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NEET, Exit Test, No DNB: Read How Scrapping of MCI Will Affect Doctors

Most of the readers must have been reading many things about changes in Medical Council of India (MCI), conduction of National Eligibility cum Entrance Test (NEET), National Exit Test (NEXT) and much other news.

We doctors have been hearing and knowing about Medical Council of India (MCI) since many years but now this is changing. MCI as per IMC Act, 1956 is going to be replaced with the National Medical Commission (NMC) Act, 2016 as soon as the draft rules are confirmed by the parliament of India.

I am dividing this article into 3 parts, in 1st part I will describe in short the changes which are going to happen because of replacement of MCI with NMC, in 2nd part I will describe these changes in much more details for interested readers and in 3rd part I will be writing some comments by myself which are going to affect all the medical students and doctors in India.

Short description of changes in National Medical Commission (NMC)

  • MCI and all its functions will be replaced by the same by National Medical Commission (NMC). So MCI will be no more after this act comes into effect.
  • All India Postgraduate Medical Entrance Exam (AIPGMEE) will be replaced with National Eligibility Cum entrance  Test (NEET) for admission into both undergraduate (UG) and Postgraduate (PG) Medical courses.
  • There will be a National Exit Test (NEXT) also known as a Common Licentiate Examination, which UG medical students have to pass to get themselves registered in National Medical Register or State Medical Register and thus practice. So without passing the exit test, no students passing out after the introduction of this act will be able to practice in India.
  • Common Licentiate Exam will come into effect within 3 years of the passing of this NMC Act.
  • Common Licentiate Examination will also serve as NEET for PG medical admission.
  • National Board of Examinations (NBE) will be merged into NMC. So even NBE will not exist after this act comes into effect.
  • MD/MS by MCI and Diplomate National Board (DNB) by the National Board of Examination (NBE) will be merged into a single course.
  • No more MCI inspection for Medical college and courses recognition. If a medical college fails to meet the minimum standards, a fine can be levied on it and it will be allowed to explain the reasons. If a college is derecognized it will be asked to maintain the facilities till the last admitted batch of students passes out.
  • Currently, only not-for-profit organisations are allowed to set up medical colleges but this act will allow for-profit organisations as well to establish medical colleges.
  • Under-Graduate Medical Education Board (UGMEB) will oversee UG medical courses
  • Post-Graduate Medical Education Board (PGMEB) will oversee PG and super speciality medical courses
  • Medical Assessment and Rating Board (MARB) will oversee assessment and rating of medical education institutions. So students will be able to see the rating of medical colleges before admission to see the quality of education in the same.
  • Board for Medical Registration (BMR) will be Maintaining the National Register (NR). Any person having a foreign medical degree will not be able to practice in India i.e. will not have their names registered in NR unless they qualify National Licentiate Examination.
  • All students studying degree, diploma or certificate course before the NMC act coming into effect, can continue the same courses and institutions have to maintain the standards and conduct the examinations as per the standards before the act comes into effect.

Detailed description of changes in National Medical Commission (NMC)

Indian Medical Council (IMC) Act came into effect in 1956. After which it has been amended multiple times by central governments for a variety of reasons. Recent ones being due to allegations of corruption by MCI officials in allowing medical colleges to function and recognition of medical courses. Ordinances included Indian Medical Council (Amendment) Ordinance, 2010 for one year with a newly constituted Board of Governors (BoG) taking over the functions of the MCI. IMC (Amendment) Act, 2010 for reconstituted of MCI within three years which was again amended in 2012 and 2013. IMC (Amendment) Second Ordinance 2013, led to the reconstitution of the MCI while also allowing the latter to continue the work done by the BoG.

Parliamentary Standing Committee on Health and Family Welfare submitted Report 92 to the Rajya Sabha on 8th March 2016 after detailed discussions, wide consultations with various stakeholders and review of published articles and written submissions by experts, it. The report offers a critical assessment of medical education in India and offers recommendations for reforming it. “The Committee observes that the Medical Council of India as the regulator of medical education in the country has repeatedly failed on all its mandates over the decades”. It mentions the failure of MCI like failure to create curriculum, maintain a uniform standard, devaluation of merit in admission, no transparent system and a heavy focus on infrastructure and human staff during MCI inspections but no substantial evaluation of the quality of teaching, training and imparting of skills.

Recommendation were made by expert committee led by (late) Prof. Ranjit Roy Chaudhury which asked for creation of NMC and four verticals like (i) UG Board of Medical Education and Training, (ii) PG Board of Medical Education and Training (iii) National Assessment and Accreditation Board and (iv) National Board for Medical Registration. Also, Hon’ble Supreme Court has reinforced the sentiment expressed by the Parliamentary Standing Committee Report in the Judgement dated 2nd May 2016 in the Civil Appeal No. 4060 of 2009.

