B.                 TEACHING HOSPITAL
 
  • GENERAL REMARKS
 
*B.1. 1 A functional teaching hospital with 700 beds having a minimum of 60% indoor bed occupancy shall be available at the time of submission of application to Medical Council of India, at the time of inception of the hospital by Medical Council of India and upto 2nd renewal of the medical college. There shall be a minimum of 75% bed occupancy at the time of inspection for third renewal and thereafter for subsequent renewals  and recognition.
 
*  As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
Lifts for the patients and ramp for fire protective services and for handicapped persons shall be provided in the hospital at the time of letter of permission. An electric generator of not less than 700 KVA shall be provided.  A  play  area including T.V., Music, Toys, Books, etc. shall be provided for Peadiatric  patients. All the teaching hospitals shall be under the academic, administrative and disciplinary control of the Dean/ Principal/Director who shall not be concurrently Head of Department but can be a component of teaching faculty in the concerned respective department.
 
*  As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
The first para shall be substituted, as under:
 
A functional teaching hospital with 300 beds having a minimum of 60% bed occupancy shall be available at the time of submission of application to Medical Council of India, at the time of inception of the hospital by the Medical Council of India and upto 2nd  renewal of the medical college..   There shall be minimum    of
75% bed occupancy at the time of inspection for third renewal and thereafter for subsequent renewals and recognition.
 
*As per the terms of Notification published on 03.11.2010 in the Gazette of India.
 
# The above clause shall be substituted with the following: –
 
“B.1.1 A functional teaching hospital with 300 beds having a minimum of 60% indoor bed occupancy shall be available at the time of submission of application to Medical Council of India, at the time of inception of the hospital by Medical Council of India and upto 2nd renewal of the medical college. There shall be a minimum of
 
75% bed occupancy at the time of inspection for third renewal and thereafter for subsequent renewals and recognition.”
# As per the terms of Notification published on  03.07.2015 in the Gazette of    India.
 
  • Accommodation shall be provided for Dean (36 Sq.mt.) and Medical Superintendent (36 Sq.mt.) and hospital offices for the supportive staff, Nursing Superintendent’s room and office *along with computer and internet facility in each department, waiting space for visitors. There shall also be accommodation for:
 
  • Enquiry office,
  • Reception area (400 mt.) including facilities for public telephone, waiting space for patients and visitors, drinking water facility with nearby toilet facilities.
  • Store rooms.
  • Central Medical Record Section (250 m.)
  • Linen
  • Hospital and Staff Committee room (80 mt.)
 
*  As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
  • One Central lecture theatre of gallery type with a seating capacity of 200 persons and audio-visual aids shall be provided in the hospital *in addition to those in medical college/institution.
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
  • Central Registration and statistics department with computer facilities shall be
 
  • Intercom network alongwith paging and bleep system between various sections, hospitals and college shall be provided for better service, coordination and patient
 
  • Residential accommodation shall be provided in the hospital campus for interns, Residents, Senior Residents,* etc.
 
*Registrar ”DELETED” As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
# The above clause shall be substituted with the following: –
 
B.1.6 Residential accommodation shall be provided in the hospital campus for interns, Jr.Residents, Senior Residents,* etc @100% of total number prescribed.”
 
# As per the terms of Notification published on  03.07.2015 in the Gazette of    India.
 
  • *There shall be a minimum OPD attendance of 4 patients (old & new) per day per student intake of the subjects of Undergraduate curriculum at the time of Letter of This should be increased in such a manner that at the end of fourth year it comes to 8 patients (old & new) per day per student intake.
 
 
* As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
B.1.8        *Indoor beds occupancy-Average occupancy of indoor beds shall be a minimum of 75% per annum.
 
*As per the terms of Notification published on 03.11.2010 in the Gazette of India.
 
B.1.9. Clinical Departments in the Hospital.
 
