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The National Medical Commission Bill, 2017 was introduced in Lok Sabha recently and is listed for consideration and passage today.[1] The Bill seeks to regulate medical education and practice in India. To meet this objective, the Bill repeals the Indian Medical Council Act, 1956 and dissolves the current Medical Council of India (MCI). The MCI was established under the 1956 Act, to establish uniform standards of higher education qualifications in medicine and regulating its practice.[2]
A Committee was set up in 2016, under the NITI Aayog with Dr. Arvind Panagariya as its chair, to review the 1956 Act and recommend changes to improve medical education and the quality of doctors in India.[3] The Committee proposed that the Act be replaced by a new law, and also proposed a draft Bill in August 2016.
This post looks at the key provisions of the National Medical Commission Bill, 2017 introduced in Lok Sabha recently, and some issues which have been raised over the years regarding the regulation of medical education and practice in the country.
What are the key issues regarding the regulation of medical education and practice?
Several experts have examined the functioning of the MCI and suggested a different structure and governance system for its regulatory powers.3,[4] Some of the issues raised by them include:
Separation of regulatory powers
Over the years, the MCI has been criticised for its slow and unwieldy functioning owing to the concentration and centralisation of all regulatory functions in one single body. This is because the Council regulates medical education as well as medical practice. In this context, there have been recommendations that all professional councils like the MCI, should be divested of their academic functions, which should be subsumed under an apex body for higher education to be called the National Commission for Higher Education and Research.[5] This way there would be a separation between the regulation of medical education from regulation of medical practice.
An Expert Committee led by Prof. Ranjit Roy Chaudhury (2015), recommended structurally reconfiguring the MCI’s functions and suggested the formation of a National Medical Commission through a new Act.3 Here, the National Medical Commission would be an umbrella body for supervision of medical education and oversight of medial practice. It will have four segregated verticals under it to look at: (i) under-graduate medical education, (ii) post-graduate medical education, (iii) accreditation of medical institutions, and (iv) the registration of doctors. The 2017 Bill also creates four separate autonomous bodies for similar functions.
Composition of MCI
With most members of the MCI being elected, the NITI Aayog Committee (2016) noted the conflict of interest where the regulated elect the regulators, preventing the entry of skilled professionals for the job. The Committee recommended that a framework must be set up under which regulators are appointed through an independent selection process instead.
Fee Regulation
The NITI Aayog Committee (2016) recommended that a medical regulatory authority, such as the MCI, should not engage in fee regulation of private colleges. Such regulation of fee by regulatory authorities may encourage an underground economy for medical education seats with capitation fees (any payment in excess of the regular fee), in regulated private colleges. Further, the Committee stated that having a fee cap may discourage the entry of private colleges limiting the expansion of medical education in the country.
Professional conduct
The Standing Committee on Health (2016) observed that the present focus of the MCI is only on licensing of medical colleges.4 There is no emphasis given to the enforcement of medical ethics in education and on instances of corruption noted within the MCI. In light of this, the Committee recommended that the areas of medical education and medical practice should be separated in terms of enforcement of the appropriate ethics for each of these stages.
What does the National Medical Commission, 2017 Bill seek do to?
The 2017 Bill sets up the National Medical Commission (NMC) as an umbrella regulatory body with certain other bodies under it. The NMC will subsume the MCI and will regulate the medical education and practice in India. Under the Bill, states will establish their respective State Medical Councils within three years. These Councils will have a role similar to the NMC, at the state level.
Functions of the NMC include: (i) laying down policies for regulating medical institutions and medical professionals, (ii) assessing the requirements of human resources and infrastructure in healthcare, (iii) ensuring compliance by the State Medical Councils with the regulations made under the Bill, and (iv) framing guidelines for determination of fee for up to 40% of the seats in the private medical institutions and deemed universities which are governed by the Bill.
Who will be a part of the NMC?
