Activists flag accountability gap as NMC scraps 2023 rules

1. At a Glance

• The National Medical Commission (NMC) has withdrawn the Maintenance of Standards of Medical Education Regulations, 2023 (MSMER-2023), effective 17 October 2026 [1].
• No single new regulation replaces it. Activists and experts say this leaves a regulatory and accountability gap: there is now no clear way to penalise medical colleges that break the rules or to verify what they disclose [1].
• UPSC relevance: the topic covers regulatory bodies set up by statute (the NMC Act, 2019), how standards are enforced in higher and medical education, the power to make delegated legislation, and patient safety (GS-II: Health, Education, Statutory Bodies).

2. Why in the News

• The NMC withdrew MSMER-2023 with immediate effect through a notification dated 14 October 2026, published in the Gazette on 17 October 2026 [1].
• Bejon Kumar Misra, a consumer rights activist, wrote to the Union government. He warned that false faculty declarations, inflated patient records or inadequate clinical training could go undetected and put patients at risk [1].
• He asked the Union Health Ministry and the NMC to say which enforcement mechanisms remain and to make sure standards can be independently verified [1].
• Ophthalmologist and medical activist Babu K.V. also raised concerns [1].

3. Background & Evolution

• Predecessor regime: the Medical Council of India (MCI) was set up under the Indian Medical Council Act, 1956. That Act was repealed and the MCI was dissolved [2].
• Interim phase: a Board of Governors replaced the MCI for a period. It was dissolved when the NMC came into being [2].
• NMC Bill, 2017: this was the earlier attempt at reform, which PRS analysed in a legislative brief [5].
• NMC Act, 2019: it took effect on 25 September 2020, the date the NMC was constituted [2][3].
• Main structural change: the MCI's members were elected by practitioners. The NMC is a non-elected, selected regulator [4].
• MSMER-2023: these regulations set out specific penalties, annual disclosure requirements, and procedures and timelines for enforcement and appeals. All of these lapsed when the regulations were withdrawn in 2026 [1].

4. Core Static Facts

5. Multi-Dimensional Analysis

Ethical / Governance

• Withdrawing the rules removes the deterrent penalties: ₹1 crore for institutions and ₹5 lakh for individuals [1].
• Colleges' annual self-disclosures may now go unverified, which raises the risk of "ghost faculty" and inflated patient loads [1].
• Activists are asking for standards that can be independently verified, as distinct from colleges certifying themselves [1].

Legal / Constitutional

• MSMER-2023 was delegated legislation made under the NMC Act, 2019. Withdrawing it leaves the parent Act's structure untouched [1][3].
• Without codified procedures and timelines for enforcement and appeals, the NMC's actions are more open to challenge for arbitrariness and to lawsuits [1].
• Under Sec. 16(2), the Boards act subject to Commission regulations. A gap in those regulations therefore weakens the Boards' operating framework [3].

Social / Public Health

• Patient safety is at stake: poor clinical training and inflated records directly affect the quality of the doctors produced [1].
• Students and their families depend on accurate disclosures about colleges when choosing where to study and how much to pay [1].

Administrative

• No single regulation replaces MSMER-2023, so compliance rules are scattered across the remaining framework [1].
• The Medical Assessment and Rating Board is the body under the Act that assesses colleges, so its tools for verification and penalties come under scrutiny [3].

Historical

• The MCI was replaced over governance concerns, and the reform swapped an elected council for a selected one [2][4]. Gaps in accountability now reopen the question of whether the new model actually works better.

6. Recent Developments (last 12-18 months)

• 14 Oct 2026: NMC notification withdrawing MSMER-2023 [1].
• 17 Oct 2026: notification published in the Gazette and withdrawal takes effect [1].
• Oct 2026: activists, led by Bejon Kumar Misra, wrote to the Union government asking for clarity on enforcement [1].
• 25 Oct 2026: The Hindu reported the concerns over the accountability gap [1].

7. Prelims Hooks

• The NMC was set up under the National Medical Commission Act, 2019 [3].
• The NMC Act came into force on 25 September 2020 [2].
• The NMC Act repealed the Indian Medical Council Act, 1956 [2].
• The NMC is the legal successor of the MCI (clause 61 of the Bill) [4].
• The Board of Governors that had replaced the MCI was dissolved on 25 September 2020 [2].
• There are four Autonomous Boards under Section 16 of the NMC Act [3].
• The Autonomous Boards are the UGMEB, PGMEB, MARB and EMRB [3].
• Each Board has a President, 2 whole-time members and 2 part-time members (Sec. 17(1)) [3].
• MSMER stands for Maintenance of Standards of Medical Education Regulations [1].
• MSMER-2023 allowed institutional fines of up to ₹1 crore [1].
• MSMER-2023 allowed personal fines of up to ₹5 lakh for submitting false records [1].
• MSMER-2023 was withdrawn effective 17 October 2026, through a notification dated 14 October [1].
• The MCI was an elected body; the NMC is not elected [4].

