Special Information

Tamil Nadu docs will have to renew licences every five years

Pushpa Narayan, TNN | Aug 31, 2012, 08.54AM IST

CHENNAI: The Tamil Nadu State Medical Council has drawn up self-regulation plans to improve the way medicine is practised in the state, making it mandatory for doctors to renew their licences every five years. By 2017, all doctors registered with the council - public and private - will have to prove that they attended at least 30 hours of continuing medical education (CME). 

Those failing to prove that their skills are up-to-date will be prevented from practising medicine, TN medical council president Dr K Prakasam said. 

The existing ways of regulating the profession are no longer good enough, he said. Doctors are expected to be upto-date and more accountable. "No doctor can stop studying after college. Now, we are ensuring they do at least minimum specified hours. Our credit system will encourage doctors to present papers and publish research in reputed medical journals but discourage events organized to promote a particular drug or equipment," he said. 

Senior doctors welcomed the decision . Tamil Nadu Dr MGR Medical University vice-chancellor Dr Mayil Vahanan Natarajan said the university had made it mandatory for PG students to get credit scores. "It will be good to extend it to practising doctors. The system exists in most countries," he said. 

First batch of licences for renewal to come up in 2017 

In 2002, the Medical Council of India, the statutory body governing medical education and doctors' ethics, made it compulsory for doctors to get licences renewed. States such as Maharashtra and Delhi implemented the renewal system, but the TN council didn't do it for a decade . 

Under the new guidelines, the first batch, the bulk of doctors , will come up for renewal in 2017. Every five years, consultants , specialists and surgeons will have attend medical education programmes organized by reputed professional academic bodies or any other authorized organizations .The council has released guidelines for accreditation of the CME programme, where medical education event organisers should apply for accreditation or credit hours a month in advance for a fee. The council will appoint a medical professional an observer for every event, Dr Prakasam said. "It took us a long time to plan this. But we have managed to bring this in now. There will be medical education programmes throughout the year. 

On an average, a doctor attending two medical conferences and at least three lectures or orations a year will fulfill the credit hour needs," he said.To ensure quality, credit hours will be awarded for the event based on subject matter, status of the speaker and quality of the papers presented . 

For instance, a guest lecture by foreign faculty of international repute or a workshop for at least three hours shall be given one hour and a daylong workshop will be credited with two hours.

 

LETTER FROM STATE IMA REGARDING CME
AND THE CREDIT HOURS
Ref.No. TNMC/G 199/2013     

Arranging C.M.E. Programme and to issue
Attendance Certificates -Regarding.
               
This Council approved and accredited the upcoming CME Programme to be
conducted by Indian Medical Association, Namakkal Branch. Whenever your
Association conducts the CME Programme, brochure may be sent before 7 days
of the programme. After the programme, attendance register may be sent to this
office within 10 days.
Consolidated Certificates (Credit Points) will be given to the each
participants by the Tamil Nadu Medical Council, Chennai after paying fee of
Rs.100/- per each participant.
For Getting TNMC CME Certificate Procedure
Separate CME Certificate will be issued to each participant by this Council.
Your educational activity will be reviewed and accredited and will be awarded for
2 Credit hours of Category 1 CME (per day) by the Tamil Nadu Medical Council,
Chennai.
Speakers at any Conference/CME/Workshop/Training Programme will be
given One Credit Hours in additional to the Credit Hours allotted to delegates for
that particular academic activity (For example 3 days conference 6+1=7 Credit
Hours)
In this connection, I request you to furnish the following documents to
enable us to issue CME Programme certificate to each participant which is
mandatory for Re-registration.il 2013 www.namakkalima.com

1. Total number of Registered participant's name, TNMC Registration
Number with fees should be given before 10 days from
commencement of the C.M.E. Programme.
2. Attendance Register containing those who have attended the
programme with signature.(After programme)
3. Prescribed Fee for Rs.100/- (Rupees One hundred only) for each
participant by consolidated Demand Draft drawn in favour of
“The Registrar, Tamil Nadu Medical Council CME, Chennai”
payable at Chennai.
4. Brief report of the Programme. (After programme)

For further correspondence addressed to
The Registrar,
Tamil Nadu Medical Council, CME,
No.914, Poonamallee High Road,
Arumbakkam, Chennai - 600 106
Email: tnmccme@gmail.com.    Phone : 044 - 26265678 Fax No. : 044 – 26285678

Contact Details of TAMIL NADU MEDICAL COUNCIL, Chennai (Madras) Tamil Nadu are : Telephone: +91-44-24727603

More Information about Tamilnadu Medical Council

No 914, Opposite Panjali Amman Koil, Poonamalle High Road, Arumbakkam, Chennai - 600106 View Map
+(91)-44-26265678, 26285678
+(91)-44-26285678
Distance: 2.27 KM

www.tnmedicalcouncil.org

Also Listed In

 

Hours of Operation


Monday, Tuesday, Wednesday, Thursday, Friday: 10:00 am to 05:00 pm

Saturday, Sunday: Closed

Year Established
1914
Additional Information
* Allopathy Doctors Registration Office

 

 

 

 