The NMC will consist of 25 members, appointed by the central government. It will include representatives from Indian Council of Medical Research, and Directorate General of Health Services. A search committee will recommend names to the central government for the post of Chairperson, and the part-time members. These posts will have a maximum term of four years, and will not be eligible for extension or reappointment.
What are the regulatory bodies being set up under the NMC?
The Bill sets up four autonomous boards under the supervision of the NMC, as recommended by various experts. Each autonomous board will consist of a President and two members, appointed by the central government (on the recommendation of the search committee). These bodies are:
What does the Bill say regarding the conduct of medical entrance examinations?
There will be a uniform National Eligibility-cum-Entrance Test (NEET) for admission to under-graduate medical education in all medical institutions governed by the Bill. The NMC will specify the manner of conducting common counselling for admission in all such medical institutions.
Further, there will be a National Licentiate Examination for the students graduating from medical institutions to obtain the license for practice. This Examination will also serve as the basis for admission into post-graduate courses at medical institutions.
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[1] The National Medical Commission Bill, 2017, http://www.prsindia.org/uploads/media/medical%20commission/National%20Medical%20Commission%20Bill,%202017.pdf.
[2] Indian Medical Council Act, 1933.
[3] A Preliminary Report of the Committee on the Reform of the Indian Medical Council Act, 1956, NITI Aayog, August 7, 2016, http://niti.gov.in/writereaddata/files/document_publication/MCI%20Report%20.pdf.
[4] “Report no. 92: Functioning of the Medical Council of India”, Standing Committee on Health and Family Welfare, March 8, 2016, http://164.100.47.5/newcommittee/reports/EnglishCommittees/Committee%20on%20Health%20and%20Family%20Welfare/92.pdf
[5] “Report of the Committee to Advise on Renovation and Rejuvenation of Higher Education”, Ministry of Human Resource Development, 2009, http://mhrd.gov.in/sites/upload_files/mhrd/files/document-reports/YPC-Report.pdf.
Explainer: The Central Educational Institutions (Reservation in Teachers’ Cadre) Bill, 2019
The Central Educational Institutions (Reservation in Teachers’ Cadre) Bill, 2019 was passed by Parliament today. It replaces an Ordinance that was promulgated in February 2019. The Bill brings about two major changes in reservation of teaching posts in central educational institutions. Firstly, it establishes that for the purpose of reservation, a university/college would be considered as one single unit. This means that posts of the same level across all departments (such as assistant professor) in a university would be grouped together when calculating the total number of reserved seats. Secondly, it extends reservations beyond Scheduled Castes (SC) and Scheduled Tribes (ST), to include socially and educationally backward classes (OBC) and economically weaker sections (EWS).
In this post, we look at how the Bill will impact the reservation of teaching posts in central educational institutions.
How has teachers’ reservation been implemented in the past?
In 2006, the University Grants Commission (UGC) issued guidelines for teacher reservations in central educational institutions.[1] These guidelines required central educational institutions to consider a university as one unit for the purpose of reservation. It stated that reservations would be calculated using a roster system specified by the Ministry of Personnel, Public Grievances, and Pension.[2]
However, the UGC Guidelines (2006) were challenged in the Allahabad High Court in 2017. The question before the Court was whether a university should be taken as a unit when applying the roster.[3] The Court found that individual departments should be taken as a unit for the purpose of reservation, instead of universities. It held that taking a university as a unit could result in some departments having only reserved candidates and others having only unreserved candidates. Following the judgment, departments were treated as a single unit for reservation at central educational institutions.
In March 2019, the Central Educational Institutions (Reservation in Teachers’ Cadre) Ordinance, 2019 was promulgated, and passed as a Bill in July 2019. The Bill overturns the Allahabad High Court judgment and reverts to the system where a university is regarded as one unit for the purpose of reservation.
Over the years, there has been deliberation on whether the university or department should be taken as a unit for reservation of teaching posts. This has to do with the manner in which the roster system [4]specified by the Ministry of Personnel, Public Grievances, and Pension is applied in both situations.
