Expert Recommendations on the National Medical Commission Bill, 2016

- A policy advocacy initiative by “Voice of Healthcare”(VoH)

Foreword

- Dr. Naveen Nishchal, Chairman, Voice of Healthcare

On behalf of Voice of Healthcare (VoH), I would like to congratulate Niti Aayog for inviting public opinion on the proposed National Medical Commission Bill, 2016, despite the fact that the report is the result of extensive deliberations and consultations from energetic and diligent persons of professional integrity and excellence.

At VoH, we have strived to bring together distinguished subject matter experts and prominent voices in the hospital and medical education sector to present their inputs and recommendations on the draft bill. What followed were vibrant and engaging discussions on the various provisions introduced in the bill, the summary of which has been captured in this report.

 There is a consensus amongst the experts that the current medical education system and prevailing medical practice in the country is in dire need of a complete overhaul. There is an urgent need to revisit existing practices and introduce reforms that support present and future generations of medical workforce in the country and at the same time ensure quality in healthcare delivery. Safeguarding interests of the medical community and providing them adequate representation in the bodies proposed in this bill (such as the Advisory Council and NMC) will allow them to voice their concerns and highlight issues faced in the current system.

- Mr. Afzal Kamal, Gen. Secretary, Voice of Healthcare

The National Medical Commission Bill and its provisions are a great initiative by the Niti Aayog towards transforming medical education sector in India, making it more transparent and democratic. It would be critical to ensure that a robust process for selection of members for the various bodies is followed, with no unnecessary interference from groups with vested interests. If the provisions are implemented well, they would go a long way in improving the supply as well as quality of medical manpower in the country.

- Mr. Vikram Anand, Director, CapBuild

Healthcare has historically taken a backseat in the government’s list of priorities with single digit GDP allocation. However, the proposed National Medical Commission Bill is a great effort in bringing focus to this important sector. We, at CapBuild Clinical Skills Pvt. Ltd., are particularly in agreement with the proposal to completely redesign the governance structure of regulatory bodies, and bring in the process of nomination/selection over election of constituent members. We have tried to bring together voices from academia and the industry by means of this report, and sincerely hope that the recommendations made here are found meaningful and practical.

List of Abbreviations

GOI

Government of India

VoH

Voice of Healthcare

CA

Chartered Accountant

IRDA

Insurance Regulatory and Development Authority

PHFI

Public Health Foundation of India

CTRI

Clinical Trials Registry- India

IISc

Indian Institute of Science, Bangalore

IISERs

Indian Institutes of Science, Education and Research

NMC

National Medical Commission (as proposed in the Bill)

MD

Doctor of Medicine

MoHFW

Ministry of Health and Family Welfare

NEET

National Eligibility-cum-Entrance Test

CBSE

Central Board of Secondary Education

CME

Continuing Medical Education

GMC

General Medical Council, United Kingdom

HEE

Health Education England, United Kingdom

NRMP

National Resident Matching Program

GP

General Physician

NABH

National Accreditation Board for Hospitals & Healthcare Providers

CL

Casual Leave

EL

Earned Leave

ML

Maternity Leave

MARB

Medical Assessment and Rating Board (as proposed in the Bill)

MCI

Medical Council of India

DCI

Dental Council of India

PPP

Public Private Partnership model

MSR

Minimum Standards Regulation

Introduction to Voice of Healthcare (VoH)

“Voice of Healthcare” is a non-profit organization conceptualized with the aim of being a discerning & visionary think tank for the healthcare sector in India. Our aim is to make healthcare a priority for all by continuously collaborating with diverse stakeholder groups to shape innovative solutions through shared learnings.

 VoH intends to be the voice of healthcare industry at national and international platforms, to facilitate exchange of ideas, learning and best practices in the healthcare sector.

 We are bringing under our fold organizations ranging from private and public hospitals to pharmaceutical companies to healthcare consultants, med tech firms, NGOs, govt. bodies, medico legal experts, healthcare IT companies and upcoming start-up firms.

 At Voice of Healthcare, we hope to introduce positive changes through policy advocacy; knowledge sharing; skills development; and liaising with the government, social entrepreneurs and private entities. Our team strongly believes that a consultative and concerted approach can go a long way in finding practical solutions to the many issues plaguing Indian healthcare systems.