TAMIL NADU MEDICAL COUNCIL,CHENNAI

Guidelines for CME Programme for getting Accreditation

1. Accreditation /Credit Hours to be awarded will be the sole discretion of the
Tamil Nadu Medical Council and will depend upon the subject matter, status
of the speaker and quality of the paper presented in the CME/Workshop
/Conference.The accreditation /Credit Hours awarded by the Tamil Nadu
Medical Council shall be final.
2. Any professional organization or body or institution holding CME’s should
apply for accreditation to the Tamil Nadu Medical Council in the prescribed
Proforma of Tamil Nadu Medical Council. The Council on verifying the
credentials of the organization will give Certificate of Accreditations to those
bodies to hold CME’s.
3. The office bearers of all Recognized Medical Associations will apply to the
Tamil Nadu Medical Council. The application should be accompanied by the
complete program of the CME/Conference including the names, designation
and country of the speakers and the subject of speech.
4. Accredited bodies like IMA/Professional bodies which hold regular CME’s
will have to inform the Tamil Nadu Medical Council, the date and time of the
CME ,at least 30 days in advance, so that the Tamil Nadu Medical Council can
send Member /Observer for the CME.
5. Credit Hours will be based on the composition of the faculty participation ,
quality and the contents of the subject matter
6. Recognized Medical Associations/Organizations should strictly issue the
Certificate to the delegate who has attended the CME.No Certificate should
be distributed on the first day at the time of Registration itself for the
CME/Conference. The Certificates should be distributed /awarded only on
the last day after completion of CME/Conference/Workshop.
7. Recognized Medical Associations/ Organizations will be duty bound to send
the feedback of the delegates and the list of delegates who attended the
CME/Conference. Separate lists for the delegates belonging to State of Tamil
Nadu and the delegates of other States /foreign countries should be submitted
to the Tamil Nadu Medical Council.
8. The delegates should enter their Tamil Nadu Medical Registration
Certificate’s registration Number and signature and time of reporting during
their entry at the venue on first days itself. No registration should be allowed
on any of the subsequent days of the programme. Attendance should be
marked in person on all days. The Registration has to be finished before the
beginning of the Scientific programme.
9. In case it is found by the Council that the Certificate issued is false, the
Accreditation Certificate of the such issuing recognized Medical
Associations/Organizations shall be cancelled.
ORGANISATIONS/ACADEMIC ACTIVITES TO BE ACCREDITED FOR C.M.E
ACCREDITATION.
1. International Conference of professional bodies.
2. National conference of professional bodies.
3. IMA, Dist. level, State level, National level & IMA academy.
4. State Level Conference of National & International organizations.
5. CME /workshop/training programme will be given one credit hour per talk
in addition to the credit hours allotted for that particular academic activity.
6. Former members and present members of Tamil Nadu Medical Council will
be deputed to attend the C.M.E.’s as observer by the Tamil Nadu Medical
Council and will be will given certificate of attendance.
Guidelines for determining Number of Credit Hours
1. One Guest Lecture by foreign faculty of international repute shall be given
one hour.
2. CME/Workshop of minimum duration of three hours i.e. half day duration
shall be eligible for one Credit Hour
3. The duration for one day CME Workshop shall be eligible for 2 Credit Hours
4. The Tamil Nadu Medical Council shall recognize International status of
conference, if five or more foreign members participating as faculty in such
conference, the Credit Hours for delegates who attend such
conferences/CME/Worshop will be as follows.,
i. One day CME/Workshop/Conference-2 Credit Hours
ii. Half day CME/Workshop/Conference-One Credit Hour
iii. 2 days -4 Credit hours.
iv. 3 days -6 Credit hours
Credit hours are limited to only maximum of 6 Hours for 3 days
conference. If the conference continues more than 3 days same 6
hours will be only allotted.
5. Speakers at any Conference/CME/Workshop/Training Programme will be
given One Credit Hours in additional to the Credit Hours allotted to delegates
for that particular academic activity(For Example 3 days conference 6+1=7
Credit Hours)
6. Director, Joint Director of Medical Education as Research /Director ,Joint
Director of Health Services and Deans of Medical Colleges will be awarded
(6) six Credit Hours per year. They will have to produce certificate to Tamil
Nadu Medical Council regarding their job status at the time of Renewal of
Registration.
7. Doctors working as Medical Teachers can claim (6) six Credit Hours per year
on producing certificate from their Head of Institution indicating that, they
are taking Undergraduate /Postgraduate classes and are engaged in Post
graduate ,Research Work.
8. Doctors doing Post Graduate Courses e.g. Diploma /PG /Super
Speciality /CPS etc., from recognized /Reputed Institutions will get (3)
Three Credit Hours per year of the duration of the Courses., e.g. 1st Year (4)
four Credit Hours ,2nd Year (4) four Credit Hours ,3rd year (4) four Credit
Hours
9. The Doctors who attend the International CME/Conferences held in
overseas as delegates on production of the certificates of attendance
Thereof will get (6) Credit Hours.
10. Any paper published in index National /International Medical Journal will
entitle the Author /Co Author (3) three Credit Hours per paper
11. Any chapter published in a text book or update book published by
professional bodies will entitle the Author (5) five Credit Hours
12. Paper presentation in a CME/Workshop/Conference per chapter will
be entitled to (1) one Credit Hour.
13. Credit Hour Certificate of CME/Workshop/International Conference
will be signed by the President , TNMC & Registrar, TNMC
14. It is the responsibility of the organizer to give a list of Participants who
have attend CME/Workshop/Conference .Video Conference conducted by
the Government Conference on Public Health/ University sponsored
programme on Medical Education would be awarded (1) one Credit Hour
to the Medical Fraternity attended the Video Conference.
15. The organization like IMA/professional bodes who hold regular
monthly meeting will issue a CME credit certificate at the end of every year to
its members specifically stating how many credit hours were acquired by each
members of that year. These certificates will be issued by the Tamil Nadu
Medical Council on production of Attendance Certificate.
Continued Medical Education (CME) which will not be accredited.
1. The C.M.E.’s organized by a Drug/equipment company for promotion of the
drug/equipment will not be entertained/considered.
2. C.M.E.’s organized by the individual nursing home/hospitals/persons for
marketing purposes shall not be credited.
3. C.M.E. organized for self promotion/advertisement will not be credited.
Categories of C.M.E.
Category-I
Formal and structured learning opportunities offered at International or
National or State level by recognised educational or scientific institutions or
professional bodies.
A. Congress or a Conference should
a) Be conducted for not less than 3 full days, a full day being 5-8 hours.
b) Involve speakers of international standing
c) Contain plenary lectures/symposia
d) Allow presentations of free communications of posters.
Category 2
Activities conducted with a local or regional participant ground in mind such as
Conferences, seminars or symposia organized by recognised educational
institutions.
Category 3
Workshops and courses.
Category 4
-Hands on Training on Models and skills Lab Workshops.
-operative procedures relay live to a group of practitioners maybe
Considered for registration as CME/CPD only if they for a practical
Component of planned learning activity and the CME Center is
Provided with information on the learning objectivities content area and
How the observers are to be guided during the session.

