Affordable medical education, PG expansion, digital monitoring of institutes: Parliamentary panel's key recommendations to NMC

New Delhi: Calling for a more affordable, accessible and closely monitored medical education system, the Department-related Parliamentary Standing Committee on Health and Family Welfare has made a series of recommendations to the National Medical Commission (NMC). 

These include strict enforcement of fee norms for 50% of seats in private medical colleges and deemed universities, greater flexibility in starting postgraduate courses and stronger digital monitoring of medical institutions.

Medical education fees:

The Department-related Parliamentary Standing Committee on Health and Family Welfare in its 176th report has recommended that the Ministry of Health and Family Welfare strictly enforce National Medical Commission (NMC) guidelines regarding the regulation of fees and all other charges for 50% of the seats in private medical colleges and deemed universities.

In the report presented before the Parliament on August 7 2026, the Committee observed that keeping medical education affordable is absolutely critical to preventing the commercialization of healthcare delivery. Under the current regulatory structure managed by the Medical Assessment and Rating Board (MARB), the evaluation of new institutions relies on strict compliance documentation, including an Essentiality Certificate from the respective State or Union Territory valid for three years, a Consent of Affiliation from a recognized university, and definitive proof of a corpus fund and financial solvency certified by a Chartered Accountant.

"The Committee, therefore, recommends that the Ministry of Health and Family Welfare stringently enforce the NMC guidelines regarding the regulation of fees and all other charges for 50% of the seats in private medical colleges and deemed universities," the report stated. 

It further recommended that these mandatory baseline financial tracking mechanisms must be leveraged to audit institutional cost structures, ensuring that hidden capitation fees do not circumvent the mandate for socio-economic inclusivity in medical education training.

More flexibility for starting PG courses and expansion:

The panel said that expanding national training capacities must be paired with operational relaxations that allow quick scaling without compromising educational integrity.

It noted that the transition from legacy MSR 1999 guidelines to the modern Minimum Standard Requirements (MSR) 2023 regulations represents a significant systemic reform. 

For instance, a 100-seat undergraduate medical college requires 420 beds and 85 faculty members, compared with the earlier requirement of 500 beds, while a 250-seat institution has seen its bed requirement optimized from 1,100 to 900 beds, balanced against an elevated mandatory bed occupancy rate of 80% to maintain rigorous clinical exposure. 

"The aggregate capacity across the country now boasts approximately 80,000 postgraduate seats inclusive of AIIMS, Institutes of National Importance (INIs), and NBEMS tracks. The Committee, therefore, recommends that the MARB fully execute its multi-pronged strategic reforms for enhancing the quality and clinical exposure of the postgraduate students by ensuring that the clinical requirement is not reduced," the panel said.

The Committee further recommended that government medical institutions be permitted to start postgraduate courses along with undergraduate courses once adequate clinical exposure is available.

For private medical colleges, the Committee suggested that PG courses could be introduced from their third operational year using streamlined resource models requiring as few as two faculty members—specifically one Professor and one Associate or Assistant Professor as per speciality, subject to proven clinical exposure and real hands-on training. 

Most significantly, the Committee strongly recommended NMC ensure cost-effective medical education and proficiency pursuit to enhance inclusivity and expand opportunities for candidature of weaker sections of society.

Further, to expand postgraduate training opportunities in underserved areas, the Parliamentary Panel recommended using non-traditional public clinical resources, such as specialized Railways and Mines hospitals, to rapidly expand regional speciality training footprints in underserved zones viz. hilly and tribal regions.

To ensure quality, the Committee recommended an Exit examination for both graduate and post-graduate students.

"The Committee further recommends that government medical institutions be permitted to initiate postgraduate courses concurrently with their undergraduate launch only after ensuring adequate cinical exposure, while private medical colleges should be cleared to introduce PG specialties from their third operational year using streamlined resource models requiring as few as two faculty members—specifically one Professor and one Associate or Assistant Professor as per specialty subject to proven clinical exposue and real hands on training. Most significantly, the Committee strongly recommends NMC to ensure cheaper cost medical education and proficiency pursuit to enhance inclusivity and expanding opportunity for candidature of weaker section of society. The Committee also recommends tapping non-traditional public clinical resources, such as specialized Railways and Mines hospitals, to rapidly expand regional specialty training footprints in underserved zones viz. hilly and tribal regions. To ensure quality, the Committee recommends for an Exit examination for both graduate and post-graduate students," the report mentioned. 