8. Why a Rule Without a Penalty Stops Working

• Self-disclosure works only if lying is costly
• Under MSMER-2023, colleges reported their own data every year: faculty, infrastructure, clinical facilities and patient load [1].
• What stopped them from lying was the fines: up to ₹1 crore on the college and up to ₹5 lakh on the person who signed a false record [1].

• With the fines gone, a college that lies risks less than before. A college that tells the truth gains nothing extra.

• The approval rules give colleges a reason to fake numbers

• Permission to open a medical college depends mainly on physical space, infrastructure and fixed faculty numbers [6].
• When approval depends on a headcount, the easy shortcut is to put names on paper. That is what "ghost faculty" means: teachers listed on the rolls who do not actually teach.

• So the need for checking has not gone away. Only the punishment for faking has.

• The punishment now falls on someone else

• When a college is caught late, its students and their patients pay the price. The management that faked the records does not.
• This is why the activists asked for standards that can be independently verified, meaning checked by someone other than the college itself [1].

9. The Same Weakness That Brought Down the MCI

• Parliament had already named this problem in 2016
• The Standing Committee on Health's 92nd Report (2016) found a conflict of interest: the MCI both gave colleges permission to open and was responsible for their quality [6].
• It asked for an independent accreditation body, separate from the body that grants licences. Accreditation means a check on whether a college actually meets quality standards [6].

• It also raised concerns about corruption. It said autonomy must come with accountability, because the regulator is funded by the government [6].

• Removing written rules brings back case-by-case discretion

• MSMER-2023 set out in writing which penalty applies, by when, and how to appeal [1].

• Without those written rules, each decision depends more on the judgement of officials. That kind of unchecked discretion is what the 2016 committee linked to the MCI's failures [6].

• Appeals have become weak again

• In 2018, the Standing Committee on the NMC Bill, 2017 said that making the central government the appeal authority over NMC decisions did not fit the constitutional principle of separation of powers (the idea that the body making rules should not also judge disputes about them) [7].
• It proposed a separate Medical Appellate Tribunal instead [7].

• MSMER-2023's appeal timelines at least gave colleges a fixed process [1]. Now even that is gone.

• The new regulator is less answerable to the profession

• The same 2018 committee noted that about 80% of NMC members are nominated, not elected [7].
• A nominated regulator answers mainly to the government. Clear, published rules were one of the few ways the public could hold it to account. Withdrawing them weakens that check.

10. The Case for Scrapping the Rules, and Where It Falls Short

• The strongest argument for withdrawal
• India's college rules have long been criticised for focusing on inputs (land, buildings, headcounts) instead of how well students are actually taught [6].
• The 2016 committee said high land and infrastructure requirements push up costs, so that even the government and genuine providers struggle to open colleges [6].

• India also has too few doctors. The Health Ministry cited one doctor for every 1,674 people, against the WHO norm of 1:1000 [6]. Heavy fines tied to rigid norms could slow the opening of new colleges.

• What this argument gets right

• Fining colleges for not meeting rigid input norms does not by itself produce better doctors. Reform of those norms is a fair goal.

• Where it falls short

• The fix for bad rules is better rules, not no rules. The withdrawal took effect with immediate effect, and no single regulation replaced it [1].
• The 2016 committee wanted to make it easier to open colleges and also to set up stronger independent quality checks. It never suggested dropping verification [6].
• Fines for false records punish dishonesty, not a lack of buildings. Removing them does nothing to cut costs for honest colleges.

11. What the NMC and Parliament Should Do Now

• The NMC should publish the replacement before the gap grows
• The Union Health Ministry and the NMC should state which enforcement powers still apply today. This is the specific demand in Bejon Kumar Misra's letter [1].

• Until a new regulation is notified, the old penalty scale and appeal timelines should be kept in place through a transition notice.

• Separate the body that checks from the body that approves

• Act on the 2016 committee's recommendation for independent accreditation, so that the Medical Assessment and Rating Board does not grade colleges using only data the colleges supply themselves [3][6].

