Regulation of Medical Practitioners
Key Takeaways
- Medical practitioners practising modern medicine in India are primarily regulated under the National Medical Commission Act, 2019, which replaced the earlier regulatory framework under the Indian Medical Council Act, 1956.
- A person generally cannot practise as a qualified medical practitioner unless the person’s name is enrolled in the State Medical Register or National Medical Register in accordance with the law.
- The National Medical Commission (NMC) is the principal national regulatory body, while the Ethics and Medical Registration Board (EMRB) deals particularly with registration, professional conduct and medical ethics.
- State Medical Councils continue to perform important functions relating to registration, ethical regulation and disciplinary action against medical practitioners within their jurisdiction.
- Registration and licensing are mainly governed by the Registration of Medical Practitioners and Licence to Practice Medicine Regulations, 2023, along with the National Medical Commission Act.
- The NMC’s Registered Medical Practitioner (Professional Conduct) Regulations, 2023 were subsequently kept in abeyance. The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 were adopted and made effective under the NMC framework.
- Regulation of medical practitioners is not limited to registration. It also covers recognised qualifications, ethical duties, professional misconduct, disciplinary proceedings, foreign medical graduates and restrictions on unregistered medical practice.
What Is Regulation of Medical Practitioners?
Regulation of medical practitioners means the legal system through which the qualifications, registration, licensing, professional conduct and disciplinary accountability of doctors are controlled.
Medical practice directly concerns human life and health. Therefore, possession of medical knowledge alone does not automatically create a legal right to practise medicine. A medical practitioner must satisfy statutory requirements concerning recognised qualifications and registration.
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In India, regulation operates at both the national and State levels. The National Medical Commission establishes the broader regulatory framework, while State Medical Councils perform several registration and disciplinary functions within their respective jurisdictions.
The objective of this framework is to ensure that persons practising modern medicine possess recognised qualifications, follow ethical standards and remain accountable for professional misconduct.
Which Law Regulates Medical Practitioners in India?
The principal legislation governing medical practitioners in modern medicine is the National Medical Commission Act, 2019.
The Act was enacted to create a medical regulatory system dealing with medical education, availability of qualified medical professionals, maintenance of medical registers and enforcement of professional and ethical standards. It replaced the institutional framework previously centred on the Medical Council of India.
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The regulatory framework includes:
- National Medical Commission Act, 2019;
- Registration of Medical Practitioners and Licence to Practice Medicine Regulations, 2023;
- regulations concerning recognition of medical qualifications;
- regulations applicable to foreign medical graduates; and
- rules concerning professional conduct, etiquette and ethics.
Together, these provisions determine who may lawfully practise modern medicine and how registered practitioners are regulated.
National Medical Commission and Regulation of Doctors
The National Medical Commission is the principal national regulatory authority established under the National Medical Commission Act, 2019.
Its responsibilities extend beyond doctors’ registration. The NMC regulates medical education, lays down standards, oversees autonomous boards, facilitates maintenance of medical registers and supports enforcement of ethical standards.
The regulatory structure is divided among autonomous boards so that specific areas such as undergraduate education, postgraduate education, medical institutions and medical ethics can be dealt with separately.
Autonomous Boards Under the NMC
The NMC framework contains four major autonomous boards:
- Under-Graduate Medical Education Board;
- Post-Graduate Medical Education Board;
- Medical Assessment and Rating Board; and
- Ethics and Medical Registration Board.
For regulation of practising doctors, the Ethics and Medical Registration Board is particularly important.
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What Is the Ethics and Medical Registration Board?
The Ethics and Medical Registration Board, commonly referred to as the EMRB, is an autonomous board functioning under the National Medical Commission.
Section 27 of the National Medical Commission Act deals with its powers and functions.
The EMRB is responsible for maintaining the National Register of licensed medical practitioners and regulating professional conduct and medical ethics.
It also develops mechanisms for continuous interaction with State Medical Councils and exercises appellate jurisdiction in relation to specified actions taken by State Medical Councils.
