National Medical Commission proposes single licence for doctors to practise across India

The National Medical Commission's (NMC) proposal for a single licence system marks a transformative shift in India's medical regulatory landscape, addressing long-standing barriers to doctor mobility across state boundaries. To understand the significance of this reform, we must first trace the historical evolution of medical regulation in India. Prior to the NMC Act, 2019, the Medical Council of India (MCI) Act, 1956 governed medical education and practice, but it was plagued by allegations of corruption, lack of transparency, and rigid state-centric registration processes that hindered workforce distribution. The MCI's dissolution in 2018 and the subsequent enactment of the NMC Act, 2019 (effective from September 2020) were driven by the need for a more accountable, efficient, and nationally integrated regulatory framework — a recommendation also echoed by the Parliamentary Standing Committee on Health and the NITI Aayog's 2018 report on medical education reform. Under the current system, a doctor registered with a State Medical Council (SMC) must seek separate registration in another state to practise there — a cumbersome process involving document verification, fees, and delays that discourage mobility. This has exacerbated regional imbalances: while states like Maharashtra, Tamil Nadu, and Kerala have relatively higher doctor-population ratios, states such as Bihar, Jharkhand, and Uttar Pradesh face acute shortages, particularly in rural areas. The NMC's proposal — where a single registration by an SMC, followed by UID allotment by the Ethics and Medical Registration Board (EMRB) under the NMC — enables pan-India practice, directly addresses this structural inefficiency. Key stakeholders include the NMC (the apex regulator), State Medical Councils (implementation arms), the Ethics and Medical Registration Board (UID authority), and the Ministry of Health and Family Welfare (policy oversight). Doctors, especially young graduates and specialists, stand to gain significantly from enhanced career mobility, while patients in underserved regions benefit from improved access. The reform also aligns with the constitutional mandate under Article 21 (Right to Life and Personal Liberty, interpreted to include Right to Health) and supports the Directive Principles under Article 47 (State's duty to raise nutrition and public health standards). Furthermore, it resonates with the National Health Policy, 2017's goal of achieving 'Health for All' and the Sustainable Development Goal 3 (Good Health and Well-being). Economically, the reform can reduce recruitment costs for public health systems, optimize human resource deployment, and support telemedicine expansion — especially relevant post-COVID-19. Politically, it reflects cooperative federalism, as states retain registration authority while accepting national portability. However, challenges remain: ensuring uniform ethical standards, preventing misuse of UID, and integrating with the National Digital Health Mission (NDHM) for seamless verification. Future implications include potential extension to paramedics and nurses, integration with the proposed National Commission for Allied and Healthcare Professions, and serving as a model for other professional councils (e.g., Bar Council of India). This reform is not merely administrative — it is a foundational step toward a unified, equitable, and resilient health workforce architecture for India.