Requirement of Beds and units: This shall be as under:
 
*“The  number  of  beds  required  for  150  admissions  annually  is *700.    They  may  be distributed for the purposes of clinical teaching as under, namely: –
 
 
*(i) MEDICINE AND ALLIED SPECILITIES:-
 
No. of beds and units required
 
Beds/units
 
General Medicine
150/6
Paediatrics
90/3
Tuberculosis and Respiratory Diseases
30/1
Dermatology, Venerealogy and Leprosy
15/1
Psychiatry
15/1
 
300/12
 
Note: (1) There shall be well  equipped  and  updated  intensive  Care  Unit  (I.C.U.), Intensive Coronary Care Unit (I.C.C.U.) Intensive Care Paediatric beds and preferably Intensive care in Tuberculosis and Respiratory Disease.
 
(2) Wherever possible, the facilities available in larger  tuberculosis  and chest diseases hospitals, infectious diseases hospitals and mental hospitals may be utilised for training in these specialties. However, if these hospitals are not under the total administrative control of the Medical College, the  required beds in these specialities shall have to be provided in the attached teaching hospital itself.
 
*(ii) SURGERY AND ALLIED SPECIALITIES:
 
No. of beds/units required
 
1.
General surgery
150/6
2.
Department of Orthopaedics
90/3
3.
Department of Ophthalmology
30/1
4.
Oto-Rhinolaryngology
30/1
   
300/11
 
Note: There shall be well-equipped and updated intensive Care Burn Unit and Surgical post operative critical care Unit.
 
*As per the terms of Notification published on 03.11.2010 in the Gazette of India.
 
*(iii) OBSETETRICS AND GYNAECOLOGY
 
No. of beds and units required
 
 
1.  Obstetrics
60
2.   Gynaecology
40
   
100/3
(iv)
GRAND TOTAL
700/26
 
*As per the terms of Notification published on 03.11.2010 in the Gazette of India.
 
# The above clause shall be substituted with the following: –
 
B.1.9. Clinical Departments in the Hospital. Requirement of Beds and units:
“The number of beds required for 150 admissions annually is 650. They may be distributed for the purposes of clinical teaching as under, namely: –
MEDICINE AND ALLIED SPECILITIES:-
 
 
 
Beds/units
No. of beds and units required
 
General Medicine                                                                                 150/5
Paediatrics                                                                                             90/3
Tuberculosis and Respiratory Diseases                                                  20/1
Dermatology, Venerealogy and Leprosy                                                15/1
Psychiatry                                                                                              15/1
 
290/11
 
Note: (1) There shall be well equipped and updated intensive Care Unit (I.C.U.), Intensive Coronary Care Unit (I.C.C.U.) Intensive Care Paediatric beds and preferably Intensive care in Tuberculosis and Respiratory Disease.
 
  • Wherever possible, the facilities available in larger tuberculosis and chest diseases hospitals, infectious diseases hospitals and mental hospitals may be utilised for training in these specialties. However, if these hospitals are not under the total administrative control of the Medical College, the required beds in these specialities shall have to be provided in the attached teaching hospital
 
  • SURGERY AND ALLIED SPECIALITIES:
No. of beds/units required
 
 
1. General surgery
150/5
2. Department of Orthopaedics
90/3
3. Department of Ophthalmology
15/1
4. Oto-Rhinolaryngology
15/1
 
270/10
Note: There shall be well-equipped and updated intensive Care Burn Unit and Surgical post operative critical care Unit.
 
  • OBSETETRICS AND GYNAECOLOGY
 
No. of beds and units required
 
1. Obstetrics
60/2
2. Gynaecology
30/1
 
90/3
(iv) GRAND TOTAL
650/24
 
# As per the terms of Notification published on  03.07.2015 in the Gazette of    India.
 
Note :  (1)  In case a super  speciality is  developed,  it  shall necessitate creation of   extra beds alongwith additional staff over and above the minimum requirement stated hereinabove in accordance with the provisions of the Postgraduate Medical Education Regulations, 1971.
 
(2)        The teaching hospital may provide additional beds in any speciality depending upon their patients load.
 
*B.1.10 Dean, Medical Superintendent and each department shall  have independent computer and printer facility.
 
