National Medical Commission (NMC) has come into being from 25 September and the six-decade-old Indian Medical Council Act 1956 has been repealed. There are four autonomous boards under the NMC Act— the Under-Graduate Medical Education Board (UGMEB), the Post-Graduate Medical Education Board (PGMEB), the Medical Assessment and Rating Board and the Ethics and Medical Registration Board.
Why is Medical Council of India being replaced?
- The Medical Council of India has repeatedly been found short of fulfilling its mandated responsibilities.
- Quality of medical education is at its lowest ebb; the current model of medical education is not producing the right type of health professionals that meet the basic health needs of the country because medical education and curricula are not integrated with the needs of our health system.
- Medical graduates lack competence in performing basic health care tasks like conducting normal deliveries; instances of unethical practice continue to grow due to which respect for the profession has dwindled.
- Compromised individuals have been able to make it to the MCI, but the Ministry is not empowered to remove or sanction a Member of the Council even if he has been proved corrupt.
Accessing Medical Education:
- Equity in accessing medical education is of vital importance. While public institutions substantially subsidise medical education, the NMC will determine fees for a percentage of the seats in private medical colleges and deemed universities.
- This move will broaden the opportunity for students from all sections of the society to undertake medical education.
- This democratisation of medical education is important since it is growing more expensive with every passing year. The rising fees, expensive books and equipment become a barrier for several deserving students.
- Social responsibility and empathy for fellow humans are vital traits for any doctor. The presence (or absence) of a paying capacity should not be a determinant for enrolling in an educational programme.
- The NMC’s authority to determine a percentage of fees in private medical colleges and deemed universities can open doors for those who want to pursue a career in medicine, but do not have the financial means to do so.
What are the regulatory bodies being set up under the NMC?
The Bill sets up four autonomous boards under the supervision of the NMC. Each board will consist of a President and four members (of which two members will be part-time), appointed by the central government (on the recommendation of a search committee). These bodies are:
- The Under-Graduate Medical Education Board (UGMEB)
- The Post-Graduate Medical Education Board (PGMEB):
- The Medical Assessment and Rating Board
- The Ethics and Medical Registration Board
How will the commission change the eligibility guidelines for doctors to practice medicine?
- 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.
- Further, it introduces a common final year undergraduate 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 this Bill.
- Foreign medical practitioners may be permitted temporary registration to practice in India.
- However, it does not specify the validity period of this license to practice. In other countries such as the United Kingdom and Australia, a license to practice needs to be periodically renewed. For example, in the UK the license has to be renewed every five years, and in Australia it has to renewed annually.
How does the Bill regulate community health providers?
- As of January 2018, the doctor to population ratio in India was 1:1655 compared to the World Health Organisation standard of 1:1000.
- To fill in the gaps of availability of medical professionals, it provides for the NMC to grant limited license to certain mid-level practitioners called community health providers, connected with the modern medical profession to practice medicine.
- These mid-level medical practitioners may prescribe specified medicines in primary and preventive healthcare. However, in any other cases, these practitioners may only prescribe medicine under the supervision of a registered medical practitioner.
- This is similar to other countries where medical professionals other than doctors are allowed to prescribe allopathic medicine. For example, Nurse Practitioners in the USA provide a full range of primary, acute, and specialty health care services, including ordering and performing diagnostic tests, and prescribing medications. For this purpose, Nurse Practitioners must complete a master’s or doctoral degree program, advanced clinical training, and obtain a national certification.
Significance and the need:
- The body seeks to regulate medical education and practice in India.
- The body attempts to tackle two main things on quality and quantity: Corruption in medical education and shortage of medical professionals.
- The body aims to overhaul the corrupt and inefficient Medical Council of India, which regulates medical education and practice and replace with National medical commission.
- Over the years, Medical Council of India has been marred by several issues regarding its regulatory role, composition, allegations of corruption, and lack of accountability.
- In 2009, the Yashpal Committee and the National Knowledge Commission recommended separating the regulation of medical education and medical practice.
- India has suffered from the problem of inappropriately trained doctors of varying quality since a very long time.
- Decades back, the Mud liar Committee Report (1959) pointed out that doctors had neither the skills nor the knowledge to handle primary care and infectious diseases that were a high priority concern at the time.
- In recent times, the excessive reliance on a battery of diagnostic tests is reflective of commercial considerations and weak knowledge.
- The aspirations of an emergent India introduce an urgency to manage medical systems optimally.
- Medical education has to keep pace with these rapid developments. The NMC Act is not a matter of choice, but an imperative in the national interest.