Brief on the Policy Advocacy Meet held on 26th August, 2016

In pursuance of the above objectives, VoH, with support from its knowledge partner, CapBuild Clinical Skills Pvt. Ltd., organized a ‘Policy Advocacy Meet’ with changemakers of healthcare industry on Friday, 26th August at New Delhi.

The key objective of this round table discussion was to bring together subject matter experts and prominent voices in the hospital and medical education sector to deliberate on the National Medical Commission Bill, 2016, and provide their valuable recommendations/inputs/feedback.

 Prominent healthcare experts including Dr. Prof. M Wali (Physician to the President of India), Dr. Anand Prakash (Medical Director, Tirath Ram Hospital; and Ex-Director and Prof. of Surgery, Maulana Azad Medical College), Dr. DP Saraswat (Medical Director, Jaipur Golden Hospital), Dr. Prof. V.H. Talib (Ex. Prof. and HoD, Pathology, Vardhman Mahaveer Medical College), and Dr. Vinod Shah (Dean, NIMS Jaipur) suggested practical and innovative approaches to improve the medical education sector in India.

The event also saw active participation from medical institutes such as Sharda University, National Institute of Medical Sciences (NIMS), PGIMS (Rohtak), and SRGH (Delhi).

We also received many suggestions from the larger VoH community through emails and messages. This community comprises of doctors, academicians, healthcare consultants, public health specialists, medical technology experts, health insurance providers etc.

Voice of Healthcare and CapBuild team has collated these recommendations in this draft report for deliberation and inclusion in the Bill before it is tabled in the Parliament.

 We hope to have brought together practical and innovative ideas/concepts for the improvement of Indian medical education sector.

Key Recommendations from the Policy Advocacy meet

  • Members in the Medical Advisory Council, NMC and all the governing bodies proposed under the Bill must be selected by a fair and transparent process with 75% of them coming from the field of healthcare (including academic institutions like PHFI, IISc, CTRI and regulatory bodies like IRDA), and at least 50% of these members should belong to the medical community
  • Search and Selection Committee should comprise of at least 2 members from the medical background instead of bureaucrats and selection of members should be based on a robust rating structure to ensure greater transparency in the process
  • Along with the selection, there should be a structured performance appraisal system for re-appointments taking into consideration the skill sets and experience required to realize the desired goals of the NMC and other governing bodies
  •  The NMC must periodically publish a register of members’ interests, listing the organizations they are associated with, current designations and various roles held in these organizations to allow for greater transparency and address any conflict of interest
  • The NMC must form a representative body of private medical colleges for regulation of fee for such institutions, by employing a bottoms-up approach to determine the fee structure based on fixed and operational costs
  • A separate board should be constituted to conduct NEET for entry into medical colleges, which should have representation from all educational boards, and de-link CBSE with the process of conducting NEET. The board must ensure that entrance tests are comprehensive in nature, assessing students on their cognitive skills and mental aptitude along with their technical knowledge
  • The curriculum in medical colleges must be revisited with emphasis on practical training and inclusion of clinical medicine courses along with basic medicine, in line with the European model of integrated clinical education
  • Behavioral & communication skills along with bioethics should be introduced as an important part of the curriculum in medical institutions, especially in undergraduate education
  • Existing private hospitals with larger bed occupancies should be allowed to be used for education & training of UG/PG students to address the lack of adequate infrastructure. In addition, district hospitals should be upgraded and converted into medical colleges to provide medical education in local settings
  • Deficiency of teaching faculty in medical institutions should be addressed by revising existing guidelines in order to utilize qualified doctors from both public and private sector
  • Seats in post graduate courses should be allotted based on manpower requirements for various specialties in the state, in line with the workforce needs assessment conducted by the HEE (Health Education England) in UK
  • Robust Family medicine program should be introduced in post graduate specialization, which combines a broad set of clinical competencies, to introduce family physicians as the first Point of Contact for patients and reduce the burden on specialists and tertiary care centers
  • Public private partnerships to be encouraged for providing infrastructure in rural and semi-urban areas to meet the growing demand for doctors in these regions
  • Minimum Standard Regulation (MSR) for setting up medical colleges should be revisited to focus more on the quality of medical education than meeting infrastructure and faculty norms like physical area, auditoriums, animal laboratories etc. Vertical expansion should be allowed for medical colleges to reduce the capital costs associated with land acquisition
  • Periodic renewal of medical licenses should be implemented along with a robust CME programme to ensure competence to practice in terms of current medical knowledge and maintenance of skills in line with medical ethics and professionalism
  •  There should be no examinations for renewal of licenses with State medical councils
  • Key positions like Chairperson and Presidents of Boards must be representatives from the field of allopathic medicine
  • No licentiate exam for Indian medicine graduates keeping in mind the deficiency of workforce