What was the roster system specified by the Ministry of Personnel, Public Grievances, and Pension?
The roster system calculates reservation based on cadre strength. A cadre includes all posts available to be filled within a unit, i.e. either department or university. For instance, all associate professor positions within a university or within a department would be considered a cadre.
At present, the roster system is applied in two ways, i.e., the 13-point system or the 200-point system. For initial recruitment in both systems, all posts in a cadre are numbered and allocated. This means that in a cadre with 18 posts, each post will be assigned a number from 1 to 18 and allocated to a particular category, i.e., either SC, ST, OBC, EWS or unreserved. Therefore, hiring of teachers for all posts takes place on the basis of this list.
However, there are two fundamental differences between the 200 point and 13 point systems.
When a university is taken as the unit for reservation, the 200-point system is used, as there tend to be more than 13 posts in a university. However, when a department is taken as a unit, the 13-point system or the 200-point system may be used, depending on the size of the department.
How are the number of reserved seats calculated in the roster system?
For both the systems, the number of seats reserved for SC, ST, OBC, and EWS is determined by multiplying the cadre strength with the percentage of reservation prescribed by the Constitution. The percentage of reserved seats for each category is as follows: (i) 7.5% for ST, (ii) 15% for SC, (iii) 27% for OBC, and (iv) 10% for EWS.
If the number of posts needed to be filled is 200, and the percentage of reservation for ST is 7.5%, we would use the following formula to calculate the number of reserved posts for that class:
Number of posts needed to be filled x percentage of reservation/100
= 200 x 7.5/100
= 15
Thus, the number of seats reserved for ST in a cadre with the strength of 200 posts is 15. Using the same formula, the number of seats reserved for SC is 30, OBC is 54, and EWS is 20.
How are these reserved seats distributed across posts?
To determine the position of each reserved seat in the roster systems, 100 is divided by the percentage of the reservation for each category. For instance, the OBC quota is 27%. Therefore, 100/27 = 3.7, that is, approximately every 4th post in the cadre list. Likewise, SC is approximately every 7th post, ST is approximately every 14th post, and EWS will be approximately every 10th post.
What is the difference in the application of the roster between the department and university systems?
To demonstrate the difference between the department and university systems, a hypothetical example of a university with 200 posts for associate professors, and nine departments with varying number of posts is provided below.
When the university is taken as a unit
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If the university is taken as the unit for reservation, then the total number of posts for the reserved categories would be 119 (i.e., 30 for SC, 15 for ST, 54 for OBC, and 20 for EWS), whereas the number of unreserved (UR) seats would be 81. This is mentioned in Table 1. The method of calculation of these numbers is based on the roster system prescribed by the Ministry of Personnel, Public Grievances, and Pension. |
Table 1: No. of posts reserved when university is taken as a unit
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When departments are taken as separate units
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If different departments of a university are taken as separate units for reservation, then the total number of posts for the reserved categories would be 101 (i.e., 25 for SC, 9 for ST, 49 for OBC, and 18 for EWS), whereas the number of unreserved (UR) seats would be 99. This is mentioned in Table 2. The method of calculation of these numbers is based on the roster system prescribed by the Explainer: The Central Educational Institutions (Reservation in Teachers’ Cadre) Bill, 2019 The Central Educational Institutions (Reservation in Teachers’ Cadre) Bill, 2019 was passed by Parliament today. It replaces an Ordinance that was promulgated in February 2019. The Bill brings about two major changes in reservation of teaching posts in central educational institutions. Firstly, it establishes that for the purpose of reservation, a university/college would be considered as one single unit. This means that posts of the same level across all departments (such as assistant professor) in a university would be grouped together when calculating the total number of reserved seats. Secondly, it extends reservations beyond Scheduled Castes (SC) and Scheduled Tribes (ST), to include socially and educationally backward classes (OBC) and economically weaker sections (EWS). In this post, we look at how the Bill will impact the reservation of teaching posts in central educational institutions. How has teachers’ reservation been implemented in the past? In 2006, the University Grants Commission (UGC) issued guidelines for teacher reservations in central educational institutions.[1] These guidelines required central educational institutions to consider a university as one unit for the purpose of reservation. It stated that reservations would be calculated using a roster system specified by the Ministry of Personnel, Public Grievances, and Pension.