• Make faculty and patient data public and checkable

• The 2016 committee found that the Indian Medical Register still listed dead and retired doctors, and asked for it to be kept as a live database [6].

• The same idea can be applied to college disclosures: a public, regularly updated faculty and patient-load register that students and activists can check against what colleges claim.

• Set up a proper appeals body

• Parliament should take up the 2018 committee's proposal for a Medical Appellate Tribunal, so that appeals against penalties do not go only to the ministry [7].

• Parliament should check how the rules were withdrawn

• The Committee on Subordinate Legislation reviews rules that regulators make under the powers an Act gives them. It can ask why MSMER-2023 was withdrawn without a replacement. This tests how well Parliament oversees delegated legislation (rules made by a body under powers given by an Act of Parliament).

12. Anchors for Answers

• Data: MSMER-2023 allowed fines of up to ₹1 crore on institutions and ₹5 lakh on individuals for false records, and both lapsed in October 2026 [1]; the Health Ministry cited one doctor per 1,674 people against the WHO norm of 1:1000 [6]
• Report/Committee: Standing Committee on Health and Family Welfare, 92nd Report on the Functioning of the MCI (2016): conflict of interest between approving colleges and ensuring their quality, and a call for independent accreditation [6]; Standing Committee report on the NMC Bill, 2017 (March 2018): proposed a Medical Appellate Tribunal and noted that about 80% of NMC members are nominated [7]
• Law/Case: National Medical Commission Act, 2019, Sec. 16 (four Autonomous Boards, including the MARB) and Sec. 16(2) (Boards act subject to Commission regulations) [3]; repealed the Indian Medical Council Act, 1956 [2]

13. Mains Relevance

• GS-II: Statutory, regulatory and quasi-judicial bodies; Issues relating to development and management of the Social Sector/Services relating to Health and Education.
• GS-IV: Probity in governance, accountability and transparency in institutions.
• Possible question stems: 1. "Replacing the MCI with the NMC was meant to end regulatory capture, yet questions of accountability remain." Critically examine this statement. 2. Discuss how withdrawing enforcement-oriented regulations affects the quality of medical education and patient safety in India. Suggest measures to make standards independently verifiable. 3. Delegated legislation gives regulators flexibility but can produce regulatory vacuums. Illustrate with reference to recent changes in medical education regulation.

14. Related Topics to Study Next

• NMC Act, 2019 (full provisions): the source of the NMC's power to make regulations and to impose penalties.
• Medical Assessment and Rating Board: the body that assesses and rates colleges, which is central to verification.
• NEET-UG/PG and NExT: entry and exit tests regulated under the NMC framework.
• National Commission for Indian System of Medicine Act, 2020: a parallel regulator for AYUSH systems.
• Delegated legislation and parliamentary oversight: the Committee on Subordinate Legislation.
• Proposed HECI (Higher Education Commission of India): a similar overhaul of education regulation.
• Consumer Protection Act, 2019: the angle of patients and students as consumers.

15. NCERT Concepts to Revise

• National Medical Commission (Polity): The regulator that scrapped the 2023 rules; know its Act, boards and how it replaced the MCI.
• Delegated legislation (Polity): MSMER-2023 was a regulation made under the NMC Act, so withdrawing it shows how delegated rules work.
• Accountability (Polity): The core complaint is that, without penalties and verification, colleges and the regulator can't be held answerable.
• Regulatory capture (Polity): The NMC replaced the MCI to curb capture by the medical profession; the exam asks whether it succeeded.
• Committee on Subordinate Legislation (Polity): This parliamentary committee checks regulations like MSMER-2023, and the note lists it as a topic to study.
• Transparency (Polity): Annual college disclosures and independent verification of them are about open, checkable information for students and patients.

16. Common Errors / Trap Areas

• The NMC Act's dates: it was enacted in 2019 but came into force on 25 September 2020, not in 2019 [2].
• Number of boards: there are four Autonomous Boards, not three. The MARB is often left out [3].
• Board composition: read Sec. 17(1) of the enacted Act (a President plus 4 members, 2 of them part-time). Some summaries of the Bill describe it differently [3][4].
• Withdrawal vs. replacement: MSMER-2023 was withdrawn and not replaced by a single new regulation [1].
• Notification date vs. effective date: the notification is dated 14 October, but the withdrawal took effect from Gazette publication on 17 October [1].