Category-5
BLS/ATLS/PLS First Aid courses.

 

APPLICATION FORM FOR REGISTRATION OF MEDICAL ORGANI ZATION / INSTITUTION
BY THE TAMIL NADU MEDICAL COUNCIL, TO CONDUCT CME PROGRAMMES AND TO
ISSUE ATTENDANCE CERTIFICATES.
To Date:
The Registrar, --------------------------
Tamil Nadu Medical Council,
New No.914, Poonamallee High Road,
Arumbakkam,Chennai-600106.
Name of the Organization or
/Institution :____________________________________________________
Registered Address :____________________________________________________
____________________________________________________
Cell/Phone No: _______________Fax No.:_______________E-Mail:_______________________
Registered Number with Place and Date of Registration :
PRESIDENT: Dr._____________________________________ TNMC REGN. NO.__________
ADDRESS: ______________________________________________________________________
______________________________________________________________________
Cell/Phone No: _______________Fax No.:_______________E-Mail:_______________________
GEN.SECRETARY: Dr.__________________________________TNMC REGN. NO._________
ADDRESS: ______________________________________________________________________
______________________________________________________________________
Cell/Phone No: _______________Fax No.:_______________E-Mail:_______________________
CME CHAIRMAN: Dr._________________________________TNMC REGN. NO.__________
ADDRESS: ______________________________________________________________________
_____________________________________________________________________
Cell/Phone No: _______________Fax No.:_______________E-Mail:_______________________
CME VICE CHAIRMAN: Dr._____________________________TNMC REGN.NO._________
ADDRESS: _______________________________________________________________________
______________________________________________________________________
Cell/Phone No: _______________Fax No.:_______________E-Mail:_______________________
MEDICAL SUPERINTENDENT OR PROGRAM DIRECTOR (If it is an institution)
Dr. TNMC REGN.NO.____________
ADDRESS: ______________________________________________________________________
______________________________________________________________________
Cell/Phone No: _______________Fax No.:_______________E-Mail:_______________________

&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&

DETAILS OF THE CME’S BEING CONDUCTED:
a) For the past how many years:
b) Approximately how many in a year (send copies of the invitations for the last twelve
months)
c) Are the subjects aimed for General Practitioners or Specialists:
d) Average attendance in each meeting:
e) Average duration of scientific discussion in each meeting:
f) Usual venue of the meetings:
DECLARATIONS:
1. We shall abide by the rules and regulations laid down by the MCI/TNMC and maintain a
complete register of the proceedings of all the meetings, for future reference.
2. We will send a copy of every CME to be conducted by our organization , to the TNMC , in
advance and have no objection for surprise verification of the meetings by a doctor,
authorized by the Tamil Nadu Medical Council.
3. We shall issue attendance certificates to all the participants, in the prescribed format and
maintain counterfoils for the same , for a period of seven years.
4. After each CME program, we shall send the list of the doctors participated to the Tamil Nadu
Medical Council within 7 days under Registered post.
5. We shall keep the Tamil Nadu Medical Council informed immediately, whenever there is a
change in the office bearers of our organization/Institution.
6. The information given above is true to the best of our knowledge.
We request you to register our Medical Organization / Institution, authorizing to conduct
period CME Programmes and issue attendance certificates to the participating doctors, for purposes
of re-registration.

