CME Linked Renewal Scrapped in Karnataka

Withdraw the National Medical Register Portal

The Karnataka Medical Registration Act 2017 has been amended by the Karnataka legislature on July 25, 2024 and the new Karnataka Medical Registration Act 2024 (Karnataka Act No 41 of 2024) has  received the Governor’s ascent on August 15, 2024 and it has been published in the Karnataka Gazette on August 16, 2024. With this amendment, the amendments made to the KMR Act in 2017 that enabled renewal of registrations and CME accreditation have now been annulled. This is the culmination of the heroic efforts of the Karnataka doctors against the illegal renewals imposed in the state since 2013 December. The new amendments also synchronise the Karnataka state registration with the norms stipulated by the National Medical Commmission.

It may be recalled that the Karnataka Medical Council had started pressing for renewal of registration of the doctors from December 2013 and the RTI application in 2014 April had revealed that such renewal did not have adequate legal basis. When the Karnataka Medical Council went ahead with the renewal process, the doctors of Karnataka conducted a statewide campaign to boycott the renewal from June 2016, and later, in December 2016, approached the Hon’ble High Court of Karnataka by filing writ petitions, and obtained stay against removal of the names of the doctors who did not renew their registrations. therefater, several writ petitions were filed (WP 65832-34/2016, 65861-65862/2016, 407-421/2017, 820-832/2017, 954-983/2017, 1584-93/2017, 21324/2017) to secure such relief for all members of the Indian Medical Asscoiation, Karnataka state branch.

However, to justify this renewal process which had no legal basis until then, the Karnataka Medical Registration Act was amended in 2017 to make provisions for renewal and CME credits. This amendment was also challenged in another writ petition (21324/2017). The new amendments passed on July 25, 2024 have removed the clauses brought in by the amendments made in 2017.

The KMR Act 2017 had the following in Sec 19:

19. Renewal of Registration.- (1) Every Medical practitioner shall once in five years renew his registration by paying prescribed fees to the medical Council.

For renewal of registration such applicant shall submit his application in such manner along with the evidence to the effect that he has participated or attended to a minimum of thirty credit hours of continued Medical Education Programme (one credit hour = four hours of continued Medical Education Programme) not less than six credit hours per year over a period preceding five years in any recognized Medical Conference or Seminar or Workshop or Continued Medical Education approved in this behalf by the Karnataka Medical Council.

(2) The Medical Practitioner who fails to renew his registration under subsection (1) shall cease to be a registered practitioner under sub-section (1) of section 13, the Registrar shall remove the name of such practitioner from the Register maintained under section 12:

Provided that participation in such continued Medical Educational Programme shall not be necessary in respect of such class of Medical Practitioners as may be prescribed.

Provided further that the name so removed may be re-entered in the register on payment of the renewal fee in such manner and subject to undergoing continued Medical Education Programme specified in sub-section(1).

Explanation.- For the purpose of the section “CME” means a Continued Medical Education Programme or recognized medical conference or seminar or workshop as may be approved or conducted by the medical Council in the State headquarters or regional headquarters or district headquarters or teaching hospitals or medical colleges or any institution run by the Karnataka Medical Council.

With the new amendments made on July 25, 2024, these sections, as shown above, have been removed.

Section 19 (1) of the KMR Act 2017, as above, has been removed and replaced with the following:

a) for sub-section (1), the following shall be substituted, namely:-
“(1) All the existing medical practitioner enrolled in the State Medical Register, not having the registration number as prescribed by National Medical Commission shall submit an application to National Medical Commission within a period prescribed by notification by National Medical Council and obtain the new Registration Number as a onetime measure and the licence so obtained shall be valid for period of five years from the date of issuance. For the purpose of updating of licence of such medical practitioner, no fee shall be charged by the Commission.
Further renewal of registration shall be as per rules and guidelines prescribed by National Medical Commission.”;

With this, there is no more renewal at Karnataka Medical Council, and all the registrations will be synced with the regulations at the NMC. (See below)

Section 19 (2) of the KMR Act 2017, as above, has been completely removed, as shown in the amendment cited below:

(b) in sub-section (2) the first proviso and the explanation shall be omitted.

With this amendment, no name can be removed for not renewing by not obtaining the CME Credit points.

