• Users Online: 768
  • Print this page
  • Email this page

 Table of Contents  
Year : 2023  |  Volume : 4  |  Issue : 1  |  Page : 17-23

Study of anxiety among medical teachers about the recent change in “publication-based faculty promotions” as per the National Medical Commission Guidelines 2022

1 Department of General Surgery, Bharatratna Atalbihari Vajpayee Medical College and Hospital, Pune, Maharashtra, India
2 Department of OBGY, MIMER Medical College and BSTR Hospital, Talegaon, Pune, Maharashtra, India

Date of Submission23-Aug-2022
Date of Decision14-Oct-2022
Date of Acceptance23-Oct-2022
Date of Web Publication10-Jan-2023

Correspondence Address:
Dr. Priya Manohar Bagade
Department of OBGY, MIMER Medical College & BSTR Hospital Talegaon, Pune, Maharashtra
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jopcs.jopcs_27_22

Rights and Permissions

Background: Primarily collegiate promotions, placement retention, professional progress, and career mobility of any medical fraternity are determined by the growth in their research productivity. Universities and medical institutes also recruit and promote those academicians who have voluminous resume with ample number of publications. However, the mandatory criteria for article publication and the frequent changes made in them, challenge the medical professionals and create a sense of anxiety and insecurity in them about their future prospects. This study aims at screening these medical academicians, for generalized anxiety disorder (GAD) in response to the recent change in "Minimum Teachers Eligibility Qualifications in Medical Institutions Regulations" as per the National Medical Commission (NMC) guidelines 2022. Materials and Methods: It was a cross-sectional pilot study conducted in two medical institutes including 76 medical teachers due for their promotions. Knowledge and anxiety towards the recent change in "Minimum Teachers Eligibility Qualifications in Medical Institutions Regulations" as per the NMC guidelines 2022 was assessed by the GAD-7 scoring system with help of a questionnaire. The medical professionals were grouped into minimal, mild, moderate, and severe anxiety depending on their GAD-7 score. Results: Hundred percent of medical teachers were aware of the recent changes in the promotion criteria laid down by the NMC in February 2022. 31.57% and 34.78% of medical professionals were found to have mild and moderate anxiety respectively about the promotion criteria. Although less, but 15% of them were screened to be severely anxious about the same matter. Conclusion: All the study participants were updated about the recent changes in the promotion criteria put forward by NMC in February 2022 but this revision has created a sense of apprehension and uncertainty among the medical professionals regarding their due promotions.

Keywords: Academic publications, anxiety, medical teachers, minimum qualification for promotion

How to cite this article:
Gowardhan AK, Bagade PM. Study of anxiety among medical teachers about the recent change in “publication-based faculty promotions” as per the National Medical Commission Guidelines 2022. J Prim Care Spec 2023;4:17-23

How to cite this URL:
Gowardhan AK, Bagade PM. Study of anxiety among medical teachers about the recent change in “publication-based faculty promotions” as per the National Medical Commission Guidelines 2022. J Prim Care Spec [serial online] 2023 [cited 2023 Jun 6];4:17-23. Available from: https://www.jpcsonline.org/text.asp?2023/4/1/17/367483

  Introduction Top

Research and publications are very essential for academic growth of any medical fraternity. The academic and financial growth of any country is also based on research prospective. USA, China and Japan, the topmost three countries have reported research and innovations as their most potential aspect for growth.[1] Scientific publications are the triggers that stimulate other scientists.[2] Over the years, there have been repeated efforts to persuade creativity and research among medical professionals including undergraduate and postgraduate students.

Research is inculcated even in the school era in form of projects given to school students. During MBBS, students participate in various short-term research projects granted by the Maharashtra University of Health Sciences or the Indian Council of Medical Research. Dissertation/thesis/research work is a mandatory need for MD/MS postgraduate examination in our country. Apart from this, it is now compulsory for postgraduate students to publish/present, one paper/poster at a national or state-level conference.[3] Similarly, publications and good quality research work are required for accreditation of any university or an independent institution as well. The National Assessment and Accreditation Council, a government organization in India, allocates grades to various institutions, also considers research profile of an institute to be an important criterion of this grading system.[4]

Even the biodata of any medical fraternity is reviewed as deficient without the involvement of few publications. In simple terms, researchers can use publications and research as their academic currency.[5] However, there have been constant changes in publication criteria for the medical academic community in India. Before 2015, there were very few inclined publications, as the criteria for "Teacher eligibility qualifications in medical institutions regulation" were not specific. Over the past 7 years, a lot of changes [Table 1] have been seen over the indexing and publication criteria for medical teachers. The changes over the time have made the medical academicians run a roller coaster ride for criteria for promotion.[6]
Table 1: National Medical Council/Medical Council of India revised criteria regarding faculty promotions over the years