*B.1.11 Each and every college /institute shall have its own website wherein the following details updated in the first week of every month shall be provided:-
 
  1. Details of Dean, Principal and Medical Supdt. including their name, qualification complete address with telephone and STD code, fax and E-mail
  2. Teaching as well as non-teaching
  3. Details of the sanctioned intake capacity of various courses UG as well as PGs by the
  4. List of students admitted merit-wise category-wise (UG & PG) for the current and previous
  5. Any research publications during the last one
  6. Details of any CME programmes, conferences and/or any academic activities conducted by the institution.
  7. Details of any awards and achievement received by the students or
  8. Details of the affiliated university and its Vice-Chancellor and
  9. Result of all the examinations of last one
  10. Detailed status of recognition of all the k.. Details of clinical material in the hospital.
*  As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
B.2 CLINICAL DEPARTMENTS-INDOOR
 
  • *The following accommodation shall be available with each ward, namely:-
 
  1. Accommodation in a General Ward shall not exceed 30 patients/hall and distance between the two beds shall not be less than 5m.
  2. Nurses Duty Room/Nursing
  3. Ward should be constructed in such a way that the Nurse from her Nursing Station is able to have an overview of all the patients in the
  4. Examination and Treatment
  5. Ward
  6. Store room for linen and other
  7. Resident Doctors and students Duty Room.
  8. Clinical Demonstration
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
 
  • *The following additional accommodation shall be provided for each of the departments, namely:-
 
  1. Offices for Heads of Departments and Heads of
  2. Accommodation for other unit
  3. Clinical demonstration rooms (at least one for each department).
  4. **Departmental Library-cum-Seminar room (30sq.mt.) with a seating capacity of
50 students – DELETED” as per the terms of Notification published  on 15.07.2009 in the Gazette of India.
 
*,**As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
Note: The size and number of staff rooms shall be as per the guidelines in the pre and para clinical departments for the prescribed number of staff members in a department.
 
B.2.3   RESEARCH   LABORATORIES:  –  “DELETED”  as per terms of  Notification published on 15.07.2009 in the Gazette of India.
 
  • OPERATION THEATRE UNIT:
 
The Operation Theatre Unit shall have the following facilities; namely:-
 
  1. Waiting room for
  2. *Pre-anaesthetic/preparation room – at least 4
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
  1. Operation
  2. Post-operative recovery room (minimum of 10 beds).
  3. Soiled Linen
  4. Instrument
  5. Sterilisation
 
  1. Nurses
  2. Surgeon’s and Anaesthetist’s room (separate for male and female).
  3. Assistant’s
  4. Observation gallery for
  5. Store rooms
  6. Washing room for Surgeons and Assistants; and
  7. Students washing up and dressing up
 
*Three such units may be provided for General Surgery, one for ENT; one for Orthopaedics; one for Ophthalmology and two for Obstetrics and Gynaecology and one for septic cases.
 
Other surgical specialities shall have independent separate OT. Additional space need to be provided for various Endoscopy procedures.
Minor Operation Theatre – one minor operation theatre in addition to above shall be provided for surgical departments in casualty/emergency unit and one such theatre in O.P.D.
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
 
  • CENTRAL STERILISATION SERVICES:
 
There shall be an independent Central Sterilization unit capable of taking the total working load of operation theatres, laboratories close to or in the operation theatre block itself. It shall have adequate equipment  like bulk sterilize with separate  ends for loading unsettle material, unloading sterile, cold sterilize, Ethylene oxide sterilize, Freon ethylene instruments and mattress sterilizer, sterile racks, mixers, and trays for instruments.
 
This department shall work round the clock and all materials, instruments, trays, and dressing material etc. shall be supplied round the clock.
 
B.2.6     LAUNDRY
 
The Central Mechanical laundry shall be provided with bulk washing machine, Hydro-Extractor, flat rolling machine. Laundering of hospital linen shall satisfy two basic considerations, namely, cleanliness and disinfection. The hospital could be provided with necessary facilities for drying, pressing and storage of soiled and cleaned linens.
 
