MCI set to issue guidelines on peer group evaluation of professional incompetence of medical practitioners

MCI set to issue guidelines on peer group evaluation of professional incompetence of medical practitioners

Mumbai, September 21, 2017

The Medical Council of India (MCI) is all set to come out with guidelines pertaining to peer group evaluation of professional incompetence of a registered medical practitioner as prescribed by section 8.6 of the Code of Medical Ethics Regulation 2002.


As per Rule 8.6, professional incompetence of a professional duly registered with the State Medical Council upon fulfilling the precondition of the eligibility of having acquired recognized medical qualifications from a university and duly incorporated in the concerned schedule appended to the Indian Medical Council Act, 1956, shall be judged by peer group as per guidelines prescribed by MCI. However, these guidelines have never been made. Taking serious note of this, national president of Indian Medical Association (MA) Dr. KK Aggarwal had written to MCI to frame the guidelines.


A study group led by Dr. Vedprakash Mishra, chairman of academic committee, MCI was set up by MCI president one and half month back to chart out draft guidelines under Rule 8.6 in response to Dr Aggarwal's letter. The study group comprising of three members-- Dr Aggarwal, Dr. RN Tandon, secretary general, IMA, Dr. Vinay Aggarwal , past national president, IMA held two meetings to frame the draft which was submitted to MCI president.


The draft guidelines, titled as ‘Guidelines governing assessment of professional incompetence' by a peer group under Rule 8.6 of Code of Medical Ethics Regulation 2002 as amended from time to time will come into the force from date of its notification by MCI. The guidelines shall be applicable for any medical trial jurisdiction at the institutional (medical colleges approved by MCI) or at any council level. They shall not cover criminal aspect of professional negligence.


Professional incompetence, professional misconduct and professional incapacitation by and large are used interchangeably because all the three within their fold include failure on part of the professional to take reasonable steps to safeguard the life and health of the person under his care.


In a move to bring more clarity on which action of a medico can be attributed to professional incompetence, the draft has clearly defined it. It says 'professional incompetence’ is failure to exercise due care and diligence in professional responsibilities due to lack of knowledge, skill or judgment while professional incapacity means inability to carry out professional activities and responsibilities/obligations due to a physical or mental illness that may limit the capacity of a professional person to fulfill his/her professional responsibilities temporarily or permanently.


It also defined professional negligence for which the guidelines will not be applicable. As per the draft, an act or omission (failure to act when there is a duty to act) which a reasonable man in the circumstances would do or an act of commission (wrong doing) by a medical professional, which a reasonable man in the circumstances would not do constitutes professional negligence.


It further says a peer group at institutional (medical college) /clinical establishment/state medical council/MCI will be constituted to judge the professional incompetency of a registered medical practitioner in a time-bound manner. The peer group shall be a three-member committee with a chairman, one IMA nominee and one professional subject expert. The peer group on receipt of any complaint shall examine the allegation in a time-bound manner, preferably within two weeks and forward its reasoned-out speaking order following the principle of natural justice and based on “Bolam’s Test” to the institutional head, clinical establishment head /chairman of the ethics committee of the state medical council/chairman of the ethics committee of MCI as the case may be.


Bolam Test evolved out of the judgment in the case of Bolam v Friern Hospital Management Committee [1957] 1 WLR 582 is used to assess standard of care when deciding medical negligence.


The MCI will soon hold a meeting to deliberate and finalise the draft guidelines. The IMA which pushed for the guidelines has also convened a central working committee meeting on September 23 to discuss and pass it.