SC: State can provide separate entry to in-service candidates in PG medical courses

The Hon’ble Supreme Court, on 31st August 2020, in the matter of Tamil Nadu Medical Officers Association & Ors. v. Union of India & Ors. pronounced that the State has the legislative competence and/or authority to provide for a separate source of entry for in­-service candidates seeking admission to PG medical degree/diploma courses. However, that policy must provide that subsequent to obtaining the postgraduate degree by the concerned in­service doctors obtaining entry in degree courses through such separate channel serve the State in the rural, tribal and hilly areas at least for five years after obtaining the degree/diploma and for that they will execute bonds for such sum the respective States may consider fit and proper.

Questions before the Hon’ble Supreme Court

What is the scope and ambit of Entry 66 of List I?

What will be the impact/effect of MCI Postgraduate Medical Education Regulations, 2000 framed by the Medical Council of India in exercise of its powers under Section 33 of the Indian Medical Council Act, 1956?

Whether in view of Entry 66 of List I, the State is denuded of its power to legislate on the manner and method of the postgraduate medical courses, more particularly, making special provisions for in­service candidates in the postgraduate degree/diploma courses?

Whether Regulation 9 of MCI Postgraduate Medical Education Regulations, 2000, more particularly, Regulation 9(IV) and 9(VII) takes away the power of the States under Entry 25 of List III to provide for a separate source of entry for in­service candidates seeking admission to postgraduate medical courses?

Whether Regulation 9 of  MCI Postgraduate Medical Education Regulations, 2000 is understood to not allow for the States to provide for a separate source of entry for in­service candidates seeking admission to postgraduate degree courses, the same is arbitrary, discriminatory and violative of Articles 14 and 19(1) (g) of the Constitution of India, and also ultra vires of the provisions of the Indian Medical Council Act, 1956?

Whether Regulation 9 is a complete code in itself, as observed by this Court in the case of State of U.P. v. Dinesh Singh Chauhan (2016) 9 SCC 749 affecting the rights/authority of the States to provide for reservation and/or separate source of entry for in­service candidates seeking admission to postgraduate degree courses?

The Hon’ble Supreme Court observed that:

MCI Postgraduate Medical Education Regulations, 2000

Entry 66 of List I is a specific entry having a very specific and limited scope; it deals with “Coordination and Determination of Standards” in institutions of higher education or research as well as scientific and technical institutions. In exercise of powers under Entry 66 List I, the Union cannot provide for anything with respect to reservation/percentage of reservation and/or even mode of admission within the State quota, which powers are conferred upon the States under Entry 25 of List III. In exercise of powers under Entry 25 List III, the States have power to make provision for mode of admissions, looking to the requirements and/or need in the concerned State. (Para 10.1)

MCI Postgraduate Medical Education Regulations, 2000 are framed by the MCI in exercise of its powers conferred under Section 33 of the Indian Medical Council Act, 1956. The Indian Medical Council Act, 1956 has been enacted/passed by the Union in exercise of powers conferred under Entry 66, List I. Therefore, the main source of power of the MCI would be from Entry 66 List I. (Para 11.2)

As per Section 33 of the MCI Act, 1956, the Council may with the previous sanction of the Central Government make regulations generally to carry out the purpose of the said Act. Therefore, in exercise of powers under Section 33 of the MCI Act, MCI Postgraduate Medical Education Regulations, 2000 are made by the MCI. (Para 11.2)

As observed hereinabove, the MCI draws the power from Entry 66 List I. Entry 66 List I is a specific entry having a very specific and limited scope which deals with “Coordination and Determination of Standards” of higher education for research as well as scientific and technical institutions. In fact, such “Coordination and Determination of Standards”, insofar as medical education is concerned, is achieved by parliamentary legislation in the form of Indian Medical Council Act, 1956 and by creating the statutory body like MCI. The functions that are assigned to MCI include within its sweep “Determination of Standards” in a medical institution as well as “Coordination of Standards” and that of educational institutions. When it comes to regulating “education” as such, which includes even medical education as well as universities, that is prescribed in List III, Entry 25. (Para 11.2)