PRESIDENT         GENERAL SECRETARY           CME CHAIRMAN    CME VICE- CHAIRMAN                                                                                                            

 

 

Declaration: Each applicant, at the time of making an application for registration under the provisions of the Act, shall be provided a copy of the declaration and shall submit a duly signed Declaration as provided in Appendix 1. The applicant shall also certify that he/she had read and agreed to abide by the same.
B. Duties and responsibilities of the Physician in general:
1.1 Character of Physician (Doctors with qualification of MBBS or MBBS with post graduate degree/ diploma or with equivalent qualification in any medical discipline):
1.1.1 A physician shall uphold the dignity and honour of his profession.
1.1.2 The prime object of the medical profession is to render service to humanity; reward or financial gain is a subordinate consideration. Who- so-ever chooses his profession, assumes the obligation to conduct himself in accordance with its ideals. A physician should be an upright man, instructed in the art of healings. He shall keep himself pure in character and be diligent in caring for the sick; he should be modest, sober, patient, prompt in discharging his duty without anxiety; conducting himself with propriety in his profession and in all the actions of his life.
1.1.3 No person other than a doctor having qualification recognised by Medical Council of India and registered with Medical Council of India/State Medical Council(s) is allowed to practice Modern system of Medicine or Surgery. A person obtaining qualification in any other system of Medicine is not allowed to practice Modern system of Medicine in any form.
1.2 Maintaining good medical practice:
1.2.1 The Principal objective of the medical profession is to render service to humanity with full respect for the dignity of profession and man. Physicians should merit the confidence of patients entrusted to their care, rendering to each a full measure of service and devotion. Physicians should try continuously to improve medical knowledge and skills and should make available to their patients and colleagues the benefits of their professional attainments. The physician should practice methods of healing founded on scientific basis and should not associate professionally with anyone who violates this principle. The honoured ideals of the medical profession imply that the responsibilities of the physician extend not only to individuals but also to society.
1.2.2 Membership in Medical Society: For the advancement of his profession, a physician should affiliate with associations and societies of allopathic medical professions and involve actively in the functioning of such bodies.
1.2.3 A Physician should participate in professional meetings as part of Continuing Medical Education programmes, for at least 30 hours every five years, organized by reputed professional academic bodies or any other authorized organsiations. The compliance of this requirement shall be informed regularly to Medical Council of India or the State Medical Councils as the case may be
Maintenance of medical records
1.3.1 Every physician shall maintain the medical records pertaining to his / her indoor patients for a period of 3 years from the date of commencement of the treatment in a standard proforma laid down by the Medical Council of India and attached as Appendix 3.
1.3.2. If any request is made for medical records either by the patients / authorised attendant or legal authorities involved, the same may be duly acknowledged and documents shall be issued within the period of 72 hours.
1.3.3 A Registered medical practitioner shall maintain a Register of Medical Certificates giving full details of certificates issued. When issuing a medical certificate he / she shall always enter the identification marks of the patient and keep a copy of the certificate. He / She shall not omit to record the signature and/or thumb mark, address and at least one identification mark of the patient on the medical certificates or report. The medical certificate shall be prepared as in Appendix 2.
1.3.4 Efforts shall be made to computerize medical records for quick retrieval.

1.4 Display of registration numbers:
1.4.1 Every physician shall display the registration number accorded to him by the State Medical Council / Medical Council of India in his clinic and in all his prescriptions, certificates, money receipts given to his patients.
1.4.2 Physicians shall display as suffix to their names only recognized medical degrees or such certificates/diplomas and memberships/honours which confer professional knowledge or recognizes any exemplary qualification/achievements.
1.5 Use of Generic names of drugs: Every physician should, as far as possible, prescribe drugs with generic names and he / she shall ensure that there is a rational prescription and use of drugs.
1.6 Highest Quality Assurance in patient care: Every physician should aid in safeguarding the profession against admission to it of those who are deficient in moral character or education. Physician shall not employ in connection with his professional practice any attendant who is neither registered nor enlisted under the Medical Acts in force and shall not permit such persons to attend, treat or perform operations upon patients wherever professional discretion or skill is required.
1.7 Exposure of Unethical Conduct: A Physician should expose, without fear or favour, incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession.
1.8 Payment of Professional Services: The physician, engaged in the practice of medicine shall give priority to the interests of patients. The personal financial interests of a physician should not conflict with the medical interests of patients. A physician should announce his fees before rendering service and not after the operation or treatment is under way. Remuneration received for such services should be in the form and amount specifically announced to the patient at the time the service is rendered. It is unethical to enter into a contract of "no cure no payment". Physician rendering service on behalf of the state shall refrain from anticipating or accepting any consideration.
1.9 Evasion of Legal Restrictions: The physician shall observe the laws of the country in regulating the practice of medicine and shall also not assist others to evade such laws. He should be cooperative in observance and enforcement of sanitary laws and regulations in the interest of public health. A physician should observe the provisions of the State Acts like Drugs and Cosmetics Act, 1940; Pharmacy Act, 1948; Narcotic Drugs and Psychotropic substances Act, 1985; Medical Termination of Pregnancy Act, 1971; Transplantation of Human Organ Act, 1994; Mental Health Act, 1987; Environmental Protection Act, 1986; Pre–natal Sex Determination Test Act, 1994; Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954; Persons with Disabilities (Equal Opportunities and Full Participation) Act, 1995 and Bio-Medical Waste (Management and Handling) Rules, 1998 and such other Acts, Rules, Regulations made by the Central/State Governments or local Administrative Bodies or any other relevant Act relating to the protection and promotion of public health.

Duties of Physician in Consultation

Unnecessary consultations should be avoided:

3.1.1 However in case of serious illness and in doubtful or difficult conditions, the physician should request consultation, but under any circumstances such consultation should be justifiable and in the interest of the patient only and not for any other consideration.

3.1.2 Consulting pathologists /radiologists or asking for any other diagnostic Lab investigation should be done judiciously and not in a routine manner.

3.2 Consultation for Patient’s Benefit: In every consultation, the benefit to the patient is of foremost importance. All physicians engaged in the case should be frank with the patient and his attendants.