[2] However, the UGC Guidelines (2006) were challenged in the Allahabad High Court in 2017. The question before the Court was whether a university should be taken as a unit when applying the roster.[3] The Court found that individual departments should be taken as a unit for the purpose of reservation, instead of universities. It held that taking a university as a unit could result in some departments having only reserved candidates and others having only unreserved candidates. Following the judgment, departments were treated as a single unit for reservation at central educational institutions. In March 2019, the Central Educational Institutions (Reservation in Teachers’ Cadre) Ordinance, 2019 was promulgated, and passed as a Bill in July 2019. The Bill overturns the Allahabad High Court judgment and reverts to the system where a university is regarded as one unit for the purpose of reservation. Over the years, there has been deliberation on whether the university or department should be taken as a unit for reservation of teaching posts. This has to do with the manner in which the roster system [4]specified by the Ministry of Personnel, Public Grievances, and Pension is applied in both situations. What was the roster system specified by the Ministry of Personnel, Public Grievances, and Pension? The roster system calculates reservation based on cadre strength. A cadre includes all posts available to be filled within a unit, i.e. either department or university. For instance, all associate professor positions within a university or within a department would be considered a cadre. At present, the roster system is applied in two ways, i.e., the 13-point system or the 200-point system. For initial recruitment in both systems, all posts in a cadre are numbered and allocated. This means that in a cadre with 18 posts, each post will be assigned a number from 1 to 18 and allocated to a particular category, i.e., either SC, ST, OBC, EWS or unreserved. Therefore, hiring of teachers for all posts takes place on the basis of this list. However, there are two fundamental differences between the 200 point and 13 point systems.
When a university is taken as the unit for reservation, the 200-point system is used, as there tend to be more than 13 posts in a university. However, when a department is taken as a unit, the 13-point system or the 200-point system may be used, depending on the size of the department. How are the number of reserved seats calculated in the roster system? For both the systems, the number of seats reserved for SC, ST, OBC, and EWS is determined by multiplying the cadre strength with the percentage of reservation prescribed by the Constitution. The percentage of reserved seats for each category is as follows: (i) 7.5% for ST, (ii) 15% for SC, (iii) 27% for OBC, and (iv) 10% for EWS. If the number of posts needed to be filled is 200, and the percentage of reservation for ST is 7.5%, we would use the following formula to calculate the number of reserved posts for that class: Number of posts needed to be filled x percentage of reservation/100 = 200 x 7.5/100 = 15 Thus, the number of seats reserved for ST in a cadre with the strength of 200 posts is 15. Using the same formula, the number of seats reserved for SC is 30, OBC is 54, and EWS is 20. How are these reserved seats distributed across posts? To determine the position of each reserved seat in the roster systems, 100 is divided by the percentage of the reservation for each category. For instance, the OBC quota is 27%. Therefore, 100/27 = 3.7, that is, approximately every 4th post in the cadre list. Likewise, SC is approximately every 7th post, ST is approximately every 14th post, and EWS will be approximately every 10th post. What is the difference in the application of the roster between the department and university systems? To demonstrate the difference between the department and university systems, a hypothetical example of a university with 200 posts for associate professors, and nine departments with varying number of posts is provided below. When the university is taken as a unit
When departments are taken as separate units
As can be seen in the above example, if departments are taken as separate units, there is a decrease in the number of reserved posts. The number of reserved posts decreased by five for SC, six for ST, five for OBC, and two for EWS. This example is corroborated by the special leave petition filed by the Ministry of Human Resource Development in the Supreme Court against the 2017 order of Allahabad High Court. It demonstrates that the number of reserved seats in Banaras Hindu University (BHU) decreased when departments were taken as separate units. The number of reserved posts decreased by 170 for SC, 114 for ST, and 90 for OBC.[5] EWS was not included in the reservation system when the BHU numbers were calculated. Thus, the trade off between the two systems is as follows. On the one hand, when the university is taken as a unit there is a possibility that some departments would only have reserved candidates and others would have only unreserved candidates. However, when a department is taken as a unit, there is a decrease in the total number of reserved posts within the university.
