New Delhi: The government’s push to abolish the scam-tainted Medical Council of India (MCI) and replace it with a National Medical Commission (NMC) may lead to major changes in India’s medical education system, experts said.

“There will be a sea change in medical education after MCI is scrapped and the medical commission comes into force. Though the concept of a medical commission is not faulty, the autonomy of medical education will entirely go into the hands of the government. The people who were running MCI were elected but now officials running the commission will be selected, that too by the government," said Rajeev Sood, dean, Postgraduate Institute of Medical Education and Research (PGIMER), Ram Manohar Lohia Hospital.

“MCI was accused of corruption long years ago for faulty admission process but in past few years, there have been no reports of corruption, due to several government policy changes such as National Eligibility cum Entrance Test (NEET). But in NMC also, corruption cannot be ruled out. As government is already doing what it wants for regulation of medical education, the system will become more bureaucratic," he said.

The Union cabinet on 28 March approved certain official amendments to the NMC Bill. As the bill faced stiff resistance from the Indian Medical Association (IMA), medical practitioners and students, the government considered their recommendations and those made by the Standing Committee regarding certain provisions of the bill. On 26 September, the government promulgated an ordinance to supersede MCI and the powers of the council were vested in a board of governors (BoG) on Wednesday, without waiting for Parliament’s nod to the NMC Bill.

In one of the decisions, the cabinet approved a maximum limit of 50% seats for which student fees would be regulated in private medical institutions and deemed universities. The fees would include all other charges taken by the colleges. “This may increase fees in colleges," said Sood. Maintaining that differences between the new Medical Commission and the existing MCI are merely organizational, a paper The National Medical Commission: More of the same published in the latest issue of Indian Journal of Medical Ethics by a Chennai-based doctor, George Thomas, stated, “replacing the unwieldy MCI with a more compact NMC does not guarantee the end of corruption."

Health experts allege that the NMC Bill drafted by the government think tank NITI Aayog is firmly oriented towards the market and may disturb the medical admission process in India.

“The provision to allow private colleges which will be able to set their own fees for 50% of seats will ensure that high cost private care will continue for the foreseeable future in India. The only way to recoup the huge fees for education in these colleges is to charge huge fees to patients," Thomas said.

Union Health Minister J.P. Nadda said the medical commission bill provides for simplification of procedures and is expected to enhance the governance and quality of medical education. He said the bill provides for distribution of functions among four autonomous boards whose members would be people of proven ability selected through a transparent process.

Health experts disagree. “Having a number of nominated members does not guarantee excellence. In fact, quite the reverse may happen with a number of time servers being nominated, the chief qualification being proximity to the government of the day. Regulatory capture by private colleges which are ready and able to pay bribes will continue to be a threat," said Thomas in his paper. “If India really wants to provide a high quality medical care service accessible to every citizen, it urgently needs to have a clear idea about health human resources required, decide about how to set up the requisite number of training institutions, have clear policies for employment and remuneration of the graduates of these institutions, decide on the resources required to make this possible in a realistic time scale and take the states along in any planning in this sector."

The MCI was established in 1934 under the Indian Medical Council Act, 1933, now repealed, with the main function of establishing uniform standards of higher qualifications in medicine and recognition of medical qualifications in India and abroad.

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