The Author, Noor Sachdeva, is a 4th-year, B.Com.LLB student at University Institute of Legal Studies, Panjab University. She is currently interning with LatestLaws.com.

The National Medical Commission Act, 2019 (hereinafter referred to as NMC Act) is a legislative reform in the field of medical sciences. The Act came into existence on 8^th August 2019 when the President Ram Nath Kovind gave his assent to the National Medical Commission Bill. The Act has been made with intent to make major changes in the medical education system and to make improvements in its quality and affordability for the students.

What was the law regulating medical education prior to NMC Act, 2019 and why was it repealed?

National Medical Commission has taken the place of Medical Council of India which was functioning under the Indian Medical Act, 1956 on the recommendations of NITI Aayog. The NMC Act has repealed the Indian Medical Act of 1956. There were lots of problems with the IMC Act and functioning of the regulatory body MCI. Many accusations of corruption were leveled against MCI. Also, the body did not work in a transparent manner and the quality of the medical education, medical infrastructure, medical institutions and medical research was suffering. The Medical Council of India was solely composed of doctors. Since, the medical education is very different from practice, the Council must have included the other members like public health experts, social scientists, and health economists.

What is the aim of this legislation?

According to the Union Health Minister Harsh Vardhan, this is a progressive legislation and seeks to fulfill the following objectives:

Reducing burden on the medical students
Providing affordable and high standard medical education
Ensuring the availability of high quality medical professionals in all parts of the country
Encouraging the adoption of the latest medical research
Providing better access to quality for quality healthcare infrastructure and professionals
Assessing the medical institutions in the country
Promoting the enforcement of high ethical standards by medical professionals

Who shall constitute the Commission and where will be its head office?

Section 3 of the Act provides that the Central Government will setup the Commission for conducting those functions and powers which are conferred by the Act upon the Commission. The Commission will be a legal entity (body corporate) having perpetual succession and a common seal. The head office of the Commission shall be established at New Delhi.

What is the constitution of NMC?

NMC is a statutory and regulatory body consisting of 33 members. Section 4 of the 2019 Act elaborates the members of the body who shall be appointed by the Central Government as follows:

A Chairperson of medical profession
10 ex-officio members
22 part-time members, out of which 19 members will be representing States and Union Territories.

The NMC does not solely comprise of doctors as they were in MCI. NMC included the non-medical administrators as well as bureaucrats.

What are the functions of NMC?

Section 10 of the NMC Act, 2019 has enumerated certain functions which are to be carried on by the Commission to achieve the objects of the Act. Following functions are to be performed by National Medical Commission:

The Commission is required to frame the policy for maintaining a high quality and high standards in medicinal field and make necessary regulations in this behalf.
The Commission has to lay down the policy framework for regulating medical institutions, medical researches and medical professionals.
It has to provide access to requirements in health care human resources as well as other infrastructure, and design the way to meet such requirements.
It is the function of the commission to promote, co-ordinate and frame necessary guidelines and policies for the proper functioning of the commission as well as other bodies constituted under the Act.
The Commission has to ensure co-ordination among the Autonomous Boards.
The Commission has to act as an appellate body with respect to the decisions of the Autonomous Boards.
It is the duty of Commission to form a Code of professional ethics in the medical profession and promote ethical conduct by the medical practitioners.
The Commission is required to frame the guidelines for determining the fees structure of the 50% of the seats in the private medical institutions and deemed to be universities as per the provisions of the NMC Act.

What are the autonomous boards constituted under the Act?

The Central Government of India is authorized by Section 16 of the National Medical Commission Act, 2019, to constitute four autonomous boards to carry out the functions assigned to them.

Under-Graduate Medical Education Board and Post-Graduate Medical Education Board: These boards are assigned the task of formulating the standards, curriculum, guidelines for medical education and grant recognition to the medical qualifications at the under-graduate and post-graduate level respectively.
Medical Assessment and Rating Board: This board shall perform the function of assessing and rating the medical institutions throughout the country and levy the monetary penalties upon the medical institutions which fail to maintain the minimum standards as made by the Under-Graduate and Post-Graduate Medical Education Board. This board is also responsible for granting permissions for establishing new medical college of either Under-Graduation or Post-Graduation course or for increasing the number of seats in existing medical institutions.
Ethics and Medical Registration Board: This board shall have the function of regulating the professional conduct by the medical faculty while providing the medical services. The Board is assigned the work of maintaining a National register of all the medical practitioners and regulating the professional conduct. The ones who are included in the register will be allowed to practice medicine and a separate National Register will be made for Community Health Providers.

