One of the biggest reforms in medical education in India, the National Medical Commission (NMC) Bill, 2019, is facing major resistance from medical fraternity even after getting passed in Lok Sabha.
The Indian Medical Council Act 1956, which constituted Indian Medical Council, was alleged to be corrupt. It has been alleged that the process by which the MCI regulated medical colleges was flawed. Hence a new bill to reform the council has been introduced and passed.
- Under-Graduate Medical Education Board to set standards and regulate medical education at undergraduate level.
- Post-Graduate Medical Education Board to set standards and regulate medical education at postgraduate level.
- Medical Assessment and Rating Board for inspections and rating of medical institutions.
- Ethics and Medical Registration Board to regulate and promote professional conduct and medical ethics and also maintain national registers of licensed medical practitioners and Community Health Providers (CHPs).
- The Bill also proposes for the NMC to frame guidelines for determination of fee and other charges for 50% of seats in private medical institutions and deemed to be universities.
- Recommended separation of functions by forming four autonomous boards and appointment of regulators through selection, rather than election.
Reasons for making Changes
- The Statement of Object and Reasons of the Bill says the IMC had failed to keep pace with time and various bottlenecks had crept into the system with serious detrimental effects on medical education and on delivery of quality health services.
What the Bill aims to provide
- As for admissions and licensing, the Bill provides for a National Eligibility-cum-Entrance Test (NEET) for admission to all undergraduate and post-graduate super-specialty medical education, while providing for another one, National Exit Test (NEXT) for granting license to practice and admission to postgraduate "broad-specialty courses".
- Other powers of the NMC include permission to establish new medical colleges, start post-graduate courses, increase the number of seats, recognition of medical qualifications in and outside India etc.
Reasons for change
- The Statement of Object and Reasons of the Bill says the IMC had failed to keep pace with time and various bottlenecks had crept into the system with serious detrimental effects on medical education and, by implication, on delivery of quality health services.
- A Parliamentary panel which had looked into the matter had recommended restructuring and revamping of the regulatory system of medical education and practice.
- It had also recommended separation of functions by forming four autonomous boards and appointment of regulators through selection, rather than election.
Indian Medical Association’s major concerns
- The Bill gives permission for medical related individuals to apply for license. This may open the door for persons with inadequate training in modern medicine to practice, putting patients at risk and lowering standards of healthcare.
- Persons with some connections with modern medicine like pharmacists, practitioners of other systems of medicines with a bridge course, ophthalmologists and even existing healthcare workers at the primary health centers may get licenses to practice modern medicine.
- While the Medical Council of India (MCI) was an autonomous body with two-third of its members (160 plus) being directly elected by the medical fraternity, the new one would have 25 members with no directly elected member.
- The IMA's other major objection is to the proposed National Exit Test (NEXT) for giving both licenses for practice (to those who have already cleared the MBBS exam) as well as for admission to post-graduate "broad-specialty courses".