National Medical Commission Act, 2019: Objectives, Provisions, Powers and Functions
Key Takeaways
- The National Medical Commission Act, 2019 is the principal Central legislation governing medical education, medical institutions, registration of medical practitioners and professional standards in modern scientific medicine in India.
- The Act established the National Medical Commission (NMC) and replaced the earlier regulatory framework of the Medical Council of India under the Indian Medical Council Act, 1956. The NMC became operational as the new regulatory body on 25 September 2020.
- The Act creates four Autonomous Boards dealing separately with undergraduate medical education, postgraduate medical education, assessment and rating of medical institutions, and ethics and medical registration.
- The NMC has important powers relating to medical education standards, regulation of medical institutions and professionals, professional ethics, healthcare workforce planning and guidelines for fees in respect of 50% of seats in specified private medical institutions and deemed universities.
- The Act provides statutory frameworks for NEET, the National Exit Test (NExT), the National Medical Register, licensing of medical practitioners and recognition of medical qualifications.
- State Medical Councils continue to play an important role in registration and disciplinary matters, while the Ethics and Medical Registration Board performs coordinating and appellate functions under the Act.
- The Act is not limited to medical colleges. Its framework extends to medical professionals, ethical conduct, registration, medical qualifications, institutional standards and grievance redressal.
What Is the National Medical Commission Act, 2019?
The National Medical Commission Act, 2019 is a Central legislation enacted to regulate medical education and the medical profession in India. It was enacted as Act No. 30 of 2019 on 8 August 2019 and extends to the whole of India. Different provisions of the Act were brought into force on different dates.
The legislation introduced a new institutional framework for regulating medical education and medical professionals. Its central body is the National Medical Commission, established under Section 3.
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The Act seeks to create a medical education system that improves access to quality and affordable medical education, ensures the availability of adequate and high-quality medical professionals, promotes equitable and universal healthcare, encourages medical research and provides for transparent assessment of medical institutions.
It also seeks to maintain a medical register for India, enforce high ethical standards in medical services and establish an effective grievance redressal mechanism.
The NMC Act is therefore an important part of the broader framework of medical laws in India.
Why Was the National Medical Commission Act, 2019 Enacted?
The NMC Act reorganised the regulatory structure governing medical education and the medical profession in India.
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Before this framework became operational, the Medical Council of India (MCI) functioned principally under the Indian Medical Council Act, 1956. Section 60 of the NMC Act provides for repeal of the 1956 Act and dissolution of the Medical Council of India from the date appointed by the Central Government.
The new framework distributes important regulatory functions among the National Medical Commission and four specialised Autonomous Boards instead of concentrating them within a single regulatory institution.
The statutory objectives include:
- Improving medical education: The Act seeks to maintain high standards of undergraduate and postgraduate medical education throughout India.
- Improving access: One of its objectives is to increase access to quality and affordable medical education.
- Ensuring availability of doctors: The regulatory system is intended to support the availability of adequate and high-quality medical professionals across the country.
- Regulating medical institutions: Medical colleges and other institutions falling within the Act are subject to prescribed standards, assessment and regulatory supervision.
- Promoting professional standards: The Act places considerable importance on professional ethics and responsible conduct by medical practitioners.
- Maintaining medical registers: It provides for a National Medical Register together with State Medical Registers.
- Providing grievance redressal: The Act creates appellate and regulatory mechanisms in relation to professional and institutional decisions.
The framework therefore combines medical education regulation with professional regulation and institutional accountability.
What Is the National Medical Commission?
The National Medical Commission, commonly called the NMC, is the statutory body constituted under Section 3 of the National Medical Commission Act, 2019.
It functions as the central regulatory institution within the system established by the Act. The NMC operates under the Union Ministry of Health and Family Welfare and exercises powers relating to medical education, institutions, medical professionals and the functioning of its Autonomous Boards.
The Commission consists of a Chairperson, ex officio Members and part-time Members in accordance with the composition prescribed under Section 4.
The Act also contains provisions concerning the appointment, tenure and removal of the Chairperson and Members, appointment of the Secretary and staff, and conduct of meetings.
