On 8th August 2019, the center passed the National Medical Council act, to improve access and quality of education to the medical field in India. It aims to ensure that the best quality of medical professionals is present all over the country.
Its capacity also includes roles such as assessing the quality of medical colleges and conducting the graduation course MBBS’s entrance and exit examinations i.e. the NEET and NEXT.
The bill replaces the controversial Medical Council of India (MCI) dissolved in 2010 due to corruption charges by the CBI against their president Ketan Desai. It will also repeal the National Medical Council’s Act of 1956.
The National Medical Commission Act, 2019 (NMC Act)
The National Medical Commission consists of a regulatory body of 33 members. They replaced the Medical Council of India on 8th August 2019, to oversee and develop medical education in India. The bill was first introduced in 2017 and received widespread opposition from the medical fraternity especially ayurvedic and allopathic doctors, hence it was sent back since it needed serious reconsideration
The council members are selected by a search committee, comprising seven members and the president is selected by the center on the recommendation of these members. The center also nominates these seven members including five experts.
The committee consists of a total of 8 ex-officio members, four of them are presidents of the various boards established under the act, three are nominated from ministries of Human resource Department, Pharmaceuticals and Health, and the final from the Director-General of Health Services.
The opposition has objected to this form of selection as it gives too much power to the center and could lead to “favoritism and bureaucratic interference” in the selection process.
Moreover, the members including the chairperson will serve for only one term of four years i.e. they cannot be renominated. Part-time members have a tenure of 2 years. The ratio of assents required has also increased to 13 out of 25 from the previous 15 of 100. Additionally, council meetings will take place every quarter instead of once a year thus reducing the time-period between meetings.
Functions of the bill
The powers and functions of the bill are explained in Section 10 of the National Medical Commission Act. It has several responsibilities such as improving the access and quality of medical education in all parts of India. It lays down policies to ensure that medical practitioners maintain and promote the ethics required by the profession and grant licenses to new colleges.
It has to periodically assess if medical institutions are maintaining the required standards and provide an effective grievance redressal mechanism to address any issues. It also has to assess any requirements for improvement in other areas of the sector like infrastructure and human resources and come up with plans to address the situation.
Section 10(1)(i) designates the council to determine the fee structure of medical colleges including the fee of 50% seats in all private and deemed institutions who are under this act. It also has to come up with reforms to tackle the skewed distribution of medical seats across various medical institutes in the country. This will help in addressing the problem of private colleges charging exorbitant fees due to which many less fortunate but able students unfairly lost an opportunity.
Other Features of the bill include
The bill under Section 14 aims to establish proper state and national level medical commissions within 3 years. A Medical Advisory Council will also be set up by which all states and union territories will have a platform to address their variegated issues. The council will also ensure that minimum education standards are being maintained.
Changes in testing: As per the new bill, all undergraduate medical colleges governed by this act have to accept admissions on the basis of the National Eligibility-cum-Entrance Test or NEET examinations. The Under-Graduate Medical Education Board (UGMEB) committee will be set up to oversee and conduct these exams. This will ensure uniformity and equal opportunity for all aspirants.
The NMC has not only been consigned to conduct the NEET and but also regulates the procedure for conducting common counseling by the designated authority for admission to undergraduate and postgraduate super-specialty seats in all the medical institutions that are governed by the NMC Act.
Therefore, colleges like AIIMS and JIPMER who previously conducted their own entrance exam will have to now accept students on the basis of their NEET results.
The NMC has also introduced the National Exit Test or NEXT under Section 15 to grant licenses for practicing medicine in India and for enrolment under the State Register or the National Register. Further, the NMC is additionally liable for conducting the exams and will be operational as per the date appointed by the Central Government, which is usually within three years from the date of commencement of the NMC Act. The Post-Graduate Medical Education Board (PGMEB) will be set up to oversee the NEXT examinations. NEXT would also act as a screening test for foreign medical graduates and will be the basis for admission into postgraduate courses
The UGMEB and PGMEB will also regulate the curriculum and guidelines for maintaining the overall standard of medical education in India. Two other boards will be established under this bill namely the Medical Assessment and Rating Board and Ethical and Medical Registration Board.
Community Health providers:
An important amendment in the bill is introducing a practice of issuing, about 350,000 mid-level practitioners who are not qualified, licenses to practice medicine. These people may prescribe medicines for primary and preventive healthcare otherwise, under the supervision of a registered practitioner. This may help in fighting many of the diseases in rural India
Reasons for change
The main reason for introducing the bill was to replace the IMC which had prolonged its welcome. It wants to end ‘inspector raj’ in medical education and bring in significant changes in the medical education sector.
The committee was infamous for its corrupt practices and lack of accountability. Over time it was unable to address the overflowing issues and hence causing serious detrimental effects on the quality of medical education and health services in India. They also wanted to nominate more diverse members other than doctors i.e. research professionals etc. to improve their overall quality.
Though MCI had to be dissolved through ordinances and any action against the MCI president might be taken as long as directed by a court, through the new bill, the Centre will have the facility to get rid of the chairperson or any NMC member for several reasons including if their continuation in office is “prejudicial to public interest” or if the member has abused his position acquired financial or other interests which might affect the functioning of the committee.
The bill states that: “The ethics board of the commission will “exercise appellate jurisdiction with respect to actions taken by state medical councils” on issues of compliance with the ethical code.”
Analysis & Criticism
Several provisions in the Bill are raising the eyebrows of medical students and doctors across the country. Several terms such as primary and mid-level healthcare have not been clearly defined in the case of community health professionals. The IMA said that this might lead to the promotion of quackery. The medical fraternity has also completely rejected the NEXT format stating that the current NEET-PG is sufficient for admissions to postgraduate courses.
“Merit should be the determining factor in securing a PG seat and the current NEET-PG should not be scrapped,” said the All India Institutes of Medical Sciences (AIIMS) Resident Doctors Association (RDA) the Federation of Resident Doctors Association (FORDA) and the United-RDA in a joint statement opposing the NMC Bill in its current form. The regulation of just 50% of seats has also been objected to.
Mr. Harsh Vardhan, the Union Health and Family Welfare Minister of India has termed it “one of the greatest reforms ushered in by the Narendra Modi government”.
In dangerous times like these when diseases are rampant in society doctors and other medical professionals are our only saviors. There needs to be a heavy emphasis on their protection (mental and physical) and wellbeing. There is also a dire need for research because we need cures for a lot of widespread diseases like AIDS, COVID-19, etc.
New diseases are emerging every day hence we need the planning and infrastructure to tackle such epidemics. The present archaic facilities and poor pay in government facilities are driving our best outside the country to look for better opportunities. A good education will enable us to produce a better quality of doctors and medical health professionals.
The government should immediately address the problems faced by them because they put themselves at high risk of sacrificing their mental and physical health in order to protect the citizens of our country. Research and development in this field will help them do their job better, hence the government should undertake all measures possible to ensure/ facilitate that.
“The views of the authors are personal“
Frequently Asked Questions
What is the NMC Bill and how is it different from the IMC bill?
The National Medical Council bill, 2019 replaces the previous Indian Medical Council Act. It’s a revamped version of the previous bill that aims to address many of the issues its predecessor was unable to due to corruption or stagnation.
Will the NEXT replace NEET (PG)?
Yes, NEXT exams will replace NEET (PG) and also the FMGE (Foreign Medical Graduate Exam) which was taken by foreign medical graduates. It will be taken by medical students in their final year and will also be used to get admission in postgraduate courses.
The council will determine the seats for how many seats in private colleges?
50% of the seats