Straight from the heart: 41 NMC Bill 2017
Dr KK Aggarwal
National President
From SOURCES: National Medical Commission Bill, 2017
Functions
a. Replaces the Medical Council 1956 Act.
b. Enables a forward movement in the area of medical education reform.
c. Moves towards outcome based regulation of medical education rather than process oriented regulation.
d. Ensures proper separation of functions within the regulator by having autonomous boards.
e. Creates accountable & transparent procedures for maintaining standards in Medical Education.
f. create a forward-looking approach towards ensuring sufficient health workforce in India.
Aim
The Bill provides for a medical education system that ensures availability of adequate and high quality medical professionals; that encourages medical professionals to adopt latest medical research in their work and to contribute to research; that has an objective periodic assessment of medical institutions and facilitates maintenance of a medical register for India and enforces high ethical standards in all aspects of medical services; that is flexible to adapt to changing needs and has an effective grievance redressal mechanism and for matters connected therewith or incidental thereto.
Benefits
• End of heavy handed regulatory control over medical education institutions and a shift towards outcome based monitoring.
• Introduction of a national licentiate examination. This will be the first time such a provision is being introduced in any field of higher education in the country, as was the introduction of NEET and common counselling earlier.
• Opening up the medical education sector will lead to significant addition in the number of UG and PG seats and substantial new investment in this infrastructure sector.
• Better coordination with AYUSH systems of treatment.
• Regulation of up to 40% seats in medical colleges to enable all meritorious students to have access to medical seats irrespective of their financial status.
FUNCTIONS
(a) lay down policies for maintaining a high quality and high standards in medical education and make necessary regulations in this behalf;
(b) lay down policies for regulating medical institutions, medical researches and medical professionals and make necessary regulations in this behalf;
(c) assess the requirements in health care, including human resources for health and health care infrastructure and develop a road map for meeting such requirements;
(d) 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;
(e) ensure coordination among the Autonomous Boards;
(f) 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;
(g) exercise appellate jurisdiction with respect to the decisions of the Autonomous Boards, except that of the EMR Board;
(h) 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;
(i) frame guidelines for determination of fees in respect of such proportion of seats, not exceeding forty per cent., in the private medical institutions and deemed universities which are governed under the provisions of this Act ;
(j) exercise such other powers and perform such other duties as may be prescribed.
Structure:
· 25-member commission (NMC) will include Chairman, Member Secretary.
· 12 ex-officio members: 4 Presidents of Boards, DGHS, DG (ICMR), Dir (AIIMS, New Delhi), Nominee of Ministry, nominees of PGI Chandigarh, JIPMER Puducherry, TMCH Mumbai and NEIGRIHMS Shillong.
· 11-part time members: 3 members from management, economy, law, consumer rights, health research, science and technology; 3 members from the Medical Advisory Council; 5 elected medical persons.
· At least 16 and up to 22 of the 25 members of NMC would be medical professionals.
· All selected members would be finalised by a search committee chaired by Cabinet Secretary.
Medical Advisory Council
The Central Government shall constitute an advisory body to be known as the Medical Advisory Council as a platform for States/UTs.
Constitution: 64 members body.
1 member from each State+7 members nominated by MHA to represent UTs.
Members to be VCs of State Health University/University having maximum medical colleges.
All members of NMC.
Chairman UGC, Director (NAAC), 4 members from Directors of IIT, IIM, IISc.
Functions:
(1) The Council shall be the primary platform through which the States and Union territories may put forth their views and concerns before the Commission and help in shaping the overall agenda, policy and action relating to medical education and training.
(2) The Council shall advise the Commission on measures to determine and maintain, and to coordinate maintenance of, the minimum standards in all matters relating to medical education, training and research.
(3) The Council shall advise the Commission on measures to enhance equitable access to medical education.
AUTONOMOUS BOARDS under the Commission
The Central Government shall, by notification, constitute the following autonomous Boards, under the overall supervision of the Commission, to perform the functions assigned to such Boards under this Act.
(a) the Under- Graduate Medical Education Board (UGME Board);
(b) the Post-Graduate Medical Education Board (PGME Board);
(c) the Medical Assessment and Rating Board (MAR Board); and
(d) the Ethics and Medical Registration Board (EMR Board).