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The significance of the Commission lies in the fact that the regulation of medical education, institutional quality, registration and professional ethics is brought within an interconnected statutory system.
What Are the Powers and Functions of the National Medical Commission?
Section 10 contains the principal powers and functions of the National Medical Commission.
The NMC is required to lay down policies for maintaining high quality and standards in medical education. It may also make regulations for carrying out the purposes of the Act.
Regulation of Medical Institutions and Professionals
The Commission lays down policies concerning medical institutions, medical research and medical professionals.
Its regulatory jurisdiction therefore extends beyond medical education alone and forms part of the wider statutory regulation of the medical profession.
Medical practitioners are subject not only to educational and registration requirements but also to professional obligations. The wider duties of a medical professional or doctor include obligations connected with competent treatment, confidentiality, medical records, professional conduct and responsible medical practice.
Healthcare Workforce Planning
The Commission can assess requirements relating to healthcare, including human resources and healthcare infrastructure, and develop a roadmap for addressing those requirements.
This function connects medical education policy with the wider requirement for trained medical professionals in different parts of India.
Coordination between Regulatory Bodies
The NMC coordinates the functioning of its Autonomous Boards and frames guidelines for their proper functioning.
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It also takes measures to ensure that State Medical Councils comply with guidelines and regulations made under the Act.
Regulation of Professional Ethics
Section 10 expressly authorises the Commission to lay down policies and codes for observance of professional ethics in the medical profession and promotion of ethical conduct while medical practitioners provide care.
Professional ethics therefore forms part of the statutory regulatory responsibilities of the Commission.
Breaches of professional duties may lead to disciplinary proceedings before the appropriate medical regulatory authority. The process of complaining against a medical professional is distinct from a civil claim for compensation or criminal prosecution.
Regulation of Fees
An important power under Section 10 is the authority to frame guidelines for determining fees and other charges in respect of 50% of seats in private medical institutions and deemed-to-be universities governed by the Act.
The provision should not be understood as allowing the NMC to fix the fees for every seat in every private medical college. The statutory power specifically concerns the category of seats mentioned under Section 10.
What Are the Four Autonomous Boards under the NMC Act?
Section 16 provides for four specialised Autonomous Boards functioning under the overall supervision of the National Medical Commission.
They are:
- Under-Graduate Medical Education Board (UGMEB)
- Post-Graduate Medical Education Board (PGMEB)
- Medical Assessment and Rating Board (MARB)
- Ethics and Medical Registration Board (EMRB)
The division is important because each Board performs a specialised regulatory role.
Under-Graduate Medical Education Board
The UGMEB regulates undergraduate medical education.
Under Section 24, its functions include determining standards of undergraduate medical education, developing competency-based curricula and prescribing minimum standards for courses and examinations.
It also lays down norms relating to infrastructure, faculty and quality of education and deals with recognition of medical qualifications at the undergraduate level in accordance with the Act.
Post-Graduate Medical Education Board
The PGMEB performs corresponding functions for postgraduate and super-speciality medical education.
Its responsibilities include:
- determining educational standards;
- developing competency-based curricula;
- prescribing minimum requirements for courses and examinations;
- fixing standards relating to infrastructure and faculty;
- facilitating research and faculty development; and
- dealing with recognition of postgraduate and super-speciality medical qualifications.
Section 25 also refers to the promotion and facilitation of postgraduate courses in family medicine.
Medical Assessment and Rating Board
The Medical Assessment and Rating Board (MARB) is primarily responsible for assessment and rating of medical institutions.
Under Section 26, it determines procedures for assessing whether medical institutions comply with standards prescribed under the Act.
Its functions also include matters relating to permission for:
- establishment of a new medical institution;
- commencement of postgraduate courses; and
- increase in the number of seats.
MARB can inspect medical institutions, publish assessment and rating information and take regulatory measures where institutions fail to maintain prescribed standards.
Ethics and Medical Registration Board
The Ethics and Medical Registration Board (EMRB) plays a central role in professional regulation.