Click here to view

Potential impact of these frequent changes in mandatory publications has raised a lot of questions among medical teachers[1] as to "Why publications are given more significance for collegiate promotions in the medical stream since their primary task is teaching and patient care?" However, the National Medical Commission (NMC) is yet to propose standards for promotion established on teaching, and the clinical and technical ability of the teachers. Recently changed criteria[7] have created a lot of anxiety among medical teachers about their expected due promotions. The aim of our study was to find out the knowledge and anxiety about the recent changes[7] in the "Minimum Teachers Eligibility Qualifications in Medical Institutions Regulations" among the medical academicians who were due for their promotions in February 2022.

  Materials and Methods Top

It was a pilot study conducted in two medical institutes. This cross-sectional study included 76 medical professionals who were due for their promotions in February 2022. A questionnaire was developed to get details from these candidates about their knowledge and level of their anxiety. A validated Google Form was circulated over 1 month. The questionnaire included demographic variables of the participants, medical qualifications, and other necessary data. The survey was absolutely computerized, anonymous, and participation was voluntary.

Anxiety was screened using the Generalized Anxiety Disorder 7 (GAD-7)-item[8] grading system. For each item, a score of 0, 1, 2, and 3 was assigned to the response categories of "not at all," "several days," "more than half the days," and "nearly every day," respectively. A total score was obtained by adding counts of answer to each of the seven questions. Participants were classified according to their level of anxiety as minimal anxiety (GAD-7 score <5), mild anxiety (GAD-7 score between 5 and 9), moderate anxiety (GAD-7 score between 10 and 14), and severe anxiety (GAD-7 score ≥15).

The data were collected, compiled, and analyzed using a Microsoft Excel worksheet. Statistical analysis was done using percentages.

  Results Top

Seventy-six medical teachers due for their promotion in February 2022 were surveyed and screened using a questionnaire and the following information was obtained.

Medical colleges

The study reported more participants from Bharatratna Atal Bihari Vajpayee Medical College, Pune as compared to MIMER Medical College, Talegaon, Pune [Figure 1].
Figure 1: Faculty Participation from Medical Colleges

Click here to view

Knowledge and source of information

As seen in the above [Figure 2] and [Figure 3], all of the study participants were well acquainted with the changes in promotion criteria, with social media/Internet being the most common source of information.
Figure 2: Knowledge about changes in "Minimum Teachers Eligibility Qualifications in Medical Institutions Regulations" as per the NMC guidelines 2022

Click here to view
Figure 3: Source of Information

Click here to view

Level of anxiety

[Figure 4] depicts that mild and moderate level of anxiety was mostly observed in these medical professionals. However, severe anxiety was screened in nearly 15% of the study participants.
Figure 4: Overall anxiety among the medical teachers as per GAD-7 score system about changes in "Minimum Qualification for teachers in Medical Institutes Regulation" as per the NMC guidelines 2022

Click here to view

Age distribution

[Table 2] shows that the majority of the study population belonged to the age group from 41 to 45 years with a mean age of 43.2 years followed by the 46–50 year age group. Even anxiety of all degrees was observed more in these age groups only.
Table 2: Age distribution

Click here to view

Gender distribution

More male participants (55.26%) were involved in the study as noticed in [Figure 5]; however, major degrees of anxiety were observed in female candidates.
Figure 5: Gender Distribution

Click here to view

Professional degree

More or less equivalent medical professionals had MD/MS (52.63%) and DNB (47.36%) qualifications in the study population as identified in [Figure 6]. However, DNB candidates were more nervous and anxious about their due promotions.
Figure 6: Professional Degree of Medical Professionals

Click here to view

Promotion levels

[Figure 7] depicts that 79% of teachers were due for their promotion from assistant to associate level and 21% were due for their professor-level promotion. The anxiety of higher levels was more common in the 1st Group who were expecting their promotion to associate level.
Figure 7: Professional levels of Participating Doctors

Click here to view

Duration of particular post

As observed in [Table 3], in Group 1, most of the candidates had held the Assistant professor post for a period of 6–7 years (36.66%) followed by 5–6 years (26.66%); however, elevated anxiety levels were seen in participants holding the post for a longer duration. Similarly, in Group B, many (31.25%) Associate professors had been in their positions for 7–8 years followed by 6–7 years (25.00%) with increasing anxiety levels with prolonged duration of the post.
Table 3: Duration of particular post

