TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. UNION OF INDIA & OTHERS

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Judgment · Supreme Court of India · decided · Bench: ARUN MISHRA, INDIRA BANERJEE, VINEET SARAN, M. R. SHAH and ANIRUDDHA BOSE

[2020] 8 S.C.R. 583

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Headnote — Supreme Court Reports (editorial summary, not part of the judgment)

Catchwords

Medical Council of India Post Graduate Medical Education Regulations, 2000: C Regulations 9(IV) and (VII) (as it stood prior to 5 th April 2018) and 9(4) and (8) (as it stood after amendment dated 5 th April 2018) – Whether take away the power of State Governments to reserve seats in Post-Graduate Medical degree courses for in- service medical professionals –

Held

Per Shah, J. – In exercise of power under Entry 25 of List III of Seventh Schedule to the Constitution, State has power with respect to reservation/ percentage of reservation and/ or mode of admission within State quota – Scope of Entry 66 of List I to Seventh Schedule is limited to prescribe the standard of education – The source of power to Medical Council of India (MCI) to frame Regulations is from s. E 2.33 of MCI Act which is emanating from Entry 66 of List I – Regulation 9(IV) is limited to reservation in favour of SC/ ST/ OBC – Therefore, Regulation 9(IV) cannot be said to be taking away power of States under Entry 25, List III, to provide separate source of entry for in-service candidates – There is legitimate rational basis in providing a separate source of entry to in-service candidates – Such act of the State is in discharge of its constitutional obligation provided u/Art. 47 which is corresponding fundamental right u/Art. 21 of the Constitution – Therefore Regulation 9, to the extent it tinkers with the reservation provided by State to in-service doctors, is ultra vires on the ground that it is arbitrary, discriminatory and violative of Arts. 14 and 21 of Constitution – However, the doctors who would obtain admission through such separate channel, need to serve the State in rural, tribal and hilly areas at least for five years after obtaining the degree – Per Bose, J. – Allocation of seats for in-service candidates H 583

A is only a separate or exclusive source of admission which cannot be equated with reservation provisions incorporated as compensatory discrimination – The field of legislation in question is shared field between Union and the State – In such case legislative disability of the States would occur only when the Union legislation covers the same subject on which State undertakes legislative exercise and the State legislative instrument is found to be repugnant – Such repugnancy has to be direct and positive – There cannot be implied repugnancy – If certain area of legislative entry is left void by Union, this void can be filled by the State legislature – The Regulations in question, though a self-contained code are not an exhaustive code covering all the aspects of admission in post-graduate medical degree courses – The provision for reservation in clause 9(4) for in-service doctors by the State from State-wise merit list, cannot be interpreted to mean that the State is denuded of its power to make separate channel of admission – There is no bar on the State Authorities to provide for such reservation – Therefore, such reservation provided by the State would not be contrary to the Regulations – The doctors in employment form a separate and distinct class and hence can be given certain element of preference – But to take benefit of such separate entry channel, the aspiring in-service doctors must clear E NEET Examination with minimum prescribed marks – In order to avail the separate source of entry, the State should make a minimum service in rural, remote or difficult areas for a specified period before seeking admission and subsequent to obtaining the degree – Constitution of India – Arts. 14, 21, 47, 245, Schedule VII, List I, Entry 66, List III, Entry 25. F Disposing of the matters, the Court

Held

PER M. R. SHAH, J.

A T.N. Medical Officers Association v. Union of India (2018) 17 SCC 478 : [2018] 3 SCR 541 ; Pre-PG Medical Sangharsh Committee v. Dr. Bajrang Soni (2001) 8 SCC 694 : [2001] 1 Suppl. SCR 506 ; Tamil Nadu Medical Officers Association v. Union of India (2018) 17 SCC 426 : [2018] 3 SCR 551 ; Narayan B Sharma (Dr) v. Pankaj Kr. Lekhar (Dr) (2000) 1 SCC 44 : [1999] 4 Suppl. SCR 364 – referred to. PER ANIRUDDHA BOSE, J.

Held

1.1 Legislations pertaining to medical education is primarily guided by two entries of the Seventh Schedule to the Constitution of India, being Entry 66 of List I (Union List) and Entry 25 of List III (Concurrent List). [Para 2][689-D] 1.2 Two other entries in the State List are the source of State’s power to effect such reservation. Entry 6 in the State List D covers “Public Health and Sanitation; hospitals and dispensaries”. Entry 32 of the same List specifies Incorporation, regulation and winding up of corporation, other than those specified in List I, and universities, unincorporated trading, literary, scientific, religious and other societies and associations; co-operative societies.” Admission to postgraduate degree courses in medical education cannot be linked to the subject- heads specified against the said two entries. The consequence of reservation of this nature may have impact on functioning of the institutes vis-à-vis the items referred to in the said two entries, but the said entries cannot be linked to any statutory instrument originating from a State providing for reservation of in-service doctors in postgraduate medical degree courses. [Para 3][690-A-D] 1.3 The expression “reservation” used in the present case is not “reservation” in the manner the same is referred to in the Constitution, providing for compensatory discrimination. But so far as the subject-controversy is concerned, this expression really implies a separate source of entry to the postgraduate medical degree courses. [Para 3][690-D-E] 1.4 A self-contained code can cover only those subjects which are contained in such code. If the code does not refer to

Reporter's headnote (continued) and case details

583

(Writ Petition (Civil) No. 196 of 2018)

p. 584

G 1.1. Entry 66 of List I of Seventh Schedule of the Constitution 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. The words “Coordination and Determination of Standards” would mean laying down the H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 585 UNION OF INDIA & OTHERS said standards and therefore when it comes to prescribe the A standards for such institutions of higher learning, exclusive domain is given to the Union. That would not include conducting of examination etc. and admission of students to such institutions or prescribing the fee in these institutions of higher education, etc. Thus, in exercise of powers under Entry 66 List I, the Union B 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 C concerned State. [Para 10.1][652-G-H; 653-A-C] Modern Dental College and Research Centre and Others v. State of Madhya Pradesh and Others (2016) 7 SCC 353 : [2016] 3 SCR 579 – followed. Gujarat University v. Krishna Ranganath Mudholkar D (1963) Suppl. 1 SCR 112 ; R. Chitralekha v. State of Mysore [1964] 6 SCR 368 ; Dr. Preeti Srivastava & Anr. v. State of M.P. & Ors. (1999) 7 SCC 120 : [1999] 1 Suppl. SCR 249 ; Bharati Vidyapeeth v. State of Maharashtra (2004) 11 SCC 755 : [2004] 2 SCR 775 E – relied on. 1.2 Post Graduate Medical Education Regulations, 2000 are framed by the Medical Council of India (MCI) in exercise of its powers conferred under Section 33 of the Indian Medical Council Act, 1956 (MCI Act). The MCI Act has been enacted/ F 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. As per Section 33 of the MCI Act, 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 G Section 33 of the MCI Act, Regulations 2000 are made by the MCI. [Para 11.2][657-F-G] D.N. Chanchala v. The State of Mysore and Ors. (1971) 2 SCC 293 ; Pradeep Jain v. Union of India H