*The physical facilities for housing the laundry equipment shall be provided in the campus. However, services can be handed over the any agency but with overall supervision of Hospital Administrator.
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
  • *DEPARTMENT OF RADIO-DIAGNOSIS:
 
  • The staff of Radio-Diagnosis department shall be covered by Personal Monitoring System of
 
Accommodation shall be provided for the following namely:
 
  • Room for 300mA, 500mA, 600mA. I.I.T.V. System, Fluroscopy System (36 m.).
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
Subclause I (a) shall be further amended/substitiuted as under:
 
*a) Room for 300mA, 500mA, 800mA, I.I.T.V. System, Fluoroscopy System (36 Sq.m.)
 
* As per the terms of Notification published on 02.02.2010 in the Gazette of India.
 
  • Ultrasound Room (15 m.)
  • Room for 60 mA Mobile X-ray system (15 m)
  • Accommodation for CT Scan system. There shall be three equipment rooms, (examination room, control room and computer room). In addition, a service room for Electrical Panels, UPS and Servo Stablizer shall be The total area requirement is 80 sq.m.
  • There shall be preferable a Magentic Resonance Imaging (MRI) system. The space requirement shall be according to the standard
  • Store room for X-Ray films related material (15 m)
  • Museum (25 m.)
  • Waiting room for patient, enquiry office and staff rooms for Professor & HOD, Profs., Asstt. Profs., Residents, Tutor shall be provided as per requirement.
  • Accommodation for demonstration room shall be
 
# The above clause 1(a) & 1(c) shall be substituted with the following: –
 
“1(a)   Accommodation shall be provided for the following namely:
Room for 300mA, 600 mA, 800mA, I.I.T.V.System, Flurocscopy System (36 sq.m.)”
1(c)       Room for 60 mA and 100 mA mobile x-ray system (15 sq.m.)
 
# As per the terms of Notification published on  03.07.2015 in the Gazette of    India.
 
  • The room sizes for various Diagnostic Imaging Systems shall be as per the following provision of the Atomic Energy Regulatory Board Safety Code, namely:
 
The room size of the room housing X-ray equipment must not be less than 25 Sq.m.  for  a  general purpose  X-Ray machine.                          In  case  of  diagnostic X-Ray
 
equipment operating at 125kV or above the control panel must be installed in separate control room located outside but contiguous to the X-Ray room. Rooms housing fluoroscopy equipment must be so designed that adequate darkness can be achieved conveniently when desired. Patient waiting areas must be provided outside the X-ray room and a dark room must be provided.
 
 
B 2.8   DEPARTMENT OF ANAESTHESIOLOGY
 
Accommodation for the department of Anaesthesia shall be provided for staff on duty in operation theaters in that block itself as far as possible in addition to following accommodation; namely:-
 
  1. Offices for Heads of Departments and Heads of
  2. Accommodation for the other unit
  3. Clinical demonstration rooms (at least two for each department); and
  4. Departmental Library-cum-Seminar room (30 Sq.m.) with a seating capacity of 50
 
 
OPTIONAL DEPARTMENTS
 
  • DEPARTMENT OF RADIOTHERAPY:
 
The department needs to be planned in such a way that there is a minimum movement of Radio-active sources through the general corridors of the Hospital. It is therefore desirable that the outpatient wing, treatment wing, dosimetry/planning equipments, wards, operation theatre and other facilities are located in the same block, may be on two floors. It should be closely connected with the rest  of the hospital to  facilitate free interaction of the facilities of various disciplines for multidisciplinary management of the patients. Separate rooms should be provided for Teletherapy Unit (100 Sq.m.area), intracavitory treatment room (50 sq.m.area)  interstitial, endocavitory, surface mould therapy room (50 sq.m.area), planning room (50sq.m.area), rooms for metalling treatment planning equipments, mould room (50 sq.m.area), record room (100sq.m.area), medical physics laboratory (50sq.m.area) outpatient waiting room (200 sq.m.area), indoor beds (at least 40 beds and an isolation ward) (200 sq.m.area), day care ward for short chemotherapy/radiotherapy procedures etc. (70 sq.m.area). The minimum floor area shall be 2000-2500 sq.m. Prior BARC approval of the radiation therapy rooms/plan alongwith complete layout of the entire department is mandatory.
.
B.2.10   DEPARTMENT OF PHYSICAL MEDICINE AND REHABILITATION:
 
Accommodation (2000 sq.meter) shall be provided for professor and other teaching staff, paramedical personnel and non-medical staff, evaluation room, physiotherapy, Electrotherapy, Hydrotherapy, Occupational Therapy, Speech therapy, separately, as far as possible.
 