Recommendations/Feedback on the National Medical Commission Bill, 2016

Chapter 2: Medical Advisory Council

Reform proposed in the Bill

Expert recommendation(s)

Rationale behind recommendation(s)

3.2 Constitution of the Council

1. Members must be selected by a fair and transparent process. Along with their credentials, conflict of interest arising as a result of their membership should also be considered at the time of appointments. Conflict of interests can include: – directorships or advisory positions in medical, pharmaceutical companies or voluntary organizations in the field of health or social care; – ownership, significant shareholdings or connection to any person in companies whose business activities might be relevant to or in conflict with the decisions of the council; and – membership of a political party. These must be published on the Council’s website along with profiles of the Council members and updated periodically.


Members need to be impartial in their decision making and take steps to avoid any conflict of interest arising as a result of their membership or association with other organizations or companies. In line with this ethos, GMC, an independent regulatory body for medical education in the UK, publishes a register of members’ interest on its website listing their associations and memberships held with various organizations in the country.

2. Representation should also be provided to non-medical professionals (not more than 25%); including representatives from allied health institutions like IRDA, PHFI, CTRI, IISc and IISERs to allow a blend of academia and industry

Representation from non-medical professionals would- (a) Draw focus on patient as a consumer of healthcare (b) Enable exchange of best practices from non-health sectors (c) Facilitate synergy across allied health spaces such as insurance, med tech etc. (d) Allow academia to focus on public health and research lacking in the sector

5. Meeting

1. Medical Advisory Council should meet once every quarter or once every six months and also on a need basis, in addition to the stipulated schedules.

Frequent meetings would help in regularly assessing the specific concerns from each state and also following up on the progress of various initiatives by NMC.

 

2. Minutes of the meetings detailing agenda and actions agreed upon by attending members should be displayed on the Medical Advisory Council/ NMC website periodically. Newsletters and other periodicals must be circulated by the Council/NMC to the public, sharing updates and progress on its activities.

Ensures greater accountability and scrutiny of the work under progress when placed in public domain.

 

 

 

 

 

 

 

 

 

Chapter 3: The National Medical Commission (NMC)

Reform proposed in the Bill

Expert recommendation(s)

Rationale behind recommendation(s)

9. Mode of Appointment and 10. Search and Selection Committee

1. It is important to ensure that the selection of members (Chairperson, Presidents of Boards, Part time members and the Member Secretary) by the Search and Selection Committee is based on a robust rating structure developed by the committee which assesses each candidate on their qualifications and achievements and allows for merit over favoritism arising out of personal or political interference. The committee should lay down parameters for assessing candidates as part of this rating structure and display them in the public domain to allow for greater transparency in the entire process.


The NMC has to be a fresh regulatory body with minimum political influence to allow for reforms to be made and pushed in the field of medical education.

2. Search and Selection committee should be composed of at least two members from medical background instead of bureaucrats nominated by the government. The committee must also ensure that at the time of selection of Chairperson, Presidents of Boards and members for the NMC, at least 75% representation should be provided to the healthcare fraternity out of which 50% of the representatives should be from the field of medicine.

Allowing representation to the medical community and professionals from allied health fields will lead to greater acceptance of these bodies as well as give platform to address the important issues being faced by various sectors within the healthcare community.

11. Terms of Chairperson and Members of the Commission and President of the Board (3) Chairman, parttime Members, and the Presidents of the Boards, will be eligible for reappointment for another term of 4 years, provided the aggregate term does not exceed 8 years.

