National Medical Commission proposes a single national licence to practise medicine

Why in the News

The National Medical Commission has notified draft regulations under which a doctor registered with any one State Medical Council would be able to practise anywhere in India without fresh registration, using a unique identification number in the National Medical Register. The right to practise is being nationalised while the power to discipline stays with the State where the alleged misconduct occurred.

What do the draft Registration of Medical Practitioners and Licence to Practice Medicine (Amendment) Regulations, 2026 propose?

1. The core change: A medical practitioner once registered with a State Medical Council would be eligible to practise across India without obtaining fresh registration or a licence in another State.
2. The identifier: The practitioner would be allotted a Unique Identification (UID) number in the National Medical Register (NMR), which becomes the single reference for the right to practise.
3. What it amends: The draft amends the 2023 regulations governing registration and licensing of doctors, and routes the process through a unified registration portal of the Commission's Ethics and Medical Registration Board.
4. Stage and consultation: The draft was notified by the Commission on 11 August 2026, and objections and suggestions have been invited for 30 days from the date of notification.

What is the National Medical Register (NMR)?

1. Function: The National Medical Register is the central repository of registration details of all medical practitioners in India, maintained by the National Medical Commission alongside the State Medical Registers kept by each State Medical Council. Under the draft it would also hold disciplinary records and the active or inactive status of every licence.

Who is the Ethics and Medical Registration Board?

1. Role: The Ethics and Medical Registration Board is one of the four autonomous boards of the National Medical Commission, responsible for maintaining the National Medical Register and regulating professional conduct and ethics. Under the draft it would allot the unique identification number and operate the unified registration portal.

How would the unique identification number work?

1. Composition of the number: The unique identification number assigned in the register would incorporate the State or Union Territory code and the practitioner's State Medical Register number.
2. Sequence of grant: The State Medical Council first grants registration, and the Ethics and Medical Registration Board then allots the unique identification number.
3. Effect of allotment: Once the number is allotted, the doctor would not require fresh registration or a separate licence to practise in another State or Union Territory.
4. Register synchronisation: The draft proposes automatic electronic synchronisation between the national and State registers, so a change made in one register is reflected in the other.

What changes for State Medical Councils?

1. Entry point unchanged: State Medical Councils would continue to scrutinise applications and to grant registration and licence for doctors to practise.
2. Dual reflection of approval: The approval would be reflected in both the State Medical Register and the National Medical Register.
3. Central oversight added: The Ethics and Medical Registration Board and the Commission would have powers to seek records and monitor State Medical Councils.
4. The stated purpose of oversight: The monitoring power is intended to promote uniformity and transparency in regulation across States.

How is disciplinary jurisdiction handled under the draft?

1. Territorial principle retained: Disciplinary jurisdiction stays primarily with the State Council in whose territorial jurisdiction the alleged professional misconduct, unethical conduct or medical negligence occurred.
2. Powers of that Council: It has the power to inquire into and decide the matter, and to record the outcome against the practitioner's credentials in the online register.
3. Cross council cases: Where disciplinary action is recommended by a State Council other than the doctor's primary registering council, the action would be reflected in the National Medical Register.
4. Automatic flow back: That action would then be automatically updated in the State register of the council of primary registration.
5. What the register would carry: The National Medical Register would hold disciplinary proceedings including suspension, removal and restoration of registration, and details of disciplinary action taken.

What happens to licence validity and renewal?

1. Validity retained: The proposal retains the five year validity of a licence to practise.
2. Renewal window: If a doctor does not apply for renewal within three months of expiry, the registration will be marked inactive.
3. Consequence of inactive status: A practitioner whose registration is marked inactive is not entitled to practise medicine.
4. Visibility of status: The National Medical Register would carry whether a doctor's licence is active or inactive, so the status is nationally visible.

Does a national licence without a national disciplinary forum close the accountability gap?

1. Portability of practice is immediate: A single number confers the right to practise in every State and Union Territory from the moment it is allotted.
2. Portability of accountability is derived: Discipline still runs through whichever State Council has territorial jurisdiction over the place of the alleged misconduct, and reaches the rest of the country only through register synchronisation.
3. The gap is procedural, not conceptual: If synchronisation lags or a State Council does not record an outcome, a suspended practitioner remains visible as active elsewhere.
4. Uniformity of standards is not guaranteed: Different State Councils apply the professional conduct regulations with differing rigour, and a national licence carries the outcome of the least rigorous forum as readily as the most rigorous.
5. The Commission's answer is oversight, not adjudication: The draft responds with powers to seek records and monitor State Councils rather than with a central disciplinary forum.

