NMC Releases Final Establishment of Medical Institutions, Assessment and Rating Regulations 2023, Details

New Delhi: Introducing uniformity in the rules of setting up new medical colleges, commencing new medical courses, increasing medical seats, and assessing and rating medical institutes, the National Medical Commission (NMC) has finally published the "Establishment of Medical Institutions, Assessment & Rating Regulations, 2023" in the official Gazette.

These regulations issued by the Medical Assessment and Rating Board (MARB) of the National Medical Commission (NMC) were published in The Gazette of India on June 02, 2023.

"In exercise of the powers conferred vide sub-section (2) of Section 57 read with Sections 26, 28 and 29 of the National Medical Commission Act, 2019 (Act 30 of 2019); the National Medical Commission hereby makes the following Regulations...These Regulations may be called the ―Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses & Assessment and Rating Regulations, 2023”, in short “Establishment of Medical institutions, Assessment & Rating Regulations, 2023”." mentioned the Gazette notification.

"They shall come into force from the date of their publication in the Official Gazette," it added.

NMC on February 27, 2023, released and invited comments its draft on the Establishment of Medical Colleges and Medical institutions, Assessment and Rating and Increase of Seats for Medical Education Regulations 2023.

Also Read: NMC releases draft regulations for Establishment of new medical colleges, Assessment, Rating, increase of seats, invites comments

Now the final regulations have been published in the official Gazette and they include the scheme for the establishment of medical institutes, eligibility criteria, evaluation procedure as well as assessment and rating rules for the establishment of medical colleges and increase in seat intake.

Apart from these, the guidelines also mention the provisions regarding sanctions and penalties for the medical colleges' management in case of failure to comply with the mandated NMC regulations. Besides, these regulations also mention how the medical colleges can submit their appeals to the Commission and the Central Government.

Scheme for Establishment of Medical Institution, Starting of New Medical Courses (Undergraduate and/or Postgraduate): 

The mandate of permission: 

No medical college or medical institution can be established, or new medical course or courses be started unless it is granted permission by the MARB in writing, in response to an application submitted in this regard.

Provided any such permission by the MARB may be issued subject to such conditions as it may think fit to impose.

MARB inviting applications:

The MARB may invite applications for one or more of the following –

a) Establishing a new medical institution intending to offer undergraduate courses.

b) Establishing a new medical institution intending to offer postgraduate medical courses.

c) Establishing a new medical institution intending to offer both undergraduate and postgraduate medical course/s.

d) For starting undergraduate course or increase or decrease in the numbers of UG seats in an established medical institution.

e) For starting postgraduate medical course/s or increase or decrease in the numbers of PG seats in an established medical institution.

Applicant and application: 

No entity other than the following shall be eligible to apply for establishing a new medical college or medical institution or to start a new course or courses in medicine as the case may be –

a. The Central Government; or

b. The State Government or State Governments in partnership; or

c. The Union Territory; or

d. A university duly established in India; or

e. An autonomous body promoted by the Central or the State Government by or under a statute, and has no conflict of objectives for undertaking medical education by starting a medical institution; or

f. A society registered under the Societies Registration Act, 1860 (21 of 1860) or any respective statute meant to establish and regulate Societies in the respective State; or

g. A Section 8 Company duly incorporated under the Companies Act, 2013 or any other corresponding law in force during its establishment; or

"The eligible entity shall apply only upon invitation by the MARB by way of Notification of inviting applications for establishing new medical institutions and starting new medical courses (UG and/or PG) within the deadline prescribed therein," further mentioned the regulations.

"Provided the eligible entity shall apply, through a web portal made available on the website of the National Medical Commission, or by such means as may be duly Notified, to the MARB in a proforma provided in this regard along with such fees as may be specified in the Notification," it added.

The NMC Regulations added, "Without prejudice to anything stated in these Regulations, such entities as specified in Section-7 above, shall submit their application seeking permission to establish a medical institution or for starting a new medical course or courses, as the case may be, only if they satisfy all conditions provided under the Notified MSRs by the UGMEB or PGMEB as on the date of the application."