If one considers the Statement of Objects and Reasons of the Indian Medical Council Act, 1956, it cannot be said that the Medical Council of India would have any authority or jurisdiction to frame any regulations with respect to reservation and/or making special provision like providing for a separate source of entry for in-­service candidates seeking admission to postgraduate degree courses. MCI Postgraduate Medical Education Regulations, 2000 have been made in exercise of powers under Section 33 of the MCI Act. (Para 11.3)

On a fair reading of entire Section 33 of the MCI Act, 1956, it does not confer any authority and/or power to the MCI to frame the regulations with respect to reservation in the medical courses, more particularly, to provide for a separate source of entry for in­ service candidates seeking admission to postgraduate degree courses. (Para 11.3)

The title of Regulation 9 is “Procedure for selection of candidate for postgraduate courses”. Regulation 9(I) provides that there shall be a single eligibility­-cum­-entrance examination, namely, NEET. Regulation 9(II) further provides that 3% seats of the annual sanctioned intake capacity shall be filled up by candidates with locomotory disability. Regulation 9(III) provides for the eligibility criteria. It provides that in order to be eligible for admission to any postgraduate course in a particular academic year, it shall be necessary for a candidate to obtain minimum of marks at 50th percentile in NEET for postgraduate courses. However, in respect of candidates belonging to SC/ST/OBC, the minimum marks shall be at 40th percentile. Thus, it can be seen that Regulation 9(III) can be said to be providing the standards which shall be within the domain and legislative competence of the Union and the MCI, in exercise of powers under Entry 66, List I. The first part of Regulation 9(IV) speaks for the reservation of seats in medical colleges/institutions. It provides that the reservation of seats in medical colleges/institutions for respective categories shall be as per applicable laws prevailing in States/Union Territories. It further provides for preparing all­India merit list as well as State­ wise merit list of the eligible candidates on the basis of the marks obtained in NEET and candidates shall be admitted to postgraduate courses from the said merit lists only. To that stage, it can be said that the same is within the legislative competence of the Union/MCI, in exercise of powers under Entry 66 List I. (Para 12)

However, proviso to Regulation 9(IV) further provides that in determining the merit of candidates who are in service of Government/public authority, weightage in the marks may be given by the Government/competent authority as an incentive at the rate of 10% of the marks obtained for each year of service in remote and/or difficult areas up to the maximum of 30% of the marks obtained in NEET. It further provides that the remote and difficult areas shall be as defined by the State Government/competent authority from time to time. Thus, it can be seen that even the proviso can be said to be with respect to preparing the merit list only. (Para 12)

Regulation 9(IV) is limited only to reservation in favour of SC/ST/OBC and as per the prevailing laws in the States. If that be so, then the proviso which as such is not dealing with the reservation cannot be said to be in the form of an exception to first part of Regulation 9(IV) and it can be seen that it is an independent provision dealing with the in-­service candidates and that too for the purpose of preparing the merit list. Thus, the proviso becomes the substantive provision and is more concerned with the marks to be allocated which is the concern of Regulation 9(III). It is also required to be noted that even this proviso confers a discretion on the State to provide for weightage in marks for the services rendered in remote or difficult areas. The proviso only enables the States by conferring the discretion for weightage. The proviso has nothing to do with the reservation in the postgraduate degree courses and therefore it shall not negate the State’s power to make reservation and/or make special provision to provide for a separate source of entry for in­-service candidates seeking admission to postgraduate degree courses. Thus, Regulation 9(IV) as such cannot be said to be taking away the power of the States under Entry 25, List III, to provide for a separate source of entry for in-­service candidates seeking admission to postgraduate degree courses. Any contrary view would affect the right of the States to make reservation and/or to make special provision for admission in exercise of powers under Entry 25 List III. If it is construed that Regulation 9 of the MCI Postgraduate Medical Education Regulations, 200, more particularly Regulation 9(IV) provides for reservation and/or deals with the reservation for in-­service candidates, in that case, it will be beyond the legislative competence of the Union as well as it will be ultra vires to the Indian Medical Council Act, 1956. As observed hereinabove, Section 33 of the Indian Medical Council Act, 1956 does not confer any power on the MCI to make regulations with respect to reservation. At the cost of repetition, it is observed that “institutional preference”, despite MCI Postgraduate Medical Education Regulations, 2000, has been upheld and held to be permissible by the concerned States. (Para 12)