3.3 Punctuality in Consultation: Utmost punctuality should be observed by a physician in making themselves available for consultations.

3.4 Statement to Patient after Consultation:

3.4.1 All statements to the patient or his representatives should take place in the presence of the consulting physicians, except as otherwise agreed. The disclosure of the opinion to the patient or his relatives or friends shall rest with the medical attendant.

3.4.2 Differences of opinion should not be divulged unnecessarily but when there is irreconcilable difference of opinion the circumstances should be frankly and impartially explained to the patient or his relatives or friends. It would be opened to them to seek further advice as they so desire.

3.5 Treatment after Consultation: No decision should restrain the attending physician from making such subsequent variations in the treatment if any unexpected change occurs, but at the next consultation, reasons for the variations should be discussed/explained. The same privilege, with its obligations, belongs to the consultant when sent for in an emergency during the absence of attending physician. The attending physician may prescribe medicine at any time for the patient, whereas the consultant may prescribe only in case of emergency or as an expert when called for.

3.6 Patients Referred to Specialists: When a patient is referred to a specialist by the attending physician, a case summary of the patient should be given to the specialist, who should communicate his opinion in writing to the attending physician.

3.7 Fees and other charges:

3.7.1 A physician shall clearly display his fees and other charges on the board of his chamber and/or the hospitals he is visiting. Prescription should also make clear if the Physician himself dispensed any medicine.

3.7.2 A physician shall write his name and designation in full along with registration particulars in his prescription letter head.

Note: In Government hospital where the patient–load is heavy, the name of the prescribing doctor must be written below his/her signature.

Duties of Physicians to their Patients

Obligations to the Sick:
2.1.1 Though a physician is not bound to treat each and every person asking his services, he should not only be ever ready to respond to the calls of the sick and the injured, but should be mindful of the high character of his mission and the responsibility he discharges in the course of his professional duties. In his treatment, he should never forget that the health and the lives of those entrusted to his care depend on his skill and attention. A physician should endeavor to add to the comfort of the sick by making his visits at the hour indicated to the patients. A physician advising a patient to seek service of another physician is acceptable; however, in case of emergency a physician must treat the patient. No physician shall arbitrarily refuse treatment to a patient. However for good reason, when a patient is suffering from an ailment which is not within the range of experience of the treating physician, the physician may refuse treatment and refer the patient to another physician.

2.1.2 Medical practitioner having any incapacity detrimental to the patient or which can affect his performance vis-à-vis the patient is not permitted to practice his profession

2.2 Patience, Delicacy and Secrecy : Patience and delicacy should characterize the physician. Confidences concerning individual or domestic life entrusted by patients to a physician and defects in the disposition or character of patients observed during medical attendance should never be revealed unless their revelation is required by the laws of the State. Sometimes, however, a physician must determine whether his duty to society requires him to employ knowledge, obtained through confidence as a physician, to protect a healthy person against a communicable disease to which he is about to be exposed. In such instance, the physician should act as he would wish another to act toward one of his own family in like circumstances.

2.3 Prognosis: The physician should neither exaggerate nor minimize the gravity of a patient’s condition. He should ensure himself that the patient, his relatives or his responsible friends have such knowledge of the patient’s condition as will serve the best interests of the patient and the family.

2.4 The Patient must not be neglected: A physician is free to choose whom he will serve. He should, however, respond to any request for his assistance in an emergency. Once having undertaken a case, the physician should not neglect the patient, nor should he withdraw from the case without giving adequate notice to the patient and his family. Provisionally or fully registered medical practitioner shall not willfully commit an act of negligence that may deprive his patient or patients from necessary medical care.

2.5 Engagement for an Obstetric case: When a physician who has been engaged to attend an obstetric case is absent and another is sent for and delivery accomplished, the acting physician is entitled to his professional fees, but should secure the patient’s consent to resign on the arrival of the physician engaged

Duties of Physician to the Public and the Para medical Profession

5.1 Physicians as Citizens: Physicians, as good citizens, possessed of special training should disseminate advice on public health issues. They should play their part in enforcing the laws of the community and in sustaining the institutions that advance the interests of humanity. They should particularly co-operate with the authorities in the administration of sanitary/public health laws and regulations.

5.2 Public and Community Health: Physicians, especially those engaged in public health work, should enlighten the public concerning quarantine regulations and measures for the prevention of epidemic and communicable diseases. At all times the physician should notify the constituted public health authorities of every case of communicable disease under his care, in accordance with the laws, rules and regulations of the health authorities. When an epidemic occurs a physician should not abandon his duty for fear of contracting the disease himself.

5.3 Pharmacists / Nurses: Physicians should recognize and promote the practice of different paramedical services such as, pharmacy and nursing as professions and should seek their cooperation wherever required.

Responsibilities of Physicians to each other

4.1 Dependence of Physicians on each other : A physician should consider it as a pleasure and privilege to render gratuitous service to all physicians and their immediate family dependants.

4.2 Conduct in consultation: In consultations, no insincerity, rivalry or envy should be indulged in. All due respect should be observed towards the physician in-charge of the case and no statement or remark be made, which would impair the confidence reposed in him. For this purpose no discussion should be carried on in the presence of the patient or his representatives.

