The National Medical Commission (NMC) was established under the National Medical Commission Act in 2019 after the Medical Council of India was dissolved and the 64-year-old Indian Medical Council Act was abolished in the same year. The main ideas behind the establishment of NMC were:
- To build a medical education system that improves the quality of education and make it accessible for people
- To ensure the availability of medical professionals in the country who promote equality in healthcare, believe in community service, and make these services reach people
- To promote national health goals
- To make research feasible and make medical professionals use the latest research techniques
- To promote transparency in medical colleges in India
- To maintain a medical and to improve the standards of medical services in the country, and
- To adapt to the changing needs and to have an effective grievance redressal mechanism.
The new bill is a landmark bill that aims to change the whole infrastructure and functioning of not only medical education but also the statutory medical colleges in India. The three major changes that the bill brings with it are to strengthen the medical education body, bring coherence in all fields of medical education and shift the credibility from an independent body to a centralized body.
The change was brought to address the serious issues faced in the field of medical education like corruption, lack of accountability, composition, and regulatory role of the Medical Council of India. While NMC is a 25 member body, MCI was a single-headed body. The new commission consists of people from the medical fraternity who have a strong understanding of medical education and health care scenarios and can be better decision-makers for the same. A lot has been said about the changes that the emergence of the National Medical Commission might bring with it. While there was much deliberation about the new act, there were many who also welcomed it. Let’s discuss the various changes with the emergence of NMC.
CONSTITUENT BODY: STRONGER THAN BEFORE
The main agenda behind the abolishment of the Medical Council of India was to bring uniformity in the scattered pieces of the medical education body. National Medical Commission is aimed to strengthen the medical constituent body by bringing clarity in the law and functioning of Medical Education, Research and Practice which lacked in MCI. The Act, therefore, brought along the emergence of four autonomous boards, namely,
- The Under-Graduate Medical Education Board
- The Post-Graduate Medical Education Board
- The Medical Assessment and Rating Board, and
- The Ethics and Medical Registration Board
These boards were created to improvise the standards of medical education and service in the country. These autonomous boards are the sole deciding factors to set up guidelines for setting up medical colleges in India, determine the minimum requirements and standards for conducting courses and examinations, granting recognition of medical qualification, assess medical institutions, carry out inspections, specify norms, facilitate research, regulate professional conduct and promote medical ethics in accordance with the regulations made under this Act.
The National Medical Commission is a 25 member body out of which 17 members are medical professionals unlike the Medical Council of India. The appointment of more medical professionals can be considered as a thoughtful step because they have a better understanding of the problems in the medical fraternity and can come out as better representatives.
REGULATION OF COMMUNITY HEALTH PROVIDERS
The National Medical Commission proposed the introduction of a bridge course in all the medical colleges in India. This bridge course allows practitioners of alternative medicines like Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy to practice conventional medicine at primary and preventive levels after the completion of the course. These practitioners will be permitted to practice as community health providers. This is done to bridge the gap of the dire need for doctors in rural areas and to reduce the doctor-patient ratio which is as huge as 1:1500 in the country.
It generally takes 7-8 years to produce a specialist doctor in India and with the current rate of producing doctors in the country, the ratio is not likely to reduce anytime soon. With the introduction of this bridge course, the ratio can decrease along with the production of surplus doctors at the primary and preventive levels. This can also increase the availability of doctors in rural areas.
EVISED ELIGIBILITY GUIDELINES FOR DOCTORS
The National Medical Commission has put forth a uniform National Exit Test (NEXT)which will be a common exit exam that would serve as a license to practice medicine all across India, a gateway for PG medical admission, and as a screening test of foreign medical graduates. If approved, NEXT may replace the National Eligibility cum Entrance Test (NEET PG), recruitment exam for Central Health Services, and Foreign Graduate Medical examination (FMGE) as it caters to all medical graduates within and outside the country.
NEXT was proposed as a method for quality certification of graduating doctors and to bring parity in medical education. Thousands of students graduate from medical colleges in India, all taught and trained differently. NEXT standardize a level of medical education and aims to bring forward more skilled and qualified medical practitioners in the country.
NEXT is proposed in two sessions. The candidate will attempt the first session after the final year MBBS exam qualifying which, he/she can go for the internship. The second attempt is a passing examination which the candidates take on the completion of their internship.
FEE REGULATION IN PRIVATE MEDICAL COLLEGES
A high fee is a major issue for medical admissions in Private Medical Colleges in India. With such a high fee, it is difficult for every student to take admission to such colleges. The National Medical Commission has also recommended regulation of fees and other charges for 50% of seats in Private Medical colleges in India. Capping fees can enable access to medical education for all.
Many Private Medical Colleges in India charge a surplus amount of money during admissions making it difficult for students to avail medical education even after the capitation of fees is banned since 2002. The regulation of fees can stop the overflow of money to these institutions.
NMC, undoubtedly, is going to bring some milestone changes along with it but there are also a few things that cannot be ignored in the act. Let’s check out what they could be.
License to Quackery?
There are innumerable examples of Quackery that we come across in our everyday lives. People practice medicine with fake MBBS degrees and license to earn money. With the introduction of a bridge course in the coming years, anyone may get a license after having an AYUSH degree and start practicing medicine. Introduction of bridge course may increase the number of doctors but their quality may go down.
Is NEXT justified?
Medical students take a number of exams and years to complete MBBS. NEXT exam can come out as a challenge and add to their problems. With NEXT being the deciding factor for a student to get a license and internship, not getting through it can make students lose a year. This not only creates a burden for the students but also hampers the objective of NMC which was to create more doctors which might not be possible with another medical entrance examination like NEXT.
Regulation of Fee: Boon or Bane?
The regulation of fees for 50% of seats in Private Medical Colleges in India might be a great step to stop the unnecessary flow of money but this doesn’t mark an end to the capitation of fees in these colleges. There are chances that these colleges increase the fees for NRI seats and may lead to more corruption as the NRI vacant seats are often converted to management seats at much higher fees.
There are speculations that MBBS students who clear the final year exam will have to serve in a rural or tribal area for a minimum period of 3 years. The students are who are planning to pursue PG medical course may be asked to work for another 3 years in rural/tribal areas, in their chosen specialization. If this happens, it not only decreases student’s interest throughout the course of study but can also fall as a burden as they will have to wait for years to complete their education and become a specialized doctor.
The abolishment of MCI marks an end to the age-old problems in the structure of medical education but it’s only the time that can say if the proposed changes with the emergence of NMC are going to work for the better or not. While the new act has garnered appreciation for most of its positive changes, the issues raised along with it cannot be ignored by the government.
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