The National Medical Commission (NMC) came into existence from September 25 as the country’s apex regulator of medical education and profession replacing the Medical Council of India (MCI).

With this, the nearly 64-year-old Indian Medical Council Act stands repealed and the Board of Governors appointed in supersession of the MCI has also been dissolved. The NMC will carry forward the reforms initiated by the Board of Governors under Dr.V.K. Paul. The Board came into being after the MCI was dissolved in 2018, following charges of corruption. 

National Medical Commission

The National Medical Commission Act, which seeks to usher in mega reforms in the medical education sector, received the assent of the President on August 8, 2019.

The NMC Act provided for setting up of a National Medical Commission in place of the scam-tainted MCI. 

There are four autonomous boards under the NMC Act. They have also been constituted and came into existence from September 25. 

They are:

1) Under-Graduate Medical Education Board (UGMEB).

2) Post-Graduate Medical Education Board (PGMEB).

3) Medical Assessment and Rating Board. 

4) Ethics and Medical Registration Board.  

Functions of the NMC:

* It will further streamline regulations on medical institutions and medical professionals, rating of institutions, HR assessment and focus on research. 

* Work on modalities of the common final year exam after MBBS (National Exit Test) to serve for both registration and PG entrance. 

* Framing guidelines for determination of fees for up to 50 per cent of the seats in private medical institutions and deemed universities.

* Developing standards for Community Health Providers to serve in primary health care with limited practicing license.

Members of NMC

The NMC comprises a chairman, 10 ex-officio members and 22 part-time members. The ex-officio members include presidents of the four autonomous boards. NMC has 10 nominees from vice chancellors of health universities from States/UTs, nine nominees from State Medical Councils and three expert members from diverse professions. 

Dr. Suresh Chandra Sharma, former head of Delhi All India Institute of Medical Sciences ENT department, has been appointed as chairman for a period of three years with effect from September 25. Rakesh Kumar Vats, who was secretary general in the Board of Governors of the MCI, is the secretary of the commission.

Major provisions under the NMC Act

Community Health Providers

India has a doctor-population ratio of 1:1,456 as compared with the WHO standards of 1:1000. In addition, the distribution of doctors working in the urban and rural areas is skewed. 

Under the NMC Act, limited licenses can be granted to non-medical persons or Community Health Providers (CHPs). They can counsel, provide early warnings, treat elementary ailments and provide early referral to a higher facility.

There were many protests against this provision. The government said that there are international examples of permitting such Community Health workers. Countries such as Thailand, US, UK and China have permitted Community Health Workers/Nurse Practitioners into mainstream health services, with improved health outcomes.

Fee regulation

There was no provision to regulate fees in the Indian Medical Council Act, 1956. As a result, states had to resort to signing MoUs with medical colleges at the time of granting Essentiality Certificate and thereby gain a handle to regulate fees of state quota seats. 

Nearly 50 per cent of the total MBBS seats in the country are in government colleges. The NMC would regulate 50 per cent of the remaining seats. This means, almost 75 per cent of total seats in the country would be available at reasonable fees.

The state governments would have the liberty to decide fees for remaining seats in private medical colleges on the basis of individual MoUs signed with colleges on the basis of mutual agreement.

National Exit Test

The NMC shall conduct a common final year undergraduate medical examination, to be known as the National Exit Test (NEXT). It will be held for granting license to practice medicine as medical practitioners and for enrolment in the State Register or the National Register. It shall be the basis for admission to the postgraduate broad-speciality medical education in medical institutions. 

Any person with a foreign medical qualification shall have to qualify the National Exit Test for the purpose of obtaining licence to practice medicine as a medical practitioner.

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