The establishment of the National Medical Commission (NMC) in the year 2020 marked a pivotal moment in the evolution of medical education in India. It was envisioned to be a contemporary regulator to support quality education, foster ethical standards, and align with the aspirations of the medical profession and the healthcare needs of the country.
Replacing the Medical Council of India (MCI)—which had long guided Indian medical education and professional standards—the NMC was expected to introduce reform and usher in greater transparency, improved governance, and forward-looking reforms suited to contemporary challenges.
While it may still be too early for a comprehensive judgment, initial assessments by the medical community and public health professionals suggest that much more needs to be done and with a greater sense of urgency.
The Commission continues to face significant structural and operational hurdles. A considerable number of key posts within the NMC and its affiliated boards remain vacant, slowing decision-making and limiting the ability to implement essential reforms.
One recurring concern is the process of inspection and accreditation of medical colleges. Many medical institutions report that inspection periods are times of great uncertainty and stress. It is widely known that irregularities and inefficiencies influence outcomes.
Such situations, if left unaddressed, have far reaching implications not only for institutions but also for the students they graduate, and ultimately for the quality of care delivered across India’s healthcare system.
Among the most ambitious proposals under the NMC was the National Exit Test (NEXT)—a single exam intended to serve as the final MBBS examination, a licensure requirement, and an entrance to postgraduate studies rolled into one. It was designed with the aim to bring uniformity, fairness, and accountability into the system. However, its implementation has been delayed.
A well-structured and efficiently conducted NEXT exam could serve as a valuable tool to evaluate both students and the institutions they graduate from. It would also offer a transparent mechanism to ensure consistency in educational outcomes nationwide. There is still time to re-energize this initiative and make it a cornerstone of quality assurance.
The National Board of Examinations (NBE), which provides another stream of postgraduate medical education, offers a successful example of what autonomy and focused leadership can achieve.
Over the years, the NBE has built a strong reputation for transparency, efficiency, and academic integrity. Its examination processes, institutional assessments, and stakeholder engagement practices are generally seen as reliable, consistent, and forward-thinking.
The NBE’s success lies in its operational autonomy, professional governance, and adoption of technology-enabled systems. Its model of functioning—free from excessive bureaucracy and driven by meritocratic principles—can offer valuable lessons to the NMC. Adapting similar frameworks could help the NMC address long-standing challenges and deliver on its mandate more effectively.
At a time when digital tools and artificial intelligence are transforming every sector, medical regulation must also evolve. Modern technology can enable continuous, real-time monitoring of key indicators such as hospital load, faculty strength, patient volumes, teaching hours, and student attendance.
This offers a compelling alternative to traditional manual inspections. A transparent, data-driven, and technology-enabled system would reduce the burden on institutions, promote consistency, and significantly limit the scope for subjectivity or error. The NMC now has a tremendous opportunity to pioneer such systems and set a new benchmark for regulatory practices in the healthcare education sector.
To achieve its full potential, the NMC must be strengthened structurally. One important step is to ensure that its members are individuals with deep professional knowledge and experience, drawn from the highest levels of medical education, clinical practice, public health, and institutional governance.
The post of Secretary, in particular, requires urgent attention. This critical role should not be treated as a routine administrative appointment but rather entrusted to someone with adequate domain expertise, as is done with the Executive Director of the NBE.
In the case of the NBE, the Executive Director is selected through a search-and-selection committee comprising reputed medical professionals—ensuring both legitimacy and professional competence.
A similar process should be instituted for the NMC Secretary. At present, the role risks being reduced to bureaucratic oversight and staff management, rather than leading key academic and regulatory functions. Given the complex, technical decisions required, the Secretary must be empowered with the knowledge, independence, and stature necessary to lead with credibility and vision.
Just as essential is granting the NMC the operational autonomy it needs to implement reforms with confidence and agility. Within a framework of accountability, the Commission must be empowered to take independent action in the interest of the profession and public health. Without this, reform efforts will remain fragmented, and trust among stakeholders will be difficult to restore.
India’s healthcare landscape is evolving rapidly. With rising demand for quality care, equitable access, and well-trained professionals, our regulatory systems must be ready to support innovation, ethics, and excellence.
The medical community feels that there is an urgent need to recalibrate and strengthen the NMC. With the right leadership, enhanced autonomy, and a commitment to transparency, the NMC can fulfil the role it was created for: an enabler of quality education, professional integrity, and system-wide trust.
The future of India’s healthcare workforce depends on the institutions that educate and regulate them. By embracing thoughtful reform, leveraging technology, and drawing lessons from successful models like the NBE, the NMC can still emerge as a catalyst for national progress.
The decision-makers must ensure that the NMC lives up to its promise: to serve students, empower educators, guide institutions, and ultimately, secure the health and well-being of the people of India.
The article is written by Dr Alexander Thomas Founder Patron, AHPI, ANBAI, CAHO and and Prof. O. V. Nandimath Prof. at National Law School of India University [NLSIU], Bangalore.
(DISCLAIMER: The views expressed are solely of the author and ETHealthworld.com does not necessarily subscribe to it. ETHealthworld.com shall not be responsible for any damage caused to any person/organisation directly or indirectly)
