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The draft National Medical Commission bill 2022 seeks to introduce a fifth autonomous body under the country’s apex medical education regulator to conduct the National Exit Test — a two-part examination that will act as a qualifying exam for granting registration to doctors as well as the basis for post-graduate admissions. Called the ‘Board of Examinations in Medical Sciences’, it will take over the functions of the National Board of Examinations that currently conducts the entrance tests for all post-graduation and super-speciality courses.
The National Board of Examinations also conducts the screening test for foreign medical graduates, which will also be replaced by the new NExT examination.
In addition to conducting the NExT tests, the new board will also accredit institutions for diploma, diplomat, postgraduate fellowship, and super-speciality fellowships. It will determine the minimum requirements for conducting these courses and grant them.
The draft bill also goes on to state that the existing National Board of Examinations will be dissolved, however, all the orders or accreditation provided by the body will continue to exist till the date of expiry. The officials will be given the option to be “subsumed under the NMC” as per the draft bill.
This will be the fifth autonomous board under NMC after Under-Graduate Medical Education Board (sets norms for undergraduate courses), Post-Graduate Medical Education Board (sets norms for post-graduate courses), Medical Assessment and Rating Board (inspects and rates the medical education institutes), and Ethics and Medical Registration Board (regulates professional conduct of the doctors and registers them).
Dr Sunil Kumar, former director general of health services, said, “On a similar note ‘Board of Counsellors or Counselling’ should be constituted under NMC. Such a move will streamline and fast track admissions and eliminate confusion which arose recently, leading to wastage of seats due to poor work ethics, lack of coordination, and disparate bodies doing disparate components of the same job.” At present, the counselling is conducted by the Medical Counselling Committee independent of NMC.
The new board under the National Medical Commission will subsume the role of independent National Board of Examinations, which many think will streamline the process. This comes at a time when the role of NMC is expanding, with the government working towards implementing NexT, a nationwide screening test for doctors before they are registered with the medical council.
The UG entrance is conducted by the National Testing Agency and no changes have been suggested to that in the new bill.
After several delays in conducting the PG examinations for the years 2021 and 2022 due to the pandemic, court cases, and other procedural delays, resident doctors’ associations asked the government to set up such a body to streamline the process.
In a list of demands submitted to the union health minister, the Federation of Resident Doctors’ Association (FORDA) this year they had demanded “an apex body controlling every facet of medical education such that there are no discrepancies of decision making between NMC, NBE, and MCC (Medical Counselling Committee that conducts the counselling after the qualifying tests), which has been the root cause of many procedural delays.”
The counselling was repeatedly delayed in 2021 due to the pandemic and a set of cases in the courts regarding the newly introduced quota for economically weaker sections. It finally started in February 2022. Resident doctors had taken to the streets in December 2021 demanding that the counselling be expedited as the medical college hospitals, where the PG students work as junior residents, were short staffed.
While the 2022 examinations were conducted just days after the 2021 counselling ended – leading to protests by students attempting a second time – the counselling again started months later and there were delays a couple of times because of procedural issues.
The draft bill also proposes a section in the parent act stating that any cases against the commission by medical colleges or institutions will lie under the jurisdiction of the Delhi high court. This is significant given that the order of the NMC for regulation of fee at private medical colleges and deemed universities was first challenged in Kerala, with the court ruling in favour of the institution stating that the order will not be applicable in the state. The NMC order was to reduce the fee for 50% of the seats to the levels of government medical colleges in the state and decide fees for the rest based on a specific set of criteria.
The draft also makes provision for patients and their relatives to appeal with the Ethics and Medical Registration board or the National Medical Commission against decisions of the state medical council in cases of medical negligence.