The bill does not provide details on the terms and conditions of the reappointment process. A structured appraisal process should be laid down for re-appointments which must take into account the following aside from the qualifications and contributions of individual members: -re-appointment is in line with the skills and experience required in fulfilling the strategic aims and goals of the commission -Members’ intention regarding seeking re-appointment and their commitment for the length of a future term -360 degree feedback drawn from fellow members

While re-appointments should be considered to ensure a degree of continuity and tap into the experience built in the previous term, it is necessary to introduce control mechanisms like members’ appraisal to provide for a merit based selection over favoritism.

12. Terms and Conditions of service of Chairperson, Boards President & Members (4), (5) Chairperson, President of Boards and Members to accept employment in central or state govt. bodies and private medical institutions (whose matter has been dealt with by such a Chairperson/Preside nt/Member)

It is imperative that a register of members’ interest be maintained listing the organizations they are associated with and various roles and designations held under these organizations. The Chairperson, Presidents of Boards and Members must be required to furnish this information periodically and submit it to the govt. Such a document must also be placed on the NMC website for disclosure to the public..

Members need to be impartial in their decision making and take steps to avoid any conflict of interest arising as a result of their membership or association with other organizations or companies. In line with this ethos, GMC, an independent regulatory body for medical profession in the UK, publishes a register of members’ interest on its website listing their associations and memberships held with various organizations in the country

14. Power and functions of NMC 7. Prescribe norms for determination of the fee for upto 40% seats in private medical education institutes

1. Members from the private medical colleges proposed the formation of a body representative of private institutions to determine and regulate the fee structure for private medical colleges (to be substantiated by evidence of financial resources employed in the construction and operation of private colleges).

Need to control exorbitant fees charged by private medical colleges by employing a bottoms-up approach to determine the fee structure based on fixed and operational costs. Private medical colleges in the US (Harvard, Stanford etc.) independently determine their fee structure and students opt for them based on the quality of education and reputation of the institution.

2. NMC should work to create a cross subsidy model for funding education for reserved seats in private colleges.

Most private institutions do not receive subsidy from the government in contrast to government institutions and hence the need for subsidizing the education for reserved seats.

3. NMC should also bring under its purview non- medical degree holders, who propagate medical quackery, to regulate the treatment being provided without training in allopathic medicine.

Affects a large section of the population who cannot afford medical treatment along with dangers of antibiotic resistance, etc.

Chapter 4: National Examination

Reform proposed in the Bill

Expert recommendation(s)

Rationale behind recommendation(s)

16. Uniform NEET (National Eligibility-cumEntrance Test)

1. Separate Board to be constituted to conduct NEET. Should have representation from all the educational boards and they should have equal say and voice while setting up the examination papers. CBSE Board should be delinked from NEET and the syllabus for standard XII should be made uniform across the country as a pre-requisite for conducting a uniform entrance test.

Students from other boards should be given a fair chance to perform in the eligibility tests based on their curricula and medium of education including vernacular languages as CBSE/English medium schools are restricted only to tier 1 & 2 cities.

2. Entrance examinations should also assess students on their cognitive skills and mental aptitude along with technical assessment as done in advanced medical education systems in the US, UK etc.

Imperative to assess students on their aptitude along with the inclination and professional behavior required to be successful in the medical profession.

17. National Licentiate Examination

Such an exam should be only be conducted for students graduating in foreign countries like Russia, China etc. and wanting to practice in India. Apart from providing the license to registration, renewal of medical licenses should also be implemented with a robust CME programme. A time period for renewal should be defined and examination for the same should be made voluntary for practicing doctors

A national licentiate exam would bring students with foreign medical degrees at par with Indian medical education system. Moreover, there is a continuous need for updating medical knowledge based on advancements in the field of medicine for practicing physicians. Hence, along with an exit exam emphasis needs to be laid on the renewal of medical licenses based on CME credits.