NMC has clarified that no application submitted by the eligible entity shall be entertained unless it is accompanied with –

a. Essentiality Certificate (EC) issued by the concerned State Government or Union Territory administration or the appropriate authority as the case may be unless otherwise specified. The EC shall be valid at the time of application; and

b. A Consent of Affiliation (CoA) letter obtained from a recognized university, issued in the name of the applicant entity in writing. The CoA shall be valid at the time of application; and

c. Documentary proof indicating the establishment of a corpus fund by the entity dedicatedly applicable to functioning of the new medical institution year after year; and

d. A solvency certificate issued by a Chartered Accountant within ninety days prior to the last date of submission of the application as mandated by the Notification issued by the MARB; and

e. Documents by way of proof that such reasonable area of land is either owned or arranged under lease or such other arrangement by the eligible entity; and

f. Capabilities with regard to the provision of required basic infrastructure, administrative and financial support of the applicant, if the eligible entity is other than Central or a State Government or Union Territory administration; and

g. Documentary proof of owning or running a hospital of required capacity as indicated in the MSRs.

h. Proof indicating remittance of prescribed application fee and bank guarantee; and

i. Any such other documents are to be notified from time to time by the MARB.

Explanation 1–the period of validity of the EC indicated in (a) above shall be in accordance with that mentioned by the issuing authority for a period of three years from the date of issue or an earlier date if the issuing authority has specified.

Explanation 2 – the CoA obtained from a recognized university issued in the name of the eligible entity shall lose its validity after the application for which it was used. The eligible entity shall obtain a new CoA if the application is rejected. Provided the CoA shall have a total life of three years from the date of its issuance or an earlier date if the issuing authority has specified.

Explanation 3– Established medical institutions applying for seats for new medical courses, may be exempted from some of these documents as will be specified while calling the applications.

Clarifying that incomplete applications will be rejected, the regulations mentioned, "Provided any incomplete applications received, meaning applications without the mandated documents specified in the present Regulation, shall be rejected by the MARB."

"Provided further that once rejected the eligible entity shall lose the chance of reapplying till the next window of opportunity in calling for the applications," it added.

Eligibility criteria: 

a. No medical institution shall be provided permission unless they satisfy the conditions pertaining to but not limited to physical infrastructure, teaching staff, clinical material and hospital as detailed in the MSRs notified from time to time.

b. Without prejudice to anything stated in the sub-section (a) above, the UGMEB or PGMEB as the case may be, shall from time to time publish the MSR with such modifications or amends required, keeping in mind the overall objectives of the Act.

c. Notwithstanding anything stated above in Section 10, all modified or amended MSRs shall have to be implemented.

MARB evaluating the application: 

Keeping in mind the objective of the Act, without prejudice to anything stated elsewhere in the Regulations, the MARB shall evaluate the applications received from the eligible entity under Section 9 above, based on all of the following broad criteria viz.,

a. The desirability and feasibility of setting up the medical institution at the proposed location.

b. Assess whether the eligible entity fulfils the required conditions prescribed by the corresponding MSRs in vogue, which shall include physical infrastructure, qualified faculty, and adequate clinical material in terms of hospital, laboratory, patients, clinical procedures and others as specified in the corresponding MSR/s.

c. Assess whether the scheme submitted by the applicant shows that, once established the medical institution will reasonably sustain itself.

Referring to Section 11 specifying the process of MARB evaluating the application, the Regulations mentioned, "Without prejudice to Section 11 above, at its sole discretion, the MARB may seek any additional information or clarification or additional documents from the applicant while considering the application for grant of permission for establishment of a new medical institution or for starting a new medical course."

"The eligible entity shall provide or furnish such information or clarification, or additional documents sought under Section 12 above, within a specified time or 15 days, whichever is earlier, from the date of receipt of communication from the MARB.

Provided failure to remove or correct the deficiency or submit such information or clarify or provide additional documents etc., as mandated by the MARB within such specified time shall result in the rejection of the application," they further added.

Assessment for Permission:

Notwithstanding anything stated elsewhere, the MARB determines the appropriate method of assessment and/or inspection, before granting permission to the applicant to establish a medical institution.

Provided such methods shall include, but not be limited to verification of documents in digital or another form, Aadhar-based attendance register, verification of live video feed, photographs, Hospital Management Information System (HMIS) data, or a surprise physical assessment etc.

