Hundreds of doctors from Maharashtra, Tamil Nadu and Andhra Pradesh were in Kerala providing medical care for victims of the flood. Strictly speaking, these doctors were violating the Kerala law that stipulates that only doctors registered with the state’s medical council can practice there. Similar laws exist in most states.This has given rise to an absurd situation where thousands of doctors are registered in more than one state and some in as many as five. This is despite the central act governing all Indian doctors clearly stating that anyone registered in the Indian Medical Register (IMR) can practice anywhere in the country.Doctors in Kerala and Karnataka have gone to court against the law that compels them to register with the state medical councils and renew their registration every five years. The doctors argue that there is no such stipulation in the central law. In areas on the concurrent list, like health, where both Centre and states can enact laws, when a state law is in conflict with the central one, the latter prevails.The Medical Council of India has added to the confusion by shifting positions. According to the minutes of a MCI ethics committee meeting and its general body in late 2004, the committee had decided that there was no need to register in more than one state as “any doctor who has registered with any state medical council is automatically registered in the Indian Medical Register”. And it had pointed out that under section 27 of the IMC Act, 1956, a person whose name is included in the IMR can practice anywhere.However, 12 years later, the MCI filed an affidavit in the Punjab & Haryana High Court in July 2016 stating that “persons possessing recognized medical qualification are required to be registered with the respective state medical councils within the jurisdiction of which they wish to practice medicine”.Multiple registration has led to problems in enforcing disciplinary action against a doctor. Even if one state council suspends or cancels his/her registration, s/he can continue to practice using the registration with another. This had happened in the case of an orthopaedic surgeon practicing in Chennai. His name was removed from the medical register permanently by the Tamil Nadu council after he was convicted of pornographic crimes. MCI upheld the permanent removal and stated that all state councils would be informed. However, he continues to practice and his name still figures in the IMR as being registered in MP.The MCI cannot remove the name of any doctor registered with a state medical council from the IMR without the state council seeking removal of his/her name. MCI has repeatedly maintained that state councils are established under Acts of state legislatures and hence are independent statutory authorities over which it does not have any supervisory role or authority.In response to a petition from Dr KV Babu from Kerala to MCI president Dr Jayshree Mehta on this issue, she responded that the matter would be taken up in a meeting with state medical councils in Mumbai on September 28 and 29.Last year, the MCI had tried to initiate a system of Unique Permanent Registration Number (UPRN) for doctors to be able to track them in cases of medical negligence, to get a clearer picture of how many doctors are practicing in India, and to tackle the menace of fake doctors or ones with unrecognized degrees. Little has come of that effort so far.