A) ABSTRACT / HEADNOTE

The judgment adjudicates the constitutional and statutory competence of State Governments to provide a separate source of admission or reservation for in-service medical officers in postgraduate medical degree courses, vis-à-vis the regulatory framework under the Post Graduate Medical Education Regulations, 2000 framed by the Medical Council of India. The dispute arose due to conflicting interpretations of Regulation 9, particularly clauses (IV) and (VII), and their alleged preclusive effect on State policies granting in-service quotas. The Court undertook an extensive examination of the federal distribution of legislative powers under the Seventh Schedule, focusing on the interplay between Entry 66 of List I and Entry 25 of List III. The judgment clarifies that while the Union retains exclusive authority to prescribe minimum standards of medical education, the States are constitutionally empowered to regulate admissions within their quotas, including the creation of a distinct channel for in-service candidates. The Court rejected the doctrine of implied repugnancy and overruled earlier precedent to the extent it treated Regulation 9 as a complete and exhaustive code. The judgment situates in-service reservation within the broader constitutional obligation of the State to ensure public health under Article 47, read with the right to health under Article 21. The ruling harmonizes federal principles, administrative necessity, and public health imperatives, while imposing mandatory post-degree rural service obligations on beneficiaries of the in-service quota.

Keywords:
In-service doctors, Postgraduate medical admission, Reservation, Entry 66 List I, Entry 25 List III, Medical Council of India, Public health, Federalism

B) CASE DETAILS

C) INTRODUCTION AND BACKGROUND OF JUDGMENT

The controversy emerged from divergent State policies reserving postgraduate medical seats for in-service government doctors and the restrictive interpretation of Regulation 9 of the Post Graduate Medical Education Regulations, 2000. The immediate trigger was the three-Judge Bench decision in State of U.P. v. Dinesh Singh Chauhan, which held that in-service reservation in postgraduate degree courses was impermissible due to the absence of an express enabling provision under the Regulations. This interpretation led to widespread invalidation of State policies across Tamil Nadu, Kerala, West Bengal, Maharashtra, and Haryana.

The petitioners contended that the earlier ruling failed to consider the constitutional allocation of legislative powers under the Seventh Schedule, particularly the concurrent nature of medical education under Entry 25 List III. The matter was therefore referred to a Constitution Bench-equivalent strength for authoritative resolution.

The Court was required to determine whether the Medical Council of India, exercising delegated legislative power under Section 33 of the Indian Medical Council Act, 1956, could restrict States from creating a separate admission channel for in-service doctors, and whether such restriction would amount to legislative overreach beyond Entry 66 List I. The background also included the 2018 amendment enabling conversion of diploma seats into degree seats, effectively eroding the only expressly permitted in-service reservation under Regulation 9(VII). This legislative and regulatory vacuum raised serious public health concerns, particularly regarding rural and remote healthcare infrastructure.

D) FACTS OF THE CASE

The petitioners comprised associations of in-service medical officers employed under various State Governments. These doctors were historically provided preferential access to postgraduate medical education through either reservation or a separate source of admission. Such policies were justified as incentives to attract and retain qualified doctors in rural, tribal, and remote areas.

Under the Post Graduate Medical Education Regulations, 2000, Regulation 9(VII) explicitly permitted 50% reservation for in-service doctors in postgraduate diploma courses. However, no parallel express provision existed for postgraduate degree courses. Despite this silence, several States continued their long-standing practice of allocating a percentage of postgraduate degree seats to in-service candidates from within the State quota.

In Dinesh Singh Chauhan, the Supreme Court held that such reservation was impermissible, treating Regulation 9 as a complete code. Following this judgment, High Courts struck down State quotas for in-service doctors. Meanwhile, the 2018 amendment allowed conversion of diploma seats into degree seats, resulting in the near-elimination of diploma courses. Consequently, in-service doctors were left without any institutional pathway for postgraduate advancement.

The petitioners approached the Supreme Court under Article 32, seeking a declaration that Regulation 9 did not curtail State power under Entry 25 List III, or alternatively, that the Regulation was unconstitutional to the extent it did so.

E) LEGAL ISSUES RAISED

i. Whether Regulation 9 of the PG Medical Education Regulations, 2000 curtails the legislative competence of States under Entry 25 List III to provide a separate source of admission for in-service doctors?

ii. Whether the Medical Council of India can frame regulations affecting reservation or admission policy under Entry 66 List I?

iii. Whether in-service reservation constitutes compensatory discrimination or a permissible classification?

iv. Whether Dinesh Singh Chauhan lays down correct law?

