NMC looks to drop HoD rotation after strong pushback from medical teachers
The NMC is likely to step back from its proposal to rotate Heads of Department every three years in medical colleges after a nationwide consultation. The move follows majority opposition from stakeholders, though supporters say rotation would broaden opportunity and curb concentration of power.
After receiving extensive feedback from medical institutions, academicians, professional bodies, and subject experts, the medical education regulator appears inclined to retain the existing system that it now says allows institutions greater flexibility in appointing departmental leaders based on merit, experience, and institutional needs.
The development follows a nationwide consultation on proposed amendments to the Postgraduate Medical Education Regulations (PGMER)-2023.
While the consultation covered several issues, including feeder qualifications for super-specialty courses, it was the proposal on HoD rotation that generated the most intense discussion.
The response from stakeholders was decisive. Nearly 59 per cent of respondents opposed the proposal, while 41 per cent supported it. The feedback has now prompted the NMC to reconsider the move and favour a more flexible, merit-based approach.
But those batting for rotatory headship are not happy with the development.
“The objective of such a system is not to weaken leadership, but to democratise opportunity, strengthen institutions, and build a healthier academic ecosystem for future generations,” Dr Amrinder Singh Malhi, president of the faculty association at the All India Institute of Medical Sciences (AIIMS), New Delhi told India Today.
When contacted for comment, NMC chairperson Dr Abhijat Sheth no final decision had been taken in the matter, but added that the proposed amendment is under "active discussion with stakeholders."
There are over 800 medical colleges in India and several of these have adopted the rotatory leadership system over the last few years.
WHY THE RESISTANCE
The proposed regulation stated that the post of HoD would rotate every three years among professors and eligible associate professors possessing a postgraduate medical degree, with seniority serving as the primary criterion.
However, many stakeholders argue that academic leadership cannot be reduced to a question of seniority alone.
Medical colleges, faculty members and subject experts maintained that leading a department requires a combination of administrative competence, academic vision, teaching excellence, research achievements and the ability to guide institutional growth. According to them, a rigid rotation policy risks overlooking these critical attributes.
Several respondents warned that frequent leadership changes could disrupt academic planning, research projects and regulatory compliance processes. Departments often pursue long-term academic and research goals extending well beyond a three-year period. A change in leadership midway could interrupt continuity, weaken collaborations and affect the implementation of strategic plans.
Another major concern related to institutional hierarchy. Stakeholders pointed out that under a strict rotation system, junior associate professors could end up heading departments that include senior professors. Such situations, critics argued, could create workplace tensions, undermine professional relationships and affect departmental harmony.
Many respondents also cautioned against the possibility of increased departmental politics. If leadership positions are automatically rotated rather than earned through performance and capability, competition for administrative roles could intensify, potentially leading to internal conflicts.
Representatives of several institutions argued that the proposal would erode their autonomy, pointing out that medical colleges have traditionally exercised discretion in selecting HoDs based on their unique requirements and performance assessments.
A centrally mandated rotation mechanism, many felt, would limit their ability to choose the most suitable leaders.
MERIT OVER SENIORITY
After analysing stakeholder feedback, the NMC's Post Graduate Medical Education Board concluded that leadership appointments should continue to be guided by a merit-cum-seniority framework rather than a rigid timeline.
The Board's observations highlight concerns that go beyond administrative convenience. It noted that the objections raised during the consultation process were rooted in sound academic and institutional reasoning.
One of the strongest arguments relates to continuity in research and postgraduate education. Academic departments function through long-term planning, mentorship structures, research collaborations and curriculum development efforts. Stability in leadership often plays a key role in ensuring that these initiatives are successfully completed.
The Board also observed that HoDs possess valuable institutional knowledge accumulated over years of experience. They understand faculty strengths, infrastructure needs, accreditation requirements and departmental challenges. Replacing such leaders solely because a fixed tenure has ended may not always serve the interests of students, faculty or institutions.
