IMA express concerns over the recently launched National Medical Register and the impact it can have on doctors and state medical councils.
Published Sep 18, 2024 | 7:00 AM ⚊ Updated Sep 18, 2024 | 7:00 AM
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The National Medical Commission (NMC) has launched a new portal – the National Medical Register (NMR) – in which, all allopathy doctors eligible to practice in India must register, upon when they will be provided with a unique ID.
However, the role of NMR in such a regulatory framework has raised concerns about whether it would undermine the authority of State Medical Councils (SMCs), which have been established through legislative procedures. Until now, SMCs were responsible for registering and licensing doctors.
The launch of NMR has sparked concerns about the potential encroachment of state autonomy, as healthcare is a subject governed jointly by state and Union governments.
According to the National Medical Commission (NMC), NMR is a dynamic database that will serve as a central repository for all registered doctors, with their authenticity verified through Aadhaar IDs.
All doctors currently registered on the Indian Medical Register (IMR) must re-register on the NMR, as announced in a recent public notice by the NMC. The notice also mentioned that all medical colleges, institutions, and state medical councils will be interconnected through the portal.
The portal was launched on 23 August by Union Minister for Health & Family Welfare, JP Nadda. The NMC is mandated under Section 31 of the NMC Act, 2019, to ensure that the Ethics & Medical Registration Board (EMRB) maintains a digital National Register in electronic form. This register will contain the name, address, and all recognised qualifications of licensed medical practitioners.
The introduction of the National Medical Register has received mixed reactions from the medical community. Dr. RV Asokan, President of the Indian Medical Association (IMA), looks at the development from both perspectives.
Talking about the positive aspects, to South First, the doctor acknowledged that NMR offers doctors the advantage of procuring license to practise in multiple states, which can in turn enhance data fidelity.
“A doctor will be able to practice in more than one state, which wasn’t possible before. Doctors are migrating a lot and this portal will make things easy for those doctors, especially in situations in which certifications or approvals cannot be acquired in time.”
Elaborating on how it was earlier difficult for migrating doctors and their families, Asokan said, “The portal enables accurate maintenance of data. We will be able to have clarity on the number of doctors in the country, how many have passed away, and who has stopped practicing. Despite these benefits, the larger issue remains that we have built this nation as a federal country, and that principle is being undermined here.”
Highlighting concerns about what it would mean for the state medical councils – independent bodies established by respective state legislatures – Dr Asokan points out that the NMR might reduce the role of these councils and make them secondary institutions.
“However, the registration process will now start with the National Medical Council (NMC). Once a doctor registers with the NMC, they are expected to approach the State Medical Council for the actual verification of their certificates and other documents to establish their bona fides. Only then will the State Medical Councils issue them a license to practice,” said Dr. Asokan, IMA President, to South First.
He added, “We were not particularly keen on this process and raised our concerns about federalism. However, this issue falls within the purview of the state governments, and they need to address it with the central government. According to the Constitution of India, this is a matter of shared powers, but that balance seems to be tampered with here.”
The doctors raised these concerns when the NMC Act was passed because NMC’s decisions are binding on State Medical Councils, which is an anachronism. This doesn’t align with the spirit of our Constitution, explained the doctor.
“This issue should have been challenged at the time, but it wasn’t, leaving us – the IMA – the sole body opposing the NMC. Isn’t it the responsibility of the state governments to defend their State Medical Councils? After all, they created these councils through the state legislature. It’s up to them to raise the matter at forums like the National Development Council, where the Prime Minister and all the Chief Ministers can decide what the way forward should be,” he said, criticising the state governments for not addressing the issue.
To begin the registration process on the National Medical Register (NMR), doctors must provide their Aadhaar ID, a digital copy of their MBBS degree certificate, and the registration certificate from the State Medical Council or Medical Council of India where they were first registered.
They can manually submit additional information, such as registration and qualification details, through the portal. The application is then automatically forwarded to the respective State Medical Council (SMC) for verification.
Once the SMC verifies these applications, it is forwarded to the relevant college or institution for further review. After verification is complete, the application is sent to the National Medical Commission (NMC).
Upon final approval, a unique NMR ID will be issued to the doctor. During this process, doctors also have the option to join the Healthcare Provider Registry, which connects them to the broader digital healthcare ecosystem.
The NMR portal allows stakeholders, including SMCs and educational institutions, to log in and verify applications from a unified platform.
It offers several features, such as adding additional qualifications, tracking applications, suspending licenses, and issuing NMR IDs and digital doctor certificates.
Currently, registration on the portal is limited to MBBS degrees, but the option to add additional qualifications will be available soon. An NMC official said that, until now, comprehensive data providing a detailed overview of the total number of doctors in the country, including those who have migrated, lost their license, or passed away, was lacking. The launch of the NMR is expected to provide data on over 1.3 million doctors.
Document submission challenges: Doctors are required to submit multiple documents, including their MBBS degree certificate, State Medical Council registration certificate, and Aadhaar number for identity verification. For many, accessing these original documents can be challenging and time-consuming, especially for those who do not have them readily available.
Technical difficulties: The online registration process has presented technical challenges, particularly for doctors who are not tech-savvy. Issues such as difficulty navigating the website, data entry errors, and system downtimes have made the process cumbersome for some users.
Data privacy and security concerns: The linking of Aadhaar IDs with the NMR has raised concerns about data privacy and security. Many doctors worry about how their personal information will be stored and used, as well as the potential risks of data breaches.
Lack of detailed guidelines: Doctors have expressed frustration over the lack of detailed guidelines and communication from the NMC about the registration process and its broader implications. Many feel that the NMC should provide more comprehensive instructions and better support to help them transition smoothly into the new system.
Consequences of non-compliance: The potential penalties or loss of the ability to practice medicine legally in India for failing to complete the re-registration process have added pressure on doctors, heightening anxiety about ensuring compliance with the new regulations.
Dependence on SMCs: The success of the NMR registration process heavily depends on the cooperation of SMCs. Delays or inefficiencies in how SMCs handle the verification process can create bottlenecks, complicating the registration process and causing additional stress for doctors.
(Edited by Neena)