4.3 Consultant not to take charge of the case: When a physician has been called for consultation, the Consultant should normally not take charge of the case, especially on the solicitation of the patient or friends. The Consultant shall not criticize the referring physician. He / she shall discuss the diagnosis treatment plan with the referring physician.

4.4 Appointment of Substitute: Whenever a physician requests another physician to attend his patients during his temporary absence from his practice, professional courtesy requires the acceptance of such appointment only when he has the capacity to discharge the additional responsibility along with his / her other duties. The physician acting under such an appointment should give the utmost consideration to the interests and reputation of the absent physician and all such patients should be restored to the care of the latter upon his/her return.

4.5 Visiting another Physician’s Case: When it becomes the duty of a physician occupying an official position to see and report upon an illness or injury, he should communicate to the physician in attendance so as to give him an option of being present. The medical officer / physician occupying an official position should avoid remarks upon the diagnosis or the treatment that has been adopted.

Unethical Acts

6. UNETHICAL ACTS : A physician shall not aid or abet or commit any of the following acts which shall be construed as unethical -
6.1 Advertising:

6.1.1 Soliciting of patients directly or indirectly, by a physician, by a group of physicians or by institutions or organisations is unethical. A physician shall not make use of him / her (or his / her name) as subject of any form or manner of advertising or publicity through any mode either alone or in conjunction with others which is of such a character as to invite attention to him or to his professional position, skill, qualification, achievements, attainments, specialties, appointments, associations, affiliations or honors and/or of such character as would ordinarily result in his self aggrandizement. A physician shall not give to any person, whether for compensation or otherwise, any approval, recommendation, endorsement, certificate, report or statement with respect of any drug, medicine, nostrum remedy, surgical, or therapeutic article, apparatus or appliance or any commercial product or article with respect of any property, quality or use thereof or any test, demonstration or trial thereof, for use in connection with his name, signature, or photograph in any form or manner of advertising through any mode nor shall he boast of cases, operations, cures or remedies or permit the publication of report thereof through any mode. A medical practitioner is however permitted to make a formal announcement in press regarding the following:
• On starting practice.
• On change of type of practice.
• On changing address.
• On temporary absence from duty.
• On resumption of another practice.
• On succeeding to another practice.
• Public declaration of charges.

6.1.2 Printing of self photograph, or any such material of publicity in the letter head or on sign board of the consulting room or any such clinical establishment shall be regarded as acts of self advertisement and unethical conduct on the part of the physician. However, printing of sketches, diagrams, picture of human system shall not be treated as unethical.

6.2 Patent and Copy rights: A physician may patent surgical instruments, appliances and medicine or Copyright applications, methods and procedures. However, it shall be unethical if the benefits of such patents or copyrights are not made available in situations where the interest of large population is involved.

6.3 Running an open shop (Dispensing of Drugs and Appliances by Physicians): - A physician should not run an open shop for sale of medicine for dispensing prescriptions prescribed by doctors other than himself or for sale of medical or surgical appliances. It is not unethical for a physician to prescribe or supply drugs, remedies or appliances as long as there is no exploitation of the patient. Drugs prescribed by a physician or brought from the market for a patient should explicitly state the proprietary formulae as well as generic name of the drug.

Rebates and Commission:
6.4.1 A physician shall not give, solicit, or receive nor shall he offer to give solicit or receive, any gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient for medical, surgical or other treatment. A physician shall not directly or indirectly, participate in or be a party to act of division, transference, assignment, subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment.

6.4.2 Provisions of para 6.4.1 shall apply with equal force to the referring, recommending or procuring by a physician or any person, specimen or material for diagnostic purposes or other study / work. Nothing in this section, however, shall prohibit payment of salaries by a qualified physician to other duly qualified person rendering medical care under his supervision.

6.5 Secret Remedies: The prescribing or dispensing by a physician of secret remedial agents of which he does not know the composition, or the manufacture or promotion of their use is unethical and as such prohibited. All the drugs prescribed by a physician should always carry a proprietary formula and clear name.

6.6 Human Rights: The physician shall not aid or abet torture nor shall he be a party to either infliction of mental or physical trauma or concealment of torture inflicted by some other person or agency in clear violation of human rights.

31.9 6.7 Euthanasia: Practicing euthanasia shall constitute unethical conduct. However on specific occasion, the question of withdrawing supporting devices to sustain cardio-pulmonary function even after brain death, shall be decided only by a team of doctors and not merely by the treating physician alone. A team of doctors shall declare withdrawal of support system. Such team shall consist of the doctor in charge of the patient, Chief Medical Officer / Medical Officer in charge of the hospital and a doctor nominated by the in-charge of the hospital from the hospital staff or in accordance with the provisions of the Transplantation of Human Organ Act, 1994.

Misconduct

7. MISCONDUCT : The following acts of commission or omission on the part of a physician shall constitute professional misconduct rendering him/her liable for disciplinary action -

7.1 Violation of the Regulations: If he/she commits any violation of these Regulations.

7.2 If he/she does not maintain the medical records of his/her indoor patients for a period of three years as per regulation 1.3 and refuses to provide the same within 72 hours when the patient or his/her authorised representative makes a request for it as per the regulation 1.3.2.

7.3 If he/she does not display the registration number accorded to him/her by the State Medical Council or the Medical Council of India in his clinic, prescriptions and certificates etc. issued by him or violates the provisions of regulation 1.4.2.

7.4 Adultery or Improper Conduct: Abuse of professional position by committing adultery or improper conduct with a patient or by maintaining an improper association with a patient will render a Physician liable for disciplinary action as provided under the Indian Medical Council Act, 1956 or the concerned State Medical Council Act.