Digital monitoring of medical colleges

The Committee highlighted that the five-year periodic recognition inspections created systemic vulnerabilities and structural inefficiencies in medical education monitoring.

Under the Maintenance of Standards of Medical Education Regulations (MSMER) 2023 and the Graduate Medical Education Regulations (GMER), the NMC has executed a sweeping digital transformation toward a continuous monitoring model based on annual self-declarations submitted via a centralised portal, the panel noted.

"Routine seat renewals and institutional approvals are now managed through standardised virtual inspections to mitigate subjective biases and eliminate assessor exploitation, while physical assessments for new applicants require real-time final assessment reports to be jointly signed and instantly uploaded via an IT-enabled module," it added. 

The Committee, therefore, recommended the absolute consolidation of the centralised, Aadhaar-enabled biometric attendance system (AEBAS), which tracks over 4 lakh enrolled faculty, students, interns, and tutors across the nation.

It called for universal compliance with the face-authentication upgrades introduced via the geo-fenced National Informatics Centre (NIC) mobile application to systematically eradicate "ghost faculty" and capture absolute employment logs.

"The Committee, in this regard, further recommends scaling the pilot Hospital Management Information System (HMIS) API integration module to bind all clinical material assessments directly to unique patient ABHA IDs. Such digital mapping, combined with live classroom and hospital area CCTV surveillance streamed through shared Network Video Recorder (NVR) links, will permanently prevent the manipulation of clinical workloads or the utilization of fake patients during institutional evaluations," the panel recommended. 

On the structural architecture of the NMC, specifically the functional coordination between the Under-Graduate Medical Education Board (UGMEB), the Post-Graduate Medical Education Board (PGMEB), and the Ethics and Medical Registration Board (EMRB) must remain anchored to public health priorities, the Committee, in this connection, recommended that the UGMEB continuously refine the Competency-Based Medical Education (CBME) curriculum to emphasise primary and preventative clinical competencies.

It said that the strict enforcement of the Village and Family Adoption Programmes within undergraduate training will ensure that future medical cohorts are structurally and culturally oriented to address the unique healthcare accessibility barriers faced by rural communities. 

Push for affordable generic medicines

Raising concerns over the high cost of medicines and its impact on patients' out-of-pocket healthcare spending, the Committee said that shifting clinical practice from expensive branded medicines to unbranded generic equivalents is one of the most effective ways to lower healthcare costs for the public.

The parliamentary panel recommended that the Ethics and Medical Registration Board (EMRB) rigidly enforce the professional conduct codes that mandate all registered medical practitioners to prescribe affordable generic molecules rather than high-cost brand names.

The report added, "The Committee is of the firms opinion that pharmaceutical expenditures represent the largest component of catastrophic out-of-pocket spending for patients in India. Shifting clinical practice from expensive branded medicines to unbranded generic equivalents is one of the most effective ways to lower healthcare costs for the public. The Committee, therefore, recommends that the Ethics and Medical Registration Board (EMRB) rigidly enforce the professional conduct codes that mandate all registered medical practitioners to prescribe affordable generic molecules rather than high-cost brand names. The Committee strongly desires that the government must integrate the National Medical Register with public procurement data and establish automated grievance mechanisms through State Medical Councils to track, review, and audit prescribing patterns across both public and private hospital ecosystems."

In May 2022, the NMC, in its draft prescription guidelines, stated that doctors should prescribe medicines with "generic"/"non-proprietary"/"pharmacological" names only.

Besides noting that "generic"/"non-proprietary"/"pharmacological" names have to be prescribed, the guidelines reiterate the point by again stating that physicians should "Avoid prescribing "branded" generic drugs". The guidelines however lay down that In the case of drugs with a narrow therapeutic index, biosimilars, and similar other exceptional cases, this practice can be relaxed.

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