FUNCTIONS of the UGME Board
(a) Prescribe standards for UG medical education;
(b) Grant recognition to new UG medical courses;
FUNCTIONS of the PGME Board
(a) Prescribe standards for PG medical education;
(b) Grant recognition to new PG medical courses;
FUNCTIONS of the MAR Board
(a) Determine the procedure for assessing and rating the medical institutions for their compliance with the standards laid down by the UGME Board or the PGME Board, as the case may be, in accordance with the regulations made under this Act;
(b) Grant permission for establishment of a new medical institution in accordance with the provisions of section 28;
(c) Carry out inspections of medical institutions for assessing and rating such institutions in accordance with the regulations made under this Act
(d) 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 regulations;
(e) 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;
(f) Take such measure, including imposition of monetary penalty, against a medical institution for failure to maintain the minimum essential standards specified by the UGME Board or the PGME Board, as the case may be, in accordance with the regulations made under this Act.
FUNCTIONS of EMR Board
a) Maintain a National Register of all licensed medical practitioners in accordance with the provisions of section 31;
b) Regulate professional conduct and promote medical ethics in accordance with the regulations made under this Act.
c) Develop mechanisms to have continuous interaction with State Medical Councils to effectively promote and regulate the conduct of medical profession;
d) Exercise appellate jurisdiction with respect to the actions taken by a State Medical Council under section 30.
Comparison of some selected features
Body
MCI: Primarily elected body with State/Central nominees.
NMC: Hybrid structure with primacy for selected members. A few non-medical members.
Permission
MCI: Application to Central Government and permission by Central Government on recommendation of NMC: Application and permission by Medical Assessment and Rating Board (MARB).
UG Courses:
MCI: Permission needed for Establishment / Renewal / Recognition / Increase of intake.
NMC: Permission needed only for Establishment and Recognition. No annual renewal needed.
Automatic increase of seats allowed.
PG
MCI: Separate permission for PG courses after UG recognition.
NMC: College can start PG courses on its own.
Penalty for not meeting requirements:
MCI: No renewal permission. No admission.
NMC: Monetary penalty – up to 10 times the annual tuition fee.
Fee
MCI: No power to prescribe fees.
NMC: To frame guidelines for determination of fees for up to 40% seats in private colleges / Deemed Universities.
Dr KK Aggarwal
National President
From SOURCES: National Medical Commission Bill, 2017
Functions
a. Replaces the Medical Council 1956 Act.
b. Enables a forward movement in the area of medical education reform.
c. Moves towards outcome based regulation of medical education rather than process oriented regulation.
d. Ensures proper separation of functions within the regulator by having autonomous boards.
e. Creates accountable & transparent procedures for maintaining standards in Medical Education.
f. create a forward-looking approach towards ensuring sufficient health workforce in India.
Aim
The Bill provides for a medical education system that ensures availability of adequate and high quality medical professionals; that encourages medical professionals to adopt latest medical research in their work and to contribute to research; that has an objective periodic assessment of medical institutions and facilitates maintenance of a medical register for India and enforces high ethical standards in all aspects of medical services; that is flexible to adapt to changing needs and has an effective grievance redressal mechanism and for matters connected therewith or incidental thereto.
Benefits
• End of heavy handed regulatory control over medical education institutions and a shift towards outcome based monitoring.
• Introduction of a national licentiate examination. This will be the first time such a provision is being introduced in any field of higher education in the country, as was the introduction of NEET and common counselling earlier.
• Opening up the medical education sector will lead to significant addition in the number of UG and PG seats and substantial new investment in this infrastructure sector.
• Better coordination with AYUSH systems of treatment.
• Regulation of up to 40% seats in medical colleges to enable all meritorious students to have access to medical seats irrespective of their financial status.
FUNCTIONS
(a) lay down policies for maintaining a high quality and high standards in medical education and make necessary regulations in this behalf;
(b) lay down policies for regulating medical institutions, medical researches and medical professionals and make necessary regulations in this behalf;
(c) assess the requirements in health care, including human resources for health and health care infrastructure and develop a road map for meeting such requirements;
(d) 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;
(e) ensure coordination among the Autonomous Boards;
(f) 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;
(g) exercise appellate jurisdiction with respect to the decisions of the Autonomous Boards, except that of the EMR Board;
(h) 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;
(i) frame guidelines for determination of fees in respect of such proportion of seats, not exceeding forty per cent., in the private medical institutions and deemed universities which are governed under the provisions of this Act ;
(j) exercise such other powers and perform such other duties as may be prescribed.
