Attention Doctors! Here's How to submit appeals against state medical council orders, NMC releases detailed SOP

Published On 2024-09-09 12:31 GMT   |   Update On 2024-09-09 13:16 GMT

Kolkata: To ensure a standardized process for the disposal of appeals received from the Registered Medical Practitioners (RMPs) against the decisions of the State Medical Councils (SMCs), the National Medical Commission (NMC) has released a Standard Operating Procedure (SoP) for handling these appeals.

Through a recent notice, the Ethics and Medical Registration Board (EMRB) of NMC informed that the SOP covers the different stages of handling an appeal- from receiving of appeal from the appellant to the disposal of the appeal.

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"Intention to frame SOP is to deliver decisions that are not only legally sound but also fair, reasonable and transparent to ensure that each case is decided on its own merits without bias or prejudice in accordance with laws and regulations," Dr. Yogender Malik, a member of NMC Ethics and Medical Registration Board mentioned in the notice dated 29.08.2024.

Referring to this notice, NMC Secretary Dr. B Srinivas mentioned, "Reference is invited to Public Notice no. R- 19022/32/2024- Ethics dated 29-08-2024 (copy enclosed) of the Ethics & Medical Registration Board (EMRB) enclosing the Standard Operating Procedure for handling appeals received from Registered Medical Practitioners (RMPs) against the order/decision of State Medical Councils. The contents of the notice are self-explanatory. All concerned stakeholders are requested to kindly take note of the same."

SOP for Handling Appeals Received from RMPs Against the orders of the SMCs: 

Objective: 

NMC has framed up the SOP to ensure the standardized process for disposal of appeals received from Registered Medical Practitioners (RMPs) against the order/decision of State Medical Councils and the entire process will be handled by the Ethics and Medical Registration Board (EMRB) of NMC.

Process to handle appeals from RMPs: 

As per the SOP released by NMC, once an appeal is filed by the RMP, it reaches Level 1 of the process, where the appeal is received by the Ethics Section (EMRB) Board. Thereafter the appeal application gets verified for completion and document verification. If the application is found deficient, a letter is sent to the appellant to complete the deficiency and after completing the document, the appellant submits the same to EMRB.

If the application is not deficient, comments (if any) are added, file number is generated and the application is forwarded to the next level. 

At the Level 2, the file is reviewed and comments are added, if any. Following this, the application reaches Level 3, where again the file is reviewed and comments (if any) are added and the same process is repeated at Level 4 as well. Consequently, at Level 4 (which includes anyone from the Board) the appeal is requested to be placed for an Internal meeting with the EMRB board.

Following this, the EMRB Board reviews the appeal and provides comments (if any. If the appeal is rejected, the decision is communicated to the appellant and process ends here.

If the appeal is accepted, it is examined if there is any condonation and if the same is granted. Following this, the Appeal Examination Process starts.

Appeal Examination Process: 

After the appeal is accepted and condonation is granted, stay is granted or not granted. Following this, letter is sent to the appellant for informing that the appeal has been accepted. Similarly, the complainant is also sent a letter and written submission for informing appeal has been accepted and the complainant is asked for comments.

A letter is also sent to the SMC to inform appeal has been accepted and stay order (if any) is on the SMC decision and the SMC is asked for sharing all the documents related to the appeal.

This is followed by an exchange of documents between complainant and Appellant. If the SMC does not share documents, reminder letters are sent with gap of 15 days, 10 days and 7 days.

Consequently, the Board nominates Subject Matter experts, and letter is sent to experts sharing the willingness, nomination and conflict of interest. Thereafter, the appeal case is reviewed by the experts (online or physical) and experts are asked for comments. Following this, the EMRB member places request of next internal meeting.

After this, EMRB Board decides the date of hearing and the intimation of of letter of hearing is sent to appellant, complainant and SMC. This is followed by hearing of appeal case with all the parties along with EMRB Board. 

If the decision is granted, an action is to be taken by the stakeholder as per decision and the process ends here. However, if the decision is deferred and more information or document is required, an internal meeting of EMRB is held once comments are received and next date of hearing is set. 

Receiving the appeal

The Ethics Section has provision of receiving appeals through online as well as offline mode. However, all appeal applications should invariably be as per the following checklist:

1. Appeal to be submitted in prescribed format alongwith stay application, if required.

2. Demand Draft of prescribed fee to be submitted along with appeal in favour of the Secretary, National Medical Commission.