Under Section 27, the EMRB maintains the National Register of licensed medical practitioners, regulates professional conduct, promotes medical ethics and coordinates with State Medical Councils.
It also exercises appellate functions in specified matters arising from decisions of State Medical Councils.
What Is the Medical Advisory Council?
Sections 11 to 13 deal with the Medical Advisory Council.
The Council provides a platform through which States and Union Territories can communicate their concerns and views to the National Medical Commission.
Its role is primarily advisory. It advises the Commission regarding measures for determining and maintaining minimum standards of medical education, training and research and contributes to the development of medical education policy.
The Council therefore creates a link between the national regulatory structure and State-level interests in medical education.
What Does the NMC Act Say about NEET?
Section 14 gives statutory recognition to the National Eligibility-cum-Entrance Test (NEET).
A uniform NEET is to be conducted for admission to undergraduate medical education in medical institutions governed by the Act.
The provision is significant because it establishes a common statutory entrance mechanism for admission to covered medical institutions rather than permitting entirely separate admission standards.
The Act also provides for common counselling for admission in accordance with the statutory and regulatory framework.
What Is the National Exit Test under the NMC Act?
Section 15 provides for a common final-year undergraduate medical examination known as the National Exit Test or NExT.
Under the statutory design, NExT is intended to serve multiple purposes. It is connected with the grant of a licence to practise medicine, enrolment in the medical register and admission to postgraduate broad-speciality medical education.
The Act also links the examination framework applicable to certain foreign medical graduates with NExT once the statutory system becomes operational.
However, the existence of Section 15 should be distinguished from the actual operational implementation of NExT. Examination requirements depend on the regulations, notifications and implementation measures issued under the Act from time to time.
What Is the National Medical Register?
Section 31 requires the Ethics and Medical Registration Board to maintain a National Register of licensed medical practitioners.
The Register contains prescribed information concerning registered medical practitioners, including their recognised medical qualifications and other particulars required under the statutory framework.
The Act requires the National Register to be maintained electronically and made available in the manner prescribed.
State Medical Councils also maintain their respective State Registers. The statutory framework provides for coordination between these registers so that information relating to registered medical practitioners can remain updated.
Registration has significance beyond professional regulation. For example, the Bharatiya Nyaya Sanhita identifies a registered medical practitioner with reference to recognised qualifications and registration under the NMC Act while dealing with medical negligence under the Bharatiya Nyaya Sanhita.
Who Can Obtain a Licence to Practise Medicine under the Act?
Section 33 connects licensing with the statutory examination and registration framework.
Under the design of the Act, a person who fulfils the applicable statutory conditions becomes eligible for a licence to practise medicine and enrolment in the National Register or a State Register.
The Act also protects practitioners who had already been registered in the Indian Medical Register under the Indian Medical Council Act, 1956 before the relevant new framework became operational.
Such practitioners are treated in accordance with the transitional provisions of the NMC Act rather than being required to establish their professional status afresh merely because the governing legislation changed.
The concept of a registered medical practitioner is also important in criminal law. Section 106 of the Bharatiya Nyaya Sanhita specifically refers to doctors whose qualifications are recognised under the NMC Act and whose names are entered in a relevant medical register. The circumstances in which a doctor can face imprisonment for medical negligence therefore also intersect with the registration system created under the NMC Act.
How Does the Act Regulate Medical Colleges?
The establishment and expansion of medical institutions is regulated primarily through the Medical Assessment and Rating Board.
Section 28 provides a statutory approval mechanism for establishing a new medical college, starting postgraduate courses or increasing the number of seats.
An application or scheme must be submitted in the prescribed manner. MARB considers the proposal in light of the statutory requirements and applicable standards.
The regulatory framework is intended to ensure that medical institutions satisfy requirements concerning infrastructure, faculty, teaching standards and other prescribed conditions before undertaking specified activities.
The Act also provides mechanisms for dealing with deficiencies and appeals against certain regulatory decisions.
How Are Medical Ethics and Professional Misconduct Regulated?
Medical ethics is one of the central elements of the NMC Act.
