The Supreme Court has noted that “over-ambitious parents” and “exploitative founders of infrastructure-deficient” colleges have led to the decline and commercialisation of medical education and upheld the National Medical Commission’s regulations that prescribe certain strictures before foreign medical graduates can practice in India.
The regulations had in the recent past been a point of debate with relation to Indian students who were forced to return due to the Ukraine crisis.
A Bench of Justices Hemant Gupta and V. Ramasubramanian, in a judgment in early May, upheld the regulatory validity of the National Medical Commission (Foreign Medical Graduate Licentiate) Regulations 2021 and the National Medical Commission (Compulsory Rotating Medical Internship) Regulations of 2021.
The first one requires the foreign medical graduates (FMGs) to undergo a medical course for a minimum 54 months; an internship for a minimum duration of 12 months in the same foreign medical institution; to be registered with a professional regulatory body competent to grant licence in the same foreign country; and further undergo a supervised 12-month internship in India after applying to the National Medical Commission. The second lists rigorous conditions for internship in India for the FMGs.
Regulations challenged
Both set of regulations had been challenged in appeals filed in the Supreme Court as violative of the right to health of the public and the right to profession of students. The appellants had argued that the regulations placed a heavy and arbitrary burden upon students who want to pursue medical education abroad.
But the Bench did not agree with the point of view. The judgment, authored by Justice Ramasubramanian, said though it was “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 motherland”.
The problem of unrecognised medical institutions and untrained doctors, the court said, was a “century-old phenomenon” and the first attempts to reign them in was visible in colonial laws like the Indian Medical Degrees Act, 1916.
Events had not taken a turn for the better post Independence. “Experts in the field of education believe (and justifiably so) that over-ambitious parents, hapless children, exploitative and unscrupulous (and sometimes unlettered) founders of infrastructure-deficient educational institutions, paralysed regulatory bodies and courts with misplaced sympathy, have all contributed to the commercialisation of education and the decline of standards in the field of education, in general and medical education, in particular,” Justice Ramasubramanian wrote.
Regulatory authorities’ steps
The court drew attention to how everytime the regulatory authorities took steps to plug the loopholes in the medical education and reform the system and their efforts would come under challenge in courts.
“Courts, sometimes, were swayed by sympathy to the plight of a few students, little realising that the plight of the patients, who would go to them, will hardly come to light and the impact such decisions would have on the population would never be known,” Justice Ramasubramanian observed.
Students are not supposed to seek admissions in foreign institutions which do not offer mandatory internship with primary medical qualification.
“The mad rush to become qualified medical professionals, cannot drive them to countries where shortcuts to success are offered,” Justice Ramasubramanian reasoned.
The court said these two NMC regulations “merely prescribe the minimum standards to be fulfilled by those who study in those [foreign] institutions but who want to practise here in India,” the court rejected the argument that the regulations encroach into the sovereignty of other countries.
“Thus 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,” Justice Ramasubramanian held, dismissing the appeals.