[1] Circular No. F. 1-5/2006(SCT), University Grants Commission, 2006. [2] O.M. No. 36012/2/96-Esst. (Res), ‘Reservation Roster- Post based- Implementation of the Supreme Court Judgement in the case of R.K. Sabharwal Vs. State of Punjab, Department of Personnel and Training, Ministry of Personnel, Public Grievances, and Pension, July 1997, http://documents.doptcirculars.nic.in/D2/D02adm/36012_2_96_Estt(Res).pdf. [3] Vivekanand Tiwari v. Union of India, Writ petition no. 43260, Allahabad High Court, April 2017. [4] O.M. No.36039/1/2019-Estt (Res), ‘Reservation for Economically Weaker Sections (EWSs) in direct recruitment in civil posts and services in the Government of India’, Department of Personnel and Training, Ministry of Personnel, Public Grievances, and Pension, https://dopt.gov.in/sites/default/files/ewsf28fT.PDF. [5] Special Leave Petition filed in Supreme Court by Ministry of Human Resource Development, January 2019, as reported in Indian Express, https://indianexpress.com/article/explained/simply-put-the-unit-in-teachers-quota-5554261/. Ministry of Personnel, Public Grievances, and Pension. |
Table 2: No. of posts reserved when department is taken as the unit
Note: Number of posts in each department are hypothetical. |
As can be seen in the above example, if departments are taken as separate units, there is a decrease in the number of reserved posts. The number of reserved posts decreased by five for SC, six for ST, five for OBC, and two for EWS. This example is corroborated by the special leave petition filed by the Ministry of Human Resource Development in the Supreme Court against the 2017 order of Allahabad High Court. It demonstrates that the number of reserved seats in Banaras Hindu University (BHU) decreased when departments were taken as separate units. The number of reserved posts decreased by 170 for SC, 114 for ST, and 90 for OBC.[5] EWS was not included in the reservation system when the BHU numbers were calculated.
Thus, the trade off between the two systems is as follows. On the one hand, when the university is taken as a unit there is a possibility that some departments would only have reserved candidates and others would have only unreserved candidates. However, when a department is taken as a unit, there is a decrease in the total number of reserved posts within the university.
[1] Circular No. F. 1-5/2006(SCT), University Grants Commission, 2006.
[2] O.M. No. 36012/2/96-Esst. (Res), ‘Reservation Roster- Post based- Implementation of the Supreme Court Judgement in the case of R.K. Sabharwal Vs. State of Punjab, Department of Personnel and Training, Ministry of Personnel, Public Grievances, and Pension, July 1997, http://documents.doptcirculars.nic.in/D2/D02adm/36012_2_96_Estt(Res).pdf.
[3] Vivekanand Tiwari v. Union of India, Writ petition no. 43260, Allahabad High Court, April 2017.
[4] O.M. No.36039/1/2019-Estt (Res), ‘Reservation for Economically Weaker Sections (EWSs) in direct recruitment in civil posts and services in the Government of India’, Department of Personnel and Training, Ministry of Personnel, Public Grievances, and Pension, https://dopt.gov.in/sites/default/files/ewsf28fT.PDF.
[5] Special Leave Petition filed in Supreme Court by Ministry of Human Resource Development, January 2019, as reported in Indian Express, https://indianexpress.com/article/explained/simply-put-the-unit-in-teachers-quota-5554261/.