7.5 Conviction by Court of Law: Conviction by a Court of Law for offences involving moral turpitude / Criminal acts.

7.6 Sex Determination Tests: On no account sex determination test shall be undertaken with the intent to terminate the life of a female foetus developing in her mother’s womb, unless there are other absolute indications for termination of pregnancy as specified in the Medical Termination of Pregnancy Act, 1971. Any act of termination of pregnancy of normal female foetus amounting to female foeticide shall be regarded as professional misconduct on the part of the physician leading to penal erasure besides rendering him liable to criminal proceedings as per the provisions of this Act.

7.7 Signing Professional Certificates, Reports and other Documents: Registered medical practitioners are in certain cases bound by law to give, or may from time to time be called upon or requested to give certificates, notification, reports and other documents of similar character signed by them in their professional capacity for subsequent use in the courts or for administrative purposes etc. Such documents, among others, include the ones given at Appendix –4. Any registered practitioner who is shown to have signed or given under his name and authority any such certificate, notification, report or document of a similar character which is untrue, misleading or improper, is liable to have his name deleted from the Register.
7.8 A registered medical practitioner shall not contravene the provisions of the Drugs and Cosmetics Act and regulations made there under. Accordingly, -

a) Prescribing steroids/ psychotropic drugs when there is no absolute medical indication; selling Schedule ‘H’ & ‘L’ drugs and poisons to the public except to his patient; in contravention of the above provisions shall constitute gross professional misconduct on the part of the physician.

7.9 Performing or enabling unqualified person to perform an abortion or any illegal operation for which there is no medical, surgical or psychological indication.

7.10 A registered medical practitioner shall not issue certificates of efficiency in modern medicine to unqualified or non-medical person.

(Note: The foregoing does not restrict the proper training and instruction of bonafide students, midwives, dispensers, surgical attendants, or skilled mechanical and technical assistants and therapy assistants under the personal supervision of physicians.)

7.11 A physician should not contribute to the lay press articles and give interviews regarding diseases and treatments which may have the effect of advertising himself or soliciting practices; but is open to write to the lay press under his own name on matters of public health, hygienic living or to deliver public lectures, give talks on the radio/TV/internet chat for the same purpose and send announcement of the same to lay press.

7.12 An institution run by a physician for a particular purpose such as a maternity home, nursing home, private hospital, rehabilitation centre or any type of training institution etc. may be advertised in the lay press, but such advertisements should not contain anything more than the name of the institution, type of patients admitted, type of training and other facilities offered and the fees.

7.13 It is improper for a physician to use an unusually large sign board and write on it anything other than his name, qualifications obtained from a University or a statutory body, titles and name of his specialty, registration number including the name of the State Medical Council under which registered. The same should be the contents of his prescription papers. It is improper to affix a sign-board on a chemist’s shop or in places where he does not reside or work.

7.14 The registered medical practitioner shall not disclose the secrets of a patient that have been learnt in the exercise of his / her profession except –
• in a court of law under orders of the Presiding Judge;
• in circumstances where there is a serious and identified risk to a specific person and / or community; and
• notifiable diseases.
In case of communicable / notifiable diseases, concerned public health authorities should be informed immediately.

7.15 The registered medical practitioner shall not refuse on religious grounds alone to give assistance in or conduct of sterility, birth control, circumcision and medical termination of Pregnancy when there is medical indication, unless the medical practitioner feels himself/herself incompetent to do so.

7.16 Before performing an operation the physician should obtain in writing the consent from the husband or wife, parent or guardian in the case of minor, or the patient himself as the case may be. In an operation which may result in sterility the consent of both husband and wife is needed.

7.17 A registered medical practitioner shall not publish photographs or case reports of his / her patients without their permission, in any medical or other journal in a manner by which their identity could be made out. If the identity is not to be disclosed, the consent is not needed.

7.18 In the case of running of a nursing home by a physician and employing assistants to help him / her, the ultimate responsibility rests on the physician.

7.19 A Physician shall not use touts or agents for procuring patients.

7.20 A Physician shall not claim to be specialist unless he has a special qualification in that branch.

7.21 No act of invitro fertilisation or artificial insemination shall be undertaken without the informed consent of the female patient and her spouse as well as the donor. Such consent shall be obtained in writing only after the patient is provided, at her own level of comprehension, with sufficient information about the purpose, methods, risks, inconveniences, disappointments of the procedure and possible risks and hazards.

7.22 Research: Clinical drug trials or other research involving patients or volunteers as per the guidelines of ICMR can be undertaken, provided ethical considerations are borne in mind. Violation of existing ICMR guidelines in this regard shall constitute misconduct. Consent taken from the patient for trial of drug or therapy which is not as per the guidelines shall also be construed as misconduct.

7.23 If a physician posted in rural area is found absent on more than two occasions during inspection by the Head of the District Health Authority or the Chairman, Zilla Parishad, the same shall be construed as a misconduct if it is recommended to the Medical Council of India/State Medical Council by the State Government for action under these Regulations.

7.24 If a physician posted in a medical college/institution both as teaching faculty or otherwise shall remain in hospital/college during the assigned duty hours. If they are found absent on more than two occasions during this period, the same shall be construed as a misconduct if it is certified by the Principal/Medical Superintendent and forwarded through the State Government to Medical Council of India/State Medical Council for action under these Regulations.

