The Union cabinet has approved a bill that will replace the Medical Council of India, the regulatory body for medical education in the country, with a new commission. Drafted by experts from the Niti Aayog, the National Medical Commission Bill proposes key changes to "ease" the regulatory processes for medical education.
For instance, medical colleges need the MCI's approval for establishing, recognising, renewing recognition, and increasing number of seats. This clause had given an impetus to several corrupt practices such as propping up fake faculty and patients during MCI inspections for approvals. Inspectors of MCI have also been accused of accepting bribes in exchange for granting these permissions. In 2010, in one of the biggest scandals that rocked the MCI, then MCI president Dr Ketan Desai was accused of taking a bribe of Rs 2 crore from a private medical college for granting approvals.
To counter such corrupt practices and reduce "inspector raj", the NMC Bill proposes to do away with most regulations and retain only a few—permissions would be required only for establishment and recognition of medical colleges.
In a significant move, the bill also allows the government to fix tuition fees for 40 per cent of the seats in private colleges, even as experts feel that this clause leaves enough room for medical colleges to charge a high amount of fees.
To divide power, the bill proposes to create four autonomous boards to oversee undergraduate education, post-graduate education, assessment and accreditation, and ethics and registration, instead of the multiple committees that exist within the MCI.
The draft law also proposes a common entrance and licentiate exit exam, to "ensure minimum standards of ethical knowledge and skills of medical professionals". This exit exam will also serve as an entrance test for PG courses. Currently, MBBS graduates have to clear separate examinations for medical colleges to gain entry into a PG course.
Even as Amitabh Kant, CEO, Niti Aayog hailed it as the "biggest institutional reform", there have been a few criticisms of the Bill. For instance, the bill allows medical colleges to be set up for profit, a clause that public health experts say will lead to commercialisation of medical education.
In a recent paper titled, "Restructuring the Medical Council of India", researchers with Brookings India point out that the draft law does not address the issue of improving standards of research in medical colleges.
Quoting a study by the Dean of the Ganga Ram Institute for Postgraduate Medical Education and Research, New Delhi, authors of the Brookings paper draw attention to the fact that "57 per cent of India’s then 579 medical colleges did not publish any research in peer reviewed medical journals from 2005-14." Nearly 40 per cent of medical research came from 25 (4 per cent) medical schools, the study shows. Authors of the paper recommend that the NMC Bill should tackle the issue of reforming research at the postgraduate level and encourage "research-based meritocracy" by tying it to accreditation. Other key recommendations by the authors include creation of regional medical councils, clarifying minimum medical procedures that MBBS doctors and nurses are allowed to perform, introducing a "mandatory three-year work period for all graduating students of medical institutions" and adopting WHO guidelines to ensure quality in both medical education and clinical practice.