B 3      CLINICAL DEPARTMENTS-OUT DOOR
 
B 3.1   Accommodation shall be provided for:-
 
  1. Waiting/reception space rooms for patients and attendants,
  2. Enquiry and record
  3. Four examination rooms (cubicles) and case demonstration rooms to be provided for each department in the outdoor in self-contained blocks with their sub-sections. Each clinical unit in the out-patient department  shall be provided with examination
  4. The following additional accommodation shall be provided in the departments specified below:-
 
  • In Surgery & its specialities:
Dressing room for men and women patients respectively. Operation theatre for out patient surgery.
  • In Ophthalmic Section:
Refraction rooms, dark rooms, dressing rooms etc.
  • In Orthopaedics Section:
Plaster room, Plaster-cutting room, out-patient X-ray desirable.
  • In ENT Section:
Sound proof audiometry Room, ENG laboratory and speech therapy facilities.
  • In Paediatrics:
Child Welfare including Immunization Clinic Child Guidance Clinic
Child Rehabilitation Clinic including facilities for speech therapy and occupational therapy.
  • In obstetrics and Gynaecology: Antenatal Clinic, Family Welfare Clinic Sterility Clinic
Cancer Detection Clinic.
 
There shall be an additional students duty room (separately for males and females) attached to the labour room.
 
  • In Dental Section:
Accommodation for Dental Surgery and Prosthetic dentistry.
 
B 2.2   Reception and Waiting Hall for Patients.
 
  1. 2.3. A seminar room for students.
 
B.4       CENTRAL LABORATORIES:
 
There shall be well-equipped and updated central laboratories preferably alongwith common collection entire for all investigations in histopathology, cytopathology, haematology, immunopathology, microbiology, biochemistry and other specialized work if any.
 
B.5             CENTRAL CASUALTY DEPARTMENT
 
* There shall be well equipped and updated intensive care unit (I.C.U) -5 beds, Intensive Coronary Care Unit (I.C.C.U.)-5 beds, Intensive Care Paediatric/Neonatal Unit -5 beds and preferably Intensive Care in Tuberculosis and Respiratory Diseases. The number of beds in casualty trauma unit shall be 25. ICU should be located near casualty. These shall be functional at the time of inception of the college.
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
 
  • *CENTRAL HOSPITAL PHARMACY
 
It shall have qualified pharmacist incharge and other staff certified by statutory authorities to dispense the drugs.
 
The following shall be added, as under:
 
  1. Space Requirement
 
Dispensary : 2000 Sq.ft. (It should include all areas of dispensing services available in wards and OPDs, patient counseling, Inventory, staff and all stores).
 
Drug and poison information services
 
They are being provided by the Pharmacology Department as a part of MBBS curriculum & should be continued as such.
 
  1. Staff requirement
 
As per existing Regulations of Minimum Standard Requirements for the Medical College for 150 Admissions Annually Regulations, 1999 under point number B6 “Central Hospital Pharmacy” – the Incharge of central hospital pharmacy should be a qualified pharmacist. He should be preferably B. Pharma from a recognized university/D.Pharma from a recognized body. He/she may be Head of the central hospital pharmacy and should work under the supervision of Medical Superintendent.
 
 
 
drugs.
Other staff certified by statutory authorities should be available to dispense the
 
 
  1. Infrastructural Requirements (Numbers may vary as required) –
 
Refrigerators                                                   :
02
 
Tables                                                             :
10
Chairs
Dispensing tables (2×8 ft)                              :
: 05
15
Computers(depending on the need)              :
05
 
Computer chairs                                             :
05
 
File cabinets                                                   :
02
 
Text book racks                                              :
02
 
 
Computer tables                                             :          05
Telephone facilities Printing facilities
Internet facilities (high speed)
 
The above numbers are minimum requirement. However the actual number may vary as per requirement of the hospital.
 
