSUI), the Congress’ student wing, said, “If the state is confident enough to look after the college, it is the dream of every citizen of the state to [study] under the state of Mizoram. But it is very tough for the state to take care of such a prestigious medical college. If the central government takes over ZMC, the educational facilities will be much better.”

That said, they also want most seats earmarked for Mizo students. “We want a better institution, but that is not possible because of the financial status of the state. Ours is a tax-free state because it is a tribal state. Greater facilities should be given to ZMC, but it should not be like other centrally-funded medical colleges. There should be a special arrangement for seat sharing,” they said.

They believe that an amendment to Article 371G to include education as an area in which the state legislature will have final say will enable this. Article 371G of the Constitution aims to protect the tribal customs of the Mizos.

Also read‘Medical education needs ground-breaking reforms’: IMA students’ network head

ZMC: Funding shortage

The medical college is currently state-funded. “If the centre would have taken over, the funding would have been better and the salaries and increments for the doctors would have been much better. It would have been able to recruit faculties from across India with better pay packets,” said director Zohmingthanga.

Plus, better equipment would be available. “Like AIIMS Delhi and similar Institutes of National Importance, like Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry and Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh, we could have procured state-of-the-art equipment. Procuring can never be as efficiently done by the state government,” he further explained.

Then, research grants from bodies like the Indian Council of Medical Research would come more easily, feels the director. “Only faculty cannot do things, but we need proper equipment, infrastructure, maintenance, research proposals, and postgraduate programmes, all of which are equally important and require more funding,” he added.

But the handover was not to be. “The centre does not currently have the policy to take over a state medical college as a central medical college,” said Zohmingthanga. “The new government may be able to make some kind of amendments. We are hopeful.”