Therefore, medical regulation is not concentrated entirely in one national authority. The EMRB and State Medical Councils operate within an interconnected regulatory framework.
Is Registration Compulsory for Doctors in India?
Yes. Registration is a basic legal requirement for practising modern medicine as a qualified medical practitioner in India.
Section 34 of the National Medical Commission Act creates a statutory bar against medical practice by persons who are not enrolled in the State Register or National Register, subject to the provisions of the Act.
A person who is not properly enrolled cannot ordinarily:
- practise medicine as a qualified medical practitioner;
- hold an office meant to be held by a physician or surgeon;
- sign or authenticate medical or fitness certificates where the law requires certification by a duly qualified medical practitioner; or
- exercise certain statutory rights attached to the status of a registered medical practitioner.
The purpose of registration is therefore much wider than maintaining a database. Registration gives legal recognition to the practitioner’s professional status.
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Registration of Medical Practitioners in India
The detailed framework is contained in the Registration of Medical Practitioners and Licence to Practice Medicine Regulations, 2023.
These regulations were notified by the NMC through the Ethics and Medical Registration Board and form an important part of the present registration system.
Registration broadly involves verification of the practitioner’s qualification and eligibility followed by entry in the relevant medical register.
The regulatory framework also addresses matters relating to additional qualifications, registration information, foreign medical qualifications and temporary registration in appropriate cases.
What Is the National Medical Register?
The National Medical Register, or NMR, is the national register of licensed medical practitioners maintained under the National Medical Commission framework.
Section 31 of the NMC Act deals with the National Register and State Registers.
The register is intended to create an organised and accessible record of persons legally recognised to practise medicine. The information maintained through the registration framework helps regulatory authorities verify the professional identity and qualifications of medical practitioners.
The National Register must be understood along with State Medical Registers because medical regulation in India operates through both national and State institutions.
What Is the Role of State Medical Councils?
State Medical Councils continue to play a major role in the regulation of medical practitioners.
Their functions may include registration, maintenance of State registers, dealing with complaints and exercising disciplinary authority where such powers are conferred under the applicable State legislation.
The NMC Act specifically recognises this State-level role. The Ethics and Medical Registration Board is expected to ensure compliance with ethical standards through State Medical Councils where the relevant council possesses disciplinary powers under State law.
This creates a layered regulatory system.
State Medical Councils May Deal With
State Medical Councils may be involved in matters such as:
- registration of qualified practitioners within the State;
- maintenance and updating of registration records;
- complaints alleging professional or ethical misconduct;
- disciplinary proceedings against registered practitioners;
- suspension or other action where authorised by law; and
- implementation of professional standards within the State.
The process of complaining against a medical professional may involve a State Medical Council where the complaint concerns professional or ethical misconduct and the Council has jurisdiction over the practitioner.
Certain decisions may also become subject to appellate mechanisms under the NMC framework.
Right to Practise Medicine Under the NMC Act
Section 33 of the National Medical Commission Act concerns the right to obtain a licence to practise medicine and to be enrolled in the National Register or State Register.
The Act also contains transitional protection for persons who were already registered under the earlier Indian Medical Council Act framework.
Registration, therefore, creates a legally recognised professional status. However, the right to practise remains subject to compliance with applicable professional, ethical and disciplinary rules.
Possession of an MBBS degree should consequently be distinguished from registration. A recognised medical qualification establishes academic eligibility, while lawful professional practice additionally requires compliance with registration requirements.
Regulation of Professional Conduct and Medical Ethics
Medical practitioners are expected to maintain professional and ethical standards while dealing with patients, colleagues, hospitals and the wider medical profession.
The Ethics and Medical Registration Board has statutory responsibility for regulating professional conduct and promoting medical ethics.
The duties of a medical professional or doctor extend beyond providing treatment and include professional competence, ethical behaviour, proper communication, respect for patient rights and compliance with applicable professional standards.
Professional regulation commonly concerns matters such as:
- duties towards patients;
- confidentiality of patient information;
- maintenance of professional standards;
- appropriate medical certification;
- relationships with other medical professionals;
- improper solicitation or advertising;
- financial and professional integrity; and
- conduct amounting to professional misconduct.
