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National Medical Commission

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In this article, we shall study the former association of medical professionals called the Medical Council of India and present the National Medical Commission (NMC)

Medical Council of India is a statutory body. Initially, it was set up in 1934 under the Indian Medical Council Act, 1933. The Council was later reconstituted under the Indian Medical Council Act, 1956 that supplanted the 1934 Act. Thus The Medical Council of India (MCI) was set up under the Medical Council Act 1956, for setting standards for medical professionals, new medical colleges, and revision of curriculum, among others. It establishes the uniform and high standards of medical education in India. It also registers doctors to practice in India.

Objectives:

  • To promote and advance medical and allied sciences in all their different branches and to promote the improvement of public health and medical education in India
  • To maintain the honour and dignity and to uphold the interest of the medical profession and to promote co-operation amongst the members thereof;
  • To work for the abolition of compartmentalism in medical education, medical services, and registration in the country and to achieve equality among all members of the profession.

Amid allegations of corruption against MCI office bearers and probe into opaque accreditation to medical colleges, the Supreme Court in May 2016 directed the government to set up an oversight committee with the authority to oversee all statutory functions of MCI until the new legislation comes in. In view of these developments and to put an alternative mechanism in place of MCI so as to bring transparency, accountability, and quality in the governance of medical education in the country.

The NITI Aayog has suggested the substitution of the Medical Council of India (MCI) with the National Medical Commission (NMC). Accordingly, it was decided to supersede the MCI through the Indian Medical Council (Amendment) Ordinance, 2018, promulgated on 26th September 2018, and entrust its affairs to a Board of Governors consisting of eminent doctors. Once the National Medical Commission becomes operational, the Board of Governors will be dissolved. In April 2020, due to the COVID-19 pandemic, the Medical Council of India permitted the practice through telemedicine by its registered medical practitioners. The practice of Telemedicine involves remote diagnosis and treatment of patients through telecommunications such as video, phone, and apps.

National Medical Commission Act, 2019:

National Medical Commission Bill, 2019 was introduced by the Minister of Health and Family Welfare, Dr Harsha Vardhan in Lok Sabha on July 22nd 2019. The Bill seeks to repeal the Indian Medical Council Act, 1956. The Bill was passed in Lok Sabha on July 29, 2019. It was passed in Rajya Sabha in August 2019.

Objectives of National Medical Commission Act 2019:

  • To set up of the National Medical Commission (NMC), for development and regulation of all aspects of medical education, profession and institutions. 
  • To make sure that there are sufficient highly qualified medical professionals.
  • To give an impetus to Grievance Redressal Mechanisms.
  • Medical Institutions will be evaluated to make sure that standards do not deteriorate.
  • To make sure that medical professionals give importance to medical research and adopt the latest developments in the field of medical science.

National Medical Commission (NMC):

National Medical Commission

The National Medical Commission (NMC) has been constituted by an act of Parliament known as the National Medical Commission Act, 2019 which came into force on 25.9.2020 by gazette notification dated 24.9.2020. The Board of Governors in supersession of Medical Council of India constituted under section 3A of the Indian Medical Council Act, 1956 stands dissolved thereafter. The head office of the Commission shall be at New Delhi.

Objectives:

The Aim of the National Medical Commission are

  • To improve access to quality and affordable medical education,
  • To ensure availability of adequate and high-quality medical professionals in all parts of the country;
  • To promote equitable and universal healthcare that encourages community health perspective and makes services of medical professionals access to all the citizens;
  • To encourages medical professionals to adopt latest medical research in their work and to contribute to research;
  • To objectively assess medical institutions  periodically in a transparent manner;
  • To maintain a medical register for India;
  • To enforce high ethical standards in all aspects of medical services;
  • To have an effective grievance redressal mechanism.
Constitution of the National Medical Commission:
  • The Act sets up the National Medical Commission (NMC). 
  • As per the Act, State Governments need to set up State Medical Councils.
  • The National Medical Commission will consist of 25 members and will include Chairperson, Presidents of Post Graduate Medical Education Boards and Undergraduate Education Boards, Director General of Indian Council of Medical Research (ICMR), and Director General of Health Services.
Functions of the National Medical Commission:
  • lay down policies for maintaining a high quality and high standards in medical education and make necessary regulations in this behalf;
  • lay down policies for regulating medical institutions, medical researches and medical professionals and make necessary regulations in this behalf;
  • assess the requirements in healthcare, including human resources for health and healthcare infrastructure and develop a road map for meeting such requirements;
  • promote, co-ordinate and frame guidelines and lay down policies by making necessary regulations for the proper functioning of the Commission, the Autonomous Boards and the State Medical Councils;
  • ensure co-ordination among the Autonomous Boards;
  • take such measures, as may be necessary, to ensure compliance by the State Medical Councils of the guidelines framed and regulations made under this Act for their effective functioning under this Act;
  • exercise appellate jurisdiction with respect to the decisions of the Autonomous Boards;
  • lay down policies and codes to ensure observance of professional ethics in medical profession and to promote ethical conduct during the provision of care by medical practitioners;
  • frame guidelines for determination of fees and all other charges in respect of fifty per cent. of seats in private medical institutions and deemed to be universities which are governed under the provisions of this Act;
  • exercise such other powers and perform such other functions as may be prescribed.

National Medical Commission (NMC) – Autonomous Boards:

The National Medical Commission will have 4 Boards. 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 UGMEB:
  • Determine standards of medical education at the undergraduate level and oversee all aspects relating thereto;
  • Develop competency-based dynamic curriculum at the undergraduate level in accordance with the regulations made under this Act;
  • Develop competency-based dynamic curriculum for addressing the needs of primary health services, community medicine, and family medicine to ensure healthcare in such areas, in accordance with the provisions of the regulations made under this Act;
  • Frame guidelines for setting up of medical institutions for imparting undergraduate courses, having regard to the needs of the country and the global norms, in accordance with the provisions of the regulations made under this Act;
  • Determine the minimum requirements and standards for conducting courses and examinations for undergraduates in medical institutions, having regard to the needs of creativity at local levels, including designing of some courses by individual institutions, in accordance with the provisions of the regulations made under this Act;
  • Determine standards and norms for infrastructure, faculty, and quality of education in medical institutions providing undergraduate medical education in accordance with the provisions of the regulations made under this Act;
  • Facilitate development and training of faculty members teaching undergraduate courses;
  • Facilitate research and the international student and faculty exchange programs relating to undergraduate medical education;
  • Specify norms for compulsory annual disclosures, electronically or otherwise, by medical institutions, in respect of their functions that has a bearing on the interest of all stakeholders including students, faculty, the Commission and the Central Government;
  • Grant recognition to a medical qualification at the undergraduate level.
Functions of PGMEB:
  • Determine the standards of medical education at the postgraduate level and super-speciality level in accordance with the regulations made under this Act and oversee all aspects relating thereto;
  • Develop competency based dynamic curriculum at postgraduate level and super-speciality level in accordance with the regulations made under this Act, with a view to develop appropriate skill, knowledge, attitude, values and ethics among postgraduates and super-specialists to provide healthcare, impart medical education and conduct medical research;
  • Frame guidelines for setting up of medical institutions for imparting postgraduate and super-speciality courses, having regard to the needs of the country and global norms, in accordance with the regulations made under this Act;
  • Determine the minimum requirements and standards for conducting postgraduate and super-speciality courses and examinations in medical institution, in accordance with the regulations made under this Act;
  • Determine standards and norms for infrastructure, faculty and quality of education in medical institutions conducting postgraduate and super-speciality medical education, in accordance with the regulations made under this Act;
  • Facilitate development and training of the faculty members teaching postgraduate and super-speciality courses;/li>
  • Facilitate research and the international student and faculty exchange programmes relating to postgraduate and super-speciality medical education;
  • Specify norms for compulsory annual disclosure, electronically or otherwise, by medical institutions in respect of their functions that has a bearing on the interest of all stakeholders including students, faculty, the Commission and the Central Government;
  • Grant recognition to the medical qualifications at the postgraduate level and super-speciality level;
  • Promote and facilitate postgraduate courses in family medicine.
Functions of Medical Assessment and Rating Board:
  • Determine the procedure for assessing and rating the medical institutions for their compliance with the standards laid down by the Under-Graduate Medical Education Board or the Post-Graduate Medical Education Board, as the case may be, in accordance with the regulations made under this Act;
  • Grant permission for establishment of a new medical institution, or to start any postgraduate course or to increase number of seats, in accordance with the regulations made under this Act;
  • Carry out inspections of medical institutions for assessing and rating such institutions in accordance with the regulations made under this Act;
    Provided that the Medical Assessment and Rating Board may, if it deems necessary, hire and authorise any other third party agency or persons for carrying out inspections of medical institutions for assessing and rating such institutions: Provided further that where inspection of medical institutions is carried out by such third party agency or persons authorised by the Medical Assessment and Rating Board, it shall be obligatory on such institutions to provide access to such agency or person;
  • Conduct, or where it deems necessary, empanel independent rating agencies to conduct, assess and rate all medical institutions, within such period of their opening, and every year thereafter, at such time, and in such manner, as may be specified by the regulations;
  • Make available on its website or in public domain the assessment and ratings of medical institutions at regular intervals in accordance with the regulations made under this Act;
  • Take such measures, including issuing warning, imposition of monetary penalty, reducing intake or stoppage of admissions and recommending to the Commission for withdrawal of recognition, against a medical institution for failure to maintain the minimum essential standards specified by the Under-Graduate Medical Education Board or the Post-Graduate Medical Education Board, as the case may be, in accordance with the regulations made under this Act.
Functions of Ethics and Medical Registration Board:
  • Maintain National Registers of all licensed medical practitioners;
  • Regulate professional conduct and promote medical ethics in accordance with the regulations made under this Act:
    Provided that the Ethics and Medical Registration Board shall ensure compliance of the code of professional and ethical conduct through the State Medical Council in a case where such State Medical Council has been conferred power to take disciplinary actions in respect of professional or ethical misconduct by medical practitioners under respective State Acts;
  • Develop mechanisms to have continuous interaction with State Medical Councils to effectively promote and regulate the conduct of medical practitioners and professionals;
  • Exercise appellate jurisdiction with respect to the actions taken by a State Medical Council.

National Medical Council (NMC) – Functions

  1. Medical institutions and Medical Professionals will be regulated.
  2. State Medical Councils will have to comply with the guidelines issued by the council.
  3. To handle the exorbitant fees charged in private institutions, this Act provides authority to the Council to fix the fees for 50% of the seats in private medical colleges including deemed universities.
  4. Assess the requirements of healthcare-related infrastructure and human resources.

Medical Advisory Council

  1. Under the National Medical Commission Bill 2019, the Central Government will constitute a Medical Advisory Council (MAC).
  2. The Council will advise the NMC on measures to determine and maintain standards of medical education.

National Exit Test (NEXT)

  1. As per the NMC Act, it has proposed a common final year MBBS exam which will be known as National Exit Test (NEXT). 
  2. NEXT results would be used for obtaining a license to practice and will also be used for admissions to Post – Graduate Medical Courses. 
  3. It would also act as an entrance test for medical graduates from other nations.

Ranking of Medical Colleges

  1. Medical Colleges would be ranked by the Medical Assessment and Rating Board of the National Medical Commission. 
  2. Ranking systems would help students to choose their institutes.
  3. It would also help in the transparent admission process.

Conclusion:

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