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A (1984) 3 SCC 654 : [1984] 3 SCR 942 ; Dr. Dinesh Kumar v. Motilal Nehru Medical College, Allahabad (1986) 3 SCC 727 : [1986] 3 SCR 345 ; Gujarat University v. Rajiv Gopinath Bhatt (1996) 4 SCC 60 : [1996] 2 Suppl. SCR 184 AIIMS Students Union v. AIIMS (2002) 1 SCC 428 : [2001] 2 Suppl. SCR 79 ; B Saurabh Chaudri v. Union of India (2003) 11 SCC 146 : [2003] 5 Suppl. SCR 152 ; Yatinkumar Jasubhai Patel & Ors v. State of Gujarat and Ors (2019) 10 SCC 1 : [2019] 12 SCR 848 – relied on. 1.3 On a fair reading of entire Section 33 of the MCI Act, C 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][660-B-C] D 1.4 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 all- E India 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. However, proviso to F 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 G 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. Regulation 9(IV) is limited only to reservation in favour of SC/ H ST/OBC and as per the prevailing laws in the States. If that be

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 587 UNION OF INDIA & OTHERS 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). 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 C 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. [Paras 12 and 12.1][660-F-H; 661- A-F] 1.5 If it is construed that Regulation 9 of the MCI Regulations, 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 the MCI Act. Section 33 of the MCI Act does not confer any power on the MCI to make regulations with respect to reservation. “Institutional preference”, despite MCI Regulations has been upheld and held to be permissible by the concerned States. F [Para 12.1][661-G-H; 662-A] Kumari Chitra Ghosh and Anr. v. Union of India & Ors. (1969) 2 SCC 228 : [1970] 1 SCR 413 – referred to. 2.1 It has been consistently held by this Court that there is a legitimate and rational basis in providing a separate channel/ G 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 H

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A funds, in the absence of which there would be serious dearth of qualified Post-graduate doctors to meet the requirements of the common public. That the Government is facing public health crisis. The effective and competent medical treatment is not available in the rural and difficult areas. In-service doctors who pursue higher studies would naturally serve in rural and difficult B areas if such incentive in the form of reservation is provided. [Para 15][680-G-H; 681-A] K Duraiswamy & Anr v. State of Tamil Nadu and Ors. (2001) 2 SCC 538 : [2001] 1 SCR 490 ; State of Madhya Pradesh & Ors v. Gopal D Tirthani and Ors C (2003) 7 SCC 83 : [2003] 1 Suppl. SCR 797 ; Sudhir N v. State of Kerala and Ors. (2015) 6 SCC 685 : [2015] 1 SCR 884 – relied on. State of U.P. v. Dinesh Singh Chauhan (2016) 9 SCC 749 : [2016] 6 SCR 571 – referred to. D 2.2 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. It is settled law that 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. [Paras 15.1 and 15.2][681-B-D] Municipal Council, Ratlam v. Vardhichand [1981] 1 SCR 97 ; Devika Biswas v. Union of India (2016) 10 G SCC 726 ; CESC Ltd. v. Subhash Chandra Bose (1992) 1 SCC 441 : [1991] 2 Suppl. SCR 267 ; Paschim Banga Khet Mazdoor Samity v. State of West Bengal [1996] 2 Suppl. SCR 331 ; Association of Medical Superspeciality Aspirants & Residents v. Union of India (2019) 8 SCC 607 : [2019] 12 SCR 1011– relied on.

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 589 UNION OF INDIA & OTHERS

2.3 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. Even otherwise, 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. [Paras 15.4 and 15.7][683-A-B, F] Vincent Panikurlangara v. Union of India AIR 1987 C SC 990 : [1987] 2 SCR 468 – relied on. 2.4 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. [Para 15.9][684- B-D] 2.5 The occupied field 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][684-D] 2.6 It is a settled proposition of law that in case of two entries might be overlapping, in that case, the interpretation must be in furtherance of achieving the ultimate object, in the present case to provide better health care in the rural, tribal and difficult areas. 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. In the present case, as such there shall not be any conflict between the power of the Union and the State, while exercising the powers under H

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A Entry 66 List I by the Union and under Entry 25 List III by the States. Therefore, as such, 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][684-D-F] B 2.7 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][684- G-H] 2.8 The State has the legislative competence and/or authority to provide for a separate source of entry for in-service 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 in- E service 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)][688-B-D]

F 3.1 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 G not permissible for admission to postgraduate degree courses. Therefore, if the very concept of in-service reservation is permissible and incorporated in the MCI Regulations, 2000, opposition to similar reservation for postgraduate degree courses is unreasonable and irrational. [Para 17][685-D-E] H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 591 UNION OF INDIA & OTHERS

3.2 The subsequent amendment in the year 2018, as made by notification dated 12.07.2018, provides that a medical college/ medical institution shall be entitled to seek equal number of Post Graduate Degree (MD/MS) seats by surrendering recognised diploma seats in corresponding course. In view of the above, it has so happened that by and large in every State the diploma seats are converted in PG Degree (MD/MS) seats by surrendering recognised diploma seats. The resultant effect is that in-service candidates/doctors shall not be entitled to any seat even in PG Diploma courses which has been provided under Regulation 9(VII) of MCI Regulations 2000, as amended from time to time. Therefore, ultimately, it will affect the public health and the common people in the rural, tribal and hilly areas where there is a dearth of good and highly qualified doctors. Therefore, if the rights of the States to provide such reservation for in- service doctors in postgraduate degree/diploma courses is not recognised, in that case, the ultimate sufferer would be the public health and the common people, particularly the people residing in rural, tribal and hilly areas. [Para 19][686-D-G]

4. The observations in the case of *Sudhir N that Regulation 9 is a complete code in itself may not be construed with respect to providing reservation and/or making special provision like providing separate source of entry for in-service candidates within the State quota and subject to fulfilling of other criteria fixed and provided by the MCI. Therefore, the observations made by this Court in the case of **Dinesh Singh Chauhan and as held by this Court in the case of Sudhir N that Regulation 9 is a complete code in itself cannot be accepted and is held to be not a good law. [Para 18.1][686-B-C] *Sudhir N v. State of Kerala and Ors. (2015) 6 SCC 685 : [2015] 1 SCR 884 ; **State of U.P. v. Dinesh Singh Chauhan (2016) 9 SCC 749 : [2016] 6 SCR 571 – held not good law. G

5. 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][688-D-E] H

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TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 593 UNION OF INDIA & OTHERS certain matters, which do not have impact on or dilute the main subject for which the code is made, appropriate authorities are not enjoined from making provisions for such uncovered areas. The field of legislation involved in the subject-dispute is a shared field between the Union and the States. The legislative disability of the States would occur only when the Union legislation covers the same subject on which State undertakes legislative exercise and the State legislative instrument is found to be repugnant to the latter. There also can be vacant legislative zones within a code, and such vacant zones can be filled up by the appropriate legislature. Clause 9(4)(or Clause 9(IV) in its earlier form) of the Regulations stipulates that candidates shall be admitted to post-graduate courses from the two merit lists only, as referred to in the said clause. Though it is correct that if a statute requires a thing to be done in a particular manner, it must be done in that manner or not at all. But, application of this principle solely on the basis of a Union legislation, without examining the scope of the State’s legislative power in the given context, would be contrary to the constitutional scheme in having concurrent field of legislation. Having regard to Clause 9(4) of the Regulations, the provision for reservation of in-service doctors by the State from the State-wise merit list published in pursuance of that provision would not result in deviation from a mandatory statutory scheme. The aforesaid sub-clause is required to be construed in the light of the State’s power to make provisions over the admission norms, provided the candidates fulfil the basic admission criteria contained in the Regulations. Having regard to the legal and factual context of the present case and considering the fact that the issue of legislative competence arises in respect of an entry belonging to shared, and not exclusive field of legislations, the said sub-clause cannot be interpreted to mean that the State is denuded of the power to make a separate channel of admission to the said courses for in-service doctors from the State merit list.The said sub-clause does not prescribe specific bar on the State authorities in providing for such reservation or such separate entry-channel. [Para 35][724-C-H; 725-A-D] Nazir Ahmed v. King Emperor AIR 1936 PC 253 – held inapplicable. H