That Entry 66 List I is a specific entry having a very limited scope (Para 13(1))  

It deals with “coordination and determination of standards” in higher education; (Para 13(2))

The words “coordination and determination of standards would mean laying down the said standards(Para 13(3))

The Medical Council of India which has been constituted under the provisions of the Indian Medical Council Act, 1956 is the creature of the statute in exercise of powers under Entry 66 List I and has no power to make any provision for reservation, more particularly, for in­service candidates by the concerned States, in exercise of powers under Entry 25 List III; (Para 13(4))

That Regulation 9 of MCI Postgraduate Medical Education Regulations, 2000, does not deal with and/or make provisions for reservation and/or affect the legislative competence and authority of the concerned States to make reservation and/or make special provision like the provision providing for a separate source of entry for in­service candidates seeking admission to postgraduate degree courses and therefore the concerned States to be within their authority and/or legislative competence to provide for a separate source of entry for in-­service candidates seeking admission to postgraduate degree courses in exercise of powers under Entry 25 of List III; (Para 13(5))

If it is held that Regulation 9, more particularly, Regulation 9(IV) deals with reservation for in­-service candidates, in that case, it will be ultra vires of the Indian Medical Council Act, 1956 and it will be beyond the legislative competence under Entry 66 List I. (Para 13(6))

There is a legitimate and rational basis in providing a separate channel/source of entry for in-­service candidates in order to encourage them to offer their services and expertise to the State. There is a sufficient nexus with the larger goal of equalization of educational opportunities and to sufficiently prefer the doctors serving in the various hospitals run and maintained out of public funds, in the absence of which there would be serious dearth of qualified Post­graduate doctors to meet the requirements of the common public. It is stated that the Government is facing public health crisis. The effective and competent medical treatment is not available in the rural and difficult areas. In­service doctors who pursue higher studies would naturally serve in rural and difficult areas if such incentive in the form of reservation is provided. (Para 15)

The action of the State to provide for the in­-service quota is in the discharge of its positive constitutional obligations to promote and provide better health care facilities for its citizens by upgrading the qualifications of the existing in­-service doctors so that the citizens may get more specialized health care facility. Such action is in discharge of its constitutional obligations as provided in Article 47 of the Constitution of India, which is the corresponding fundamental right of the citizens protected under Article 21 of the Constitution of India. (Para 15.1)

Article 21 of the Constitution of India confers on the citizens of India a fundamental right to life and personal liberty. Right to health is integral part of the Right to life and is a facet of Article 21. (Para 15.2)

A healthy body is the very foundation for all human activities. In a welfare State, therefore, it is the obligation of the State to ensure the creation and the sustaining of conditions congenial to good health. Maintenance and improvement of public health have to rank high as these are indispensable to the very physical existence of the community and on the betterment of these depends the building of the society of which the Constitution makers envisaged. (Para 15.4)

The power of the State under Entry 6, List II of Schedule VII to legislate in the subject matter of public health and hospital is exclusive. (Para 15.7)

Article 21 of the Constitution of India imposes an obligation on the State to safeguard the life of every person. Preservation of human life is thus of paramount importance. Thus, when the State provides a separate source of admission for in-­service doctors as a distinct class and within the State quota and the object is laudable, the State is within its power to provide such separate source of admission in exercise of the powers under Entry 25 List III, read with Entry 6, List II. It cannot be said that there is no nexus with the laudable object of meeting the requirement of qualified postgraduate doctors for the public health services, more particularly, in the rural, tribal and difficult areas. As such, there is no conflict between the power of the Union and the State. The occupied filed of Union legislation in exercise of power under Entry 66, List I is related to minimum standards of medical education and the State is providing the in-­service quota without impinging the prescribed minimum standards. (Para 15.9)

In case of two entries might be overlapping, in that case, the interpretation must be in furtherance of achieving the ultimate object. Any interpretation which would negate and/or become nugatory the other entry, is to be avoided. There must be a harmonious reading between the two entries. (Para 15.9)

