National Medical Commission (Foreign Medical Graduate Licentiate) Regulations 2021 – Regn.4(a)(i), 4(a)(ii), 4(b) & 4(c) – Consitutionality of – The challenge to Regn.4(a)(i) was based upon the premise that it puts an obligation upon students seeking foreign medical course to select only that Institution which offer the course of a duration of 54 months – The challenge to Regn.4(a)(ii) and 4(b) was based upon the ground that it was an extra territorial legislation as it makes mandatory for foreign medical graduate to undergo 12 months internship in the same foreign medical institution and also to get registered in that country’s professional regulatory body – The challenge to Regn.4(c) was on the basis that the same caused undue hardship to foreign medical graduate as it mandates
12 month supervised internship in India thus compelling them to undergo two internships, one in the foreign land and another in the mother land – Writ petition dismissed by High Court on the ground that that the said provisions do not violate Arts.14, 19(1)(g) and 21 of the Constitution – Correctness of – Held: Correct – Prescription of minimum standards would certainly include the prescription of the minimum duration for a course and it may be open to the medical institutions of other countries to prescribe a duration of less than 54 months for the students of their country but it is not necessary for the National Medical Commission and the Central Government to recognise foreign medical degrees of a lesser duration, if the incumbent wants to have permanent registration in India – The prescription of an internship for a minimum duration of 12 months in the same foreign medical institution cannot be said to be a duplication of internships since the purpose of internship is to test the ability of the students to apply their academic knowledge on their subjects, namely the patients – Constitution of India – Arts.14, 19(1)(g) and 21.
National Medical Commission (Compulsory Rotating Medical Internship) Regulations, 2021 – Schedule -II 2(a) and 2(c)(i) – Schedule II- Para 2(a)(i) requires all foreign medical graduate to undergo internship at par with Indian Medical Graduate – The challenge to Schedule-II Para 2(c)(i) is upon the premise that the same puts a question mark upon the future of students as it requires foreign medical gradutes to be first posted in colleges which have been newly opened and yet to be recognised – High Court dismissed the writ petition holding that the none of the provision violate Arts.14, 19(1)(g) and 21 of the Constitution – On appeal, held: The requirement under Para 2(a) of Schedule-I for foreign medical graduates to undergo internships at par with Indian medical graduates is to ensure that only those who have acquired similar skills are allowed to practice Medicine and therefore challenge to the same is without any substance – The prescription in para 2(c)(i) of Schedule-II that such foreign medical graduates may be posted first in colleges which have been newly opened and have yet to be recognised, is a prescription of necessity since all medical institutions of the country are equipped to provide internships only to as many students as their permitted intake may allow and therefore, the Regulation is intended to ensure that an undue burden is not cast upon the already recognised institutions. Dismissing the appeals, the Court
HELD: 1. The appellant challenged the validity of Regulation 4(a)(i) and Regulation 4(a)(ii), 4(b) and (4(c) of the Licentiate Regulations on several grounds, one of which is the lack of power under the Act. The provisions extracted above would show that NMC had the power to frame the above Regulations. Prescription of minimum standards would certainly include the prescription of the minimum duration for a course. It may be open to the medical institutions of other countries to prescribe a duration of less than
54 months for the students of their country. But it is not necessary for the NMC and the Central Government to recognise foreign medical degrees of a lesser duration, if the incumbent wants to have permanent registration in India. The prescription of an internship for a minimum duration of 12 months in the same OF INDIA MOH&FW
foreign medical institution cannot also be said to be a duplication of internships. The purpose of internship is to test the ability of the students to apply their academic knowledge on their subjects, namely the patients. Medical institutions of other countries may not insist on rigorous internship for students who may not put to test their skills on the population of their country. Similarly, the requirement under Regulation 4(b) has been necessitated to ensure that the students who were imparted medical education in a foreign country demonstrate their skills first on the population of the country where they studied. The necessity for a Master Chef to taste the food prepared by him, before it is served on the guests, cannot be said to be arbitrary. Therefore, the challenge to the Licentiate Regulations, are wholly without basis. [Paras 51-54][942-C-H; 943-A]
2. The contention that Section 36(4) recognises M.B.B.S. courses of a duration of less than 54 months and that therefore the Licentiate Regulations being a subordinate legislation is ultra vires, is wholly unsustainable. All that sub-section (4) of Section
36 saves, are the qualifications already recognised before the date of commencement of the Act and included in the Second Schedule and Part-II of the Third Schedule to the 1956 Act. The fact that past sins are sought to be washed away, is no ground to hold that there cannot be a course correction. As a matter of fact, Section
60 which deals with repeal and saving, also saves under clause
(b) of sub-section (2), any right, privilege or obligation already acquired. This cannot be stated to be in conflict with what is prescribed for the students of the future. In any case, Section 36 deals only with recognition of the foreign medical courses and not registration as medical practitioner. Registration is covered by Section 33. Therefore, Section 36(4) cannot help the appellant. [Para 55][943-A-D]
3. The contention that the country needs more doctors and that by restricting the registration of foreign medical graduates, the fundamental right of the professionals under Article 19(1)(g) and the fundamental right of the citizens under Article 21 are impaired, is to be stated only to be rejected. It is true that the country needs more doctors, but it needs really qualified doctors and not persons trained by institutions abroad, to test their skills only in their mother land. [Para 56][943-D-E]
4. The argument that these Regulations constitute an extraterritorial law is misconceived. These Regulations do not encroach into the sovereignty of the countries where those institutions are located, by stipulating minimum standards for the students who want to practise there. These Regulations merely prescribe the minimum standards to be fulfilled by those who study in those institutions but who want to practise here in India. [Para 57][943-F]
5. Insofar as the challenge to the CRMI Regulations are concerned, the same is without any substance. If there are institutions in some countries which offer primary medical qualification without mandatory internship, the students are supposed not to seek admissions in those institutions. The mad rush to become qualified medical professionals, cannot drive them to countries where short-cuts to success are offered. The requirement under Para 2(a) of Schedule-II of these Regulations for foreign medical graduates to undergo internships at par with Indian medical graduates is to ensure that only those who have acquired similar skills are allowed to practice Medicine. The prescription in para 2(c)(i) of Schedule-II of these Regulations that such foreign medical graduates may be posted first in colleges which have been newly opened and have yet to be recognised, is a prescription of necessity. All medical institutions of the country are equipped to provide internships only to as many students as their permitted intake may allow. Therefore, this Regulation is intended to ensure that an undue burden is not cast upon the already recognised institutions. [Paras 58 and 59][943-G-H] Medical Council of India v. Indian Doctors from Russia Welfare Associations & Ors. (2002) 3 SCC 696; Sanjeev Gupta v. Union of India (2005) 1 SCC 45 : [2004] 6 Suppl. SCR 49; Medical Council of India v. J. Saai Prasanna & Ors. (2011) 11 SCC 748; Modern Dental College and Research Centre & Ors. v. State of Madhya Pradesh & Ors. (2016) 7 SCC 353 : [2016] 3 SCR 579 – referred to.
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The Registrar, Travancore- Cochin Medical Council and Ors. 2019 (4) SCT 224 (Kerala); Sadhiya Siyad v. State of Kerala and Ors. 2021 (6) KLT 94 – referred to.
As published in the Supreme Court Reports, Supreme Court of India. Text from the Indian Supreme Court Judgments open data set (Dattam Labs), CC BY 4.0.
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