Challenges to the proposed national licence framework

1. Synchronisation dependence: The entire accountability design rests on electronic updates between the national and State registers working without delay. e.g. a suspension recorded by one State Council but not reflected in the National Medical Register would leave a barred doctor practising elsewhere.
2. Uneven State Council capacity: State Medical Councils differ widely in staffing, digitisation and case disposal, and the weakest becomes the entry point for the whole country. e.g. State Councils with long pending complaint backlogs would still be the first scrutiny layer for national practice rights.
3. Forum shopping in registration: Applicants may seek primary registration with the council perceived to have the lightest scrutiny, since the licence is then valid everywhere. e.g. the unique identification number carrying the State code makes the choice of registering State visible but does not restrict it.
4. Renewal lapse risk: A three month renewal window creates a cliff on which an administrative omission ends the right to practise. e.g. a practitioner on long clinical assignment abroad missing the window and finding registration marked inactive.
5. Data accuracy in the register: A national register carries forward whatever errors and duplicates the State registers already contain. e.g. duplicate entries across State registers have long complicated counts of registered allopathic practitioners in India.
6. No stated appellate route in the draft: The draft records the State Council's power to inquire and decide without setting out a national appellate forum against an adverse finding. e.g. a doctor disciplined by a State Council other than the primary registering council faces consequences nationally through the register.
7. Interface with the criminal and consumer forums: Professional discipline runs alongside criminal prosecution and consumer litigation, and the register reflects only the first. e.g. a practitioner facing a medical negligence complaint under the Consumer Protection Act, 2019 with no corresponding entry in the register.

Conclusion

The draft Registration of Medical Practitioners and Licence to Practice Medicine (Amendment) Regulations, 2026 stand notified by the National Medical Commission on 11 August 2026, with objections and suggestions invited for 30 days from the date of notification, which is the next milestone in the process. The proposal creates portable practice rights through a unique identification number while leaving discipline with the State Council of the place of misconduct. The accountability question turns on whether automatic synchronisation between the National Medical Register and the State registers actually works in practice. A national licence with a fragmented disciplinary record would widen mobility faster than it widens accountability.

Medical Regulation in India

1. The apex regulator: The National Medical Commission (NMC) regulates medical education and medical practice in India, having replaced the Medical Council of India in 2020.
2. Four autonomous boards: The Under Graduate Medical Education Board, the Post Graduate Medical Education Board, the Medical Assessment and Rating Board, and the Ethics and Medical Registration Board.
3. Two tier registration: Registration is granted by State Medical Councils and recorded in State Medical Registers, with the National Medical Register maintained centrally.
4. Common entrance and exit: Admission to undergraduate and postgraduate medical courses runs through the National Eligibility cum Entrance Test, and the National Exit Test is provided for as a common final year and licentiate examination.
5. Scale of the system: India has expanded medical college and undergraduate seat capacity substantially over the past decade, with the government citing a doctor to population ratio better than the World Health Organization norm of one per thousand when practitioners of all recognised systems are counted.
6. Plural systems of medicine: Allopathic practice is regulated by the National Medical Commission. Ayurveda, Yoga, Unani and Siddha are regulated by the National Commission for Indian System of Medicine, and homoeopathy by the National Commission for Homoeopathy.

Laws and Rules Governing Medical Practice in India

1. National Medical Commission Act, 2019: Establishes the Commission and its four autonomous boards, provides for the National Medical Register, the National Eligibility cum Entrance Test and the National Exit Test, and repealed the Indian Medical Council Act, 1956.
2. Statutory basis of the register: The Act requires a National Register of licensed practitioners to be maintained and made publicly available.
3. Registration of Medical Practitioners and Licence to Practice Medicine Regulations, 2023: The regulations the present draft seeks to amend, governing registration and licensing procedure.
4. National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2023: Set out the ethical duties of doctors, including on prescribing by generic name, telemedicine and consent.
5. Clinical Establishments (Registration and Regulation) Act, 2010: Provides for registration and minimum standards for clinical establishments in adopting States and Union Territories.
6. Consumer Protection Act, 2019: Provides the forum for medical negligence claims as deficiency in service, separate from professional disciplinary proceedings.
7. Drugs and Cosmetics Act, 1940: Regulates the manufacture, sale and prescription of drugs that registered practitioners are authorised to prescribe.
8. Mental Healthcare Act, 2017: Governs the treatment and rights of persons with mental illness and the registration of mental health professionals and establishments.
9. Transplantation of Human Organs and Tissues Act, 1994: Regulates removal, storage and transplantation of human organs, with obligations placed on registered practitioners.

Government Initiatives in Medical Regulation and Health Human Resources

1. National Medical Register portal: Launched by the Commission to create a verifiable public register of allopathic practitioners with unique identification numbers.
2. Ayushman Bharat Digital Mission: Maintains the Healthcare Professionals Registry and the Health Facility Registry, linking verified practitioner identity to digital health records.
3. Pradhan Mantri Swasthya Suraksha Yojana: Funds new All India Institutes of Medical Sciences and upgrades existing government medical colleges to expand tertiary care and teaching capacity.
4. Centrally Sponsored Scheme for district hospital upgradation: Supports establishment of new medical colleges attached to existing district and referral hospitals in underserved districts.
5. National Exit Test: Provided for under the National Medical Commission Act, 2019 as a single examination serving as the final year undergraduate examination, the licentiate examination and the postgraduate entrance test.
6. Telemedicine Practice Guidelines, 2020: Permit registered practitioners to consult remotely within a defined professional and ethical framework.
7. eSanjeevani: The national teleconsultation platform connecting patients to registered practitioners through health and wellness centres and directly from home.