NMC clarified that "Evaluation result and issuance of letter of approval – based on the assessment carried out; the MARB shall communicate its decision of permission or otherwise to the eligible entity within a period of six months from the date of receipt of the completed application."

"Provided if approved, the MARB shall issue a letter of permission to the eligible entity under its seal, with such conditions as it may deem fit. Provided further, the letter of permission shall also be notified on the National Medical Commission‘s website," it further added.

"Without prejudice to anything stated elsewhere, it shall be the duty of the eligible entity to abide by all such conditions laid down in the letter of permission, and the MARB will have the right to seek such information or cause an inquiry done into the matter to verify all such conditions are observed in both letter and spirit," clarified the Commission.

Scheme for Increase of Seats for the Existing Courses in a Medical Institution: 

NMC has clarified in these regulations that no medical institution shall increase the seats of any of the ongoing courses without prior permission of the MARB, provided no grant of permission for an increase in seats will be given by the MARB if the medical institution has not admitted earlier sanctioned seats.

Referring to this, the Regulations added that-

"Without prejudice to anything stated in section 17 above, the application for an increase in the seats shall be accompanied with –

a. Consent of affiliation from the recognized university concerned for the proposed number of seats in the specified courses in writing; and

b. Such prescribed application fees and bank guarantees as determined by the MARB from time to time by way of Notification; and

c. Any other documents as may be prescribed while inviting applications."

"Once the application for an increase of seats is received from the medical institution, the MARB shall evaluate the same on its merit before granting approval," it further added.

"Provided the same criteria indicated in Chapter II of these Regulations shall apply mutatis mutandis for such evaluation," it mentioned.

Assessment and Rating: 

Assessment by the MARB for the purpose of rating a medical institution: 

According to these regulations, MARB shall conduct an assessment and rating of all medical institutions and shall be vested with all such authority in discharging its functions under the Act.

Provided, without prejudice to anything stated in these Regulations, the MARB may appoint one or more independent third-party agency or agencies to conduct an assessment and rating of medical institutions, and on its behalf.

Provided further the MARB may prepare detailed guidelines in appointing independent third-party agency or agencies to carry on the work of assessment and rating of medical institutions.

Provided further that, if appointed the independent third-party agency or agencies shall have such power as indicated in their appointment letter issued by the MARB.

"The MARB may seek any information, clarification, documents, or digital material from any medical institution at any time for the purpose of assessment and rating," the regulations mentioned.

"In furtherance, the MARB shall conduct an assessment of all or a specific number or any individual medical institution, either directly by itself or through such designated agency or agencies," it added.

NMC further clarified that "Without prejudice to anything stated in these regulations, the MARB shall develop such methodology whereby, the medical colleges or medical institutions are continuously monitored for their performance, leading to assessment and rating."

The regulations further stated that, Notwithstanding anything stated elsewhere, either in these regulations or otherwise, the MARB rating shall be based on the following parameters, with such due weightage assigned to the respective parameters viz.,

a. Compliance with the standards laid down by the UGMEB and PGMEB.

b. Academic excellence shown through innovative methods of teaching adopted and courses (other than prescribed) offered to the students.

c. The research output of the medical institution that has contributed to the existing knowledge and the research impact created by the medical institution.

d. Student discipline and satisfactory teaching and learning environment created by the medical institution.

e. The student feedback on various affairs of the medical institution, with due weightage assigned to them.

f. Participation of students/faculty in academic activities at national and international level.

g. Standards/facilities/participation in sports and social activities.

h. Any other evaluable criteria may be notified by the MARB from time to time.

"Provided, without prejudice to the above the MARB shall notify the criteria for assessment and rating of the medical institutions, from time to time," it mentioned.

Publication of rating: 

The MARB shall make available on its website or otherwise in the public domain the latest annual assessment results and ratings of medical colleges or medical institutions, in such a manner as to facilitate public understanding and consumption.

Submission of annual disclosure reports: 

all medical institutions shall furnish a Compulsory Annual Disclosure Report to UGMEB and/or PGMEB in compliance with the norms specified under the Act [24(i) and 25(h)] in the prescribed format and prescribed fee, with a copy to the MARB.

