Medical Commission Bill: More visionary, less reformatory
The medical commission bill has been passed in the Lok Sabha. It has so far convinced everyone but people from the medical industry itself, suggesting more thought needs to be given on what could be the next big thing in the education of medical science for India.
The medical sector needed a revolution. Dr Harsh Vardhan thumpingly on 8 August declared this talked revolution in the form of Medical Commission Bill. This was also a goodbye to the Indian Medical Council Act,1956. With some endings we may welcome the birth of a new commission: National Medical Commission. So there’s a commission, a new bill, a structure in place and a lot of protest along with it. Let’s dive deeper into what makes up for a good reform and why the Medical Commission Bill is facing such flak.
Understanding the changes
Salient features of the new Medical Commission are about the structural changes that the commission adopts. Now there will be four autonomous monitoring boards in place: Under-Graduate Medical Education Board, Post-Graduate Medical Education Board, Medical Assessment and Rating Board, and Ethics and Medical Registration Board.
These are expected to be the control centres of overall activities. Another important addition is of limited license to Community Health Provider who can prescribe limited medicines too.
Next comes the real game changer, the entrance and exit test. NMC Act mandates a National Eligibility-cum-Entrance Test for admission to the undergraduate and postgraduate super-specialty medical education in all medical institutions and, not just that, there is to be a final year exit exam as well. This is a common final year MBBS exam. This is called National Exit Test (NEXT). Also, medical students from countries like the US and UK will have to take a test in India to practice medicine here.
Paramount concerns
Concerns were raised the moment the bill was passed. Although, after one month there are still voices from within the fraternity that are unable to accept the logic behind the big changes that they believe the government is not yet prepared for.
Dr. Prahlad, a post-graduate medical student from Jaipur, told The Dispatch how this bill could impact the industry. He said: ‘The first concern for me is that CHPs are now allowed to practice medicine. Who will find out what qualifications do they hold? What are they doing? How will you inspect before they start practicing? I’m asking all this because right after you pass this bill, a lot of, and mind you, a lot of practitioners become eligible without even proper guidance and that is what I’m a bit worried out.’
On being asked whether more doctors with limited permission to practice is the right step, he said: ‘There are 68,000 medical graduates every year. Less than a third of them end up joining PG course and become a doctor. We are talking about allowing around 30,000 of them who didn’t pass the PG exam to start their medical career wherever they are. Patients are not jokes.’
What’s NEXT?
The press conference was ringing with the word ‘game changer’. Notably, this can be attributed to be the biggest of all the changes that have been introduced in the form of common exit exam for MBBS students and for post graduate ‘broad specialty courses’.
Dr. Ashwani Kumar, preparing for his own post graduate exam in Delhi, told The Dispatch: ‘While I understand all the streamlining requirements, and what not, in the name of needed change for the medical science stream as it was long time impending, I have to say that post graduate exam is something that will require you a lot more technical grasp to clear. The MBBS to practice the exam requires less competency and it’s a fact. Root of the whole reform is to increase manpower is what I heard, but this [the act] does not solve that problem.’
Less power, more autonomy?
Major concerns reflected in the protests were, first, the fee allotment that the center has decided to keep for only 50% of seats for states to decide (for private institutes) that may end up making it a highest-bidder system and increasing the overall fees. Not just that, the National Medical Commission Bill emphasises on a centrally planned structure and yet it boasts of four autonomous boards to regulate the working of the institutes. This is being seen as a pseudo-liberal move by the people in the medical science field.
For a profession with creeping bottleneck issues, reform has to be carried out. This was on the cards. Albeit that, the one introduced and enacted by the government looks to be more a vision paper than a reform that can work without solving the real issues of lack of trained manpower, corruption and need for streamlining the selection process.
Suresh Chouksey is a journalism student at IIMC Delhi. He tweets at @sureshchouksey8.
