National Medical Commission Bill 2017

The Union Cabinet has approved National Medical Commission Bill, 2017. It will replace the Medical Council, 1956 Act and enable a forward movement in medical education reform.
The bill is aims at bringing reforms in medical education sector of the country which has been under scrutiny for corruption and unethical practices.
  • The bill replaces existing apex medical education regulator Medical Council of India (MCI) with National Medical Council (NMC), a new body to ensure transparency.
  • It empowers NMC to lay down policies for maintaining high quality and high standards in medical education and make necessary regulations in this behalf and ensure coordination among Autonomous Boards.
  • It provides for constitution of four autonomous boards entrusted with conducting undergraduate and postgraduate education, assessment and accreditation of medical institutions and registration of practitioners under NMC.
  • The commission will have 25-members including Chairman and Member Secretary. It will have 12 ex-officio members and 11-part-time members of which five will be doctors elected to the commission. The selected members will be picked by a search committee headed by Cabinet Secretary.
  • The bill proposes a common entrance exam and national licentiate examination which every candidate, who completes five years of MMBS course need to clear to become medical practitioner or get entry into post-graduation studies.
  • This examination will also bring those students who do medical education from abroad at par with those who graduate from Indian institutions.
Synergies among medical streams proposed:
  • Doctors pursuing the Indian systems of medicine, including Ayurveda, and homoeopathy may be allowed to practise allopathy after clearing a bridge course.
  • Joint sittings: Bill calls for a joint sitting of the National Medical Commission, the Central Council of Homoeopathy and the Central Council of Indian Medicine at least once a year “to enhance the interface between homoeopathy, Indian Systems of Medicine and modern systems of medicine”.
  • The Bill has also proposed that specific educational modules or programmes for developing bridges across the various systems and promotion of medical pluralism, can be done with the approval of all the members present in the joint sitting.
  • It provides for the constitution of four autonomous boards entrusted with conducting undergraduate and postgraduate education, assessment and rating of medical institutions and registration of practitioners under the National Medical Commission.
  • The bill aims to move towards outcome-based regulation of medical education rather than process oriented.
  • It will ensure proper separation of functions within regulator by having autonomous boards, create accountable and transparent procedures for maintaining standards in Medical Education.
  • Opposition from the Indian Medical Association: It will “cripple” the functioning of the profession by making it answerable to the bureaucracy and non-medical administrators.
What else could be done?
  • Another way to bolster healthcare delivery is a three-year diploma for rural medical-care providers, along the lines of the Licentiate Medical Practitioners who practised in India before 1946.
  • Chhattisgarh tried this experiment in 2001 to tackle the paucity of doctors it faced as it was formed. Graduates from such a three-year programme would only be allowed to provide basic care in under-served pockets.
  • Massive protests by the Indian Medical Association and poor execution derailed the Chhattisgarh experiment, but the idea wasn’t without merit. India has no choice but to innovate with health-care delivery models to tackle the challenges it faces.
Amendments approved in Bill:
  • Final MBBS Examination and exit test: The final MBBS examination will be held as common exam throughout country. It will serve as exit test to be called National Exit Test (NEXT). It will ease burden on medical students as they will not have to appear in separate exam after MBBS to get license to practice. NEXT will also serve as screening test for doctors with foreign medical qualifications in order to practice in India.
  • Provision of Bridge course: It removes provision dealing with bridge course for AYUSH practitioners to practice modern medicine to limited extent. Now state governments have been empowered to take necessary measures for addressing and promoting primary health care in rural areas.
  • Fee regulation:  The maximum limit of 40% seats for which fee will be regulated in private medical institutions and deemed universities has been increased to 50% seats. The fee will also include all other charges taken by colleges.
  • Number of nominees from States/UTs in NMC: The nominees of States and UTs in National Medical Commission (NMC) have been increased from 3 to 6. TNMC will comprise of 25 members of which at least 21 will be doctors.
  • Monetary penalty for medical colleges: It adds provision providing different options for warning, reasonable monetary penalty, reducing intake, stoppage of admission leading up to withdrawal of recognition on medical college non-compliant with norms. Earlier, wide range of monetary penalty, ranging from one half to ten times annual fee recovered from batch was to be imposed in a graded manner.
  • Stringent punishment for quacks: It provides severe punishment for any unauthorized practice of medicine or by quacks with imprisonment of up to 1 year along with fine extending up to Rs. 5 lakhs.

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