Will dissolving the Medical Council of India help medical education?

Hundreds of doctors across the country are protesting against the proposed National Medical Commission Bill (NMC Bill), which seeks to dissolve the Medical Council of India (MCI), calling it “an undemocratic move.”

One of the primary responsibilities of the MCI is to regulate medical education in the country. The NITI Aayog suggested the creation of NMC in August 2016. The proposed bill has suggested forming an NMC, which will be a policy-making body for medical education. Scrapping MCI might not be the right move in the long term, experts have said.

The proposed NMC Bill 2016 suggests that the Central government will establish autonomous Boards for conducting undergraduate and postgraduate education, assessment and rating of medical institutions and registration of medical practitioners, among other things.

According to Dr KK Aggarwal, national president elect, Indian Medical Association, “Scrapping MCI will cripple the functioning of the medical profession by making it completely answerable to the bureaucracy and non-medical administrators. Instead, the government must consider introducing amendments to the existing MCI Act to make it transparent, accountable, robust and self-sufficient.”

Dr Aggarwal says the autonomy of the regulatory body has to be upheld. Experts also suggest that providing for an accreditation authority for medical education on the lines of the authority vested with the All-India Council for Technical Education in respect of technological institutions through National Accreditation Board can be a solution.

Vesting MCI with the authority to prescribe service conditions and payable scales for full-time teaching faculties in medical colleges on par with the UGC can be another solution.

The government had invited suggestions from stakeholders and public on the proposed NMC Bill. Dr Manish Prabhakar, president, Indian Medical Students’ Association, says an NMC, if formed, will be “undemocratic and highly detrimental to budding doctors, community and medical associations.”

The NMC also aims to prescribe norms for determination of fees for a proportion of seats, not exceeding 40%, in private medical educational institutions. The Commission will also be responsible for conducting the National Eligibility-cum Entrance Test and a National Licentiate Examination for admission into post-graduate courses in medical colleges.

The bill also seeks to establish Undergraduate and Postgraduate Medical Education Boards that will be responsible for determining and prescribing standards and overseeing all aspects of medical education at undergraduate and postgraduate levels, respectively. They will also be given the task to develop a competency-based dynamic curriculum (including assessment) at the two levels and prescribing guidelines for setting up medical institutions, besides developing curricula and conducting examinations.

But will dissolving MCI help achieve these goals? Dr Arun Aggarwal, former president Delhi Medical Council and professor of excellence, Maulana Azad Medical College, Delhi, says, “Replacing MCI with another regulatory body does not guarantee that the current issues in medical education will be resolved. How can we be sure that the new commission will function without any glitches and be corruption-free?”

The new commission also seeks to merge the existing National Board of Examination (NBE), which is responsible for regulating post-graduate medical education in the country, with the Postgraduate Medical Education Board.

“The Supreme Court in its judgment dated April 3, 2016, while placing an oversight committee for MCI, had mandated a period of one year for the government to undertake reforms in regulation of medical education and set up appropriate systems in place. The apex court will review the position in April 2017. The tenure of MCI will also be completed in a year’s time. Thus, achieving high growth in healthcare to meet the growing needs is an area of high priority. Reforms in medical education are necessitated and will have to be undertaken sooner than later. However, the needs of medical profession namely professional autonomy and identity have to be appropriately addressed while holding the professionals accountable,” says Dr Bipin Batra, executive director, NBE.