The proposed National Medical Commission (NMC) Bill 2017 is all set to bring transparency in the medical education sector, sources told The Sunday Guardian. Experts believe that the new bill, which seeks to replace the existing Medical Council of India (MCI), will check rogue elements effectively, infamously known as Munnabhais, who procure fake degrees by taking advantage of the lapses in the medical education sector.
The bill, which was cleared by the Union Cabinet recently, is likely to be tabled in the ongoing Parliament session. It is expected to increase the number of good quality medical professionals, both at the undergraduate and postgraduate levels. At present, medical colleges produce only around 1.25 lakh MBBS doctors annually (from both private and government colleges), which is low compared to what the country’s ailing sector requires. Hardly 25% of these graduates go for postgraduate courses.
However, several “status quoist” doctors, who fear that that they will lose their power in the new system, have started a misinformation campaign against the bill. Sources say they are creating a sense of fear among students by calling the bill “draconian” and a potential threat to the medical profession. Instead, sources assert that the bill is “path breaking” and will completely overhaul the medical education sector.
As per the provisions of the draft bill, medical colleges will not have to seek permission to add new seats or to start postgraduate courses. This is expected to bring more medical practitioners into the system. The new system is also expected to put an end to inspector raj as it will shift to an accreditation system, which will give the desired boost to investment.
One of the most significant features of this bill is that it proposes a common entrance examination and licentiate exit examination, which all medical graduates will have to clear in order to get their practicing licences. According to sources, this is a paradigm shift from input-based regulations to outcome-based regulatory philosophy in line with international practices.
“All students, who clear MBBS from their respective universities, will have to sit for the licentiate exam. Since there will be no reservation, it will ensure that only quality students get the licence to practice medicine. It will also ensure that the Munnabhais, who somehow get admitted through the backdoor, or through other unfair means, will not get the licence. Only the deserving and hard working students will be able to get through,” said a senior doctor.
Indian students doing MBBS abroad will not be required to sit for a separate FMGE (Foreign Medical Graduate Examination) test. The NMC Bill will allow them to take the licentiate exit examination along with their Indian counterparts, thereby ending discrimination between foreign medical graduates of Indian origin and Indian medical graduates.
Sources say that the status quoist doctors’ lobby, over the years, has deliberately kept the FMGE a tough nut to crack so that the pass percentage remains low. This, sources say, is done just to discourage students from going abroad to study medicine, and pressure them into taking admission in private medical colleges in India by shelling out a hefty amount. With more foreign MBBS students likely to clear the licentiate examination, the number of doctors is expected to increase further.
Sources say most countries have adopted the licentiate system. In the United States, on an average, 95% students clear this examination, whereas, in India, only 10% students qualify in the FMGE test.
The bill will make sure that a medical college is ranked strictly on the performance of the students in the licentiate examination. This will lead to a positive competition among the colleges and will hence push the college management to improve quality of teaching.
Sources say that the number of specialist doctors will also increase under the new system, as both the undergraduate board and the postgraduate board will come under one commission. “At present, starting a PG course is a cumbersome process. The management needs to first start an MBBS course, and only then it can start a PG course. Now any hospital would be able to start a PG course. Moreover, at present, the DNB degree (for PG) is awarded by National Board of Examinations (NBE), while MBBS is given by universities. So there is often a step-motherly treatment by the MCI. All these things will be a thing of the past and there will be uniformity in the degrees,” said a source.
The bill also provides for the constitution of four autonomous boards entrusted with conducting undergraduate education, assessment and accreditation of medical institutions and registration of practitioners under the NMC. The draft bill proposes that the NMC would have government-nominated chairman and members, and the board members would be selected by a search committee under the Cabinet Secretary. There will be five elected and 12 ex-officio members in the Commission. The body will have eminent doctors and experts.
The previous UPA government had also made such a move. In 2005, the then Union Health Minister, Dr Anbumani Ramadoss, had tried to bring in a legislation to dissolve the MCI and set up another council under the control of the Ministry of Health. However, the Narendra Modi government, sources said, is committed to bring about reforms in the medical education sector.