3. Affidavit on Rs 50/- stamp paper duly attested by Notary Public.

4. Appeal should be received within the stipulated time i.e. 60 days from issuance of SMC's order else application for condoning the delay with reasons of delay should be attached along with. Board may condone the delay beyond 60 days of stipulated time as mentioned above.

Appeal application can be rejected on following grounds by Ethics section:

· Incomplete appeal application and documents as per checklist

· Appeal not filed by Registered Medical Practitioner

*Deficiency, if any, will be communicated to the applicant. Applicant needs to submit the pending documents to EMRB section or else application will be rejected

Stage 1:

The Appeal application categorized as complete on the ground that the documents as prescribed under the checklist are complete. A note for completed appeal should contain following essential points-

i. raised in initial complaint

ii. Issues raised in appeal

iii. Regulation(s) violated

iv. Relevant parts of Order of SMC's order

v. Instruction from Hon'ble Courts in this case, if any.

Stage 2:

All complete appeals shall be processed to-

i. apprise the Board of the appeal;

ii. seeking permission of the Board to place it in upcoming internal meeting*; and

* Internal meeting should be held on monthly basis and as and when required

*Index to be made by section for each appeal file in prescribed format (as per Annexure-2)

Stage 3:

Respective dealing hand will present its Appeal case to the Board in internal meeting wherein Board shall take decision regarding-

i. Acceptance/Rejection of the appeal,

ii. Grant of stay, and

iii. Condonation of delay.

iv. Any other

Stage 4.1:

Decision of the Board shall be communicated to the Appellant. In case of acceptance of appeal, following actions are to be taken-

i. State Medical Council (SMC) to be informed about the decision of the Board i.e. acceptance of appeal and stay of the order of the SMC till the Board decides the case with the request to furnish all documents related to the case. Also, a copy of the same may be endorsed to the appellant as well as respondent (Letters will be send in gap of 15 days, 10 days and 7 days)

[Mostly SMCs do not provide case related documents within stipulated time and sometimes they respond after issuance of a number of reminders, therefore it was decided in internal meeting that calculation of 61St day will start from the date of receival of case documents.]

ii. A copy of appeal to be forwarded to the respondent (appellant) seeking his/her written submission on it alongwith an affidavit with complete contact details (Mobile no. & email id) [Complainant did not furnish its statement in stipulated time or became unapproachable due to change of residence/mobile no.Board will decide the case ex-parte after issuing three successive letters duly giving time of 15 days, 10 days and 07 days respectively.]

iii. Concerned parties* shall be informed about the acceptance of appeal duly informing them that they are party in the case and may be called during hearing of the appeal case.

*Memo of parties approved by the Board in its internal meeting held on 22.11.2023 (The EMRB approved to issue Memo of Parties to the concerned in appeal cases in its internal meeting 09.01.2024)

Stage 4.2: Receiving the response and exchange of documents

Written statement so received from the complainant to be exchanged with appellant seeking his/her comments on affidavit. [In the event of non-furnishing of written statement by the appellant/ death/ become unapproachable due to change of contact details, Board will decide the case ex-parte after issuing three successive letters duly giving time of 15 days, 10 days and 07 days respectively.- to be confirmed]

Stage 5:

· Nomination of Forensic Medical Experts- one Forensic Medical Expert* to review the case and assist the Board in deciding Subject Experts.

· Nomination of Subject Experts : preferably three Experts of the related specialty to give their opinion. The experts trained as per training module should be preferred.

· Willingness and Conflict of Interest be sought from the Subject Experts.

*As decided by the Board in its internal meeting held on 12.02.2024.

Apart from this, the SOP also includes a proforma for submitting appeal cases. The proforma includes instructions for appeal, an acknowledgement to be filled by the candidate, an affidavit by the complainant/appellant and a verification statement by complainant/appellant stating that the contents of the appeal/complaint are true.

To view the complete SOP in detail, click on the link below:

https://medicaldialogues.in/pdf_upload/sop-for-appeals-by-rmps-251750.pdf

Also Read: Proposal allowing Patients to appeal against State Medical Council Decisions to NMC gone on hold

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