The National Medical Commission (NMC) has withdrawn its 2023 regulations governing medical education standards, removing a framework that prescribed specific penalties for colleges found violating norms.
However, the regulator clarified that the decision aims to eliminate overlapping procedures rather than dilute oversight, while questions remain about how violations will be addressed under the existing framework.
What did MSMER 2023 cover?
Introduced in September 2023, the MSMER framework sought to ensure that medical colleges maintained prescribed educational standards and provided accurate information about their faculty, infrastructure and clinical facilities.
The regulations specified consequences for violations, including cases involving ghost faculty, or teachers listed in institutional records who did not actually work at the college, as well as false declarations and manipulated records.
Under the 2023 regulations, the NMC could impose a range of penalties depending on the nature of the violation. Medical colleges faced financial penalties of up to ₹1 crore for each violation or act of omission. The framework also allowed the regulator to issue warnings and direct institutions to rectify deficiencies within a specified period.
Other penalties for medical colleges included:
- Restrictions on new courses and seats: The regulator could withhold the processing of applications for new courses or increases in existing seats for the relevant academic year or subsequent years
- Reduction in student intake: Colleges could be directed to reduce the number of students admitted in subsequent academic years
- Suspension of admissions: Admissions to one or more courses could be stopped for the next or subsequent academic years
- Accreditation and permission restrictions: The regulator could withhold accreditation, withdraw it for up to five academic years, or recommend withdrawing permission to operate
- Suspension of applications: Any attempt to pressure the NMC or its boards through intermediaries could lead to an immediate halt in the processing of all applications and requests from the institution
The regulations also prescribed individual accountability for false declarations. Faculty members, heads of departments, deans, directors and doctors who submitted false declarations, documents or records, including patient records, could face fines of up to ₹5 lakh. They could also face action for professional misconduct under the applicable Registered Medical Practitioner (Professional Conduct) Regulations. The NMC’s boards could initiate criminal proceedings where false information was furnished or documents were fabricated, in accordance with the criminal law in force.
The framework allowed institutions a reasonable opportunity to rectify deficiencies before further action was taken where applicable. It also provided an appeal mechanism under which an aggrieved institution could approach the NMC within 60 days and, subject to the prescribed conditions, appeal to the central government within a further 30 days if dissatisfied with the decision or if the NMC did not decide the appeal within 45 days.
What changes for medical colleges?
The key change is the removal of the specific penalties prescribed under MSMER 2023. The NMC says its decision is intended to eliminate overlapping regulatory procedures, with the Medical Assessment and Rating Board (MARB) retaining its statutory authority to inspect institutions, verify compliance and take action against colleges that fail to meet prescribed standards.
The NMC Act provides the statutory basis for regulating medical education, while other laws may apply when misconduct involves fraud or other offences. However, Dr Sabine Kapasi, UN adviser and global health strategist, pointed out, “The withdrawn regulations prescribed financial penalties and restrictions on admissions or permission to operate for different forms of non-compliance. The NMC must now clarify which of these consequences remain available under existing provisions and where fresh regulations may be needed to ensure colleges continue to be held accountable.”
Annual Disclosures remain mandatory
Medical colleges must continue submitting Annual Disclosure Reports under Sections 24(i) and 25(h) of the NMC Act, 2019, and the applicable regulations.
These reports contain information about faculty strength, infrastructure, clinical facilities, patient load and other prescribed parameters. According to the NMC, the disclosures will remain subject to scrutiny and verification through the MARB’s statutory assessment and inspection mechanisms.
The notification, issued last week, also contains transitional provisions. Actions already taken, approvals granted and liabilities incurred under the 2023 regulations remain unaffected, while pending proceedings will continue under the earlier rules, as applicable. Matters arising after the withdrawal will be governed by the statutory and regulatory provisions then in force.
Impact on medical students
For students, the central concern is whether robust inspections and enforcement will safeguard the quality of medical training.
“If a college claims to have faculty members who do not actually work there, students may lose valuable teaching time and clinical guidance, affecting the quality of doctors entering the healthcare system,” Dr Kapasi warned.