India moves forward with NMC

July 29, 2019 -  From the Economic Times

The following article concerns important changes in India that will affect foreign medical education.  The Indian government has passed a bill that in essence, provides for setting up a National Medical Commission (NMC) in place of the MCI to develop and regulate all aspects of medical education, profession and institutions in India.

The following are important changes that are introduced with this bill:

Community Health Providers

— The bill envisages defining Community Health Providers (CHPs) as persons granted a licence to practice medicine at mid-level. It's not yet clear as to what kind of professionals could be certified as CHPs.

— These CHPs would be allowed to prescribe specified medicines independently in primary/preventive healthcare, but "only under the supervision of medical practitioners" at higher levels, says the bill.

Uniform exit examination

— A key provision of the bill aims to bring in uniformity in medical education standards in India. It seeks a common final-year MBBS exam, to be called National Exit Test (NEXT), for admission to PG courses and also for obtaining a practice licence.

— It proposes that that the "final year MBBS exam be treated as an entrance test for PG and a screening test for students who graduate in medicine from foreign medical colleges." NEET will continue to be the entrance examination; premier medical institutes such as AIIMS will also have to stick to it.

— Foreign educated medical students — who have been subjected to a screening test no Indian medical graduate had to clear — had long been demanding something on the lines of the NEXT.

— Currently, MBBS passouts from such countries as US, UK, Canada, Australia and New Zealand are automatically permitted to practise in India. Under the new law, such students will now have to clear the exit exam.

— The new exit examination is expected to be implemented within three years of the bill becoming a law.

Inspections and medical seats 

— The bill seeks to do away with the practice of yearly inspections. It will ensure the end of inspector raj and will facilitate the addition of undergraduate and post-graduate medical seats, the government says.

— Under the new bill, states can only "advise" the NMC. But the council can choose not to accept those advices. However, no medical college will be set up without the state government's permission, the centre has clarified.

— MCI didn't have the power to regulate fees. The new commission, in contrast, is envisaged with the power to determine fees in 50% private medical college seats. According to critics, it would be akin to "allowing 100% of private college seats to be unregulated." Most states currently have committees that fix the fees.

Binding decisions

— So far, even if MCI suspends a doctor, the decision is not binding state medical councils who can refuse to comply with it. In contrast, the new NMC bill clearly states that the ethics board will “exercise appellate jurisdiction with respect to actions taken by state medical councils”.

— The basic objection from doctors pertains to section 45 of the bill, which, according to them, empowers the Centre to override any suggestion of the NMC.

— A host of amendments are being demanded. If not amended, the bill will lead to deterioration of medical education and degradation of healthcare, said doctors.


— The Indian Medical Association (IMA), the largest body of doctors and medical students in India with three lakh members, is opposing the introduction of NEXT by scrapping the NEET-PG and regulation of fees by the NMC for 50% seats in private colleges and deemed varsities.

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