F) PETITIONER / APPELLANT’S ARGUMENTS

The counsels for the petitioners submitted that Entry 66 List I is confined strictly to prescribing minimum educational standards and does not extend to regulating admissions or reservations. Reliance was placed on Modern Dental College and Research Centre v. State of Madhya Pradesh [2016] 3 SCR 579 to assert that admission policies fall squarely within Entry 25 List III.

It was argued that Section 33 of the Indian Medical Council Act, 1956 does not delegate power to regulate reservation. Therefore, any regulation attempting to do so would be ultra vires. The petitioners emphasized that in-service doctors constitute a distinct class, and preferential treatment is justified by intelligible differentia and rational nexus, as upheld in K. Duraisamy v. State of Tamil Nadu [2001] 1 SCR 490.

The conversion of diploma seats into degree seats post-2018 was highlighted as a decisive factual change, rendering the reasoning in Dinesh Singh Chauhan obsolete. It was further contended that the State’s obligation under Article 47 and the derivative right to health under Article 21 necessitated continued in-service reservation.

G) RESPONDENT’S ARGUMENTS

The counsels for the Union of India and the Medical Council of India contended that Regulation 9 constituted a complete code governing postgraduate admissions. It was submitted that allowing States to create separate admission channels would undermine uniformity and compromise educational standards.

Reliance was placed on the doctrine that where a statute prescribes a particular manner of doing an act, it must be done in that manner alone. The respondents asserted that any State policy deviating from Regulation 9 would attract Article 254 due to repugnancy.

It was also argued that in-service reservation effectively amounted to double reservation, diluting merit-based selection and encroaching upon the exclusive domain of the Union under Entry 66 List I.

H) RELATED LEGAL PROVISIONS

i. Article 21, Constitution of India
ii. Article 47, Constitution of India
iii. Article 245, Constitution of India
iv. Entry 66, List I, Seventh Schedule
v. Entry 25, List III, Seventh Schedule
vi. Section 33, Indian Medical Council Act, 1956
vii. Regulation 9, PG Medical Education Regulations, 2000

I) JUDGMENT 

The Court held that Entry 66 List I has a narrow and specific ambit confined to coordination and determination of standards. Admissions, reservation, and mode of entry fall outside its scope. The power of States under Entry 25 List III to regulate admissions remains intact, subject only to compliance with minimum standards.

Justice M.R. Shah held that Regulation 9(IV) deals primarily with merit list preparation and SC/ST/OBC reservation, and cannot be interpreted as restricting State competence. Any such interpretation would render the Regulation ultra vires the parent Act. The Court expressly overruled Dinesh Singh Chauhan, holding it to be not good law.

Justice Aniruddha Bose, concurring, emphasized that allocation of seats for in-service doctors is a separate source of entry and not compensatory reservation. The doctrine of implied repugnancy was rejected. The Regulations were held to be non-exhaustive, leaving legislative space for State action.

The Court mandated that States must impose compulsory rural service bonds of at least five years on in-service candidates admitted through this channel.

a) RATIO DECIDENDI

The decisive ratio is that the power to prescribe minimum standards under Entry 66 List I does not include the power to regulate reservation or admission policy. States retain constitutional competence under Entry 25 List III to create a separate admission channel for in-service doctors, provided NEET-based minimum standards are met. Any regulation framed under Section 33 of the Indian Medical Council Act, 1956 that trenches upon this domain is ultra vires. The concept of in-service quota is a permissible classification serving a compelling public interest.

b) OBITER DICTA

The Court observed that public health infrastructure in rural and tribal areas would collapse without incentives for doctors to serve in such regions. It noted that education policy cannot be divorced from ground realities of healthcare delivery. The Court also cautioned against mechanical application of the doctrine of expressio unius est exclusio alterius, describing it as a “dangerous master” in constitutional interpretation.

c) GUIDELINES

i. States may provide a separate source of admission for in-service doctors within State quota.
ii. Minimum NEET qualifying standards must be strictly complied with.
iii. Mandatory rural or remote area service must precede and follow postgraduate education.
iv. States must enforce service bonds with appropriate financial penalties.
v. The judgment shall operate prospectively.

J) REFERENCES

a. Important Cases Referred

i. Modern Dental College and Research Centre v. State of Madhya Pradesh [2016] 3 SCR 579
ii. K. Duraisamy v. State of Tamil Nadu [2001] 1 SCR 490
iii. Sudhir N v. State of Kerala [2015] 1 SCR 884
iv. State of U.P. v. Dinesh Singh Chauhan [2016] 6 SCR 571 (overruled)

b. Important Statutes Referred

i. Constitution of India
ii. Indian Medical Council Act, 1956
iii. Post Graduate Medical Education Regulations, 2000