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A 1.5 The principle of implied exclusion also would not apply. The principle of implied exclusion is derived from the latin dictum “expressio unius est exclusio alterius”. There are authorities, which caution the Courts against indiscriminate application of this doctrine, describing it to be a “dangerous master”. [Para 35][725-D] B Mary Angel and Ors. v. State of Tamil Nadu (1999) 5 SCC 209 : [1999] 3 SCR 594 ; State of Karnataka v. Union of India & Anr. (1977) 4 SCC 608 : [1978] 2 SCR 1 ; Assistant Collector of Central Excise v. National Tobacco of India Ltd. (1972) 2 SCC 560 : C [1973] 1 SCR 822 – relied on. 1.6 When a subject falls in a shared field of legislation, there may be cases where the dominant legislative body may not have had made provisions in a legislative instrument for which it had power to do so. But in such a situation the dominant D legislative body (i.e. Union Legislature) cannot prevent the secondary legislative body (State Legislature) from making provisions in that regard. If certain areas of legislative entry is left void by the Union Legislature, these void areas would come within the legislative power of the secondary legislative body as the constitutional entry gives both the legislative bodies co- E existing, power to legislate on such subjects. Clause 9 of the Regulations is no doubt a self-contained code. But, it is not an exhaustive code covering all aspects of admission in postgraduate medical degree courses. [Para 36][725-F-H; 726-A] F 1.7 Negation of power of the State cannot be a matter of inference, or such negation cannot be in anticipation that the Union Legislature may make provisions in future in the vacant legislative space. Only in cases where the State legislature makes a law repugnant to any provision of law made by the Parliament, the Parliamentary law would prevail. The entire field G of admission to postgraduate medical course cannot be said to be covered by the Regulations. In the facts of the present case, the Court cannot proceed on the basis of there being implied repugnancy. Such repugnancy has to be direct and positive. [Para 36][726-B-E] H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 595 UNION OF INDIA & OTHERS

West U.P. Sugar Mills Association & Ors v. State of A Uttar Pradesh & Ors. (2020) SCC Online SC 380 ; U.P. Cooperative Cane Unions Federations v. West U.P. Sugar Mills Association & Ors. (2004) 5 SCC 430 : [2004] 2 Suppl. SCR 238 ; S.R. Bommai & Ors. vs. Union of India & Ors. (1994) 3 SCC 1 : [1994] 2 SCR B 644 ; Tika Ramji & Ors.etc v. State of U.P.& Ors. AIR 1956 SC 676 : [1956] SCR 393 – relied on. 2.1 Allocation of seats for in-service candidates is only a separate or exclusive channel of entry or source of admission and such entry-path cannot be equated with reservation provisions incorporated as compensatory discrimination. But C classifying a category of candidates for such distinct or separate channel has been upheld consistently, provided such categorisation is based on intelligible differentia. [Para 28] [717-G] Yatinkumar Jasubhai Patel & Ors v. State of Gujarat D and Ors (2019) 10 SCC 1 : [2019] 12 SCR 848 ; D.N. Chanchala v. The State of Mysore and Ors. (1971) 2 SCC 293 ; K Duraisamy & Anr v. State of Tamil Nadu and Ors. (2001) 2 SCC 538 : [2001] 1 SCR 490 ; AIIMS Students Union v. AIIMS (2002) 1 SCC 428 : [2001] 2 Suppl. SCR 79 ; State of Madhya Pradesh E & Ors v. Gopal D Tirthani and Ors (2003) 7 SCC 83 : [2003] 1 Suppl. SCR 797 ; Dr. Snehalata Patnaik & Ors v. State of Orissa & Ors (1992) 2 SCC 26 : [1992] 1 SCR 335 ; Pre-PG Medical Sangharsh Committee v. Dr. Bajrang Soni (2001) 8 SCC 694: [2001] 1 Suppl. F SCR 506 ; Satyabrata Sahoo & Ors. vs State of Orissa & Ors. (2012) 8 SCC 203:[2012] 10 SCR 204. – relied on. 2.2 The doctors in employment of the States and allied sectors form a separate and distinct class and for the purpose G of admission in postgraduate degree courses they can be given certain elements of preference. Holding them to be a distinct group fits in with overall objective of having medical professionals with superior qualification for tending to the needs of the general public. Moreover, the Regulations by permitting award of incentive marks to them and also providing for 50 per H

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A cent reservation in diploma courses indirectly recognise this category of doctors as a separate class. [Para 29][719-H; 720- A-B] 2.3 The question of providing a separate entry-path to in-service doctors may have some effect on overall standard of medical education at the postgraduate degree level institutions, as the students who would gain admission to such courses may not come purely on the basis of a uniform order of merit. But that is not the manner in which the Court ought to interpret the expression “standards” in institutions of higher education. Analysis of Clause 9 of the Regulations reveals that the said clause provides a minimum entry standard in the form of clearance of the NEET on obtaining minimum of marks of 50 per cent by general category candidates. Once these standards are laid down, if the State authorities provide an independent channel of entry for in-service doctors in postgraduate medical degree courses, who fulfil the aforesaid minimum standards, provisions to that effect would not be in breach of the constitutional scheme. The impact on the “standards”, as the expression is to be construed in Entry 66 of List I, would be far too distant from admission norms framed by the State authorities for such in-service doctors. The separate entry-channel for in- E service doctors would be integral to the admission norms, relatable to the Entry 25 of the Concurrent List. Such admission norms if compatible with minimum standards laid down by the MCI, would fall under the items specified against the aforesaid entry of List III. [Para 32][720-G-H; 721-A-D] F 2.4 The admission process stipulating a distinct source of entry for in-service candidates by itself would not constitute breach of the provisions of Clause 9 of the Regulations, provided that the minimum standards mandated by the said Regulations for being eligible to pursue postgraduate medical degree course are adhered to. A separate source of entry for in-service doctors G through the State merit list would come within the legislative power and competence of the State. Reservation for in-service doctors has been a long standing practise and the rationale behind such reservation appears to be reasonable. [Para 38][727- A-C] H 2.5 Clause 9(4) of the Regulations stipulates entry into the postgraduate courses from the two merit lists, one all India and

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 597 UNION OF INDIA & OTHERS the other that of the State. If the State authorities provide reservation for in-service doctors from within the State’s own merit list, such an exercise would be relatable to the admission process and the same would not be in breach of any prohibition flowing from the Regulations. This would entail some form of variation of the merit list of the State, but there is no prohibition under the Regulations against a State undertaking that exercise. Such step undertaken by the State would be relatable to the State’s legislative power derived from Entry 25 of the Concurrent List and not covered by the Regulations. There is no repugnancy with the Regulations if the State authorities create such a distinct channel of entry. [Para 39][727-D-F] C 2.6 Reservation of in-service candidates was made through Executive Orders of the State Government. Its original or earlier version provided no provision for reservation or separate entry- channel for in-service doctors. The State Government Orders laid down such distinct source of entry. Interpretation of the same clause in its present form should also be based on the same underlying reasoning. [Para 41][729-B-C] 2.7 Thus, there is no bar in Clause 9 of the Regulations as it prevailed on 15th February 2012 and subsequently amended on 5 th April, 2018 on individual States in providing for reservation of in-service doctors for admission into postgraduate medical degree courses. But to take benefit of such separate entry channel, the aspiring in-service doctors must clear the NEET Examination with the minimum prescribed marks as stipulated in the Regulations. Reservation for the category of in-service doctors by the State would not be contrary to the provisions of the Regulations. [Para 42][729-D-E] State of U.P. v. Dinesh Singh Chauhan (2016) 9 SCC 749 : [2016] 6 SCR 571 – Not affirmed. 2.8 The statutory instruments of the respective State G Governments are expected to provide for such separate channel of entry should make a minimum service in rural or remote or difficult areas for a specified period mandatory before a candidate could seek admission through such separate channel and also subsequent to obtaining the degree. On completion of the H