These ethical duties exist in addition to obligations imposed by other laws relating to medical negligence, consumer protection, criminal liability, hospitals, pharmaceuticals and patient rights.
Which Code of Medical Ethics Currently Applies?
An important distinction is necessary regarding the ethical regulations governing registered medical practitioners.
The NMC notified the National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2023 on 2 August 2023.
However, on 23 August 2023, the NMC issued another notification keeping those regulations in abeyance with immediate effect. The notification expressly stated that the 2023 Professional Conduct Regulations would not be operative until a further Gazette notification on the subject.
At the same time, the NMC adopted and made effective the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002, treating them as regulations operating under the powers available under the NMC Act.
Therefore, the 2023 Professional Conduct Regulations should not be treated as the presently operative code merely because they were originally notified.
What Amounts to Professional Misconduct by a Doctor?
Professional misconduct refers to conduct that violates recognised professional and ethical duties attached to medical practice.
Not every unsuccessful treatment amounts to professional misconduct. Medical treatment may involve uncertainty, and an unfavourable result by itself does not establish wrongdoing. Similarly, an error of judgment by a doctor does not automatically amount to negligence if reasonable professional skill and care were exercised.
Disciplinary liability generally depends upon the conduct involved and the professional standard allegedly violated.
Examples of conduct that may attract regulatory scrutiny can include:
- violation of professional ethical obligations;
- improper disclosure of confidential information without lawful justification;
- issuing improper medical certificates;
- professional association with unqualified persons in circumstances prohibited by law;
- unethical solicitation or prohibited forms of professional promotion;
- misrepresentation concerning qualifications; and
- other behaviour falling within the applicable ethical regulations.
Whether particular conduct amounts to misconduct depends upon the facts, applicable regulations and the authority’s disciplinary determination.
How Are Complaints Against Doctors Dealt With?
Complaints involving professional or ethical misconduct may be dealt with through the relevant State Medical Council, subject to the statutory framework applicable in that State.
The NMC Act also provides a role for the Ethics and Medical Registration Board in relation to disciplinary regulation and appellate jurisdiction.
Section 30 deals with State Medical Councils and the relationship between State-level disciplinary action and the national regulatory structure.
Thus, the system broadly operates at two levels:
First Level: State Medical Council
Where the relevant State Medical Council possesses disciplinary jurisdiction, complaints concerning professional or ethical misconduct may initially be considered by that Council.
Appellate or Supervisory Level
The EMRB exercises appellate jurisdiction in relation to actions taken by State Medical Councils as contemplated by the NMC Act. This helps maintain national oversight while preserving State-level disciplinary administration.
A disciplinary complaint before a medical regulatory body is different from other legal remedies that may arise from the same treatment. For example, medical negligence and consumer rights in healthcare may involve compensation or deficiency in service, whereas disciplinary proceedings primarily examine professional conduct and regulatory compliance.
Can an Unregistered Person Practise Medicine in India?
An unregistered person cannot ordinarily practise modern medicine as a qualified medical practitioner.
Section 34 of the NMC Act expressly creates a bar on practice by persons who are not enrolled in the State Register or National Register.
The restriction protects patients from persons who may possess inadequate, unrecognised or falsely claimed medical qualifications.
It also prevents an unregistered person from exercising certain privileges reserved for qualified medical practitioners, including holding designated medical offices and authenticating certificates that legally require certification by a qualified doctor.
Regulation of Foreign Medical Graduates
Indian citizens or other eligible persons who obtain medical qualifications outside India are also subject to regulatory requirements before practising medicine in India.
A foreign medical qualification does not automatically confer an unrestricted right to practise in India.
The regulatory framework considers matters such as:
- recognition and acceptability of the foreign medical qualification;
- compliance with eligibility requirements;
- completion of applicable internship or training requirements;
- satisfaction of the applicable licensing or screening framework; and
- registration with the appropriate medical authority.
