New Delhi: The health ministry has invited applications to fill posts at the country’s medical education regulators following a management crisis at the National Medical Commission (NMC). 

It has sought applications for the posts of president, secretary and members of NMC, and key positions in the four boards under the NMC—the Undergraduate Medical Education Board (UGMEB), Postgraduate Medical Education Board (PGMEB), Ethics and Medical Registration Board (EMRB) and Medical Assessment Rating Board (MARB).

The NMC that had replaced the Medical Council of India faces a management crisis, with the NMC administration raising the issue with the health ministry on several occasions seeking reforms as reported by Mint earlier.

Mint reported on 27 September that the NMC has sought government intervention to resolve an internal crisis with its four autonomous boards working at cross-purposes, two people aware of the development said. The commission had had to cancel several public notices following poor internal consultations, and had flagged the matter to the Union health ministry.

“While reviewing applications of the medical colleges to the health ministry in July and August, it came to our notice that many such applications have seen conflicting decisions within boards,” the first person said on the condition of anonymity.

Increasing mismanagemet

The disarray comes in the wake of an outcry over leaked question papers in the National Eligibility cum Entrance Test (NEET) that selects candidates for various undergraduate medical courses. NMC, which replaced the erstwhile Medical Council of India, administers NEET, taken by more than 2.3 million candidates this year.

According to a person aware of the matter, while UGMEB imposed penalties on one college, PGMEB allowed the same institution to increase the number of seats. In another case, MARB allowed a college to increase the number of PG seats, only for PGMEB to reduce them. Mint could not identify the institutions involved. The NMC has taken the matter to the health ministry several times, including as recently as August, the people cited above said.

Withdrawing official communications due to poor internal discussions has become frequent, the second official said. On 16 August, PGMEB issued a notice discontinuing all courses under the umbrella of the College of Physicians & Surgeons (CPS), Mumbai. However, it was withdrawn on 30 August after it was challenged in the Bombay High Court. Similarly, the UMEB on 31 August issued Competency-based Medical Education Curriculum (CBME) Guidelines, 2024, before withdrawing it on 5 September.

The NMC was created by a government notification on 24 September 2020, aiming to introduce objectivity, transparency and fairness in the processes, and to provide more operational flexibility and ensure prompt decision-making to improve the quality of medical education. The four boards were envisaged to achieve these objectives, functioning independently with well-defined powers and responsibilities.

A former NMC member said the individual boards are not empowered to issue notifications; only the NMC secretariat may do so. “In fact, between 2021 and 2022, I submitted in writing that the boards were going above the head of NMC, and they cannot take decisions without NMC’s order,” the former member said on the condition of anonymity.

Dr J.L. Meena, a former MARB member, said he had raised his concerns about the conduct of the boards to NMC in April. “I myself wrote to the NMC leadership regarding mismanaged boards within NMC. Boards are not doing roles as defined in NMC Act,” he said.

Queries sent to the Union health secretary, the health ministry spokesperson and the NMC secretary remained unanswered.

In December, former NMC secretary Vipul Aggarwal highlighted these issues in a letter to the health ministry, saying the separation of powers between boards was disregarded and the commission is reduced to a “mere rubber stamp”. Mint has seen a copy of the letter.

The letter said the boards were acting independently of each other and the NMC, leading to poor transparency, accountability and grievance redressal, potentially damaging the standards of medical education and harming the NMC’s image. The boards had misinterpreted their autonomy to mean independence, and were directly interacting with the ministry and outsiders, potentially leading to serious embarrassment, the letter stated. It suggested the NMC’s supervision should be with the NMC secretariat, headed by the secretary.

Aggarwal declined to comment on this matter. “I am not part of NMC now and it is hardly within my responsibility,” Aggarwal told Mint.

The NMC typically imposes meagre fines of a few lakhs of rupees and allows erring institutions to renew their licences without getting deficiencies rectified, alleged Dr. Neeraj Bedi, former medical superintendent of a private medical college in Bhopal, calling it illegal and unethical. At many medical institutions, deans and medical superintendents defer to management demands and the roles themselves are defunct, he said.

“NMC’s regulation on Maintenance of Standards of Medical Education Regulations, (MSMER), 2023, clause VIII, which deals with penalties, recommends denial of permission or renewal to medical college applications. This practice is bringing down the quality of medical education in the country. NMC has miserably failed to regulate as apex medical education statutory body to deliver,” Dr. Bedi said.

Dr R.V. Asokan, national president of the Indian Medical Association (IMA), recalled the autonomous tenure of the Medical Council of India. The council had nurtured medical education in India and produced world-class doctors in India for seven decades after independence, Asokan said, adding the NMC has been structurally defective and constrained in many ways.