In its second iteration, the National Medical Commission (NMC) Bill seems to have gained from its time in the bottle, like ageing wine. The new version has some sharp divergences from the original. Presented in Parliament in 2017, it proposed to replace the Medical Council Act, 1956, but it lapsed with the dissolution of the Lok Sabha. The NMC will have authority over medical education — approvals for colleges, admissions, tests and fee-fixation. The provisions of interest are in the core area of medical education. The Bill proposes to unify testing for exit from the MBBS course, and entry into postgraduate medical courses. A single National Exit Test (NEXT) will be conducted across the country replacing the final year MBBS exam, and the scores used to allot PG seats as well. It will allow medical graduates to start medical practice, seek admission to PG courses, and screen foreign medical graduates who want to practise in India. Per se , it offers a definite benefit for students who invest much time and energy in five years of training in classrooms, labs and the bedside, by reducing the number of tests they would have to take in case they aim to study further. There are detractors, many of them from Tamil Nadu — which is still politically opposing the National Eligibility-cum-Entrance Test (NEET) — who believe that NEXT will undermine the federal system, and ask whether a test at the MBBS level would suffice as an entry criterion for PG courses.
The Bill has also removed the exemption hitherto given to Central institutions, the AIIMS and JIPMER, from NEET for admission to MBBS and allied courses. In doing so, the government has moved in the right direction, as there was resentment and a charge of elitism at the exclusion of some institutions from an exam that aimed at standardising testing for entry into MBBS. The government also decided to scrap a proposal in the original Bill to conduct an additional licentiate exam that all medical graduates would have to take in order to practise, in the face of virulent opposition. It also removed, rightly, a proposal in the older Bill for a bridge course for AYUSH practitioners to make a lateral entry into allopathy. It is crucial now for the Centre to work amicably with States, and the Indian Medical Association, which is opposed to the Bill, taking them along to ease the process of implementation. At any cost, it must avoid the creation of inflexible roadblocks as happened with NEET in some States. The clearance of these hurdles, then, as recalled from experience, become fraught with legal and political battles, leaving behind much bitterness. NEXT will have to be a lot neater.