Click here to view


From [Figure 8] and [Figure 9], we can make out that participants who had minimum of two publications from the old criteria were more anxious as compared to those who had a minimum of two publications from the new criteria for academic promotions laid down by NMC in February 2022.
Figure 8: Duration of the Post

Click here to view
Figure 9: Duration of the Post

Click here to view

  Discussion Top

Publication is an extremely influential communication medium for researchers to share their work, ideas, difficulties, and achievements. Published literature is a gifted heritage to science. Published theories inspire more research, hypotheses are redesigned, refuted, or validated, and advanced paradigms are established at the cost of old ones. In addition to this, publications have also become a substantial key factor for medical professionals for the number of other purposes such as professional evolution,[9] obligatory bureaucratic commitments, academic promotions, financial incentives, and the desire to prosper in the scientific associations.[10],[11]

The medical academicians in teaching institutes in India have to play multiple roles of clinician, teacher, as well as a researcher with the technical and scientific aptitude and their academic promotions considers publications as one of the most essential criteria. The obligatory criteria for these published articles have been repeatedly revised by the regulatory authorities [Table 1] over the past few years. The recent guidelines put forth by NMC in February 2022[7] have created a sort of anxiety among medical professionals about their due promotions. The current pilot study aims at identifying the consciousness and apprehension about the "Minimum Teachers Eligibility Qualifications in Medical Institutions Regulations" proposed by NMC in February 2022 among the medical teachers who were expecting their promotions.

National medical commission/medical council of India revised criteria regarding faculty promotions over the years

[Table 1] gives us information about the time-to-time changes in the guidelines for the promotion criteria.


[Figure 2] shows that almost all the medical professionals included in the study were familiar about the change in the new regulations, either from their friends, colleague, or from the media/Internet. This can be explained by the fact that medical personnel always keep themselves updated and with respect to this information as it forms an essential part of their promotions, all the study participants were thoroughly acquainted with it.

Source of information

Most of the study participants have obtained their knowledge from social media/Internet as this is the most commonly used medium for information collection in today's world as depicted in [Figure 3].

Level of anxiety

[Figure 4] emphasized on the fact that severe anxiety was surveyed in 15.78% of the study candidates about the matter, whereas 18.42% had minimal anxiety, 31.57% had mild anxiety, and 34.21% had moderate anxiety regarding the issue. This is comparable with a study done by Kurdi SM et al.[12] in 2015 where they reported that 27% of their study respondents felt that publications are mandatory stress.

Age distribution

[Table 2] suggests that excessive levels of anxiety were more commonly seen in the middle-aged (45–50 years and 40–45 years age group) participating population. This is comparable to a study done by Ramsawh et al.[13] in 2009 and an article by Guarnotta in 2020[14] where they have stated that middle-age group people are more anxious due to various contributing factors.

Gender distribution

Gender difference in anxiety levels is depicted in [Figure 5]. The present study shows that female participants have higher levels of apprehension as compared to their male counterparts. This goes well with another study done by Carmen et al.[15] in 2011 where they have proposed that women are more anxious than men. Similar findings have been put forward in a clinical psychological review by Carmen et al.[16] in 2009.

Professional degree of participants

As observed in [Figure 6], it was noticed that DNB candidates had higher levels of anxiety as compared to their MD/MS peers. This fact has been reviewed in an article by Bhattacharya et al. in 2020[17] due to continuous injustice with DNB candidates regarding promotion criteria by the regulatory authorities.

Promotion levels

[Figure 7] notifies that 78.94% of study participants were Assistant professors and 21.06% were Associate professors waiting for their promotions. Of these two groups, higher levels of anxieties were seen in the Assistant professor group as compared to the Associate professor group. This can be explained by the fact that Assistant professors are usually middle-aged individuals who are more prone to anxiety.

Duration of particular post

[Table 3] identifies the duration of Assistant/Associate professor post held by each participating personnel. Anxiety levels are bound to be high in individuals with increasing duration of the occupied post.


[Figure 8] and [Figure 9] show the difference in the publications done by study participants as per the old and new criteria. Candidates with minimum of two publications as per new criteria had less anxiety as compared to those who had publications with old criteria, as they have already achieved the target.

The survey attempts to analyze the several factors seen in the medical professionals screened to be apprehensive and concerned about their expectant promotions related to their publications. However, there were several limitations of our study. First, the GAD-7 scale points to only 1 anxiety disorder, whereas there are many participants with other anxiety disorders, such as social phobia and other stress disorders, who need clinical evaluation. Anyways, GAD is one of the most common mental disorders seen in outpatient practice. Second, the GAD-7 comes up with only probable diagnoses that should be confirmed by further assessment. Third, as our study was cross-sectional, prospective observational and treatment trials are required to ascertain the receptiveness of the GAD-7 in assessing change across time. Finally, there is always a possibility of selection bias as a modest number of medical professionals have responded to the study questionnaire.