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A course, to ensure the successful candidates serve in such areas, the State shall formulate a policy of making the in-service doctors who obtain entry in postgraduate medical degree courses through independent in-service channel execute bonds for such sum the respective States may consider fit and proper. [Para 43][729-G-H; 730-A] B Modern Dental College and Research Centre and Others v. State of Madhya Pradesh and Others (2016) 7 SCC 353 : [2016] 3 SCR 579 – followed. Sudhir N v. State of Kerala and Ors. (2015) 6 SCC C 685 : [2015] 1 SCR 884 ; R. Chitralekha v. State of Mysore [1964] 6 SCR 368 ; Kumari Chitra Ghosh and Anr. v. Union of India & Ors. (1969) 2 SCC 228 : [1970] 1 SCR 413 ; Gujarat University v. Krishna Ranganath Mudholkar [1963] Supp 1 SCR 112 ; Dr. Preeti Srivastava & Anr. v. State of M.P. & Ors. (1999) D 7 SCC 120 : [1999] 1 Suppl. SCR 249 – referred to. Case Law Reference In the judgment of M.R. Shah, J. [2018] 3 SCR 541 referred to Para 2 E [1970] 1 SCR 413 referred to Para 3.11 [2001] 1 Suppl. SCR 506 referred to Para 4.7(f) [2018] 3 SCR 551 referred to Para 8.2 [1999] 4 Suppl. SCR 364 referred to Para 8.4 F [2016] 3 SCR 579 followed Para 10.1 [1963] Supp (1) SCR 112 relied on Para 10.1 [1964] 6 SCR 368 relied on Para 10.1 [1999] 1 Suppl. SCR 249 relied on Para 10.1 G [2004] 2 SCR 775 relied on Para 10.1 (1971) 2 SCC 293 relied on Para 10.2 [1984] 3 SCR 942 relied on Para 10.2

H [1986] 3 SCR 345 relied on Para 10.2

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 599 UNION OF INDIA & OTHERS

[1996] 2 Suppl. SCR 184 relied on Para 10.2 A [2001] 2 Suppl. SCR 79 relied on Para 10.2 [2003] 5 Suppl. SCR 152 relied on Para 10.2 [2019] 12 SCR 848 relied on Para 10.2 [2001] 1 SCR 490 relied on Para 14.1 B [2003] 1 Suppl. SCR 797 relied on Para 14.2 [2015] 1 SCR 884 relied on Para 14.3 [2016] 6 SCR 571 referred to Para 14.4 C (2016) 10 SCC 726 relied on Para 15.2 [1991] 2 Suppl. SCR 267 relied on Para 15.2 [1996] 2 Suppl. SCR 331 relied on Para 15.2 [2019] 12 SCR 1011 relied on Para 15.3 D [1987] 2 SCR 468 relied on Para 15.4 [1981] SCR 197 relied on Para 15.6 [2015] 1 SCR 884 held not good law Para 18.1 [2016] 6 SCR 571 held not good law Para 18.1 E In the judgment of Aniruddha Bose, J. [2016] 6 SCR 571 Not affirmed Para 12 [2015] 1 SCR 884 referred to Para 12 [1964] 6 SCR 368 referred to Para 16 F [1970] 1 SCR 413 referred to Para 16 [2016] 3 SCR 579 followed Para 16 [1963] 1 Suppl. SCR 112 referred to Para 18 [1999] 1 Suppl. SCR 249 referred to Para 20 G [2019] 12 SCR 848 relied on Para 23 (1971) 2 SCC 293 relied on Para 28 [2001] 1 SCR 490 relied on Para 28 H

p. 600

A [2001] 2 Suppl. SCR 79 relied on Para 28 [2003] 1 Suppl. SCR 797 relied on Para 28 [1992] 1 SCR 335 relied on Para 29 [2001] 1 Suppl. SCR 506 relied on Para 29 B [2012] 10 SCR 204 relied on Para 29 [1999] 3 SCR 594 relied on Para 35 [1978] 2 SCR 1 relied on Para 35 [1973] 1 SCR 822 relied on Para 35 C (2020) SCC Online SC 380 relied on Para 36 [2004] 2 Suppl. SCR 238 relied on Para 36 [1994] 2 SCR 644 relied on Para 36 [1956] SCR 393 relied on Para 36 D CIVIL ORIGINAL JURISDICTION : Writ Petition (Civil) No. 196 of 2018. [Under Article 32 of the Constitution of India] With E Writ Petition (Civil) Nos. 252/2018, 295/2018, 293/2018, Civil Appeal Nos. 3025/2020, 3026-3029/2020, 3030-3031/2020, 3032-3035/ 2020, 3036/2020 and 3037/2020. Aman Lekhi, ASG, Jayant Muthuraj, Balaji Srinivasan, AAGs, F Arvind Datar, Rakesh Dwivedi, Vinay Navare, Vikas Singh, Ms. Meenakshi Arora, Sanjay R Hegde, C.S.Vaidhyanathan, V.Giri, Sr. Advs., Ajay Bhargava, Ms. Vanita Bhargava, Ms. Saman Ahsan, Mr. Rahul Unnikrishnan, Mr. Aayush Jain for Khaitan & Co., Soumitra G. Chaudhuri, Chanchal Kumar Ganguli, Jose Abraham, M.P. Srivignesh, G Blessan Mathews, Robin Raju, Shashibhushan P Adgaonkar, Rana Sandeep Bussa, Dr. Wolf Sandeep Bussa, Dr. Anni Jhon, Ms. Pradnya S Adgaonkar, Motahar Hossain, Tejaswi Kumar Pradhan, Sarad Kumar Singhania, Ms. Rashmi Singhania, Kuldeep Rai, Suman Baneerjee, Jayesh Gaurav, Robin khokhar, Ranjan Mukherjee, Subhasish Bhowmick, Nishesh Sharma, Anmol Chandan, Apoorva Kurup, G.S. H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 601 UNION OF INDIA & OTHERS

Makker, Gaurav Sharma, Ankit Anandraj Shah, Saurabh Rajpal, Govind A Jee, Krishna Kumar Singh, M. Yogesh Kanna, Rahul Chitnis, Sachin Patil, Jishnu. M. L, Ms. Priyanka Prakash, G. Prakash, Kathivel J., Amit Kumar, Avijit Mani Tripathi, Ms. Rekha Bakshi, Shaurya Sahay, Kumar Abhishek, Chetan Joshi, Atul Kumar, V. N. Raghupathy, M/S. S-Legal Associates, Advs. for the appearing parties. B

Judgment

The Judgments of the Court were delivered by M. R. SHAH, J.

