In a significant development for India’s healthcare sector that has also brought renewed focus on years of regulatory inertia, the National Medical Commission (NMC) has finally granted recognition to the Post Graduate Diploma in Clinical Cardiology (PGDCC), redesignated as Clinical Cardio Physician (Non-Invasive) PGDCCP (NI), bringing long-awaited relief to nearly 1,700 doctors who spent close to two decades battling for professional recognition.
The programme, launched in 2006 with the support of the Union Health Ministry, was designed to bridge the acute shortage of cardiologists in India by training MBBS doctors in non-invasive cardiology, preventive cardiac care, and early diagnosis of heart disease, particularly for underserved semi-urban and rural areas where specialist services remain scarce.
With formal recognition now granted, these doctors are expected to become eligible for government recruitment and integration into the public healthcare system, potentially strengthening cardiac care services in underserved regions.
For doctors such as Dr. Rakesh Ranjan and hundreds of others trained under the programme, the decision marks not merely an administrative correction but the restoration of professional dignity after years of uncertainty, litigation, and social stigma.
However, in 2013, the then Medical Council of India (MCI) refused to recognise the course, arguing that mandatory regulatory approvals had not been obtained before its commencement, resulting in 1,706 doctors across the country losing their specialist status despite years of training and clinical service.
The decision triggered widespread concern among cardiologists and healthcare experts, many of whom warned that the move would adversely affect cardiac care access outside major cities.
Eminent cardiac surgeon Dr. Devi Shetty, who was involved in designing the PGDCC curriculum, had then criticised the decision, pointing out that the course had been conceptualised specifically to strengthen community cardiology services.
“The objective of this course was to train physicians working in semi-urban areas in community cardiology to diagnose and prevent cardiac ailments. It was never intended to compete with super-speciality medical college programmes,” Dr. Shetty had observed, adding that the irony lay in the fact that a programme initiated under the Union Health Ministry itself had failed to secure regulatory backing.
He had also cautioned that while metropolitan centres may continue to attract specialist cardiologists, the real impact of the derecognition would be felt in district hospitals and smaller towns where trained cardiac physicians were often the first point of care for patients with heart disease.
India continues to face a severe shortage of cardiologists relative to its growing cardiovascular disease burden. Cardiovascular diseases account for nearly 28% of all deaths in the country, while estimates suggest that India has barely 5,000 to 6,000 trained cardiologists serving a population exceeding 1.4 billion.
The shortage is compounded by stark geographic disparities, with a majority of specialists concentrated in urban tertiary-care centres.
Dr. Rakesh Gupta, from the Indian Academy of Echocardiography, said the imbalance has long left large sections of rural India dependent on general physicians for cardiac evaluation and emergency stabilisation.
“The PGDCC programme was conceived to address this exact gap. These doctors were trained to identify common cardiac conditions, provide preventive counselling, stabilise emergencies, and refer complicated cases to higher centres when required,” he said.
The two-year programme was conducted through 77 accredited hospitals across the country with established cardiology departments. Admission was through an all-India entrance examination, and the training involved clinical rotations rather than distance learning, contrary to widespread public perception at the time.
Despite this, the absence of formal recognition left many physicians facing professional humiliation and legal uncertainty.
Dr. Rajesh Rajan, Chairman of the Indian Association of Clinical Cardiologists (IACC), said the prolonged non-recognition had deeply affected the morale of doctors who had devoted years to cardiac care.
“Due to non-recognition of the course, many doctors faced disrespect in society and were even labelled as ‘quacks’ despite serving patients for years,” he said.
Doctors associated with the programme repeatedly argued that the issue was procedural rather than academic, since the training itself had been conducted in reputed cardiac centres under experienced faculty.
The dispute eventually reached the Delhi High Court, which in 2019 directed the Union Health Ministry to take a decision on the matter and asked the MCI to reconsider IGNOU’s application seeking recognition for the course. But sheer policy inertia was blatantly evident.
The matter remained unresolved for at least six years amid regulatory changes, including the replacement of the MCI with the National Medical Commission in 2020.
The formal recognition granted in 2025 and the subsequent start of the registration process recently is being viewed as a long-awaited corrective measure that could strengthen India’s secondary-level cardiac care infrastructure.
According to Kapil Khanna, National President of the IACC, delayed diagnosis of cardiovascular disease at the primary-care level often results in preventable complications, higher mortality, and greater financial burden on patients.
“Strengthening trained cardiac services at the district and community level can significantly reduce pressure on tertiary-care hospitals,” he said.
Experts believe the recognition may also enable PGDCC-qualified doctors to become eligible for government recruitment and wider integration into public healthcare systems, particularly in underserved districts where specialist availability remains critically low.
Public health experts say the episode also highlights the need for India’s medical regulatory framework to respond more flexibly to workforce shortages in specialised areas, particularly as non-communicable diseases continue to rise sharply.
Supreme Court advocate and Meghalaya Advocate General Amit Kumar, who fought the case as part of a legal team led by senior advocate Kapil Sibal along with Raju Ramachandran, said it was unfortunate that the legal battle had continued for nearly two decades. He described the recognition of the PGDCC qualification as “not merely a medical milestone but a public health necessity,” adding that the prolonged delay had adversely affected the availability of trained specialists in critical care medicine.
Advocate Shaurya Sahay said the prolonged litigation exposed a deeper institutional problem. “This 20-year delay reflects a larger policy inertia that has actively hindered the strengthening of the country’s public health network,” he observed.
Prof. A. K. Agarwal, former Director of the School of Health Sciences at IGNOU, who, along with parliamentarians P. J. Kurien, N. K. Premachandran, and Kanakamedala Ravindra Kumar, played a key role in pursuing the case of nearly 1,700 doctors, said the issue extended far beyond individual recognition and pointed to the country’s larger healthcare needs.
Against the backdrop of rising non-communicable diseases, he argued that the government should consider reviving similar structured training programmes in multiple specialties beyond cardiology to bridge gaps in healthcare delivery, particularly in underserved regions.
Clarifying that programmes such as the PGDCC were not intended to replace super-specialists, Prof. Agarwal said they could serve as an important public health innovation in a country facing an enormous disease burden and a shortage of specialist doctors. “Scaling such courses nationally across various specialties can become a systematic innovation in a country where the burden of non-communicable diseases is massive, specialist availability is limited, and geography itself remains a barrier to timely healthcare access,” he said.
Meanwhile, for many of the doctors who fought the battle for recognition, the decision represents something more personal — the recovery of an identity they say was unfairly denied for years despite their contribution to patient care in some of the country’s most underserved regions.
