Billed for change

Billed for change

What has happened?

The Union Cabinet this week approved six out of the dozens of changes to the contentious National Medical Commission (NMC) Bill that were suggested by a Parliamentary Standing Committee earlier this month. These changes address some of the loudest criticisms of the Bill.

Changes approved by the Cabinet

• Final year MBBS exam merged: The final year MBBS exam is now merged with an exit exam for doctors
• No bridge course AYUSH practitioners: A contentious bridge course for AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha, Homeopathy) practitioners has been axed.
• Increase in the State representation: The amendments cleared by the Cabinet also increase State representation in the NMC from three part-time members to six (against a recommendation of 10 by Parliamentary standing committee), in what seems like a gesture to please the States
• Proportion of regulated seats in private colleges raised: Another amendment that doesn’t go far enough is the decision to raise the proportion of private college seats for which fees will be regulated from 40% to 50%. The fees for unregulated seats could then skyrocket, pushing poorer medical aspirants out of the system

Changes not approved

Heavy control of the government: NMC members are to be picked by a search committee headed by the Cabinet Secretary, while the Central government is to be the appellate body for those aggrieved by the NMC’s decisions.

The Challenges in implementation

• Logistics of conducting a single exam: How, for one, will the logistical difficulty of conducting a common final year MBBS examination across the country be overcome?
• Keeping the quality of the bridge course high: Another concern is that under the new amendments States now have the freedom to implement an AYUSH bridge course, even if no longer mandatory. How will the Centre ensure the quality of such courses to prevent a new set of poorly trained doctors from emerging?

Conclusion

The coming days may see many more protests against the NMC Bill, perhaps delaying its passage and prompting further discussion. For a Bill that marks the first major reform in medical education since 1956, such an extended debate is not a bad thing.