11. Leave & permission granted in the respective special leave petitions. C

22. After considering the judgment rendered by a three Judge Bench of this Court in the case of State of U.P. v. Dinesh Singh Chauhan 1, another three Judge Bench, pursuant to order dated 13.4.2018 in the case of T.N. Medical Officers Association v. Union of India2, has referred the present batch of cases to a larger Bench. D

2.1 In the case of Dinesh Singh Chauhan (supra), a three Judge Bench construed the provisions of Regulations 9(IV) and 9(VII) of the MCI Postgraduate Medical Education Regulations, 2000, as amended on 15.2.2012 (hereinafter referred to as the “MCI Regulations 2000”). In the case of Dinesh Singh Chauhan (supra), while considering the E aforesaid Regulations, this Court held that the aforesaid Regulations do not provide for any reservation for in-service government doctors in PG degree courses, and therefore, the State Government order providing the reservation for PG degree courses for in-service government doctors is held to be illegal. F 2.2 The present batch of cases came up for hearing before another Bench of three Judges. The Bench was of the opinion that the present batch of cases require consideration by a larger Bench and that is how the present batch of cases are referred to a larger Bench. On the basis of the submissions made, the following reasons were G mentioned: “(i) The decision in Dinesh Singh Chauhan 1 has not considered the entries in the legislative lists of the 1 (2016) 9 SCC 749 2 (2018) 17 SCC 478 H

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A Seventh Schedule, more particularly Entry 66 of the Union List and Entry 25 of the Concurrent List; (ii) The main contention of the petitioners is that while coordination and determination of standards in institutions for higher education falls within the exclusive domain B of the Union (Entry 66 List I), medical education is a subject in the Concurrent List (Entry 25 List III). Though, Entry 25 of List III is subject to Entry 66 of List I, the State is not denuded of its power to legislate on the manner and method of making admissions to postgraduate medical courses; C (iii) The contentions which have been raised in the present batch of petitions were not addressed before this Court in Dinesh Singh Chauhan1; (iv) The judgment in Dinesh Singh Chauhan1 does not D consider three decisions of the Constitution Bench in R. Chitralekha v. State of Mysore (1964) 6 SCR 368 :AIR 1964 SC 1823, Chitra Ghosh v. Union of India (1969) 2 SCC 228 and Modern Dental College & Research Centre v. State of M.P. (2016) 8 SCC 353; and

E (v) There are decisions rendered by Benches of an equal strength as in Dinesh Singh Chauhan1.” 2.3 Now so far as Civil Appeals arising out of the Special Leave Petitions(C) Nos.26448-26449 of 2019 are concerned, they arise out of the impugned judgment and order dated 01/10/2019 in MAT Nos. F 1245 and 1267 of 2019 passed by the High Court at Calcutta, by which the Division Bench of the High Court has dismissed the batch of appeals confirming the order passed by the learned Single Judge holding that the State has no authority to reserve 40% seats for the in-service doctors and 60% seats for open category doctors. 2.4 In Writ Petition (Civil) No. 196 of 2018 filed under Article G 32 of the Constitution of India, the petitioners – Tamil Nadu Medical officers’ Association and others, for and on behalf of the in-service doctors in the State of Tamil Nadu have prayed for the following reliefs: a) declare by issuance of a writ of mandamus or any other suitable writ/order/direction that Regulation 9 of the Post H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 603 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

Graduate Medical Education Regulations, 2000 (more A particularly, Regulation 9(IV) and 9(VII), does not take 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 Degree courses; b) Alternatively, if Regulation 9 of the Post Graduate B Medical Education Regulations, 2000 is understood to now allow for States to provide for a separate source of entry for in-service candidates seeking admission to Degree courses, declare, by issuance of a writ of mandamus or any other suitable writ/order/direction, Regulation 9 (more particularly, Regulation 9(IV) and C 9(VII) as being arbitrary, discriminatory and violative of Article 14 and 19(1)(g) of the Constitution and also ultra vires the provisions of the Indian Medical Council Act, 1956. Somewhat similar prayers are also sought for on behalf of the D in-service doctors in the State of Kerala (Writ Petition (Civil) No. 252/ 2018); in-service doctors working in the State of Maharashtra (Writ Petition (Civil) No. 295/2018); and for and on behalf of the in-service doctors working in the State of Haryana (Writ Petition (Civil) No. 293 of 2018). E 2.5 IA Nos.61442, 61443 and 61445 of 2020 have been preferred by the GMS Class II Medical Officers Association being aggrieved by the Public Notice dated 28.02.2019 as amended by the Corrigendum dated 10.03.2019, wherein, Medical Council of India has permitted the conversion of Diploma seats into Degree seats in the State of Gujarat. The said application is filed for and on behalf of in-service Medical F Officers working in the State of Gujarat. 2.6 IA No.24759 of 2020 in Writ Petition (Civil) No. 252 of 2018 has been preferred by Kerala Government Insurance Medical Association and others supporting the reservation for in-service Medical Officers/Candidates in the Post-graduate Degree Courses. G

33. Learned counsel appearing on behalf of the respective petitioners/parties, more particularly, Tamil Nadu Medical Association, State of Tamil Nadu, State of West Bengal and others in support of the reservation for in-service Medical Officers/ Candidates/Doctors in Post-graduate Degree Courses have made the following submissions: H

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A 3.1. The moot question is whether the State Government is competent to provide for a reservation for candidates who are already serving the Government. Such reservation is made for Post-graduate seats in the different medical colleges in the State. The competence of the State Government is traceable to Article 245 r/w Entry 25 List III of the 7th schedule to the Constitution. It cannot be said that there has to be a legislature made law to provide for such reservation. The Government can in exercise of its power as an Executive under Article 154 provide for such reservation and it has been so provided as well. Once competence is found in favour of Government then only question is one of a possible conflict with a Central Law and the resolution of any question of repugnancy. It is submitted that said question really does not arise in the present case; 3.2. The competence of the State Government to bring about a law dealing with admissions of in-service candidates is upheld by the Constitutional Bench of this Court in the case of Modern Dental D College and Research Centre and Others vs. State of Madhya Pradesh and Others3. The argument raised on behalf of the Centre that Entry 25 of List III itself would be subject to Entry 66 of List I has also been considered by this Court; 3.3. There is no question of any conflict of Entry 25 of List III E and Entry 66 of List I. The subject of admission to courses is referable to Entry 25 of list III and not Entry 66 of List I. It is submitted that conflict, if any, can only be between a State Law and a Central Law both sourced to Entry 25 of List III. That no such conflict is present in the instant case; F 3.4. There is no plenary law by the Centre provided for any reservation for in-service candidates. In other words, there is no Central Law governing the said aspect, therefore, it would be competent for the State Government to provide for a reservation for in-service candidates. In the absence of a Central Law, it is obviously open to G the State Government to provide for a legal instrument, whether by way of a statute or by an executing order providing a reservation for in- service candidates; 3.5. The MCI Regulations, 2000, which are made under the Medical Council Act provide for a reservation in Post-graduate Diploma H 3 (2016) 7 SCC 353

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 605 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

