Medical Governance

Medical Governance

1 . Medical Council of India Issues

  • Medical Council of India (MCI) was established under Indian Medical Council Act-1933 and given responsibility for
    1. Maintaining standards of medical education
    2. Providing ethical oversight
    3. Maintaining the medical register
    4. Sanctioning medical colleges
  • MCI in recent times has been in the news for the wrong reasons
    1. In 2010, secretary of MCI , Ketan Desai, was arrested for accepting bribe in return for recognising a private college.
    2. March 2016Parliamentary Standing Committee on Health noted that MCI has repeatedly failed on all its mandates over  years.
    3. 2016 – Supreme Court has appointed at 3 member committee headed by former CJI R M Lodha to oversee MCI.

Weaknesses in MCI

  • Corruption : Eg : Ketan Desai Case
  • Too much power concentrated in a single body (i.e.  MCI)
  • Failure to create sufficient manpower : Doctor – Population ratio in India is 1:1700 as against the WHO norm of 1:1000. Need to produce more doctors
  • Conflict of Interest: MCI members are elected from the same medical fraternity that they have to control.
  • Failure to create a curriculum that produces doctors suited to working in Indian context especially in the rural health services and poor urban areas.
  • Devaluation of merit in admission due to prevalence of capitation fees
  • Heavy focus on nitty-gritty of infrastructure and human staff during inspections but no substantial evaluation of quality of teaching, training and imparting of skills.
  • Failure to instill respect for professional code of ethics in the medical professionals 

2. National Medical Commission Bill, 2019 (NMC)

Provisions of the act are

1 . Formation of NMC

  • It will replace MCI 
  • It will consist of 25 members, appointed by the central government

2. Functions of NMC

Functions of the NMC include:

  • Regulating medical institutions and medical professionals,
  • assessing the requirements of healthcare  human resources and infrastructure,
  • Ensuring compliance by the State Medical Councils (SMCs) of the regulations
  • framing guidelines for determination of fees for up to 50% of the seats in private medical institutions and deemed universities

3. State Medical Council

  • Each state will establish their respective State Medical Commission (SMC) having a role similar to the NMC, at the state level.

4. Four Autonomous Boards

Respecting Doctrine of Separation of Power

  • Under-Graduate Medical Education Board (UGMEB) and
  • Post-Graduate Medical Education Board
  • Medical Assessment and Rating Board (MARB) => For medical college regulation of fees, standards and permission to setup new colleges
  • Ethics and Medical Registration Board

5. Provisions regarding fees of medical students

  • Fees in private colleges can be regulated for maximum of 50% of seats

6. Community health providers

  • NMC may grant a limited license to certain mid-level practitioners connected with the modern medical profession to practice medicine.


  • Uniform National Eligibility-cum-Entrance Test (NEET) will be conducted for admission to under-graduate & post graduate medical education in all medical institutions regulated by the Bill.


  • There will be a common final year undergraduate examination called the National Exit Test (NEXT) to obtain the license for practice and admission into post-graduate courses at medical institutions.


  • Fee Capping Dilemma : Bill permits 50% of seats to be open for managements . NMC Bill will push the medical education completely away from the reach of deserving  people of lower socio economic class 
  • Two-thirds of the members in the NMC are medical practitioners.  Expert committees have recommended that the regulator should consist of more diverse stakeholders in order to reduce the influence of medical practitioners
  • Against federal setup: Previously, all the State governments had representation in MCI while in the NMC bill, only few States in rotation will have representation
  • Enforcing NEET might result in the mushrooming of expensive coaching centres . Southern states especially Tamil Nadu is against NEET

Leave a Comment