The National Medical Commission Bill, 2017 was introduced in Lok Sabha recently and is listed for consideration and passage today. The Bill seeks to regulate medical education and practice in India. To meet this objective, the Bill repeals the Indian Medical Council Act, 1956 and dissolves the current Medical Council of India (MCI). The MCI was established under the 1956 Act, to establish uniform standards of higher education qualifications in medicine and regulating its practice.
A Committee was set up in 2016, under the NITI Aayog with Dr. Arvind Panagariya as its chair, to review the 1956 Act and recommend changes to improve medical education and the quality of doctors in India. The Committee proposed that the Act be replaced by a new law, and also proposed a draft Bill in August 2016.
This post looks at the key provisions of the National Medical Commission Bill, 2017 introduced in Lok Sabha recently, and some issues which have been raised over the years regarding the regulation of medical education and practice in the country.
What are the key issues regarding the regulation of medical education and practice?
Several experts have examined the functioning of the MCI and suggested a different structure and governance system for its regulatory powers.3, Some of the issues raised by them include:
Separation of regulatory powers
Over the years, the MCI has been criticised for its slow and unwieldy functioning owing to the concentration and centralisation of all regulatory functions in one single body. This is because the Council regulates medical education as well as medical practice. In this context, there have been recommendations that all professional councils like the MCI, should be divested of their academic functions, which should be subsumed under an apex body for higher education to be called the National Commission for Higher Education and Research. This way there would be a separation between the regulation of medical education from regulation of medical practice.
An Expert Committee led by Prof. Ranjit Roy Chaudhury (2015), recommended structurally reconfiguring the MCI’s functions and suggested the formation of a National Medical Commission through a new Act.3 Here, the National Medical Commission would be an umbrella body for supervision of medical education and oversight of medial practice. It will have four segregated verticals under it to look at: (i) under-graduate medical education, (ii) post-graduate medical education, (iii) accreditation of medical institutions, and (iv) the registration of doctors. The 2017 Bill also creates four separate autonomous bodies for similar functions.
Composition of MCI
With most members of the MCI being elected, the NITI Aayog Committee (2016) noted the conflict of interest where the regulated elect the regulators, preventing the entry of skilled professionals for the job. The Committee recommended that a framework must be set up under which regulators are appointed through an independent selection process instead.
The NITI Aayog Committee (2016) recommended that a medical regulatory authority, such as the MCI, should not engage in fee regulation of private colleges. Such regulation of fee by regulatory authorities may encourage an underground economy for medical education seats with capitation fees (any payment in excess of the regular fee), in regulated private colleges. Further, the Committee stated that having a fee cap may discourage the entry of private colleges limiting the expansion of medical education in the country.
The Standing Committee on Health (2016) observed that the present focus of the MCI is only on licensing of medical colleges.4 There is no emphasis given to the enforcement of medical ethics in education and on instances of corruption noted within the MCI. In light of this, the Committee recommended that the areas of medical education and medical practice should be separated in terms of enforcement of the appropriate ethics for each of these stages.
What does the National Medical Commission, 2017 Bill seek do to?
The 2017 Bill sets up the National Medical Commission (NMC) as an umbrella regulatory body with certain other bodies under it. The NMC will subsume the MCI and will regulate the medical education and practice in India. Under the Bill, states will establish their respective State Medical Councils within three years. These Councils will have a role similar to the NMC, at the state level.
Functions of the NMC include: (i) laying down policies for regulating medical institutions and medical professionals, (ii) assessing the requirements of human resources and infrastructure in healthcare, (iii) ensuring compliance by the State Medical Councils with the regulations made under the Bill, and (iv) framing guidelines for determination of fee for up to 40% of the seats in the private medical institutions and deemed universities which are governed by the Bill.
Who will be a part of the NMC?
The NMC will consist of 25 members, appointed by the central government. It will include representatives from Indian Council of Medical Research, and Directorate General of Health Services. A search committee will recommend names to the central government for the post of Chairperson, and the part-time members. These posts will have a maximum term of four years, and will not be eligible for extension or reappointment.
What are the regulatory bodies being set up under the NMC?
The Bill sets up four autonomous boards under the supervision of the NMC, as recommended by various experts. Each autonomous board will consist of a President and two members, appointed by the central government (on the recommendation of the search committee). These bodies are:
What does the Bill say regarding the conduct of medical entrance examinations?
There will be a uniform National Eligibility-cum-Entrance Test (NEET) for admission to under-graduate medical education in all medical institutions governed by the Bill. The NMC will specify the manner of conducting common counselling for admission in all such medical institutions.
