Family medicine takes center stage in India: National Medical Commission Act 2019

Abstract

The National Medical Commission—NMC—Act has been passed in the Indian parliament. NMC replaces the MCI—Medical Council of India act and promises to facilitate in delivering quality primary health care. Family medicine has been mentioned thrice in this act and both undergraduate and postgraduate boards of the NMC have been mandated to promote family medicine discipline.

Family Medicine and National Medical Commission

The National Medical Commission—NMC—Act has been passed in the Indian parliament. NMC replaces the MCI—Medical Council of India act and promises to facilitate in delivering quality primary health care. Family medicine (FM) has been mentioned thrice in this act. This is an outcome of a successful advocacy campaign of the Academy of Family Physicians of India—AFPI over the past several years.

AFPI currently has a membership base across India and functions through several state chapters. The members include FM specialists, practicing family physicians, general practitioners, medical officers who provide generalist medical care irrespective of age groups, genders, and organ systems. The academy is working toward empowering primary care physicians in India for better health outcomes. AFPI advocates the academic institutionalization of community health services. As an outcome of advocacy initiatives of AFPI, the first MD FM program was started at Kozhikode Medical College, Kerala. Under PMSSY (Prime Minister's Swasthys Suraksha Yojana) all newly instituted AIIMS (All India Institute of Medical Sciences) has established a new department in the name of the department of community medicine and FM. AFPI has advocated for equal professional opportunities and career progression for the primary care physicians at par with any other hospitalist specialists.

AFPI Advocacy

AFPI adopted a multipronged approach engaging political leadership, bureaucracy, higher judiciary, and other stakeholders. In 2018, a Public Interest Litigation was filed in the Supreme Court of India. In pursuance to the Supreme Court of India order, AFPI approached the ministry as well as the Medical Council of India. In 2018, we had received written assurance from the Prime Minister's Office—PMO that the FM discipline will be addressed in the NMC bill. Earlier FM was included only as aspiration of the National Health Policies (NHP 2002 and NHP 2017) and finally, it has become a part of the act and law.

Mandate of NMC on Family Medicine

As per the provision of the NMC Act 2019 under section 24 (c), the Under Graduate Medical Education Board is mandated to develop a competency-based dynamic curriculum for addressing the needs of primary health services, community medicine, and FM to ensure health care in such areas. Similarly, under section 25, (j) the Post-Graduate Medical Education Board is mandated to promote and facilitate postgraduate courses in FM. This has legal validity and eligibility for a challenge in a court of law if not implemented. Recently FM has also been included in the foundation course of undergraduate MBBS training and is for implementation across all medical colleges in India, though the new MBBS curriculum doesn't even mention it.[1]

This is one of the greatest success stories of FM advocacy anywhere in the world, more specifically for a large country like India having a complex governance system.