NMC withdraws 2023 rules on medical education standards, raising accountability concerns

The National Medical Commission (NMC) has withdrawn the Maintenance of Standards of Medical Education Regulations, 2023 (MSMER-2023), with effect from October 17. The move has raised questions about how violations by medical colleges will be penalised, and how compliance with prescribed standards will be verified under the remaining regulatory framework.The MSMER-2023 was withdrawn with immediate effect through a notification dated October 14, published in the Gazette on October 17. There is no single new regulation replacing MSMER 2023. Instead, the requirement for medical colleges to submit Annual Disclosure Reports (ADRs) will continue under the National Medical Commission Act, 2019, and other applicable regulations, the NMC said.Rules on penalties, enforcement removedThe withdrawal comes close on the heels of a nationwide agitation for greater accountability in the undergraduate medical entrance examination.Healthcare activists and medical education experts have raised concerns about three key areas that may fall through the gaps with the withdrawal of these regulations: the alleged removal of specific penalties under MSMER-2023, including fines of up to ₹1 crore for specified violations and personal fines of up to ₹5 lakh for faculty and administrators submitting false records; the verification of colleges’ annual disclosures on faculty, infrastructure, clinical facilities, and patient load; and the removal of the specific procedures and timelines for enforcement and appeals laid out in the MSMER-2023.‘Patients at risk’Bejon Kumar Misra, consumer rights activist and founder-director of the Patient Safety and Access Initiative of India Foundation (PSAIIF), said the withdrawal raised concerns about transparency, accountability, and the quality of medical education.While the NMC Act, 2019, provides statutory powers for inspections and enforcement, Prof. Misra said that withdrawing a detailed regulatory framework without clarifying equivalent safeguards creates uncertainty over how institutional deficiencies and false disclosures will be addressed.“Medical colleges cannot be judged merely by their buildings, equipment, or number of approved seats. The real measure of medical education is the competence of graduating doctors, the availability of qualified faculty, adequate supervised clinical exposure, and their ability to deliver safe and ethical patient care,” he said.Prof. Misra has also written to the Union government, warning that misleading faculty declarations, inflated patient records, or inadequate clinical training going undetected could ultimately put patients at risk. He urged the Union Health Ministry and the NMC to clarify the enforcement mechanisms that will remain in place and to ensure that medical education standards are independently verifiable.‘Dilution of regulatory oversight’Babu K.V., an ophthalmologist and medical activist, said the withdrawal could dilute the penalty framework. He explained that by denotifying the stronger MSMER 2023 September regulation and retaining the June regulation, some clauses have been deleted.“Like the clause 8(2)c, which states that monetary penalty not exceeding ₹5 lakh [will be imposed] for the faculty/Head of the Department (HoD)/Dean/Director/doctor submitting false declaration/documents/records (including patients’ records). Further, they can also be charged or penalised for misconduct under the Registered Medical Practitioner (Professional Conduct) Regulations in vogue,” he said.“This is the key regulation ,where the individual doctors are made accountable and hence deleting it is dilution of regulatory oversight,” Dr. Babu explained, refuting the NMC’s argument that there is no dilution of regulatory oversight.‘Eliminates duplication’However, a senior NMC official told The Hindu that the decision had been “misinterpreted”. The withdrawal followed a review by the Commission’s legal team, which recommended streamlining regulatory powers and removing overlapping responsibilities, the official said.The Commission functions through four autonomous boards, of which two set standards for undergraduate and postgraduate medical education. Another assesses and rates medical colleges and undertakes institutional inspections and regulatory action, while the fourth oversees medical registration, professional conduct, and ethics.The NMC maintains that the move eliminates duplication without diluting standards, and that its inspection and verification powers remain intact.Not retrospectiveThe Gazette notification provides that the withdrawal will not affect actions already taken, approvals granted, or rights, obligations and liabilities accrued under MSMER-2023. Applications, proceedings, appeals and inquiries pending before the withdrawal will continue to be dealt with under the regulations, insofar as applicable. Matters arising after the withdrawal will be governed by the NMC Act and the statutory and regulatory provisions then in force.India had 846 medical colleges, 1,39,864 MBBS seats and 86,360 postgraduate medical seats, according to government data cited in August 2026. “With medical education expanding, the key question is whether the regulatory framework that remains can ensure that colleges meet prescribed standards and face effective action when they fail to do so,’’ Dr. Babu said.