The bill supersedes the Indian Medical
Council Act 1956. It replaces the Medical Council of India (MCI) with a National
Medical Commission (NMC).
The National Medical Commission will comprise of
25 members who will be appointed by the central government through a research
committee. The fees of 40% of seats in private medical institutions will be
decided by the commission.
The bill will set up a Medical Advisory Council
which will function as a medium to convey dialogue between the National Medical
Commission and states/union territories.
Four autonomous boards will be established under
the commission to supervise and assess the undergraduate and postgraduate
The National Medical Commission will regulate
medical education as well as a medical practice.
A National Licentiate Examination will be
conducted to get the license for medical practice as well as to get admission
into the postgraduate medical course.
The bill provides for a consolidated NEET
(National Eligibility-cum-Entrance Test) for admissions in all undergraduate
courses by which separate exams and multiple counseling processes for various
medical colleges will be avoided.
For admission in postgraduate level, an
equivalent NEXT will be conducted. It will also be the Licentiate Exam for
obtaining a license to practice.
This provision will erase off the multiplicities
of exams and abolish the inequality in the skill set of doctors graduating from
all parts of the country.
The doctors will need to qualify the Licentiate
exam only once in the lifetime. Considering the continuous developments in
medical science and technology, this license system keeps no checks if a
doctor’s knowledge and skills are up to date with the changing times.
The old National Medical Council Act has no
provision to regulate fees of various medical institutions. The IMC bill offers
to cap fee by enabling the commission to frame guideline for profit-driven
The IMC can directly determine the fee for up to
50% of the seats in private medical colleges. This will provide impetus to
talented and meritious students to avail the education opportunity in best
On one hand, it is a positive step in the
direction of ‘free education for all’, on the other hand, this provision can be
proved to be as a discouraging step for private investments in the field of medical
education. Thus there is a need to incentivize private entry by reducing
barriers to open medical colleges.
Representation in the NMC:
A search committee will recommend the names of
chairman and members of the National Medical Commission to the government.
Two-third of the members of the commission, including the chairperson, will be
medical practitioners. This could lead to too much influence of medical
practitioners in the field, according to expert committees.
However, the act asserts a transparent process
for selecting the members. The NMC, as well as the search committee for NMC,
will be a mix of nominated as well as elected members.
Autonomy of the Commission
The present framework of the bill provides
complete autonomy to the National Medical Commission. However we must not
forget that the government should have an overriding supervisory power over the
National Medical commission so that the regulations formulated by the
commission concur with the government policies.
Moreover, the government is expected to address
public emergencies. It might not be the best choice for the commission to
dispense government’s duties in emergency cases.
How will it affect AYUSH?
The bill offers a bridge to allow AYUSH workers
to practice allopathic medicines. Now 3.5 Lakh AYUSH practitioners across India
can also add up to the already 11 Lakh registered allopathic practitioners.
This provision has both positive and negative sides.
On one hand it can provide an integration of
these two medical schools, on the other hand, the AYUSH practitioners are
already well qualified so further integration will lead to overqualification of
practitioners. At the same time, this step can also prove to hinder the
undisturbed growth of AYUSH.
Disparities in healthcare scenario:
The biggest challenge to the Indian healthcare
system in present times is the unequal distribution of doctors between metro
cities and rural areas. The current ratio between the number of doctors in
metropolitan and rural areas is 3.8 to 1. At a time when more than 70 percent
of Indian population lives in villages, such disparity is frightening. The reason behind this discrepancy is
Inadequate investment. Furthermore, very few incentive structures in the rural
The qualification of doctors in the rural area
is much lower than those in urban. The requirement in public health in rural
areas differs vastly from what is being taught in MBBS schools.
The disparity is also wide in the number of
doctors in northern and southern states. Southern states like Kerala and Tamil
Nadu have adequate doctors while the states like Bihar and Uttar Pradesh has an
acute shortage of doctors.
We are facing an overall shortage of qualified
doctors in our country. According to the World Health Organization, the
standard population to doctor ratio is 1000:1. In India, the ratio stands at
1456:1. Over 57 percent of the practicing doctors in India are unqualified with
a large number of unaccounted quacks in the field.
While the National Medical Commission Act 2019
has brought some critical attention to it, the act brings a paradigm shift in
the philosophy of regulation. The number of doctors and their quality is bound
to increase with the implementation of this act. The autonomous commission will
work as an outcome-focused system.