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National Medical Commission: A shot in the arm for medical education

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Dr KK Aggarwal    26 October 2020

Reproduced from: India Legal https://www.indialegallive.com/column-news/national-medical-commission-indian-medical-council-act/, published August 29, 2020

The NMC Act will bring in much-needed reforms in the medical education sector by ensuring probity, bringing down costs, simplifying procedures and enhancing the number of medical seats in India.

The National Medical Commission (NMC) has come into force from September 25, 2020, thereby repealing the nearly 64-year-old Indian Medical Council Act, 1956. All its bodies such as the Medical Council of India and Board of Governors, which superseded the MCI on September 26, 2018, have also been dissolved.

 As a result, the much-awaited NMC will start to function effectively soon to bring reforms in the medical education sector. Last year, the National Medical Commission Act 2019 was passed by both Houses of Parliament.

A gazette notification by the health ministry read: “The Indian Medical Council Act, 1956 (102 of 1956) is hereby repealed with effect from September 25. The BoG appointed under Section 3A of the Indian Medical Council Act, 1956 (102 of 1956) in supersession of the MCI constituted under sub-section (1) of section 3 of the said Act shall stand dissolved.”

Dr Suresh Chandra Sharma, former Head of Department, ENT, All India Institute of Medical Sciences, has been appointed the chairman of NMC for three years, while Dr Rakesh Kumar Vats, ex-Secretary General, Board of Governors, MCI, has been appointed Secretary of NMC for three years. Apart from the Chairman, the NMC will consist of 10 ex-officio members and 22 part-time members appointed by the government.

To ensure transparency, the members will have to declare their assets at the time of joining and demitting office, along with declaring their professional and commercial engagement or involvement. Further, the chairperson/member on ceasing to hold office will not accept any employment for two years in a private medical institution whose matter has been dealt with him either directly or indirectly.

The purpose of the NMC Act, 2019, is to provide for a medical education system that improves access to quality and affordable medical education, ensures availability of adequate and high quality medical professionals in all parts of the country; promotes equitable and universal healthcare that encourages community health perspective and makes the services of medical professionals accessible to all citizens. Further, it promotes national health goals; encourages medical professionals to adopt latest medical research in their work and to contribute to research; has an objective, periodic and transparent assessment of medical institutions and facilitates maintenance of a medical register for India. It also enforces high ethical standards in all aspects of medical services; is flexible to adapt to changing needs and has an effective grievance redressal mechanism. 

The functions of the NMC include: 

  • framing policies for regulating medical institutions and medical professionals
  • assessing the requirements of healthcare related human resources and infrastructure
  • ensuring compliance by the State Medical Councils of the regulations made under the Bill
  • framing guidelines for determination of fees for up to 50 percent of the seats in private medical institutions and deemed universities which are regulated under the Bill.

The NMC will frame policies and co-ordinate the activities of four autonomous boards.  Each autonomous board will consist of a president and four members, appointed by the central government. These boards are—Under-Graduate Medical Education Board (UGMEB), Post-Graduate Medical Education Board (PGMEB), Medical Assessment and Rating Board (MARB) and the Ethics and Medical Registration Board (EMRB).

UGMEB and PGMEB Boards will be responsible for formulating standards, curriculum, guidelines, and granting recognition to medical qualifications at the undergraduate and post-graduate levels respectively. MARB will have the power to levy monetary penalties on medical institutions which fail to maintain the minimum standards as laid down by UGMEB and PGMEB. It will also grant permission for establishing a new medical college, starting any post-graduate course or increasing the number of seats. EMRB will maintain a national register of all licensed medical practitioners and regulate professional conduct. Only those included in the register will be allowed to practice medicine. The Board will also maintain a separate national register for community health providers. 

The NMC may grant a limited license to certain mid-level practitioners who may prescribe specified medicines in primary and preventive healthcare. In any other cases, these practitioners may only prescribe medicines under the supervision of a registered medical practitioner.

There will be a uniform National Eligibility-cum-Entrance Test for admission to under-graduate and post-graduate super-speciality medical education in all medical institutions regulated under the Bill. The NMC will specify the manner of conducting common counselling for admission in all such medical institutions. There will be common final year under-graduate examination called the National Exit Test for students graduating from medical institutions to obtain the license for practice. This Test will also serve as the basis for admission into post-graduate courses at medical institutions.

Under the NMC Act, the final year examination has been converted into a nationwide exit test called NEXT. This single examination will grant—

  • a license to practice medicine
  • an MBBS degree
  • entrance to postgraduate courses.

There is a provision for common counselling for entrance to PG courses also.

Students will be able to get admission to seats in all medical colleges and institutes of national importance like AIIMS, PGI Chandigarh and JIPMER through a single counselling process. The Act does not impose any restriction on the number of attempts at NEXT examination.

An outstanding feature of the NMC Act is that it provides for the regulation of fees and all other charges in 50 percent seats in private colleges as well as deemed to be universities. There was no provision to regulate fees in the Indian Medical Council Act 1956. According to the government, nearly 50 percent of the total MBBS seats in the country are in government colleges, which have nominal fees. Of the remaining seats, 50 percent would be regulated by NMC. This means that almost 75 percent of the total medical seats in the country would be available at reasonable fees.

According to the central government, the NMC Act will reduce the burden on students, ensure probity in medical education, bring down its costs, simplify procedures, help to enhance the number of medical seats in India, ensure quality education and provide wider access to people for quality healthcare.

 

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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