What is Medical Advisory Council and what are its functions?

The National Commission Act of 2019 has proposed to make a medical advisory council to advise the Commission on some policy matters related to the medical education, institutions and medical research. This advisory body shall be constituted under Section 11 of the NMC Act and the Section further provides who shall be the members of the council. The Medical Advisory Council provides the platform for States and Union Territories to put their views and concerns before the Commission and shape the overall agenda, policy and action relating to medical education and training. Further, the MAC shall advise NMC on the measures to determine and maintain, and to co-ordinate maintenance of, the minimum standards in all matters relating to medical education, training and research, and the measures to enhance equitable access to medical education.

Why the Government wants to regulate the Medical Education Sector?

As we know, that the Medical Council of India, constituted under Indian Medical Act, failed to achieve its objective of providing skilled and quality-oriented healthcare facilities to patients and providing good quality education. Thus, the Government intervened and enacted the NMC Act in 2019 under which the national medical commission was constituted which comprised of members appointed by the Central Government. Government wanted to reform and regulate the medical education sector to ensure that the Doctors or medical professionals are appropriately trained and skilled. The aim of government was to build a uniform standard for all the medical graduates and to make an environment of innovation and research in the medical field.

What are the eligibility guidelines for doctors to practice medicine?

A new leaf has been turned in medical education system with the passing of the National Medical Commission Act, 2019 that ensures high quality medical professionals and improvement of healthcare facility in the country. According to this Act, certain amendments have been made in the eligibility criteria for doctors to practice medicine.

Section 14 of the Act provides for conducting National Eligibility-cum-Entrance Test (NEET) for admission to the under-graduate and post-graduate medical courses throughout India. NMC will also specify the manner of conducting common counseling for admission in all such medical institutions.
Section 15 of the Act proposes to unify testing for exit from the MBBS and entry into Post-Graduate Medical courses via National Exit Test (NEXT). This single test will be conducted across the country which will decide the licensing of MBBS graduates as well as screen foreign medical graduates who want to practice in India.
All the information regarding licensed medical practitioners shall be maintained in National Register under Ethics and Registration Board.
All the foreign graduates practicing medicine in India by clearing Foreign Medical Graduates Education (FMGE) exam will have to appear for NEXT to continue the practice. The proposal for bridge course for AYUSH practitioners to make lateral entry into allopathy which was earlier conducted has been removed in the new Act.

Why the NMC Act, 2019 is being opposed by some Doctors and Medical students?

India has acute shortage of doctors and other medical staff as in comparison to the population of the country because of which many patients do not get good medical care and facilities. This led the Parliament to introduce in NMC Act, 2019, the provision for giving license to the non-medical practitioners (AYUSH practitioners i.e. Homepathic and Ayurveda Doctors) to practice modern and scientific medicine. The bridge course which was mandatory for the AYUSH practitioners to practice modern medicine was also done away by the Act which received vehement opposition by Allopathic Doctors.
The Government made certain reforms and introduced the concept of Community Health Providers (CHPs) to tackle the disease burden in the rural areas. These community health providers are mid-level medical practitioners who are not expert in the modern medicine. The NMC Act allowed CHPs to prescribe specific medicine independently only in the primary and preventive healthcare. However, in other cases, he may prescribe medicine only under the supervision of medical practitioners who are connected with modern scientific medical profession and are thus registered under Section 32(1) of the NMC Act. This provision is also opposed because it risks the life of patients at the hands of incompetent and under qualified doctors.
The Indian Medical Association is against the provision for fixation of fees of private medical colleges, capped to 50% of the seats. This will result in deregulating 100% of the private medical seats regarding the fee subject to non-binding guidelines. Hence, the medical education in the country will become more expensive placing the socio-economic backward groups in a great disadvantage.
Medical fraternity of students is strongly opposing the conduct of NEXT exam for admission to post-graduate courses and obtaining license. According to them, the merit should determine the admission for post-graduate courses and so the current pattern of NEET-PG should not be given away.
The Indian Medical Association has opposed the law because the composition of the NMC poses a threat to the functioning of medical professionals and it is likely that the medical professionals will be made answerable to the non-elected bureaucrats and non-medical administrators in the Commission.