The NMC's analysis further points out that leading academic institutions across the world increasingly rely on performance-based leadership models rather than compulsory rotational systems. Instead of automatic turnover, leaders are typically assessed on outcomes, vision, governance capabilities and departmental achievements.
Consequently, the Board has suggested that periodic performance evaluations may be a better alternative to fixed-term rotation. Such reviews could enhance accountability while preserving institutional flexibility.
LESSONS FROM EXPERIENCE
The debate over HoD appointments has not remained confined to policy discussions. The issue has already triggered administrative complications and legal disputes in several states after earlier directions regarding rotational headship were interpreted and implemented by institutions.
Senior dermatologist and academician Dr Kabir Sardana, who is with RML Hospital, believes the proposal was fundamentally misplaced in the context of medical education institutions.
According to Dr Sardana, medical colleges have traditionally followed the leadership models adopted by premier institutions such as AIIMS and PGI, where departmental headship is generally not rotated. Referring to the impact of previous regulatory directions, he noted that the move had already led to significant litigation.
As Dr Sardana put it, the system has "largely adhered to AIIMS and PGI where headship is not rotated," adding that earlier orders had resulted in "litigations across the country."
He further argued that the concept is more suited to institutions such as the Indian Institutes of Technology (IITs) and does not align with the realities of medical education and hospital administration.
Pointing to Delhi's experience, he observed that apart from a few central government hospitals, most institutions do not follow rotational headship policies.
Dr Sardana also suggested that the NMC should focus primarily on medical education standards rather than service-related administrative matters.
While supporters of the rotation proposal argued that it could encourage democratic governance, prevent concentration of power and create opportunities for leadership diversity, the overwhelming feedback indicated that stakeholders prefer reforms that strengthen accountability without compromising institutional effectiveness.
Yet, according to Dr Malhi, the rotatory system aligns with modern governance principles and was important for preventing concentration of power, encouraging democratic academic culture, faculty morale and leadership, and reducing department bias.
“Many of the objections appear to arise predominantly from traditionally entrenched administrative structures and senior groups who may be uncomfortable with leadership transition mechanisms. In contrast, among younger faculty, mid-level academicians, and institutions where collaborative governance models are emerging, there is growing support for rotational and accountable leadership systems,” Dr Malhi said.
After receiving extensive feedback from medical institutions, academicians, professional bodies, and subject experts, the medical education regulator appears inclined to retain the existing system that it now says allows institutions greater flexibility in appointing departmental leaders based on merit, experience, and institutional needs.
The development follows a nationwide consultation on proposed amendments to the Postgraduate Medical Education Regulations (PGMER)-2023.
While the consultation covered several issues, including feeder qualifications for super-specialty courses, it was the proposal on HoD rotation that generated the most intense discussion.
The response from stakeholders was decisive. Nearly 59 per cent of respondents opposed the proposal, while 41 per cent supported it. The feedback has now prompted the NMC to reconsider the move and favour a more flexible, merit-based approach.
But those batting for rotatory headship are not happy with the development.
“The objective of such a system is not to weaken leadership, but to democratise opportunity, strengthen institutions, and build a healthier academic ecosystem for future generations,” Dr Amrinder Singh Malhi, president of the faculty association at the All India Institute of Medical Sciences (AIIMS), New Delhi told India Today.
When contacted for comment, NMC chairperson Dr Abhijat Sheth no final decision had been taken in the matter, but added that the proposed amendment is under "active discussion with stakeholders."
There are over 800 medical colleges in India and several of these have adopted the rotatory leadership system over the last few years.
WHY THE RESISTANCE
The proposed regulation stated that the post of HoD would rotate every three years among professors and eligible associate professors possessing a postgraduate medical degree, with seniority serving as the primary criterion.
However, many stakeholders argue that academic leadership cannot be reduced to a question of seniority alone.
Medical colleges, faculty members and subject experts maintained that leading a department requires a combination of administrative competence, academic vision, teaching excellence, research achievements and the ability to guide institutional growth. According to them, a rigid rotation policy risks overlooking these critical attributes.