Chapter 5: Under-graduate Medical Education Board (UGMEB)

Reform proposed in the Bill

Expert recommendation(s)

Rationale behind recommendation(s)

19. Powers and Function of UGMEB

1. There must be greater emphasis on practical training in the medical education system with inclusion of clinical medicine courses along with basic medicine, in line with the European model of integrated clinical education. In addition, faculty requirements can be easily met in an integrated mode of curriculum delivery by permitting surgeons to teach anatomy and physicians to teach physiology, since their understanding of these basic disciplines is clinically relevant

(a) Improve quality of medical education by focus on practicum than didactic lectures; make students practice -ready to address demand supply gap in availability of doctors (b) Rationalize the faculty requirements in medical institutes in line with availability of teaching staff for these courses.

 

2. Behavioral & communication skills along with bioethics should be introduced as an important part of the curriculum in medical institutions. Medical graduates need to be aware of their roles and responsibilities as not just clinicians but also as professionals who need to exercise care and compassion when interacting with patients.

Importance of professional conduct and medical ethics has become paramount with the changing nature of healthcare delivery. Medical education system in the country has become increasingly commercialized, with the patient being the last focus of attention in the system.

3. The lack of adequate infrastructure also needs to be addressed in order to meet the demand for doctors in the country. It is recommended that existing private hospitals with larger bed occupancies should be allowed to be used for education & training of UG/PG students. In addition, district hospitalsshould be upgraded and converted into medical colleges to provide medical education in local settings and address the skew in demand and supply of healthcare facilities and manpower in these areas. In order to also address the lack of infrastructure, ICT tools, virtual classrooms and e-learning modules should be incorporated in the medical curriculum for theoretical/ basic medicine courses.

Shortage of adequate infrastructure can be addressed by tapping into the existing facilities and patient load without the government having to spend on greenfield projects and incurring huge expenditure. With the advent of Information Technology and Internet, the need for physical infrastructure can be made redundant without compromising on the quality of education delivery.

4. Another problem area that needs to be addressed is the deficiency in teaching faculty. Allowing practicing physicians to teach medical students will help tap into the potential of learned physicians available in the country. There is a huge pool of qualified doctors in both the public and private sector who cannot be utilized for teaching with existence of rigid guidelines and norms. These need to be revisited, in order to meet the demand for faculty in medical institutions alongside upgrading the quality of education delivery. For instance, clinical specialists in ESIC hospitals were brought into the teaching cadre, likewise, CMOs and other qualified doctors in government hospitals with experience in handling patient volumes can be brought on board as teaching faculty.

Shortage of teaching faculty in medical colleges adversely impacts the quality of medical education. Brining in experts from the government and private sector, who are currently held back due to redundant rules and guidelines, can be a major breakthrough in addressing the need for quality of teaching staff available in medical colleges

 

5. In addition to development of medical students as able clinicians and practitioners, the education system should also prepare the doctor as a scientist with emphasis on courses like population health management and social sciences research.

There is an urgent need to overhaul Preventive Social medicine (PSM) and allied courses with changing healthcare disease and demographic profile to address the lack of clinical research in the country.

Chapter 6: Post-graduate Medical Education Board (PGMEB)

Reform proposed in the Bill

Expert recommendation(s)

Rationale behind recommendation(s)

22. Powers and Function of PGMEB

1. Seats in post graduate courses should be allotted based on manpower required for various specialties in the state. Needs assessment should be conducted for obtaining actual figures of manpower required on ground and seats for post-graduation specializations should be awarded accordingly.

GMC and HEE in the UK decide specialization seats based on manpower needs assessment in the country. Likewise, National Resident Match Program (NRMP) in the US is specifically designed for matching candidate’s specialization and with the university’s requirement.

2. Robust Family medicine program should be introduced in post graduate specialization, which combines a broad set of clinical competencies, at all medical institutions to introduce family physicians as first Point of Contact for patients and encounter most medical problems at the primary level.

Aid in addressing the demand supply gap in rural areas by providing more family physicians apart from ensuring continuous healthcare for individuals. This will also minimize the need of frequent referrals to specialists.

Reform proposed in the Bill

Expert recommendation(s)

Rationale behind recommendation(s)

22. Powers and Function of PGMEB

1. Seats in post graduate courses should be allotted based on manpower required for various specialties in the state. Needs assessment should be conducted for obtaining actual figures of manpower required on ground and seats for post-graduation specializations should be awarded accordingly.