Provided the compulsory annual disclosure report shall be made once all students for the academic year are admitted to a given course and not later than thirty days to be calculated from the date of the last student‘s admission.

"Notwithstanding anything stated elsewhere, failure to submit the annual disclosure report by the medical institution as indicated in Section 26 within a notified period shall amount to non-compliance and shall result in disciplinary proceedings under Chapter-V below. Provided that, medical Institutions can use the Annual Disclosure as a form of self-appraisal and request the MARB for a voluntary decrease of seats/courses and also seek for restitution of seats / courses appropriately," the regulations mentioned.

Sanctions and Penalty: 

It shall be the duty of all medical institutions to follow the regulations and directions issued by the MARB, both in letter and spirit either within a specified time period or within a reasonable period of time, wherever the timelines are applicable.

Non-compliance defined–

Following acts or omissions of a medical institute shall amount to non-compliance–

a. Non-compliance with any of the regulations, and notifications of the National Medical Commission issued from time to time.

b. The medical institution has conducted in a manner which is not in accordance with the objectives of the medical institution and practices like ragging, exploiting students on fees etc.

c. Deficiency in infrastructure, teaching staff, clinical material and others as prescribed by way of MSR or otherwise by UGMEB and/or PGMEB.

d. Any act of misbehavior, non-cooperation, forbidding the inspection process etc., with the assessors representing the MARB or such other designated agency by the MARB in this regard.

e. Physical misbehavior by teaching staff with the students, harassment of faculty and/or students by the management etc.

f. False information declared for obtaining permission for any of the schemes including the establishment of a medical institution.

g. Falsifying information or fabricating evidence at the time of inspection by the MARB or constituent autonomous boards or NMC-appointed third parties.

h. Any attempt to bribe or pressurize or threaten assessors or officials of NMC.

i. Any such act or omission as notified by the NMC in this regard.

Penalties: 

For any of the non-compliance or intentional attempt of non-compliance act or omission by the medical institution, the MARB shall either penalize the medical college or medical institution as per sub-section (f) of section 26 of the Act and/or conduct further enquiry into such incident or act, and wherever needed provide an opportunity to rectify the same.

Without prejudice to anything stated in Section 30 above the imposition of the penalty may include one/more/ all of the following –

a. Issuance of warning with accommodation of reasonable time for compliance or rectification as the case may be by the medical institution.

b. Monetary penalty not exceeding INR one crore per every non-compliance committed by the medical institution.

c. Withholding processing of application for any new scheme/s for that academic year or for a such number of years.

d. Reducing the number of students in the next or subsequent academic years to be admitted by the medical institution.

e. Stoppage of admission to one or more of the courses in the next or subsequent academic years.

f. Recommending to NMC for withdrawal of recognition.

g. Withholding and withdrawal of rating of the medical institution for a period up to five academic years.

h. Any attempt to pressurize MARB or NMC through individuals or agency will lead to immediate halt of the processing the application/request by the medical Institution.

"Provided that the medical institution, may be granted a reasonable opportunity to rectify the deficiencies and any further action shall be taken if it fails to meet the requisite norms. Provided further that, the MARB or the Commission may also initiate criminal proceedings for furnishing false information, or fabrication of false documents as per the criminal law in force at that time," stated the regulations.

Redressal, Appeal Etc.: 

Appeal to the Commission: 

A medical institution or any such aggrieved person may file an appeal before the Commission with appropriate fees as specified against any orders passed or decision taken by the MARB which shall comprise the following –

a. Disapproval of a scheme.

b. Where no decision is taken within six months of applying or request to the MARB for approval of any of the schemes.

c. Imposition of penalty as per Section 31 of these Regulations.

Provided such an appeal to the Commission is filed within fifteen days of passing an order or decision taken by the MARB.

Appeal to Central Government: 

Where an applicant is aggrieved by the decision of the Commission under Section 15 or where the Commission fails to give its decision within forty-five days from the date of receipt of such an appeal, a second appeal may be filed before the Central Government within thirty days from the date of such order or lapse of time, as the case may be.

To view the notice, click on the link below –

https://medicaldialogues.in/pdf_upload/establishment-of-medical-institutions-211504.pdf

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