Details of changes recommended by the committee are as follows:

  • The National Medical Commission (NMC) will be the policy-making body for medical education and shall comprise a Chairperson, nine ex-officio Members and ten part-time members.
  • There will be a creation of four mutually independent and autonomous Boards whose activities will be coordinated through the NMC. Each board will have a separate president.
  • NMC will be supported by a professionally equipped permanent Secretariat.
  • Statutory basis for conducting a common entrance examination for admissions to undergraduate and post-graduate courses in Medical institutions will be provided so that there will be a transparent admissions process based on merit rather than the ability to pay capitation fee. There will be an all-India National Eligibility cum Entrance Test (NEET) for admission into UG and PG medical courses.
  • Statutory basis will be provided for a Common Licentiate Examination for practice by medical professionals after completion of the undergraduate medical degree. Central Government may also prescribe skill tests as necessary, as part of Licentiate examinations to ensure medical professionals have appropriate knowledge, skills and attitudes for providing health care as per societal needs.
  • Passing the Common Licentiate Exam will be mandatory to get a license to practice in India and for registration of the doctor in the Indian medical register. This examination will also serve as the NEET for admission to the PG courses in Medical Educational Institutions.
  • Common Licentiate Exam will come into effect within 3 years of the passing of this NMC Act and it would ensure common standards of knowledge and skills for Doctors on a Nationwide basis.
  • Committee also deliberated on enabling statutory provision of a similar licentiate examination in the PG and other Super-Speciality Courses but did not recommend the same for reasons like diversity of courses and in the practices across states, as PG and super-specialty doctors have already appeared for NEET or Common Licentiate Exam their quality is ensured and as NBE is merged with Post Graduate Medical Education Board (PGMEB) it can could continue conducting the system of voluntary examinations with those institutions/ candidates who are willing to voluntarily take part in such a process.
  • Committee also discussed on adding an additional enabling provision of voluntary recertification/ renewal of license exam once every ten years which is done in many countries but it concluded that it is desirable but this is not the right time for such radical step.
  • NMC should not engage in fee regulation of Private Colleges as there is already a merit-based admission process via NEET and NMC may be empowered to fix norms for regulating fees for a proportion of seats (not exceeding 40% of the total seats) in private medical colleges.
  • Currently, only not-for-profit organisations are allowed to set up medical colleges but this act will allow for-profit organisations as well to establish medical colleges.
  • Enough time will be given for transition from MCI into NMC.
  • Once the NMC bill becomes an act, rules will be notified for the same.
  • Under-Graduate Medical Education Board (UGMEB) for undergraduate courses and Post-Graduate Medical Education Board (PGMEB) for postgraduate and super speciality courses will oversee medical education, competency-based dynamic curriculum (including assessment), prescribe guidelines for setting up medical institutions, prescribe guidelines for medical courses, infrastructure, faculty and quality of education, development/training for the faculty, facilitate research and for compulsory annual disclosure, electronically and otherwise, by medical institutions in all aspects related to their functioning.
  • Medical Assessment and Rating Board (MARB) will do Assessment and Rating of Medical Educational Institutions as per the standards laid down by the UGMEB or PGMEB, hire credible third party agencies or to appoint such visitors and personnel as it may consider necessary to carry out inspections of the Medical Educational Institutions and  levy penalties on institutions for not meeting the minimum standards. The penalty will only be levied after giving a reasonable opportunity to institutions for explaining the reasons failures. Even after this if Medical Educational Institution fails to take the necessary corrective actions after three monetary penalties, MARB shall recommend to the NMC to initiate proceedings for derecognizing the degree/ degrees awarded by the Institution as per the procedure prescribed in section 36.
  • No medical college can be established without permission of MARB. The board will take 6 months to accept or reject the request of setting up a medical college and if not done institution is free to make a second appeal to the Government in case no decision is received within one year from the date of his submission or the scheme is disapproved.
  • The MARB or the Commission or the Government should approve or disapprove medical college set up request after looking into the financial resource of the institution, adequacy of academic faculty and hospital facilities.
  • Board for Medical Registration (BMR) will be Maintaining the National Register (NR) will which will contain the name, address, date of birth, Aadhaar ID of and all qualifications recognised by UGMEB and PGMEB possessed by the licensed practitioner. National Register and State Medical register will be in sync. If the name of a doctor is removed from state medical register, they can appeal in front of BMR for the same.
  • A person who is a citizen of India and obtains medical qualification granted by any medical institution in any country outside India recognised as medical practitioner in that country after such date as may be specified, shall not be entitled to be enrolled in the National Register unless he qualifies the National Licentiate Examination and such foreign medical qualification after such person qualifies the National Licentiate Examination shall be deemed to be recognised medical qualification for the purposes of this Act for that person.
  • A person who is a citizen of India and obtains medical qualification by medical institution outside India recognised as medical practitioner in that country after such date as may be specified, shall not be entitled to be enrolled in the National Register unless he qualifies the National Licentiate Examination and such foreign medical qualification after such person qualifies the National Licentiate Examination shall be deemed to be recognised medical qualification for the purposes of this Act for that person.
  • If the name of a person is not there in NR, they will not be allowed to practice medicine or testify in the court of law as a medical expert.
  • Schedule I, II, III and IV of the IMC Act, 1956 shall be incorporated automatically in Schedule I, II, III and IV of NMC Act.
  • All the medical institutions will have to maintain a website and display all the information as per NMC.
  • “Any student of medical institution who, immediately before the commencement of this Act was studying for a degree, diploma or certificate in any such institution shall continue and complete his course for that degree, diploma or certificate, as the case may be, and such institutions shall provide for the instruction and examination for such student in accordance with syllabus and studies as existed before commencement of this Act and shall be deemed to have completed his course of study and awarded degree, diploma, as the case may be, under this Act.”
  • “The medical institution in the lapse of its recognition whether by efflux of time or by its voluntary surrender or for any other reason whatsoever shall continue to maintain and provide the minimum standards approved by the Commission until such time that all the candidates are able to complete their study in such institutions.”
  • All the assets and liabilities of the Indian Medical Council will be transferred to the National Medical Commission.
  • Educational standards, requirements and other provisions of the Indian Medical Council Act, 1956 and the rules and regulations made thereunder will continue to be in force and operate till new standards are specified under NMC Act or the rules and regulations made.
  • The National Board of Examinations (NBE) will be merged with the PGMEB. Also, all such courses and the qualifications by the NBE shall be subsumed and added as the courses conducted by and qualifications awarded by the PGMEB and any reference to the existing National Board of Examinations in any law or rule or contract other than this Act shall be deemed as a reference to PGMEB after NMC act comes into effect.
  • If NMC fails or neglects to comply with any order within the specified period, the Central Government may make the regulations or amend or revoke the regulations made by the Commission, as the case may be, in such manner as the Central Government thinks fit.
  • NMC will be funded by the National Medical Commission Fund by the central government and will be audited by the Comptroller and Auditor-General of India (CAG).
  • If any difficulties arise due to NMC act, the central government may provide order to remove such difficulties.

