Decoded: What changes with the new medical education regulator in place

Last week, the National Medical Commission (NMC) replaced the Medical Council of India (MCI) as the new regulator for medical education and medical professionals in the country. The NITI Aayog had recommended this, and last year Parliament passed the NMC Act 2019, paving the way for the new regulator. So, what does this change for the medical profession?

What is NMC and how is different from MCI?

Unlike the MCI, which was a single regulator overseeing all aspects of medical education and profession, the NMC has been constituted along with four autonomous boards —Undergraduate (UG) Medical Education Board, Postgraduate (PG) Medical Education Board, Medical Assessment and Rating Board, and Ethics and Medical Registration Board — for shared responsibility. MCI used to singlehandedly regulate all the aspects of medical education and profession, including UG, PG, medical assessment, rating, ethics and medical registration.

According to the Ministry of Health and Family Welfare, the chairperson of the commission will be selected, and not elected. S C Sharma, former head of ear-nose-throat (ENT) department at the All India Institute of Medical Sciences (AIIMS), New Delhi, has been selected as NMC chairperson for a period of three years. In addition, NMC will have 10 nominees picked from among vice-chancellors of medical universities in states or union territories, nine nominees from state medical councils, and three expert members from diverse professions.

What led to the MCI being replaced? 

MCI has been marred with corruption. In 2010, the Central Bureau of Investigation (CBI) also arrested the then MCI president for allegedly taking a bribe to approve a medical college in Punjab. (He was acquitted in 2015.) The president of India dissolved the MCI, which was later replaced with a seven-member Board of Governors (BoG). 

Replacing the BoG to carry forward intended reforms, the NMC is aimed at doing away with such instances by dividing the responsibilities of approving and regulating various aspects of medical education and profession. 

However, the NMC has had its share of opposition. For one, the medical fraternity is concerned about the structure of the commission, with many apprehending transfer of power from the states to the Centre and lack of adequate representation of the private sector. The health ministry has, however, said that in addition to the 10 ex-officio members, NMC will have nominees from among vice-chancellors of health universities from states or union territories, from state medical councils, and expert members from diverse professions. The medical education fraternity is hoping that these structural issues will be ironed out and the NMC will have representation from the private sector.

The other concern is the announcement of a new cadre of non-MBBS, mid-level health service providers with limited rights to dispense medicines under the NMC. While certain sections believe this could address the shortage of medical practitioners that has arisen amid the current Covid-19 pandemic, others are concerned that the quality of services might deteriorate due to this move. The ministry has, however, stated that the modalities and guidelines concerning these “community health providers”, as they will be called, will be worked out before the decision on the cadre is implemented. 

Will private medical education get cheaper?

One of the NMC provisions concerns the regulation of fee for 50 per cent of the seats in private medical colleges and deemed universities. However, guidelines for this are awaited. Until then, it is not clear whether and to what extent private medical education could get cheaper.

Will this move impact the way medical entrance exams or specialty exams are conducted? 

Currently, the National Eligibility cum Entrance Test (NEET) is held for admission to postgraduate medical courses and for eligibility of foreign medical graduates. Under the NMC, in addition to NEET, the final-year MBBS exam will be applicable for admission to postgraduate medical courses. This exam is being renamed National Exit Test, or NEXT.

The final-year MBBS exam will, thus, have three purposes. First, it will continue to serve as the licentiate exam for MBBS pass-outs to issue them a licence to practise medicine. Second, it will act as an entrance exam for postgraduate medical education and for foreign medical graduates. Third, besides NEET, it will also be applicable for entrance to institutes of national importance such as AIIMS.