The National Medical Commission Act (NMC) 2019 has come into force on 8^th August 2019. The main aim of this Act is to provide a high quality of medical education, adequate availability of medical professional, equitable and universal healthcare facilities and to establish an effective grievance redressal system. Earlier the Medical Council of India (MCI) was held responsible for regulating medical education and practice. The NMC Act 2019 has repealed the Indian Medical Council Act 1956 and has replaced the MCI with the NMC. There are 8 chapters and 1 Schedule mentioned under the NMC Act 2019. Under NMC, the states shall establish their respective State Medical Councils within a period of 3 years.

Chapter II of the NMC Act deals with the provisions relating to the constitution of the NMC. The NMC consist of 25 members. The members of the NMC will be appointed by the Central Government based on the recommendation of a committee.

Following members shall be included:-

• A chairperson (who must be a senior medical practitioner and an academic with the experience of at least 20 years).
• Ten ex-officio members (which will include the director-general of Indian Council of Medical Research, director of one of the AIIMS and the presidents of under-graduate and postgraduate medical education boards).
• Fourteen part-time members (which will include the nominees of the states and union territories and experts from the field of law, management, medical ethics, etc.).

The Functions of NMC are as follows:-

• To lay down the policies for maintaining high quality and high standards in medical education.
• To lay down the policies for the regulation of medical institutions, medical researches and medical professionals.
• Assess the requirements in healthcare (including human resources for health and healthcare infrastructure).
• To promote, co-ordinate and frame guidelines for the proper functioning of Autonomous Boards.
• Any other function as mentioned under the Act

Chapter IV of the NMC Act deals with the National Examination. There will be a uniform National Eligibility-cum-Entrance Test for the admission to undergraduate and postgraduate medical education. NMC has also introduced a standard final year undergraduate examination called the National Exit Test. The National Exit Test will serve multiple purposes such as to grant the license to practice medicine, as an entrance exam for the admission in postgraduate course and also a screening test for foreign medical graduates.

Chapter V of the NMC Act deals with the provisions relating to the constitution of Autonomous Boards. There are four regulatory bodies that are set up under the NMC Act, and they are as follows:- the Under-Graduate Medical Education Board, the Post-Graduate Medical Education Board, the Medical Assessment and Rating Board and the Ethics and Medical Registration Board. The Ethics and Medical Registration Board will maintain a national register of all the licensed medical practitioners and the community health providers in the country.The NMC Act also states the provision for granting a limited license to community health providers.

The complaints relating to the professional/ethical misconduct against the registered medical practitioner shall be made to the State Medical Council. Before taking any action against the medical practitioner (including the imposition of fine), the State Medical Council shall give an opportunity of the hearing to the concerned medical practitioner or professional. An appeal can be filed by the medical practitioner or professional to the Ethics and Medical Registration Board against the order of the State Medical Council.The NMC act as an appellate authority. If the medical practitioner or professional is aggrieved by order of the Ethics and Medical Registration Board, then an appeal can be filed to the NMC.

Under NMC, the term Community Health Provider has been defined vaguely as “a person who is connected with modern scientific medical profession” and is empowering the commission to grant limited license to practice medicine at mid-level. Community Health Provider will allow people to practice medicine without having sufficient medical knowledge and background. Under MCI, there was no requirement of giving test (National Exit Test) in order to obtain a license. The only requirement was to get registered with a State Medical Council to practice. Under NMC, the commission will frame guidelines for determination of fees and all other charges in respect of only 50% of the seats in private medical institutions and deemed to be universities. Earlier under MCI, 85% of the seats were decided by the State Government.

The MCI consist of 70% of the elected representatives, whereas the NMC consist of only 20% of the elected representatives. Under MCI, the action against the president of MCI could be taken only on the directions of the court whereas, under NMC, the Central Government has the power to remove the chairperson or any other member of the NMC. Earlier the decisions of the MCI were not binding on the State Medical Council whereas now under NMC, the ethics board has the power to exercise the jurisdiction relating to the compliance of the ethical issues over the State Medical Council. NMC is thus considered as a government-controlled regulatory body.