National Medical Commission Act, 2019 is introduced to reform the Medical Educational Regulatory Architecture (MERA), legislatively in the country. NMC act has come to implementation on 8th August 2019, to replace Medical Council of India (MCI) functioning under the Indian Medical Council Act, 1956 with an intention to make major changes in the medical education system and to enhance the quality of the medical education and easy affordability for the students.

National Medical Commission is expected to establish State Medical Councils in every state in the country within 3 years, which will perform similar to the NMC.

NMC has replaced MCI for its inadequacies in regulating and improving the standards of medical education. So, National Medical Commission has to have a set of insightful objectives, so let’s look into it.

Objectives of National Medical Commission

The progressive legislative body to regulate the medical education in India will work on,

• Availability of adequate medical professionals who are highly-qualified
• Adapting and installing the new-age research findings found by the medical professionals, in to the medical practise and study.
• Periodic assessment and regulations on medical institutions.
• An effective addressing of hardships found in the medical system.
• Providing affordable high-quality medical education

Functions of National Medical Council

National Medical Commission has to perform vital functions that includes:

• Formulating policies to regulate medica practitioners and medical institutions,
• Analysing and satisfying the human resources and infrastructure requirements in the healthcare system,
• Ensuring to cooperate with the regulations made by the State Medical Councils under NMC Act,
• An effective addressing of hardships found in the medical system.
• Framing the guidelines and regulating the fees structure for 50% of the seats in deemed universities and private medical colleges, functioning under the Act.

The four boards under the Act

The Under-Graduate Medical Education Board (UGMEB) and the Post-Graduate Medical Education Board (PGMEB):

These two boards concern with medical education in the grounds of framing the curriculum, standards, guidelines for medical education, and granting recognition to medical degrees offered at the under-graduate and post-graduate levels.

The Medical Assessment and Rating Board:

This board holds the authority to levy penalties on the medical institutions that fails to follow the minimum standards to be maintained as directed by the UGMEB and the PGMEB. It also has to permit and authenticate the establishment of new medical colleges, to increase the number of seats in a medical college and starting PG courses.

The Ethics and Medical Registration Board (EMRB):

EMRB maintains a National Register, which holds track of all the licensed medical practitioners in the country. The board also regulates the professional and medical conduct of the professionals. Only the licensed doctors will be permitted to practise medicine. This board also maintains a register of all licensed community healthy providers in India. Each board will consist of a President and four members.

Entrance examinations conducted by NMC

NEET - National Eligibility-cum-Entrance Test (NEET) is a uniform test conducted for admission to under-graduate and post-graduate super-specialty medical studies in all medical institutions regulated under the Act.

NEXT - NMC has proposed an uniform nation-wide final year examination for under-graduates called the National Exit Test (NEXT)to graduate and to get licensed to practise medicine in India.

Licensure of Doctors

• NEXT would be the licentiate examination for doctors to get licensed to practise authentically after graduation in India.
• The same examination would also serve as the basis for PG medical admissions in the country.

The offences and penalties under the Act

– No person would be allowed to practise medicine in India without getting licensed by registering their medical qualifications in State Medical Council or the National Medical Commission.

– Any person violating the above-mentioned regulation would be subjected to a penalty of One lakh to five lakh rupees.

Grievance redressal Mechanism

Complaint raised against the doctor or medical practitioner is handled by the State Medical Council (SMC). If the doctor is affronted by the decision of the SMC, he/she can extend an appeal to the EMRB. The third level of appeal relies with the NMC.

Regulating the community health providers

- NMC is allowed to grant limited license to certain mid-level practitioners called community health providers, related with the new-age medical profession to practice medicine.

– The community health providers may prescribe basic medicines in primary and preventive healthcare.

– However, in any other cases, these community health practitioners may only prescribe medicine under the supervision of a licensed doctor.

Role of NMC Act

- The central government will constitute a Medical Advisory Council (MAC), under the Act

- It is the platform where the state and Union Territories can submit their views and concerns

- MAC will perform vitally on the NMC’s measures to regulate and maintain the medical education standards.

Limitations of the NMC Act

• Quality: The National Medical Commission Act does not concentrate to solve the problems in the healthcare system in India. The Act has concentrated on the short-term training of the community health practitioners which will forbid illegal medical practise. But is certainly not focusing on the quality as it does not talk about renewal of the license as practised in the US, UK and other countries. It shows that the act gives importance to quantity and not quality.
• Availability: There is a disparity on the availability of doctors in the rural areas. And the distribution of appointment of Doctors should be uniform to the per capita of the locality, throughout the country.
• Affordability: Medicine has become a luxury in the country that the common population are curtailed with the general medicine as the speciality care demands huge numbers. The act failed to address this issue of speciality medicine and its affordability.
• Accountability: A selection committee will select the presidents and the board members for all the four boards under NMC. This selection process is against democracy and forbids the opportunity to all the potential candidates. It compromises on the accountability of the NMC Act.

In the future

The state governments should promote medical practice in the rural parts of the country. Also, the government should reserve a certain number of post graduate medical seats for those doctors who had worked in the rural areas with the government.

• Quality: As recommended by the WHO, the expenditure on health needs to be increased to 5%.
• Availability: Community health providers needs to be trained and certified to practise under the supervision of a licensed doctor.
• Affordability: Public health is considered and exposed to the medical graduate to a very less weightage comparing to its necessity and so has to be instructed much intensively.
• Accountability: A strict evaluation framework and a keen regulatory governance need to be established.