Key Facts about the National Medical Commission

1. Year of operation: The Commission came into being in 2020 on the repeal of the Indian Medical Council Act, 1956 and the dissolution of the Medical Council of India.
2. Composition: It is headed by a Chairperson and includes ex officio and part time members, with the presidents of the four autonomous boards as members.
3. Medical Advisory Council: The Act creates a Medical Advisory Council as the primary platform through which States and Union Territories place their views before the Commission.
4. Rating power: The Medical Assessment and Rating Board assesses and rates medical institutions and grants permission to establish new medical colleges.
5. Fee regulation: The Commission frames guidelines for the determination of fees for a proportion of seats in private medical institutions and deemed universities.

Challenges in Medical Regulation in India

1. Maldistribution rather than absolute shortage: Doctors concentrate in metropolitan and urban districts while rural and tribal blocks remain unstaffed. e.g. persistent vacancies of specialists at Community Health Centres reported in successive Rural Health Statistics.
2. Quackery and unqualified practice: Unregistered practitioners operate widely where regulated supply is thin, and a national register alone does not displace them. e.g. State Medical Councils issuing repeated public notices against unqualified practitioners in rural districts.
3. Ethics enforcement capacity: Professional conduct proceedings are slow and outcomes are inconsistent across State Councils. e.g. complaints of professional misconduct pending for years before State Medical Councils.
4. Cost of medical education: High private medical college fees shape both who enters the profession and where graduates practise. e.g. the Commission having to issue fee determination guidelines for a share of private and deemed university seats.
5. Postgraduate seat bottleneck: Undergraduate seat expansion has outpaced postgraduate capacity, leaving a specialist training gap. e.g. the ratio of postgraduate to undergraduate seats remaining a standing constraint on specialist availability.
6. Faculty shortage in new colleges: Rapid expansion of colleges has outrun the availability of qualified teaching faculty. e.g. assessment findings of faculty deficiencies at newly permitted medical colleges.
7. Fragmented digital records: Practitioner data sits across State registers, the national register and separate health workforce databases with limited reconciliation. e.g. duplicate and outdated entries complicating any count of practising allopathic doctors.

Back2Basics: National Medical Commission (NMC)

1. Governing Act: Established under the National Medical Commission Act, 2019.
2. Year established: Constituted in 2020, replacing the Medical Council of India which functioned under the Indian Medical Council Act, 1956.
3. Parent ministry: Functions under the Union Ministry of Health and Family Welfare.
4. Jurisdiction: Regulates medical education, medical institutions, medical research and medical professionals in the allopathic system across India.
5. Composition: A Chairperson, ex officio members including the presidents of the four autonomous boards, part time members, and members representing States and Union Territories on a rotational basis.
6. Autonomous boards: Under Graduate Medical Education Board, Post Graduate Medical Education Board, Medical Assessment and Rating Board, and Ethics and Medical Registration Board.
7. Core mandate: To improve access to quality and affordable medical education, ensure availability of adequate and high quality medical professionals, and maintain a national register of licensed practitioners.
8. Key instruments: The National Eligibility cum Entrance Test, the National Exit Test, the National Medical Register and the professional conduct regulations.

Way Forward

1. Guarantee synchronisation by design: Build the national and State registers on a single source of truth rather than on periodic updates, so that a suspension takes effect nationally the moment it is recorded.
2. Set uniform disciplinary standards: Issue binding procedure and timeline norms for State Council inquiries, so that a national licence does not carry the outcome of the weakest forum.
3. Create a national appellate tier: Provide an appeal from a State Council's disciplinary decision to the Ethics and Medical Registration Board, since the consequence of that decision is now national.
4. Clean the register before nationalising it: Complete deduplication and verification of State registers before unique identification numbers become the basis of practice rights everywhere.
5. Make the register publicly searchable: Allow patients and employers to verify a practitioner's licence status and disciplinary record by unique identification number, which is the only way a register changes behaviour.
6. Provide a renewal grace mechanism: Allow reactivation on application with reasons where the three month window has lapsed for demonstrable cause, so that an administrative lapse does not end a career.
7. Use the register for workforce planning: Link active licence data to district level workforce mapping so that maldistribution can be measured and addressed rather than estimated.

Matching Previous Year Question

“No direct PYQ traced in the provided files. Closest microtheme: Sectoral Regulatory Bodies.”