The State is within its power and is empowered to make reservation in the seats of the postgraduate medical courses, more particularly, for in­-service doctors. (Para 15.9)

In the federal structure, the State, as well as the Parliament, have a constitutional directive for the upliftment of Scheduled Castes, Scheduled Tribes, and socially and backward classes. Therefore, the State Government have the right to provide reservation and in the field of employment and education, looking to the specific/special need of public requirement in the particular area. There is no constitutional bar to take further affirmative action as taken by the State Government in the cases to achieve the goal. (Para 15.10)

By allotting a specific percentage within its State quota and to provide preferential treatment to a particular class, cannot be said to be beyond the legislative competence of the State. On the contrary, the State is within its power and authority to provide such a preferential treatment to provide a better public health in the rural, tribal and hilly areas. (Para 15.10)

Regulation 9 of the MCI Postgraduate Medical Education Regulations, 2000, to the extent not providing for any reservation for in-­service candidates working in the rural, tribal and difficult areas can be declared ultra vires on the ground of being arbitrary, discriminatory and violative of Articles 14 and 21 of the Constitution of India. It is required to be noted that Regulation 9, more particularly Regulation 9(VII) makes provision for reservation for in-­service candidates for admission to postgraduate diploma courses only. However, there is no reason coming out of either from the Regulations or in any form of material produced by the MCI showing as to on what basis MCI takes a stand that similar in-­service reservation is not permissible for admission to postgraduate degree courses. Therefore, if the very concept of in-­service reservation is permissible and incorporated in the MCI Postgraduate Medical Education Regulations, 2000, opposition to similar reservation for postgraduate degree courses is unreasonable and irrational. (Para 17)

The observations made by the Court in the case of State of U.P. v. Dinesh Singh Chauhan (2016) 9 SCC 749 that Regulation 9 is a complete code in itself cannot be accepted and is held to be not a good law. (Para 18.1)

That Entry 66 List I is a specific entry having a very limited scope (Para 20(1))

It deals with “coordination and determination of standards” in higher education; (Para 20(2))

The words “coordination and determination of standards would mean laying down the said standards. (Para 20(3))

The Medical Council of India which has been constituted under the provisions of the Indian Medical Council Act, 1956 is the creature of the statute in exercise of powers under Entry 66 List I and has no power to make any provision for reservation, more particularly, for in­service candidates by the concerned States, in exercise of powers under Entry 25 List III (Para 20(4))

That Regulation 9 of MCI Regulations, 2000 does not deal with and/or make provisions for reservation and/or affect the legislative competence and authority of the concerned States to make reservation and/or make special provision like the provision providing for a separate source of entry for in­service candidates seeking admission to postgraduate degree courses and therefore the concerned States to be within their authority and/or legislative competence to provide for a separate source of entry for in­service candidates seeking admission to postgraduate degree courses in exercise of powers under Entry 25 of List III (Para 20(5))

If it is held that Regulation 9, more particularly, Regulation 9(IV) deals with reservation for in­service candidates, in that case, it will be ultra vires of the Indian Medical Council Act, 1956 and it will be beyond the legislative competence under Entry 66 List I. (Para 20(6))

Regulation 9 of MCI Regulations, 2000 to the extent tinkering with reservation provided by the State for in­service candidates is ultra vires on the ground that it is arbitrary, discriminatory and violative of Articles 14 and 21 of the Constitution of India (Para 20(7))

That the State has the legislative competence and/or authority to provide for a separate source of entry for in­service candidates seeking admission to postgraduate degree/diploma courses, in exercise of powers under Entry 25, List III. However, it is observed that policy must provide that subsequent to obtaining the postgraduate degree by the concerned in­service doctors obtaining entry in degree courses through such separate channel serve the State in the rural, tribal and hilly areas at least for five years after obtaining the degree/diploma and for that they will execute bonds for such sum the respective States may consider fit and proper. (Para 20(8))

It is specifically observed and clarified that the present decision shall operate prospectively and any admissions given earlier taking a contrary view shall not be affected by this judgment.(Para 20(9))

Copy of judgement:Judgement_31-Aug-2020

-Adv. Tushar Kaushik

Leave a Reply

Your email address will not be published. Required fields are marked *