The precise requirements depend upon the statutory and regulatory framework applicable to the candidate and the period in which the foreign medical education was undertaken.
Temporary Registration of Foreign Medical Practitioners
The law also recognises situations in which a foreign medical practitioner may require temporary permission to practise in India.
Section 34 permits a foreign citizen who is registered as a medical practitioner in another country to receive temporary registration in India in the manner and for the period prescribed by regulations.
The NMC has separately issued guidelines relating to temporary registration of foreign medical practitioners sponsored by eligible institutions or hospitals.
Temporary registration is different from permanent registration and is generally connected with a specific professional purpose and limited duration.
Recognition of Medical Qualifications
Regulation of doctors is closely connected with the legal recognition of medical qualifications.
Sections 35 to 37 of the National Medical Commission Act deal with recognition of different categories of medical qualifications, including qualifications granted by institutions in India and qualifications obtained outside India.
Recognition serves an important regulatory purpose. A qualification must satisfy the statutory framework before it can form the basis for professional registration.
The law also allows recognised additional qualifications to be entered against the name of a registered practitioner in accordance with applicable requirements.
Community Health Providers Under the NMC Act
Section 32 of the National Medical Commission Act contains a separate provision concerning Community Health Providers.
The Commission may grant a limited licence to practise medicine at the mid-level to eligible persons connected with the modern scientific medical profession, subject to conditions specified by regulations.
The statute limits the number of such licences and allows the extent, circumstances and period of practice to be regulated.
A Community Health Provider with such a licence may independently prescribe specified medicines in primary and preventive healthcare. In other areas, prescribing powers are subject to supervision requirements contemplated under the Act.
A limited licence of this nature should not be confused with unrestricted registration as a qualified medical practitioner.
Why Is Regulation of Medical Practitioners Important?
Regulation protects both the public and the integrity of the medical profession.
It performs several important functions:
- Verification of competence: Registration helps ensure that persons practising medicine possess qualifications recognised by law.
- Patient protection: Restrictions on unregistered practice reduce the risk of treatment by unqualified persons.
- Professional accountability: Ethical rules create standards that registered practitioners are expected to follow.
- Disciplinary control: Regulatory bodies can examine complaints and take action where professional misconduct is established.
- Transparency: Medical registers provide an official mechanism for identifying recognised practitioners.
- Uniform standards: National regulation helps create consistency while permitting State Medical Councils to perform important local regulatory functions.
Professional regulation also operates alongside rules governing patient autonomy. For example, a doctor generally requires legally valid consent before treating a patient, subject to recognised exceptions such as genuine medical emergencies.
Regulation of Medical Practitioners in India: Current Position
The present framework for regulation of medical practitioners in India is centred on the National Medical Commission Act, 2019.
The NMC functions as the national regulator, while the Ethics and Medical Registration Board has specific responsibility for registration, professional conduct and ethics. State Medical Councils continue to perform significant registration and disciplinary functions.
The Registration of Medical Practitioners and Licence to Practice Medicine Regulations, 2023 form an important part of the licensing framework. The NMC continues to publish regulatory updates and proposed amendments, making it necessary to distinguish final notified law from draft regulatory proposals.
At the ethical level, the NMC’s Professional Conduct Regulations notified on 2 August 2023 remain in abeyance under the subsequent notification dated 23 August 2023. The Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002 were adopted and made effective under the NMC framework.
Conclusion
The regulation of medical practitioners in India combines qualification recognition, registration, licensing, ethical regulation and disciplinary accountability.
The National Medical Commission Act, 2019 provides the principal statutory framework. The NMC and its Ethics and Medical Registration Board operate at the national level, while State Medical Councils remain essential to registration and disciplinary administration.
A recognised medical qualification alone does not provide an unrestricted legal right to practise medicine. Proper registration in the National Register or State Register is central to lawful medical practice. Registered practitioners must also comply with applicable ethical standards throughout their professional careers.
The regulatory framework ultimately serves two connected purposes: protecting patients from unqualified or unethical medical practice and maintaining professional standards within the medical profession.
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