Punishment and Disciplinary Action

8.1 It must be clearly understood that the instances of offences and of Professional misconduct which are given above do not constitute and are not intended to constitute a complete list of the infamous acts which calls for disciplinary action, and that by issuing this notice the Medical Council of India and or State Medical Councils are in no way precluded from considering and dealing with any other form of professional misconduct on the part of a registered practitioner. Circumstances may and do arise from time to time in relation to which there may occur questions of professional misconduct which do not come within any of these categories. Every care should be taken that the code is not violated in letter or spirit. In such instances as in all others, the Medical Council of India and/or State Medical Councils have to consider and decide upon the facts brought before the Medical Council of India and/or State Medical Councils.

8.2 It is made clear that any complaint with regard to professional misconduct can be brought before the appropriate Medical Council for Disciplinary action. Upon receipt of any complaint of professional misconduct, the appropriate Medical Council would hold an enquiry and give opportunity to the registered medical practitioner to be heard in person or by pleader. If the medical practitioner is found to be guilty of committing professional misconduct, the appropriate Medical Council may award such punishment as deemed necessary or may direct the removal altogether or for a specified period, from the register of the name of the delinquent registered practitioner. Deletion from the Register shall be widely publicized in local press as well as in the publications of different Medical Associations/ Societies/Bodies.

8.3 In case the punishment of removal from the register is for a limited period, the appropriate Council may also direct that the name so removed shall be restored in the register after the expiry of the period for which the name was ordered to be removed.

8.4 Decision on complaint against delinquent physician shall be taken within a time limit of 6 months.

8.5 During the pendency of the complaint the appropriate Council may restrain the physician from performing the procedure or practice which is under scrutiny.

8.6 Professional incompetence shall be judged by peer group as per guidelines prescribed by Medical Council of India

      Appendix 1: Oath.

DECLARATION
At the time of registration, each applicant shall be given a copy of the following declaration by the Registrar concerned and the applicant shall read and agree to abide by the same:
·  I solemnly pledge myself to consecrate my life to service of humanity.
·  Even under threat, I will not use my medical knowledge contrary to the laws of Humanity.
·  I will maintain the utmost respect for human life from the time of conception.
·  I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient.
·  I will practice my profession with conscience and dignity.
·  The health of my patient will be my first consideration.
·  I will respect the secrets which are confined in me.
·  I will give to my teachers the respect and gratitude which is their due.
·  I will maintain by all means in my power, the honour and noble traditions of medical profession.
·  I will treat my colleagues with all respect and dignity.
·  I shall abide by the code of medical ethics as enunciated in the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002.
·  I make these promises solemnly, freely and upon my honour.

Signature ………………
Name ………………………….
Place ………………..
Address ……………………….
Date …………………

 

Appendix 2 : Medical   and  Fitness Certificate


FORM OF CERTIFICATE RECOMMENDED FOR LEAVE OR EXTENSION OR COMMUNICATION OF LEAVE AND FOR FITNESS.
Signature of patient or thumb impression ___________________________________________
To be filled in by the applicant in the presence of the Government Medical Attendant, or Medical Practitioner.
Identification marks: -
_____________ _____________
I, Dr. _____________________________________ after careful examination of the case certify hereby that _______________whose signature is given above is suffering from ________________ and I consider that a period of absence from duty of ____________________ with effect from ______________________________ is absolutely necessary for the restoration of his health.
I, Dr. ______________________after careful examination of the case certify hereby that ______________________ on restoration of health is now fit to join service.
Place_______________ Signature of Medical attendant.
Date ________________ Registration No._______________________
(Medical Council of India/State Medical Council of ………….State)

Note:- The nature and probable duration of the illness should also be specified . This certificate must be accompanied by a brief resume of the case giving the nature of the illness, its symptoms, causes and duration.


Appendix 3: Medical Records

FORMAT FOR MEDICAL RECORD (see regulation 3.1)
Name of the patient :
Age :
Sex :
Address :
Occupation :
Date of 1st visit :
Clinical note (summary) of the case:
Prov : Diagnosis :
Investigations advised with reports:
Diagnosis after investigation:
Advice :
Follow up
Date: Observations:
Signature in full …………………………. Name of Treating Physician

 

Appendix 4: List of Certificates

LIST OF CERTIFICATES, REPORTS, NOTIFICATIONS ETC. ISSUED BY DOCTORS FOR THE PURPOSES OF VARIOUS ACTS/ADMINISTRATIVE REQUIREMENTS -


· Under the acts relating to birth, death or disposal of the dead.
· Under the Acts relating to Lunacy and Mental Deficiency and under the Mental illness Act and the
  rules made there under.
· Under the Vaccination Acts and the regulations made there under.
· Under the Factory Acts and the regulations made there under.
· Under the Education Acts.
· Under the Public Health Acts and the orders made there under.
· Under the Workmen’s Compensation Act and Persons with Disability Act.
· Under the Acts and orders relating to the notification of infectious diseases.
· Under the Employee’s State Insurance Act.
· In connection with sick benefit insurance and friendly societies.
· Under the Merchant Shipping Act.
· For procuring / issuing of passports.
· For excusing attendance in courts of Justice, in public services, in public offices or in ordinary
   employment.
· In connection with Civil and Military matters.
· In connection with matters under the control of Department of Pensions.
· In connection with quarantine rules.

· For procuring driving licence.