Courses for in-service candidates serving with the respective State A Governments. There is no bar to such reservation in Post-graduate Degree Courses. The bar, if any, has to be express and cannot be implied. Clause 9(IV) of the MCI Regulations, 2000 can be construed as provided for community reservations and also a reservation for in- service candidates. Even otherwise, it does not enable explicitly the State B Government to provide for a weightage in marks, amongst in-service candidates. Thus, the legislative instrument which could be sourced to the MCI, which in turn is a body established by the Central Government under the Medical Council Act itself recognizes an empowerment of the State Government, inter alia, to lay down the modalities to regulate or provide for a reservation for in-service candidates in Post-graduate C seats. If that be so, then the actual prescription of a reservation for in- service candidates, in relation to Post-graduate Degree seats obviously has not come into conflict with the MCI Regulations, 2000 so as to attract Article 254 of the Constitution; 3.6. The MCI Regulations, 2000, not expressly providing for a D reservation in Post-graduate Degree seats, specifically empowering the State Government to do so, but only touches upon the reservation in Diploma seats, it does not follow that the State Government is incompetent to provide for reservation for in-service candidates in Degree seats as well. The competence of the State Government to provide for reservation for in-service candidates is not sourced to the E MCI Regulations, 2000, but it is sourced to Entry 25 of List III. Thus, the absence of any mention of reservation for candidates in Post- graduate Degree seats in the Regulations, 2000 cannot support a submission by the MCI that consequently the State Government would be incompetent to provide for any reservation for in-service candidates F in Degree seats; 3.7. The MCI Regulations, 2000 would become relevant only when it provides for reservation in Post-graduate Degree seats and the State Government brings about a policy of reservation in Post-graduate Decree seats at variance from the protocol laid down in the MCI G Regulations. The MCI Regulations, 2000 are silent in regard to the reservation in Post-graduate Degree seats and therefore, possible repugnancy under Article 254 of the Constitution of India really cannot arise between an instrument by the State Government and an instrument by the Central Government which does not cover the subject or touch upon the subject provided for by the State Government; H

p. 606

A 3.8. Assuming without admitting that though MCI Regulations do provide for a conversion of Diploma seats into Degree seats, by the State Government with the approval of the MCI, the MCI Regulations, 2000 do not specifically mention the consequences of such conversion. When law provides for a particular event to take place then all reasonable consequences that emanates therefrom should also be inferred, should be applied to the present situation as well; 3.9. Even MCI Regulations, 2000 themselves provide for reservation for in-service candidates in Diploma and also provides for service condition to be fulfilled thereunder. The conversion of Diploma seats into Degree seats (now after 2018) would obviously result in the same permissible reservation for in-service candidates to be provided for Degree seats as well. All that would be required is the imposition of the same conditions as are provided in the Diploma seats; 3.10. The decision of this Court in the case of Dinesh Singh Chauhan (Supra) also requires re-look in view of the subsequent development viz. Notification dated 12.07.2018 by which, MCI has permitted the Medical College/Medical Institution to “seek equal number of Post-graduate Degree seats by surrendering recognized diploma seats in corresponding course”. It is submitted that pursuant to the said Notification the medical colleges/institutions are/were given the option of converting the available post graduate diploma seats into Post- graduate Degree seats in a 1:1 ratio. It is submitted that pursuant to the said notification most of the medical colleges/medical institutions in the respective States have surrendered the Post-graduate Diploma seats and have converted the same to Post-graduate Degree seats. It is submitted that resultant effect is that now there shall not be any Post- F graduate Diploma seats available and therefore, in-service candidates are left in a situation where even the limited benefit conferred on them in form of 50% reservations in Post-graduate Diploma Course can no longer be availed. As a result, in-service candidates have been left in a complete lurch since they would neither be able to qualify for Post- G graduate Degree course in adequate numbers nor be in a position to avail the Post-graduate Diploma seats previously available in the Government Colleges. In view of the above development, the reasoning in the case of Dinesh Singh Chauhan (supra) as to the difference in the Regulations between Post-graduate Diploma and Degree courses no longer survives; H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 607 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

3.11. Right of the State Government to set apart a definite percentage of educational seats at Post-graduate level consisting of Degree and Diploma courses exclusively for a class of persons as a separate source of entry has been repeatedly upheld by this Court with the condition that source is properly classified –whether on territorial, geographical or other reasonable basis and has a rational nexus with the object of imparting a particular education and effective selection for the purpose. Reliance is placed upon the decision of this Court in the cases of (1) Kumari Chitra Ghosh and Anr. vs. Union of India & Ors.4; (2) D.N. Chanchala vs. The State of Mysore and Ors.5; (3) K Duraisamy & Anr vs. State of Tamil Nadu and Ors 6; (4) AIIMS Students Union vs. AIIMS7; and (5) State of Madhya Pradesh & Ors C vs. Gopal D Tirthani and Ors8; 3.12. It has been consistently held by this Court that 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. It is submitted that this Court has D acknowledged that this has 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 Post-graduate doctors to meet the requirements of the common public; E 3.13. Unlike reservation envisaged for Scheduled Caste/ Schedule Tribes, this is a distinct and vitally important public purpose in itself absolutely necessitated in the best of public interest. In the case of Dinesh Singh Chauhan (supra) this Court has held that no fault can be found with the method of providing a separate channel of entry for in-service candidates for the reason that the facilities for keeping up F with the latest medical literature might not be available to such in-service candidates and the nature of the work makes it difficult for them to acquire knowledge about very recent medical research, which the candidates who has come after freshly passing their graduation examination might have; G

4 (1969) 2 SCC 228 5 (1971) 2 SCC 293 6 (2001) 2 SCC 538 7 (2002) 1 SCC 428 8 (2003) 7 SCC 83 H

p. 608

A 3.14. In the case of Modern Dental College and Research Centre (supra), the Constitution Bench of this Court has affirmed that even though Entry 25 List III is subject to Entry 66 List I, the power of States to enact laws concerning admissions would not stand extinguished so long as such laws did not have the effect of wiping out the law enacted by the Union under Entry 66 List I; B 3.15. When the States create a separate source of entry for in-service candidates, the standards of medical education are not impinged inasmuch as; (a) only eligible in-service candidates can qualify i.e. those have obtained minimum eligibility marks; C (b). amongst eligible in-service candidates admission is made based on inter-se-merit; (c). The preferential weightage would merely alter the order in which in–service candidates would rant in the merit list prepared for in-service candidates. Thus, it would not be a case of ‘double reservation’; 3.16. As held by this Court in the case of Yatinkumar Jasubhai Patel & Ors vs. State of Gujarat and Ors9, which was in the context of “institutional preference” for Post-graduate Medical Admission, only obligation by virtue of introduction of NEET is that the State cannot hold any separate test for admissions to Post-graduate courses. As observed, even while giving the admission in the State quota/institutional reservation quota, the merit determined on the basis of NEET will still have to be considered. It is submitted that therefore, provision of a separate source of entry for in-service candidates shall not dilute the standards of higher education in any manner since the candidates in question would still have to obtain the minimum merit prescribed under NEET; 3.17. The reservation referred in the opening part of Regulation 9(IV) is only with respect to reservation as per the constitutional scheme i.e. SC, ST and OBCs and not for in-service candidates or Medical G Officers in–service. This is also acknowledged by this Court in the case of Dinesh Singh Chauhan (supra) in para 25.4. It is submitted that therefore, there is no merit in the statement of defence by the respondent that in-service candidates for Post-graduate Degree Course are already governed by the reservation provided for in Regulation 9(IV); H 9 (2019) 10 SCC 1

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 609 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

