Draft Guidelines by National Medical Commission (NMC)

In News

• Recently, the National Medical Commission (NMC) has released draft guidelines for the national register of doctors after the licentiate exam.

About

• The draft guidelines are on how the doctors will be registered in order to practice medicine.
• At present, Indian students do not have to sit for a licentiate exam after MBBS to get registered in their respective state medical councils. 
• However, foreign medical graduates have to pass the screening test conducted by National Board Examinations in Medical Sciences to be registered.

Guidelines 

• Three draft regulations:
  • License to Practice Medicine, 2022; 
  • Registration of Additional Qualifications, 2022; and 
  • Temporary Registration of Foreign Medical Practitioners to Practice Medicine in India.
• Working: 
  • The guidelines provide a framework for creating a dynamic national medical register.
  • It will have a unique ID assigned to each student who qualifies NEET, with professional qualifications such as post-graduation and super-speciality training being added to the same ID.
• Open to foreigners: 
  • The registration is open for foreign doctors who want to come to India to study in post-graduation courses, fellowships, clinical research, or voluntary clinical services. 
• Change in Permission: 
  • Until now foreign experts were being granted “permission” by the Health Ministry. 
  • Now, the NMC will grant a temporary registration to such doctors that will end with the duration of the programme. 
    • The maximum duration of such a temporary registration will be 12 months.
• Registration Process:
  • Indian: Indian medical graduates would be eligible for registration in the National Medical Register after:
    • Completion of MBBS degree from a recognised college, 
    • Completion of year-long mandatory internship, and 
    • Pass the National Exit Test (NExT). 
  • Foreign: Foreign medical graduates can be registered after:
    • Completed education in a country other than India, 
    • Are registerable as doctors in the said country, 
    • Have completed a year-long internship in India, and 
    • Have passed the NExT exam.
• A new portal for all documents:
  • At present, every state maintains its own medical register, which is then sent to NMC for a consolidated country-wide register.
  • After a unique ID is created, a portal will be thrown open to all recognised institutes in India who can upload all verified documents of their students to it. 

National Exit Test(NExT) Exam

• NExT was introduced in the NMC Bill in 2019 with the objective of replacing PG-NEET.
• Purposes. 
  • It will act as a passing examination for the final MBBS examination. 
  • It will act as a qualifying examination to grant the license to practice modern medicine in India for Indian as well as foreign medical graduates. 
  • It will serve as a competitive test that will form the basis for admission to the postgraduate (PG) broad-speciality courses in the medical institutions of India.
• Primary Intent:
  • To ensure uniformity in the level of training in MBBS course (more so in private medical colleges), 
  • Quality control for medical graduates from foreign medical colleges intending to practise in India, and 
  • Abolishing the need to take multiple entrance examinations and/or multiple counselling processes for admission in PG courses.
• Written + practical exam: 
  • It will not be a theory paper, like MBBS finals or NEET PG test. Instead, It will be held in two parts – one written and one practical exam where the students will be judged on their clinical acumen.

Significance

• Level playing field:
  • The new entrance test for Post Graduation, NExT, will level the playing field for both Indian and foreign nationals. 
• One portal: 
  • This will make the registration process easier.
• Register based on real time: 
  • Since the register will keep getting updates as and when the doctors pursue specialisations or any other courses, it can be shared with various authorities to check the qualifications of people they wish to hire.
• Open registration to foreign doctors: 
  • The guidelines open the registration to foreign doctors who want to come to India to study in post-graduation courses, fellowships, clinical research, or voluntary clinical services.

Challenges 

• Discriminatory: 
  • Foreign Medical Graduate Regulations, 2021 on the face of it treats foreign medical graduates in an unfair and discriminatory manner.
• Retrospective implementation:
  • The draft Regulations are to be made applicable to even those who are as of now pursuing foreign medical education. 
  • Thus, a person who has studied in Japan or China or Russia in the language of that country would not be entitled to sit in NEXT according to the new prescription. 
• International relations can be affected:
  • The requirement of obtaining education in English medium only gives an undue advantage to institutions in English-speaking countries. 
  • Such a prescription has the potential of causing diplomatic wrangles with these countries. 
  • Also, it restricts the choices available to prospective admission seekers.
• Brain drain:
  • Given the proposed stringent entry requirements, these Indian students might consider opting for other options like USMLE or staying back in the country of their education. 
  • Thus, the brain that was required to “rain” back in the nation may turn into a brain drain. 

Way Ahead

• It would be appropriate that the NMC re-examines the proposed enactment after taking in views and concerns of all stakeholders before further proceeding with the legislative process.
• The NMC must find a balanced way forward for constructively utilizing the skills and expertise of 100,000 foreign medical graduates urgently to augment the human resources in healthcare.

Source: IE