GMC and HEE in the UK decide specialization seats based on manpower needs assessment in the country. Likewise, National Resident Match Program (NRMP) in the US is specifically designed for matching candidate’s specialization and with the university’s requirement.

2. Robust Family medicine program should be introduced in post graduate specialization, which combines a broad set of clinical competencies, at all medical institutions to introduce family physicians as first Point of Contact for patients and encounter most medical problems at the primary level.

Aid in addressing the demand supply gap in rural areas by providing more family physicians apart from ensuring continuous healthcare for individuals. This will also minimize the need of frequent referrals to specialists.

Reform proposed in the Bill

Expert recommendation(s)

Rationale behind recommendation(s)

22. Powers and Function of PGMEB

1. Seats in post graduate courses should be allotted based on manpower required for various specialties in the state. Needs assessment should be conducted for obtaining actual figures of manpower required on ground and seats for post-graduation specializations should be awarded accordingly.

GMC and HEE in the UK decide specialization seats based on manpower needs assessment in the country. Likewise, National Resident Match Program (NRMP) in the US is specifically designed for matching candidate’s specialization and with the university’s requirement.

2. Robust Family medicine program should be introduced in post graduate specialization, which combines a broad set of clinical competencies, at all medical institutions to introduce family physicians as first Point of Contact for patients and encounter most medical problems at the primary level.

Aid in addressing the demand supply gap in rural areas by providing more family physicians apart from ensuring continuous healthcare for individuals. This will also minimize the need of frequent referrals to specialists.

Chapter 6: Post-graduate Medical Education Board (PGMEB)

Chapter 6: Post-graduate Medical Education Board (PGMEB)

Chapter 7: Medical Assessment and Rating Board (MARB)

Reform proposed in the Bill

Expert recommendation(s)

Rationale behind recommendation(s)

25. Powers and Function of MARB

1. Provision should be made for medical audits- Inspection, Peer review, Re-examination and Ethical conduct, in medical education institutions to assess the clinical indicators and infrastructural parameters. Existing quality standards and regulatory bodies which already have guidance and bandwidth in terms of assessors can be utilized for inspection of medical education institutions on infrastructure related parameters while the MARB can focus on quality of medical education.

Need for assessing clinical and infrastructure related indicators on already accepted guidelines such as NABH, would assist in raising quality of infrastructure available in medical institutions and aid in improving medical education and training

2. Requirement of faculty in each department to be assessed and incremented and greater percentage of absence of faculty should be accepted by the assessors provided their regular pay slips and appointment orders and joining reports are available as proofs by the institution.

Since only 5% absence is accepted during inspections, private medical colleges do not permit their faculty to take leave during most of the year. So all leaves- be it CL, EL or ML go waste and there is gross dissatisfaction among the faculty

3. MARB must ensure fair and transparent selection of assessors based on their professional integrity and excellence with minimum experience of 10 years as a professor in govt./ private institution.

In the prevailing system of MCI, only govt. faculty is given opportunity for assessment of institution while in DCI and other Councils, faculty of private institutions are also appointed as assessors.

4. There should be a provision of self-declaration for medical education institutions to provide for ancillary facilities within a definite timeline instead of cancellation of licenses. Strict guidelines must be laid down to prevent any misuse of any leeway provided by the government.

In the past, MCI has been very rigid in assessment of infrastructure of medical educational institutions and withdrawn licenses for reasons that do not directly affect delivery of medical education, let alone its quality.

27. Permission for establishment of a New Medical College

1. Public private partnerships to be encouraged for providing infrastructure in rural and semiurban areas to meet the growing demand for doctors in these regions.

PPP model to encourage cost sharing with the private sector and reduce burden on the govt./ taxpayer along with providing medical education to students in their native cities.

2. There is an urgent need to revisit the Minimum Standard Regulation (MSR) in terms of physical and infrastructure requirements, for instance, the current physical area requirement of 22 acres for setting up a private college only increase the capital costs by several notches without any direct impact on the quality of medical education. Likewise, mandated requirements of ancillary facilities like auditoriums, libraries and medical labs only drives up the cost of establishment and renders no value to delivery of education. FAR norms for setting up medical colleges should be revised to allow for greater vertical expansion. At the same time, rigid guidelines for faculty requirements in terms of the qualifications and experience of professors and asst. professors should be revised to tap into the pool of experienced and reputed clinicians in the country who can be brought on board as full/part time faculty.

