Even though thousands of doctors staged protests all over India, yet Rajya Sabha on Thursday passed the National Medical Commission (NMC) Bill. On July 29, Lok Sabha had passed the Bill.

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The bill presents, 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.

This bill is considered as one of the biggest reforms, according to the Modi government. The bill seeks to annul the Indian Medical Council Act 1956 in the wake of allegations of corruption against the 63- year-old Medical Council of India (MCI). It also aims at addressing the shortcomings in the process of regulating medical colleges in the country.

Doctors’ bodies, meanwhile, have panned the bill as being “anti-poor” and “anti-student”.

Here is everything about the bill that has the country’s medical fraternity on the edge:

• The bill will encourage quackery, claims India’s medical fraternity. Although the bill does not openly talk of a bridge course for Ayush doctors yet it does put pressure on “enhancing the interface between systems of medicine” such as Central Council of Homoeopathy and Central Council of Indian Medicine.

• The Bil also envisions defining Community Health Providers (CHPs) as persons granted a license to practice medicine at mid-level. Although it is not certain as to what kind of professionals could be certified as CHPs.

• The bill provides that 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

• The bills key provision is to bring in uniformity in medical education standards in India. The bill 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 license.

• The bill also proposes 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.” Although 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 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.

• At present, MBBS passouts from countries like US, UK, Canada, Australia, and New Zealand are automatically permitted to practice in India. But under the new law, such students will now have to clear the exit exam.

• Within three years of the bill becoming a law, the new exit examination is expected to be implemented.

• The bill seeks to remove the practice of yearly inspections. The government said it will ensure the end of inspector raj and will facilitate the addition of undergraduate and postgraduate medical seats.

• States can only “advise” the NMC, under the new bill. But the council can choose not to accept advice. However, the center has clarified no medical college will be set up without the state government’s permission.

• No power to MCI to regulate fees. In contrast, the new commission is envisaged with the power to determine fees in 50% private medical college seats. It would be akin to “allowing 100% of private college seats to be unregulated,” according to critics. Most of the states currently have committees that fix the fees.

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

• The basic objection from doctors is related to section 45 of the bill, where according to them, it empowers the Centre to override any suggestion of the NMC.

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

• The largest body of doctors and medical students in India with three lakh members, the Indian Medical Association (IMA), 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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