The Ethics and Medical Registration Board regulates professional conduct and promotes medical ethics, while State Medical Councils continue to exercise disciplinary powers in accordance with the applicable legal framework.
Section 30 requires State Medical Councils exercising disciplinary jurisdiction to act in accordance with regulations and guidelines under the NMC Act. Before adverse action is taken, the medical practitioner concerned must be given an opportunity of hearing.
A medical practitioner aggrieved by specified action of a State Medical Council can approach the EMRB through the statutory appellate mechanism. Further appellate remedies are available within the framework provided by the Act.
Questions relating to professional misconduct must be distinguished from medical negligence. Medical negligence generally concerns failure to exercise the required standard of medical care resulting in harm, while professional disciplinary proceedings examine whether professional or ethical standards have been violated.
Where negligence or professional misconduct is alleged, the choice of forum depends on the remedy sought.
What Is the Role of State Medical Councils under the NMC Act?
State Medical Councils continue to perform an important role under the regulatory system.
They are particularly relevant in matters involving:
- registration of medical practitioners at the State level;
- maintenance of State Medical Registers;
- complaints concerning professional or ethical misconduct;
- disciplinary proceedings against registered medical practitioners; and
- coordination with the Ethics and Medical Registration Board.
For professional misconduct by an individual doctor, the State Medical Council ordinarily functions as an important first regulatory forum rather than every complaint being filed directly before the NMC.
This creates a two-level system in which State Medical Councils handle important registration and disciplinary functions while the NMC and EMRB perform national, coordinating and appellate roles.
What Happens to the Medical Council of India under the NMC Act?
Section 60 deals with repeal and saving.
It provides for the repeal of the Indian Medical Council Act, 1956 and dissolution of the Medical Council of India from the appointed date.
The National Medical Commission became operational on 25 September 2020, marking the institutional transition from the MCI framework to the NMC framework.
However, repeal did not automatically invalidate everything previously done under the earlier law.
Section 60 contains saving provisions protecting previous operations, actions, rights, obligations, liabilities and proceedings where applicable. The statutory transition also maintains continuity in relation to matters such as existing registrations, recognised qualifications and permissions in accordance with the Act.
Importance of the National Medical Commission Act, 2019
The National Medical Commission Act, 2019 brought a major structural change to the regulation of modern medical education and medical professionals in India.
Its importance lies in the creation of a specialised regulatory system in which different bodies deal with education, institutional assessment, registration and professional ethics.
The Act is particularly important in relation to:
- Medical education: It establishes the regulatory framework for undergraduate, postgraduate and super-speciality medical education.
- Medical institutions: It regulates establishment, expansion, assessment and rating of medical colleges.
- Recognition of qualifications: The statutory framework deals with recognised medical qualifications and their relevance to professional registration.
- Registration and licensing: The Act creates the National Medical Register and coordinates it with State Medical Registers.
- Professional ethics: The NMC and EMRB have important responsibilities concerning ethical standards and professional conduct.
- Disciplinary regulation: State Medical Councils, the EMRB and the NMC operate within a connected professional disciplinary framework.
- National examinations: The Act provides statutory foundations for NEET and NExT.
- Regulatory transparency: Institutional assessment, registers and specialised boards are intended to strengthen transparency and accountability within medical regulation.
The Act must also be read with the rules, regulations, notifications and guidelines issued under it because several operational matters are governed through delegated legislation.
Conclusion
The National Medical Commission Act, 2019 provides the central statutory framework for regulation of medical education and the medical profession in India. It replaced the earlier Medical Council of India framework with the National Medical Commission and four specialised Autonomous Boards.
The legislation covers areas ranging from standards of medical education and approval of medical institutions to registration, licensing, professional ethics and disciplinary regulation. It also creates statutory frameworks for NEET, NExT and the National Medical Register.
For medical law, the Act is significant because it connects medical education, professional registration, institutional regulation and ethical accountability within a single statutory structure. It also creates an important link between national regulatory bodies and State Medical Councils.
The practical operation of the National Medical Commission Act, 2019 must therefore be understood together with the rules, regulations, notifications and guidelines issued under it from time to time.
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