Land being an expensive commodity, the initial investment for setting up medical colleges is quite high with the current set of norms. These would be a deterrent for the government along with the private sector in setting up more medical colleges. Rationalizing MSR would allow medical institutions to optimally utilize their resources and focus on quality of medical education than meeting infrastructure requirements

3. Provision for facilities like housing, education etc. and incentives to medical graduates for serving in rural and remote areas

Encourage doctors to serve in such areas where there is an actual shortage of medical personnel.

Chapter 8: Board for Medical Registration (BMR)

Reform proposed in the Bill

Expert recommendation(s)

Rationale behind recommendation(s)

29. Powers and Function of BMR

1. Register should also include: • Recent photograph of the doctor
• Scanned copy of their qualification certificates
• Research publications details, if available
• CME credit points accumulated on regular basis

Comprehensive and exhaustive profiles assures validity of the data shared in public domain

Annexure

Some voices from the Voice of Healthcare Community

“To begin with, medical teaching should be replaced by training. Also, practicing doctors in
specialties such as general surgery should train under-graduate students in basic medicine
disciplines (such as anatomy and physiology) to bring about practical integrated learning”
– Dr. Anand Prakash, Medical Director, Tirathram Hospital, and Ex-Director and Prof. of Surgery,
Maulana Azad Medical College

 

“Standards of medical education and training have steadily declined in the country with paucity of adequate personnel in rural areas. The deficit in availability of doctors can be addressed by educating youngsters in their native towns which would help in retaining them in these areas when they graduate as doctors.”

 -Dr. Prof. M. Wali, Physician to the President of India

There is some trust deficit somewhere. There still seems to be some question mark about how much profit is being made by the private players. Some concrete steps need to be taken to convince Government – may be data sharing, balance sheet whatever. People have done it earlier as well. Something which can balance trust upon each other for PPP model to work.

-Anjan Bose, Founder secretary general, Healthcare Federation of India

“Existing quality guidelines (such as NABH) should be dovetailed to medical institutions to ensure they meet basic infrastructure and clinical standards laid down by the inspection bodies”

-Dr. D.P. Saraswat, Medical Director, Jaipur Golden Hospital

“There is a need for correcting the urban-rural imbalance in medical education; however, it should not be at the cost of quality in UG and PG training”

 – Dr. Prof. V.H. Talib (Ex. Prof. and HoD, Pathology, Vardhman Mahaveer Medical College

 “Faculty at medical colleges is not able to avail leaves due to regular inspections by the MCI and hence there is a lot of dissatisfaction among the teaching community. MCI must consider proofs of employment such as appointment letters, pay slips, leave approvals etc. and repeated inspections for faculty must be avoided to prevent unnecessary harassment.”

-Dr. (Mrs.) Sarla Hooda, Former Senior Professor & Head, PGIMS, Rohtak

 “Politicians and bureaucrats should not be allowed in the NMC. No politician will be able to guide/understand the rigorous education system needed to become a doctor. Since private medical colleges form ~50% of all the medical colleges in the country, their representation should be there in the committees.”

-Dr. Manisha Jindal, Associate Dean and Prof. of Physiology, Sharda University

 “During inspection of the colleges by the team from MCI, too much emphasis is given on noncore areas and infrastructural issues verified many times by MCI assessors”

 – Prof. (Dr.) Chaman Ram Verma, Medical Superintendent, NMIMS Jaipur

“Corporate sector brings in control mechanisms for regulating medical ethics and instances of medical negligence. The National Medical Commission Bill, 2016 should be working backwards on ethical practices, to ensure last mile healthcare delivery”

 -Vivek Seigell, Director, PHD Chamber of Commerce & Industry

“There is an urgent need to revisit the Minimum Standard Regulation (MSR) to provide for vertical expansion instead of focusing on physical area for setting up of medical college.”

 -Dr. R. N. Singh, Director, Arogyam Nursing College