3.18. It is submitted that so far as State of Tamil Nadu is concerned, the Hon’ble Chief Minister of Tamil Nadu in his letter dated 25.4.2017 to the Hon’ble Prime Minister, has highlighted that providing only 30% weightage to in-service candidates seeking admission to Post- graduate Degree Course is not enough since if this procedure is followed, out of the 557 Post-graduate government seats available under the State quota in Tamil Nadu, only 20 seats would go to in-service quota candidates. It is submitted that vide letter dated 6.2.2019, the State of Tamil Nadu wrote to the Ministry of Health and Family Welfare and highlighted the contribution of the policy to provide 50% reservation for in-service candidates in Post-graduate degree courses in attracting meritorious Doctors to Government service and also enabling the State C Government to provide uninterrupted health care in rural, difficult and remote areas of the State. It is submitted that it was further highlighted that this reservation was critical for the maintenance of quality health care in the government medical facilities; 3.19. Learned counsel appearing on behalf of the State of Tamil D Nadu has highlighted the benefits to be achieved by providing 50% reservation for in-service candidates in Post-graduate Degree/ Diploma Courses. It is submitted that continuance of given incentive marks and reserving 50% seats for in-service candidates who performed duty in remote, rural area, hilly terrain etc. in Post-graduate courses will sustain the achievement made by the State Government in the health sector and provide valuable medical care to the poor and vulnerable society. It is submitted that therefore, it is in the larger public interest of the State that there is a provision for 50% reservation in Post-graduate Degree/Diploma Courses/seats for in-service candidates; 3.20. So far as the State of West Bengal is concerned, learned counsel appearing on behalf of the State of West Bengal as well as Government Doctors serving in the Government Hospitals in the State of West Bengal in support of the reservation of 40% of the state quota Post-graduate Medical seats for in-service Doctors have made in addition to the following submissions: G 3.20.1. That the State of West Bengal has enacted the West Bengal Health Services Act, 1990 for controlling the services of the in-service doctors. Under Section 21 of the said Act, the State has the Rule making power and in exercise of that power the State has enacted the West Bengal Health Service and the West Bengal Medical Education H

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A Service and the West Bengal Health and Public Administrative Service (Placement on Trainee Reserve) Rules, 2015. As per the note of Rule 3 of the said Rules, the State is empowered to make reservation in the seats of the Medical Courses of the State Universities for its officers under West Bengal Health Service and the West Bengal Medical Education Service and the West Bengal Health and Public B Administrative Service. It is submitted that such note was also there in the Rules of 2008, which came to be repealed in view of enactment of Rules 2015. That the Government vide order dated 18.4.2013 provides for the reservation of 40% of the State quota Post-graduate Medical seats for the in-service doctors in exercise of such power; C 3.20.2. That the action of the State to provide 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; 3.20.3. The State can fix a separate source of admission as the in-service doctors are distinct class. The classification has sufficient nexus with the laudable object of meeting the requirement of qualified Post-graduate doctors for the public health service. Reliance is placed upon decision of this Court in the case of Sudhir N vs. State of Kerala and Ors. 10; 3.20.4. By way of providing separate source of entry to the in-service doctors, the State has not impinged upon the minimum standards prescribed by the Medical Council of India as in-service candidates are selected on the basis of their merit assessed on the basis of their marks obtained in the NEET examination; 3.20.5. The action of providing separate quota for the in-service doctors is not violative of the Regulation 9(IV) of the MCI Regulations, 2000 as the same categorically states in an unambiguous manner, inter alia, that the reservation of seats shall be as per applicable laws prevailing in the State. By giving restrictive meaning to the term ‘reservation’ as only constitutional reservation, it would be putting words 10 H (2015) 6 SCC 685 (paras 22 to 24)

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 611 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

to the legislation which is otherwise unambiguous and includes all kinds of reservation including that of in-service; 3.20.6. In-service Doctors come with vast practical experience of serving several years in the Government Health Services and treating countless patients. Whereas the fresh MBBS graduates, even though may score higher because of their recent connection with the textbooks, do not have any such experience. Their marks are only reflective of their theoretical knowledge and ability to memorize and answer examination questions. It is submitted that thus, in-service Doctors having vast experience and fresh graduates having no such experience, form two different classes and cannot be equated. It is submitted that forcing in-service Doctors to compete with the fresh graduates in their theoretical knowledge will be extremely, unfair, illogical and irrational; 3.21. In addition, learned counsel appearing on behalf of the private appellants in the Civil Appeals arising out of impugned judgment and order passed by the High Court of Calcutta and in-service candidates have further submitted that the reservation notification was issued on 18.4.2013 and the writ petition has been filed after first counselling was over for 2019 admission. All admissions were completed in May 2019 and 285 doctors out of the State quota of 699 have almost completed the first semester. It is submitted that therefore, alternatively it is prayed to observe that the impugned judgment and order passed by the High Court may not affect the admission already granted and may not affect those in-service candidates who are already admitted prior to filing of the petition / impugned judgment and order passed by the High Court;

44. The applicant of IA No.61442 of 2020 – GMS Class II F Medical Officer’s Association and Association of in-service Government Medical Officers in the State of Gujarat are as such aggrieved by the Public Notice dated 28.02.2019, as amended by a Corrigendum dated 10.03.2019, wherein Medical Council of India has permitted the conversion of Diploma seats into Degree seats on the ground of doctrine of Legitimate Expectation and on the ground that the same is in teeth G of and to bypass the order passed by this Court dated 19.5.2017 in the matter of Special Leave Petition (Civil) No.31395 of 2017. It is submitted that in the aforesaid case this Court directed the State of Gujarat to conduct the counselling keeping in view the regulation which provides for 50% of seats to be reserved in the Post-graduate Diploma H

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A Courses for Medical Officers in the government service who have served for at least three years in remote and/or difficult areas. It is the case on behalf of those in-service Medical Officers working in the Government Colleges in the State of Gujarat that by the aforesaid vested rights in favour of those in-service candidates and to avail 50% reservation in Post-graduate Diploma Courses have been taken away. B It is their case that what cannot be done directly, shall not be permitted to be done obliquely. It is also their case that so far as the State of Gujarat is concerned, there is no provision for giving 30% incentive for Post-graduate Degree Courses displaced in Clause 9(IV) of the MCI Regulations, 2000. It is submitted that therefore, on one hand Diploma C seats are being decreased and on the other hand there is no provision for providing incentive marks in the Degree Courses to the in-service Medical Officers, who have worked in rural areas. It is submitted that the applicant has already filed writ petition before the Gujarat High Court being Special Civil Application No.5773 of 2019 challenging the vires of Rule 6 of the Gujarat Professional Post-graduate Medical D Educational Courses (Regulation of Admission) Rules, 2018 as well as conversion of Diploma seats into Degree seats and the same is pending; 4.1. Learned counsel appearing on behalf of the respective writ petitioners – in-service doctors have made the following submissions in respect of their alternative prayer/prayers to declare Regulation 9, E more particularly, Regulation 9(IV) and 9(VII) of the MCI Regulations, 2000, as arbitrary, discriminatory and violative of Article 14 and 19(1)(g) of the Constitution of India and also ultra vires the provisions of the Indian Medical Council Act, 1956; 4.2 That so far as the State of Tamil Nadu is concerned, it is submitted that since the year 1989, the State of Tamil Nadu has had a policy of providing a separate source of entry to in-service candidates to the extent of 50% of the State seats in degree courses. Further, since the year 2007, by way of a Government Order, the State of Tamil Nadu has also provided for preferential weightage to those in-service candidates who have served in rural, hilly and difficult areas. Therefore, the policy of the State Government has been adopted with a view to ensure adequate healthcare in the public sector and to further ensure filling of vacancies in government hospitals, particularly in rural, hilly and difficult areas. That the aforesaid policy following by the State of Tamil Nadu has resulted in drastic improvement in the overall public H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 613 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