  1. Resources required for Drug information
Pharmacopoeias/National Formularies & important text books & journals should be available in Central library as per recommendation of Prof. & HOD, Pharmacology department.
 
  • As per the terms of Notification published on 26.02.2010 in the Gazette of
 
  • CENTRAL KITCHEN
 
The Central Kitchen shall be commodious, airy, sunny, clean with proper flooring with exhaust system. The cooking should be done either by electricity or by gas. It should be provided with proper and clean working platforms. A separate store area with proper storage facilities should also be provided. The services trolleys for food should be hot and closed stainless steel ones.
 
B.8             INCINERATING PLANT /*HOSPITAL WASTE MANAGEMENT
 
*Facilities for hospital waste management, commensurate with the State Regulatory Authorities etc. shall be provided.
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
 
  • CENTRAL DISINFECTION PLANT- “DELETED” as per terms of Notification published on 15.07.2009 in the Gazette of
 
  • STAFF QUARTERS
 
B10.1  *There shall be sufficient number of quarters for covering 100 per cent of the total Sr.
Residents and Jr. Residents as required.
 
B10.2 *There shall be sufficient number of quarters for covering at least 20% each of the Nurses, teaching and non-teaching staff.
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
  1. 11 CENTRAL HOSPITAL STORES
 
There shall be a central hospital stores for stocking & supply of drugs, equipments etc.
 
B.12     HOSTELS FOR STUDENTS
 
*The College/Institution should have at least provision for 75% of the total intake of students at a given time. Each hostel room shall not have more than three occupants. The size of such room shall not be less than 27 sq.mt. Each student shall be provided with an independent and separate furniture which shall include chair, table, bed and full size cupboard at the least. In case of single seated room it should be at least 9 sq. mt. Area. Each hostel shall have a visitor room, a study room with facilities for computer and internet and should be air-conditioned. There shall be a recreational facility room having T.V., Music, Indoor games etc. and messing facilities for the students.
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
GENERAL REMARKS Schedule – II  – STAFF REQUIREMENTS
  1. Emphasis in medical education being on practical instruction and demonstration in small groups. The number of teachers must be as per provisions of this Schedule adequate to enable such instruction to be imparted
 
  1. The teaching staff of all departments of medical college shall be full-time.
 
  1. *These regulations cover the minimum requirements of under graduate medical Additional teaching and non-teaching staff shall also be required in OPD, Indoors, Operation theatres and Intensive Care areas where the work load involved in emergency patient care, clinical laboratory work/field work is heavy or is of a specialized nature
 
*As per the terms of Notification published on 15.07.2009 in the Gazette of India.
 
  1. To ensure the exposure of undergraduate students to experienced teachers, it is essential to provide adequate number of higher posts (Professors/Readers) in every department of
 
  1. In department of Anatomy, Physiology, Biochemistry, Pharmacology and Microbiology, non-medical teachers may be appointed to the extent of 30% of the total number of posts in the department. A non-medical approved medical Sc. qualification shall be a sufficient qualification for appointment as lecturer in the subject concerned but for promotion to higher teaching post a candidate must require Ph.D. degree qualification or equivalent qualification. However, in the department of Biochemistry, non-medical teachers may be appointed to the extent of 50%  of the total number of posts in the department. In view of the paucity of teachers in non- clinical departments, relaxation upto the Head of the department may be given to non- medical persons in case a suitable medical teacher in the particular non-clinical speciality is not available for the said appointment in said department. However, all such appointments will be made only with the prior approval of the Medical Council of India. However, a non-medical person cannot be appointed as Director/Principal/Dean/Medical Superintendent or equivalent of an institution in any case. In the department of Community medicine, Statistician cum Lecturer in
 
Statistics should possess M.A./M.Sc. qualification in that particular subject from a recognised university. These requirements are as per the Teacher Eligibility Qualification Regulations.
 
  1. Teacher in higher specialities like Cardiology, neurology, Neuro-Surgery shall not be counted against the complement of teachers required for under graduate medical