  Conclusion Top

Although discussed least, the Medical fraternity in Teaching Institutes is under immense pressure due to the persistent changes in the guidelines about "Minimum Teachers Eligibility Qualifications in Medical Institutions Regulations." Research and publication should be encouraged, and an atmosphere conducive to the same should be given to medical professionals so that they can come up with more innovative ideas in the scientific field but definitely not under obligation. We would like to suggest here that although change is the law of life, these changes should not affect human lives adversely. Hence, articles published as per old promotion criteria before the amendment date should also be considered during faculty promotions.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Kumar S. From publish or perish (POP) to publish under pressure (PUP). MGM J Med Sci 2022;9:1-3.  Back to cited text no. 1
  [Full text]  
Clapham P. Publish or perish. BioScience 2005;55:390-1.  Back to cited text no. 2
National Medical Commission Postgraduate Medical Education Board. Postgraduate Medical Education Regulations. New Delhi; 2021. p. 18. Available from: https://www.nmc.org.in/MCIRest/open/getDocument?path=/Documents/Public/Portal/LatestNews/final%20PGMER%20draft.pdf. [Last accessed on 2022 Jan 28].  Back to cited text no. 3
Guidelines: Bibliometric Data Validation Methodology of NAAC (For Universities and Autonomous Colleges); 2018. p. 1-4. Available from: http://www.naac.gov.in/images/docs/Guidelines/Guidelines-for-Data-on-Publications-INFLIBNET.pdf. [Last accessed on 2018 Jun 11].  Back to cited text no. 4
Spitale G. Making sense in the flood. How to cope with the massive flow of digital information in medical ethics. Heliyon 2020;6:e04426.  Back to cited text no. 5
Mondal H, Mondal S, Behera JK. Roller coaster of publication criteria: What is new in teachers' eligibility qualifications in medical institutions regulations, 2022? Indian J Ophthalmol 2022;70:1845-6.  Back to cited text no. 6
  [Full text]  
Teachers Eligibility Qualifications in Medical Institutions Regulations, 2022. Notice: CG-DL-E-23022022-233681. National Medical Commission. Available from: https://www.nmc.org.in/wp-content/uploads/2022/02/TEACHERS%20ELIGIBILITY%20QUALIFICATIONS.pdf. [Last accessed on 2022 Feb 25].  Back to cited text no. 7
Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med 2006;166:1092-7.  Back to cited text no. 8
Tonges MC. Publishing as a career development tool: Don't forget to write. Semin Nurse Manag 2000;8:212-4.  Back to cited text no. 9
Dixon N. Writing for publication – A guide for new authors. Int J Qual Health Care 2001;13:417-21.  Back to cited text no. 10
Plumper T, Radaelli C. Publish or perish? Publications and citations of Italian political scientists in international political science journals. J Eur Public Policy 2004;11:1112-27.  Back to cited text no. 11
Kurdi MS, Ramaswamy AH, Lokare L, Sutagatti JG. Current views and practice of faculty members and consultants regarding 'Publications in India': A cross-sectional study. Indian J Anaesth 2015;59:794-800.  Back to cited text no. 12
[PUBMED]  [Full text]  
Ramsawh HJ, Raffa SD, Edelen MO, Rende R, Keller MB. Anxiety in middle adulthood: Effects of age and time on the 14-year course of panic disorder, social phobia and generalized anxiety disorder. Psychol Med 2009;39:615-24.  Back to cited text no. 13
Guarnotta E. How is Age Related to Anxiety? GoodRxHealth. Available from: https://www.goodrx.com/conditions/generalized-anxiety-disorder/how-is-age-related-to-anxiety. [Last accessed 2020 May 21].  Back to cited text no. 14
McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res 2011;45:1027-35.  Back to cited text no. 15
McLean CP, Anderson ER. Brave men and timid women? A review of the gender differences in fear and anxiety. Clin Psychol Rev 2009;29:496-505.  Back to cited text no. 16
Bhattacharya A, Sarma P, Kumar H, Medhi B. Doctor of medicine and diplomate of national board courses in India – Issues and equivalence: A comparative analysis. Innovare J Med Sci 2020;8:1-7.  Back to cited text no. 17


  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9]

  [Table 1], [Table 2], [Table 3]


Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  In this article
Materials and Me...
Article Figures
Article Tables

 Article Access Statistics
    PDF Downloaded61    
    Comments [Add]    

Recommend this journal