The National Medical Commission Act, 2019
The National Medical Commission Act, 2019
🔷 Introduction
The National Medical Commission Act, 2019 was enacted to repeal the Indian Medical Council Act, 1956, and to reform the medical education and healthcare delivery system in India.
It established the National Medical Commission (NMC) as the regulatory body for medical education and professionals, replacing the Medical Council of India (MCI), which was often criticized for corruption, inefficiency, and lack of transparency.
🔷 Objectives of the Act
To enhance access to quality and affordable medical education.
To promote equity in healthcare delivery.
To standardize medical education across India.
To regulate fees and charges in 50% of seats in private medical colleges and deemed universities.
To bring transparency, accountability, and efficiency in the medical education system.
🔷 Key Features of the Act
1. Establishment of the National Medical Commission (NMC) – Section 3
NMC is the apex regulatory body.
It consists of:
A Chairperson
10 Ex-officio Members
22 Part-time Members (nominated by the Central Government)
2. Autonomous Boards under NMC – Section 16
NMC supervises four autonomous boards, each with specific responsibilities:
| Board | Function |
|---|---|
| Undergraduate Medical Education Board (UGMEB) | Regulates UG education |
| Postgraduate Medical Education Board (PGMEB) | Regulates PG education |
| Medical Assessment and Rating Board (MARB) | Accredits institutions and conducts inspections |
| Ethics and Medical Registration Board (EMRB) | Maintains national register and enforces professional ethics |
3. National Exit Test (NEXT) – Section 15
A common final year exam for MBBS students.
Serves as:
Final MBBS exam
Licensing exam to practice medicine
Admission test for PG courses
Screening test for foreign medical graduates
(Implementation of NEXT is pending; transitional arrangements are being made.)
4. Medical Advisory Council – Section 11
Acts as the platform for states and union territories to advise NMC.
Ensures that regional issues and diversity are considered.
5. Regulation of Fees – Section 10(1)(i)
NMC has the authority to regulate fees for 50% of seats in private medical colleges and deemed universities.
Objective: Make private medical education more accessible.
6. Community Health Providers (CHPs) – Section 32
Allows the NMC to license non-MBBS healthcare providers (with limited training) as Community Health Providers to work in primary and preventive care.
This provision drew criticism from the medical community fearing “backdoor entry” into the profession.
7. National Register – Section 31
A central registry of all licensed medical practitioners in India.
Only those whose names are on the register can practice allopathic medicine.
🔷 Comparison with MCI
| Feature | MCI | NMC |
|---|---|---|
| Regulation | Centralized, often bureaucratic | Decentralized via 4 boards |
| Licensing | No unified exam | NEXT for uniform evaluation |
| Corruption Allegations | High | NMC designed to be more transparent |
| Fee Regulation | No clear mechanism | 50% of private seats regulated |
🔷 Criticism and Controversies
Medical fraternity protests: Many doctors opposed NMC, especially the NEXT exam and Community Health Providers.
Federal concerns: Some states objected to the Centre taking control over state medical colleges.
Risk of commercialization: Concerns about increased private participation.
🔷 Relevant Case Law
Although there are not many landmark constitutional challenges to the Act itself, several cases have touched upon related issues, such as the transition from MCI to NMC, rights of foreign medical graduates, and institutional autonomy.
1. Association of Medical Consultants v. Union of India (2021)
Issue: Challenged the provision for Community Health Providers under Section 32.
Held: The Delhi High Court upheld the section but emphasized strict regulation and defined scope of practice for CHPs to ensure patient safety.
2. Medical Council of India v. State of Kerala (2017)
Context: Though pre-NMC, this case is relevant for fee regulation in private colleges.
Held: The Supreme Court upheld the right of states (and now NMC) to regulate fees in the interest of equity and access.
3. National Medical Commission v. Royal Medical Trust (2022)
Issue: Whether NMC can deny recognition or approval to a medical college based on deficiencies.
Held: Courts reaffirmed that NMC has wide powers to conduct assessments and withdraw recognition in case of non-compliance.
4. Kiran Patel v. NMC (2023)
Issue: A foreign medical graduate challenged the application of NEXT as a licensing exam.
Held: The High Court ruled that uniform licensing through NEXT is constitutionally valid, reasonable, and ensures standardization.
🔷 Impact of the Act
✅ Positive
Brings transparency and modern structure to medical education.
Standardizes exit and entry mechanisms (NEXT).
Improves regulation of private institutions.
Empowers ethical oversight.
❌ Challenges
Implementation delays (especially NEXT).
Resistance from medical associations.
Balancing quality with increased access in underserved areas.
🔷 Conclusion
The National Medical Commission Act, 2019 represents a transformational reform in India’s medical education and regulatory ecosystem. It aims to build a modern, accountable, and transparent framework for producing competent medical professionals and ensuring equitable healthcare delivery. While it has faced criticism and implementation hurdles, the NMC is expected to play a pivotal role in shaping the future of medical education and public health in India.
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