Structure:
· 25-member commission (NMC) will include Chairman, Member Secretary.
· 12 ex-officio members: 4 Presidents of Boards, DGHS, DG (ICMR), Dir (AIIMS, New Delhi), Nominee of Ministry, nominees of PGI Chandigarh, JIPMER Puducherry, TMCH Mumbai and NEIGRIHMS Shillong.
· 11-part time members: 3 members from management, economy, law, consumer rights, health research, science and technology; 3 members from the Medical Advisory Council; 5 elected medical persons.
· At least 16 and up to 22 of the 25 members of NMC would be medical professionals.
· All selected members would be finalised by a search committee chaired by Cabinet Secretary.
Medical Advisory Council
The Central Government shall constitute an advisory body to be known as the Medical Advisory Council as a platform for States/UTs.
Constitution: 64 members body.
1 member from each State+7 members nominated by MHA to represent UTs.
Members to be VCs of State Health University/University having maximum medical colleges.
All members of NMC.
Chairman UGC, Director (NAAC), 4 members from Directors of IIT, IIM, IISc.
Functions:
(1) The Council shall be the primary platform through which the States and Union territories may put forth their views and concerns before the Commission and help in shaping the overall agenda, policy and action relating to medical education and training.
(2) The Council shall advise the Commission on measures to determine and maintain, and to coordinate maintenance of, the minimum standards in all matters relating to medical education, training and research.
(3) The Council shall advise the Commission on measures to enhance equitable access to medical education.
AUTONOMOUS BOARDS under the Commission
The Central Government shall, by notification, constitute the following autonomous Boards, under the overall supervision of the Commission, to perform the functions assigned to such Boards under this Act.
(a) the Under- Graduate Medical Education Board (UGME Board);
(b) the Post-Graduate Medical Education Board (PGME Board);
(c) the Medical Assessment and Rating Board (MAR Board); and
(d) the Ethics and Medical Registration Board (EMR Board).
FUNCTIONS of the UGME Board
(a) Prescribe standards for UG medical education;
(b) Grant recognition to new UG medical courses;
FUNCTIONS of the PGME Board
(a) Prescribe standards for PG medical education;
(b) Grant recognition to new PG medical courses;
FUNCTIONS of the MAR Board
(a) Determine the procedure for assessing and rating the medical institutions for their compliance with the standards laid down by the UGME Board or the PGME Board, as the case may be, in accordance with the regulations made under this Act;
(b) Grant permission for establishment of a new medical institution in accordance with the provisions of section 28;
(c) Carry out inspections of medical institutions for assessing and rating such institutions in accordance with the regulations made under this Act
(d) 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 regulations;
(e) 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;
(f) Take such measure, including imposition of monetary penalty, against a medical institution for failure to maintain the minimum essential standards specified by the UGME Board or the PGME Board, as the case may be, in accordance with the regulations made under this Act.
FUNCTIONS of EMR Board
a) Maintain a National Register of all licensed medical practitioners in accordance with the provisions of section 31;
b) Regulate professional conduct and promote medical ethics in accordance with the regulations made under this Act.
c) Develop mechanisms to have continuous interaction with State Medical Councils to effectively promote and regulate the conduct of medical profession;
d) Exercise appellate jurisdiction with respect to the actions taken by a State Medical Council under section 30.
Comparison of some selected features
Body
MCI: Primarily elected body with State/Central nominees.
NMC: Hybrid structure with primacy for selected members. A few non-medical members.
Permission
MCI: Application to Central Government and permission by Central Government on recommendation of NMC: Application and permission by Medical Assessment and Rating Board (MARB).
UG Courses:
MCI: Permission needed for Establishment / Renewal / Recognition / Increase of intake.
NMC: Permission needed only for Establishment and Recognition. No annual renewal needed.
Automatic increase of seats allowed.
PG
MCI: Separate permission for PG courses after UG recognition.
NMC: College can start PG courses on its own.
Penalty for not meeting requirements:
MCI: No renewal permission. No admission.
NMC: Monetary penalty – up to 10 times the annual tuition fee.
Fee
MCI: No power to prescribe fees.
NMC: To frame guidelines for determination of fees for up to 40% seats in private colleges / Deemed Universities.
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