New Doctor Registration Rules

Context: Recently National Medical Commission (NMC) notified new regulations on the licensing and registration of doctors, which have come in for much criticism from the medical community.

What are the new rules?

  • Under the new regulation, all registered doctors have to register afresh through a portal of the NMC’s Ethics & Medical Registration Board (EMRB), which is responsible for maintaining the IMR, now renamed National Medical Register (NMR).
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Why are the new regulations important?

  • India does not know exactly how many practising doctors it has. Every year, Parliament is told that ‘x’ numbers are registered in the Indian Medical Registry ( IMR ), but about 20% might have migrated, retired, stopped the practice, never practised, or died.
  • Under the new regulation, all registered doctors have to register afresh through a portal of the NMC’s Ethics & Medical Registration Board (EMRB), which is responsible for maintaining the IMR, now renamed National Medical Register (NMR).
  • They will be issued a unique registration number, and the licence will be valid for five years.
  • With this, India could have an exact count of its practising doctors since anyone not renewing will automatically not be counted as practising in India.

Why are doctors objecting to the new registration process?

  • Many doctors are registered through the state medical councils. The NMC Act does not give the commission the power to issue a licence for practice. This is done by the state councils.
  • NMC only maintains the IMR, which is a collection of all state registries. So, doctors are asking why they should re-register through the Central portal.
  •  All registered doctors have been asked to renew their registration within three months. Assuming that only 80% of the 13 lakh-plus doctors registered in the IMR are currently practising in India, over 10. 4 lakh doctors will need to reregister within 90 days from May 10 – an average of about 12,000 registrations per day.
  • Doctors say they have been put together without enough consultation, so they contain contradictory sections, and provisions that lack clarity, and some of the regulations might be difficult or impossible to implement.

What’s the advantage of registration through a Central portal?

  • Doctors registering every five years and specifying the state/ states in which they practise will enable better manpower planning by the Centre and the state governments.
  •  Also, the new format asks doctors to give their place of work (name of hospital/institute). This could provide an estimate of doctors in the public and private sectors.
  •  At present, multiple registrations in different state registers make it difficult to enforce disciplinary actions against doctors.
  •  A doctor whose registration is suspended by one state council can continue to practise using the registration number and entry in another registry.
  • Unique registration numbers are also expected to tackle the menace of fake doctors or those with unrecognised degrees.
  • People could look up the qualifications of any doctor on the NMC website.
  • The NMC Act stipulates real-time synchronisation of the national and state registers, which means no waiting for state councils to share/ update the state registries to update the NMR.

What’s the problem with registration through state councils?

  • State medical councils are set up through state legislation. Hence, their mandate varies between states.
  • Not all state councils stipulate renewal of registration, and where they do, many doctors do not comply, arguing that the erstwhile Indian Medical Council (IMC) Act, did not mandate such renewal. Hence, medical registries are often not updated.
  • The IMC Act required the state councils to supply copies of their state registers to the Central Council after April 1 of each year. These were combined to form the IMR.
  • However, with the state councils having different rules regarding updating the registry, and with one doctor registered in many state registries with different registration numbers, the IMR was plagued with discrepancies.
  • Even today, many state councils do not share updated registries on time.

Does NMC have the power to grant or revoke a licence?

  • The NMC Act repeatedly states a medical graduate can be registered “in the state register or the national register, as the case may be”.
  • But many states mandate registration with their state council for permission to practise.
  • Interestingly, even in the NMC Act, the list of the commission’s functions does not include granting of a licence to practise, while state councils are defined as being “for regulating the practice and registration of practitioners of medicine in that state or Union Territory”
  • Doctors argue that there is no bar on their practising in a state where they are registered even if they are not registered in the NMR.

Will doctors be barred from practising in multiple states?

  • There’s confusion on this because different sections of the regulations seem to contradict each other.
  • Under the procedure for seeking a licence to practise medicine, the regulations state: “eligible person may opt any state/states to practise medicine”. This seems to imply that a doctor may register to practise in more than one state.
  • But their regulations also state that the licence will have a unique identification number that “shall be suffixed with a code of the state/UT concerned”. Here the reference is to a single state or UT.
  • The section on the transfer of licence again implies a doctor may practise in only one state at a time.
  • This has worried doctors who practise in more than one state. For instance, many registered in Chandigarh practise in Chandigarh, Haryana and Punjab, and those registered in Delhi might practise in Noida (UP) and/or Gurgaon (Haryana).
  • During calamities or for short stints doctors might practise in another state and registering each time would be inconvenient.

Why are doctors asking NMC to redraft the regulations after consultations with state medical councils?

  • Many of the regulations suggested by NMC run counter to what is mandated in the state council Acts.
  • States have different operational protocols.

Will NMC ensure that all state council laws are harmonised with its new regulations?

  • Doctors point out that the details of the process for renewal of registration were not spelt out in the draft regulations put out in May 2022 seeking comments from the public.

Mains Practice Question

Critically examine the new New doctor registration rules laid down by the National Medical Council (NMC). (250 words , 15 marks)

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