Further, there will be a National Licentiate Examination for the students graduating from medical institutions to obtain the license for practice. This Examination will also serve as the basis for admission into post-graduate courses at medical institutions.
 The National Medical Commission Bill, 2017, http://www.prsindia.org/uploads/media/medical%20commission/National%20Medical%20Commission%20Bill,%202017.pdf.
 Indian Medical Council Act, 1933.
 A Preliminary Report of the Committee on the Reform of the Indian Medical Council Act, 1956, NITI Aayog, August 7, 2016, http://niti.gov.in/writereaddata/files/document_publication/MCI%20Report%20.pdf.
 “Report no. 92: Functioning of the Medical Council of India”, Standing Committee on Health and Family Welfare, March 8, 2016, http://188.8.131.52/newcommittee/reports/EnglishCommittees/Committee%20on%20Health%20and%20Family%20Welfare/92.pdf
 “Report of the Committee to Advise on Renovation and Rejuvenation of Higher Education”, Ministry of Human Resource Development, 2009, http://mhrd.gov.in/sites/upload_files/mhrd/files/document-reports/YPC-Report.pdf.
Yesterday, the Governor of Karnataka promulgated the Karnataka Protection of Right to Freedom of Religion Ordinance, 2022. The Ordinance prohibits forced religious conversions. A Bill with the same provisions as the Ordinance was passed by the Karnataka Legislative Assembly in December 2021. The Bill was pending introduction in the Legislative Council.
In the recent past, Haryana (2022), Madhya Pradesh (2021), and Uttar Pradesh (2021) have passed laws regulating religious conversions. In this blog post, we discuss the key provisions of the Karnataka Ordinance and compare it with existing laws in other states (Table 2).
What religious conversions does the Karnataka Ordinance prohibit?
The Ordinance prohibits forced religious conversions through misrepresentation, coercion, allurement, fraud, or the promise of marriage. Any person who converts another person unlawfully will be penalised, and all offences will be cognizable and non-bailable. Penalties for attempting to forcibly convert someone are highlighted in Table 1. If an institution (such as an orphanage, old age home, or NGO) violates the provisions of the Ordinance, the persons in charge of the institution will be punished as per the provisions in Table 1.
Table 1: Penalties for forced conversion
Fine (in Rs)
Any person through specified means
Minor, woman, SC/ST, or a person of unsound mind
Two or more persons (Mass conversion)
Sources: Karnataka Protection of Right to Freedom of Religion Ordinance, 2022; PRS.
Re-converting to one’s immediate previous religion will not be considered a conversion under the Ordinance. Further, any marriage done for the sole purpose of an unlawful conversion will be prohibited, unless the procedure for religious conversion is followed.
How may one convert their religion?
As per the Ordinance, a person intending to convert their religion is required to send a declaration to the District Magistrate (DM), before and after a conversion ceremony takes place. The pre-conversion declaration must be submitted by both parties (the person converting their religion, and the religious converter), at least 30 days in advance. The Ordinance prescribes penalties for both parties for failing to follow procedure.
After receiving the pre-conversion declarations, the DM will notify the proposed religious conversion in public, and invite objections to the proposed conversion for a period of 30 days. Once a public objection is recorded, the DM will order an enquiry to prove the cause, purpose, and genuine intent of the conversion. If the enquiry finds that an offence has been committed, the DM may initiate criminal action against the convertor. A similar procedure is specified for a post-conversion declaration (by the converted person).
Note that among other states, only Uttar Pradesh requires a post-conversion declaration and a pre-conversion declaration.
After the religious conversion has taken place, the converted person must submit a post-conversion declaration to the DM, within 30 days of the conversion. Further, the converted person must also appear before the DM to confirm their identity and the contents of the declaration. If no complaints are received during this time, the DM will notify the conversion, and inform concerned authorities (employer, officials of various government departments, local government bodies, and heads of educational institutions).
Who may file a complaint?
Similar to laws in other states, any person who has been unlawfully converted, or a person associated to them by blood, marriage, or adoption may file a complaint against an unlawful conversion. Laws in Haryana and Madhya Pradesh allow certain people (those related by blood, adoption, custodianship, or marriage) to file complaints, after seeking permission from the Court. Note that the Karnataka Ordinance allows colleagues (or any associated person) to file a complaint against an unlawful conversion.
*In Chirag Singhvi v. State of Rajasthan, the Rajasthan High Court framed guidelines to regulate religious conversions in the state.