The Registration of Medical Practitioners and Licence to Practice Medicine Regulations, 2023, published on May 10, 2023, had bifurcated the medical registration into registration based on qualification and license to practice medicine in chosen states which was to be renewed every 5 years. However, these Regulations had no provision for CME credits for such renewal of license. [See]

But the National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2023, published therafter on Aug 2, 2023, included this provision, in its Sec 4, for renewal based on CME Credits, as shown below.

4. Continuing Professional Development Program: A RMP should attend continuing professional development programs regularly each year, totaling at least 30 credit hours every five years. Only recognized medical colleges and health institutions or medical Societies accredited or authorized by EMRB/State Medical Councils can offer trainings and credit hours for this purpose. Credit hours awarded shall be updated online against the Unique Registration Number of RMP on the EMRB-NMC website. Renewal of License to practice should be done every 5 years (from the publication of the Gazette notification), after submitting documentation of CPD credit hours. The license renewal form will allow updates of details like specialization, place of work, address, contact details, or any other detail specified by EMRB/NMC.(CPD guidelines)(L2).

When the draft of these regulations were published in June 2022, this clause on CME creidts for renewal registration was opposed by us for the following reasons: 

This Clause 5 has no basis in law.

  1. The NMC Act DOES NOT provide for any renewal
  2. The NMC Act DOES NOT provide for the need for any CMEs/CPDs to maintain the registration or to renew the registration
  3. The NMC Act DOES NOT provide for any need for any credit hours, nor does it specify any limits, 30 hours or otherwise.
  4. The NMC Act DOES NOT provide for any powers to either the NMC or the EMRB or the SMCs to accredit or authorise anybody to offer training or credit hours.

Registration of a medical practitioner in India is SOLELY done on the basis of conditions listed under Sections 33,34,35 of the NMC Act. No new conditions or qualifications for registration or maintenance of it can be introduced under the pretext of Regulations. Therefore, imposing these requirements of CPDs, credit hours, their prior approvals etc., are completely beyond the scope of the NMC Act and the Regulations thereunder and therefore should be completely abandoned.

When a very similar attempt was made by the Karnataka Medical Council in 2013-2016, imposing the very similar CMEs and 30 credit hours in 5 years, it was opposed by the medical practitioners of Karnataka. The matter was challenged before the Hon’ble High Court of Karnataka in multiple Writ Petitions filed between Dec 2016 and Feb 2017 [WP 65832-34/2016, WP 65861-65862/2016, WP 407-421/2017, WP 820-832/201, WP 954-983/2017, WP 1584-93/201, WP 21324/2017, WP 40580/2017 (on behalf of IMA KSB) and the Hon’ble High Court had issued stay orders against the State Medical Council against removing any names from the register for not having the CME credits. The stay order remains in force and the matter remains sub-judice. Some of these petitions have challenged the powers of the medical council to impose conditions for registrations that are beyond the Schedules or other Sections of the principal Acts. The present attempt in this Draft, which seems to be a copy-paste of what was done by the Karnataka Medical Council earlier, is also beyond the scope of the NMC Act as already mentioned here above.

Further, the Preliminary Report of the Committee on the Reform of the Indian Medical Council Act, 1956 by NITI Aayog, dated Aug 7, 2016 had clearly stated in Sec 3.7 (f) thus: ‘The Committee also deliberated upon inserting an additional enabling provision of voluntary recertification/ renewal of license exam once every ten years which is prevalent in many countries but it concluded that while desirable in the long run this may not be an appropriate time for such a radical step. The proposed changes will already entail substantial transition from the old to a new system and it would be imprudent to frontload this change.’

Due to objections, The National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2023, published on Aug 2, 2023, has been withdrawn by the NMC on Aug 24, 2023. As of now, therefore, there is no Act/Regulation/Rule at the NMC that stipulates renewal of registration linked to CME Credits. Even the process of re-registration at the NMC and issuing of Unique ID and state-wise license to practice, as stipulated in the Registration of Medical Practitioners and Licence to Practice Medicine Regulations, 2023, published on May 10, 2023, has not been initiated and the portal that was said to open within a few months of the publications of these Regulations has not been started yet. Therefore as of now, there is no Act/Rule/Regulation that mandates mandatory CME and/or CME linke drenewals for the medical practitioners of Karnataka state.