Comments by the Author

  • It is a good initiative by the government to conduct NEET so that merit plays an important role in medical admission and students who come from the wealthy background will not get admission into the medical colleges just by paying capitation fees
  • Common Licentiate Exam is being opposed by many students and doctors in social media but this exam will ensure that only good quality doctors pass out of the medical colleges and thus reducing the risk to the life of the patients.
  • As Common Licentiate Exam will also serve as NEET, students do not have to wait for years studying for PG medical exams and many precious years of young doctors of India will be saved.
  • Common Licentiate Exam is similar to USMLE in The United States and will have to be cleared by the foreign medical degree holders which is a good news.
  • As there will be no more MCI inspections, the issue of recognition of medical degrees will no longer be an issue and students can safely take up medical course of their liking
  • NEET, Common Licentiate Exam and MCI inspection removal will significantly reduce corruption in medical colleges which is good for students, doctors and the country.
  • Although Common Licentiate Examination is in line with USMLE of USA, there should be Objective Structured Clinical Examinations (OSCE) to test the ability of the students. Also, OSCE has less scope for subjectivity as a candidate faces multiple examiners in one exam. Thus bias of the examiners towards the students is minimised.

Readers can comment below and share their opinion these drastic reforms of medical education in India. Also, readers can submit their suggestions to NITI Aayog (Government of India) as done by (Dr Jayaprakash Narayan, Dr.Siva Reddy, Dr.Praveen) Foundation for Democratic Reforms – LOKSATTA, comments can be found here.

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Founder of the desimedicos.com.
Doctor by profession & a techie by hobby.
MBBS from TNMC, Mumbai & MD Pharmacology from GSMC, Mumbai.
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  1. This will still not do away with quack system. May be it will increase More as the cost of Medical care will go up.

    Reply
    • Quack system is a totally different issue and it should not be mixed with exit test. Exit test is to improve quality of the qualified doctors.

      Reply
  2. Can DNB students do private practice?

    Reply
    • After completion of their course?

      Reply
  3. Yes. Definitely.

    Reply

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