Several respondents warned that frequent leadership changes could disrupt academic planning, research projects and regulatory compliance processes. Departments often pursue long-term academic and research goals extending well beyond a three-year period. A change in leadership midway could interrupt continuity, weaken collaborations and affect the implementation of strategic plans.
Another major concern related to institutional hierarchy. Stakeholders pointed out that under a strict rotation system, junior associate professors could end up heading departments that include senior professors. Such situations, critics argued, could create workplace tensions, undermine professional relationships and affect departmental harmony.
Many respondents also cautioned against the possibility of increased departmental politics. If leadership positions are automatically rotated rather than earned through performance and capability, competition for administrative roles could intensify, potentially leading to internal conflicts.
Representatives of several institutions argued that the proposal would erode their autonomy, pointing out that medical colleges have traditionally exercised discretion in selecting HoDs based on their unique requirements and performance assessments.
A centrally mandated rotation mechanism, many felt, would limit their ability to choose the most suitable leaders.
MERIT OVER SENIORITY
After analysing stakeholder feedback, the NMC's Post Graduate Medical Education Board concluded that leadership appointments should continue to be guided by a merit-cum-seniority framework rather than a rigid timeline.
The Board's observations highlight concerns that go beyond administrative convenience. It noted that the objections raised during the consultation process were rooted in sound academic and institutional reasoning.
One of the strongest arguments relates to continuity in research and postgraduate education. Academic departments function through long-term planning, mentorship structures, research collaborations and curriculum development efforts. Stability in leadership often plays a key role in ensuring that these initiatives are successfully completed.
The Board also observed that HoDs possess valuable institutional knowledge accumulated over years of experience. They understand faculty strengths, infrastructure needs, accreditation requirements and departmental challenges. Replacing such leaders solely because a fixed tenure has ended may not always serve the interests of students, faculty or institutions.
The NMC's analysis further points out that leading academic institutions across the world increasingly rely on performance-based leadership models rather than compulsory rotational systems. Instead of automatic turnover, leaders are typically assessed on outcomes, vision, governance capabilities and departmental achievements.
Consequently, the Board has suggested that periodic performance evaluations may be a better alternative to fixed-term rotation. Such reviews could enhance accountability while preserving institutional flexibility.
LESSONS FROM EXPERIENCE
The debate over HoD appointments has not remained confined to policy discussions. The issue has already triggered administrative complications and legal disputes in several states after earlier directions regarding rotational headship were interpreted and implemented by institutions.
Senior dermatologist and academician Dr Kabir Sardana, who is with RML Hospital, believes the proposal was fundamentally misplaced in the context of medical education institutions.
According to Dr Sardana, medical colleges have traditionally followed the leadership models adopted by premier institutions such as AIIMS and PGI, where departmental headship is generally not rotated. Referring to the impact of previous regulatory directions, he noted that the move had already led to significant litigation.
As Dr Sardana put it, the system has "largely adhered to AIIMS and PGI where headship is not rotated," adding that earlier orders had resulted in "litigations across the country."
He further argued that the concept is more suited to institutions such as the Indian Institutes of Technology (IITs) and does not align with the realities of medical education and hospital administration.
Pointing to Delhi's experience, he observed that apart from a few central government hospitals, most institutions do not follow rotational headship policies.
Dr Sardana also suggested that the NMC should focus primarily on medical education standards rather than service-related administrative matters.
While supporters of the rotation proposal argued that it could encourage democratic governance, prevent concentration of power and create opportunities for leadership diversity, the overwhelming feedback indicated that stakeholders prefer reforms that strengthen accountability without compromising institutional effectiveness.
Yet, according to Dr Malhi, the rotatory system aligns with modern governance principles and was important for preventing concentration of power, encouraging democratic academic culture, faculty morale and leadership, and reducing department bias.
“Many of the objections appear to arise predominantly from traditionally entrenched administrative structures and senior groups who may be uncomfortable with leadership transition mechanisms. In contrast, among younger faculty, mid-level academicians, and institutions where collaborative governance models are emerging, there is growing support for rotational and accountable leadership systems,” Dr Malhi said.