healthcare with adequate staffing across the State and improvement in health indicators, particularly when compared to other States in the country; 4.3 Learned counsel appearing on behalf of the in-service candidates working with the State of Kerala has submitted that the State of Kerala had a policy of reserving 40% of the seats available in postgraduate medical admission for in-service candidates serving in the Health Service Department, Medical College Lecturers and doctors serving in the ESI Department of the State. That MCI Regulations, 2000, however, made it mandatory for all candidates seeking admission to postgraduate medical courses to appear for a common entrance examination. The MCI Regulations, 2000, inter alia, provide that candidates who appear in the common entrance examination and secure 50% in the case of general category candidates and 40% in the case of SC/ST candidates alone shall be qualified for such admission. Consequently, even in-service candidates had to appear and qualify in the common entrance examination. Considering the hardship faced by the in-service candidates who were working round the clock for the benefit of the public could hardly find time to update their knowledge and compete with the general merit candidates, the Government of Kerala brought the Kerala Medical officers Admission to Post Graduate Courses under Service Quota Act, 2008 to overcome the difficulties faced by in-service candidates in the matter of getting admission to postgraduate courses; 4.4 Learned counsel appearing on behalf of the in-service candidates working with the State of Maharashtra has submitted that so far as the State of Maharashtra is concerned, the State of Maharashtra by a resolution dated 06.01.1990, decided to reserve 15% F of postgraduate seats in Government Medical Colleges for the in-service candidates to meet the acute shortage of doctors in rural areas. The said resolution was issued to serve as an incentive for graduate doctors to take up government service at primary health centres which were suffering due to the acute shortage of doctors in rural areas. However, G since the requirement of doctors was not met with, the State of Maharashtra by another Government Resolution dated 22.02.1996 increased the reservation of seats for in-service candidates from 15% to 25%. However, in view of the Regulations framed by the Medical Council of India, the in-service candidates are suffering and ultimately H

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A the public health in the rural, hilly and remote areas is being suffered and ultimate sufferer is the public at large in those areas; 4.5 So far as the State of Haryana is concerned, it is the case on behalf of the in-service candidates working with the State of Haryana that the State of Haryana had the policy of reserving 27% of B the seats in the postgraduate medical courses in the Government Colleges for in-service candidates. However, the percentage of seats reserved for the in-service candidates was increased in 2001 from 27% to 40% until 2016 for admission to postgraduate medical courses for in-service doctors in Haryana out of the 50% State quota; C 4.6 In respect of their alternative prayers referred to hereinabove, learned counsel appearing on behalf of the respective petitioners – in- service doctors have made the following further submissions: i) In catena of judgments starting from Kumari Chitra Ghosh (supra); K. Duraisamy (supra); AIIMS Students’ Union (supra); and D Gopal D. Tirthani (supra), this Court has repeatedly upheld the right of the State Governments to set apart a definite percentage of educational seats at postgraduate level consisting of degree and diploma courses exclusively for a class of persons as a separate source of entry, with the condition that the source is properly classified whether on territorial, geographical or other reasonable basis and has a rational E nexus with the object of imparting a particular education and effective selection for the purpose; It is submitted that in the aforesaid decisions, this Court has upheld providing in-service candidates a separate source of entry by accepting that the classification of candidates between in-service doctors and non- F service doctors has a reasonable nexus with the objective sought to be achieved, i.e., of providing adequate and affordable healthcare in the public sector; ii) The power of the State to provide for a separate source of entry in matters of admission in medical education flows from Entry G 25, List III of the Constitution, whereas the power of the Union in matters of “coordination and determination of standards” in matters of admission in medical education is derived from Entry 66 of List I and Entry 25 of List III; iii) This Court in the case of Modern Dental College (supra) H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 615 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

has specifically held after considering the earlier decisions that Entry A 66 of List I was a specific entry having a very specific and limited scope, i.e., dealing with “coordination and determination of standards” in institutions of higher education or research as well as scientific and technical institutions. It has been further held that the words “coordination and determination of standards” would mean laying down the said standard and thus, when it comes to prescribing the standards for such institutions of higher learning, exclusive domain is given to the Union. Insofar as medical education is concerned, the same is achieved by parliamentary legislation in the form of Medical Council of India Act, 1956 and by creating a statutory body like Medical Council of India, the functions of which take, within its sweep, determination and coordination of standards in a medical institution and that of educational institutions. It is further observed that when it comes to regulating education as such which includes medical education as well as universities (imparting higher education), that is prescribed in Entry 25 of List III, thereby giving concurrent powers to both Union as well as D States. It is further held that the power of the States to enact laws under Entry 25, List III would not stand extinguished so long as such laws did not have the effect of wiping out the law enacted by the Union under Entry 66 of List I; 4.7 It is further submitted that the observations of this Court in the case of Dinesh Singh Chauhan (supra) as regards Regulation 9 E prohibiting the States to provide a separate source of entry for in-service candidates require re-consideration inasmuch as: a) there is no express or implied bar contained in Regulation 9 which prohibits the States from exercising their power under Entry 25, List III and providing a F separate channel of entry to in-service candidates. On the contrary, the fact that preference is given to in- service candidates is perceived to be a laudable objective by the Union also, is evident from the proviso to Regulation 9(IV) and Regulation 9(VII). However, G Regulation 9 has not (rightly so) prescribed a uniform policy for a separate source of entry since only the State, which is fully aware of the unique and peculiar facts of that State, can, if necessary, provide for a separate source of entry for that State; H

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A b) that this Court relied upon the findings in Sudhir N (supra), to the effect that Regulation 9 is a complete code in itself, to arrive at the conclusion that the State Governments could not provide a separate channel of entry to in-service candidates. However, this Court failed to consider that even in Sudhir N (supra), the case of B Gopal D. Tirthani (supra) had been approved and the impugned law framed by the State of Kerala had been struck down on account of the State of Kerala giving the inter se merits of in-service candidates a go-bye by fixing the criteria for admission as inter se seniority. C Thus, even in Sudhir N (supra), the power of the State Governments to provide a separate channel of entry to in-service candidates was affirmed; c) that this Court did not take into account the fact that by providing a separate source of entry for in-service D candidates, there would be no lowering of standards prescribed by the Medical Council of India since eligible candidates would have met the minimum qualification marks set out in NEET and moreover the admission would take place based on the inter se merits of the in-service candidates; E d) that this Court did not take into account the relevant findings in the case of Modern Dental College (supra), more particularly, paragraphs 29 and 30; e) that this Court also did not consider that its interpretation of Regulation 9 in such a manner as to render the States powerless in the matter of creating a separate source of entry would be contrary to various decisions of this Court which have affirmed the right of the State Government to determine the admission process keeping in view their peculiar conditions with the caveat that there is no laying down of uniform standard prescribed by the Union; f) that mere incentives as mentioned in Clauses (IV) and (VII) of Regulation 9 of the Regulations, 2000 with respect to in-service government doctors will result in less number of people opting Government services thus

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 617 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

affecting the under-privileged and under-served population across the State. That there is an absolute dearth of doctors entering Government services since very few MBBS doctors join government service after their graduation. This situation affects the under- privileged, under-served and poorest of poor people across the country who prefer public sector/government run hospitals or primary health centres for their treatment as they are not in a financial position to afford the private hospitals. Hence, in order to retain the doctors in government services and continue with them for a longer duration, it is vitally important and absolutely necessitated in the best of public interest for the States to carve out a separate channel of entry for the in- service candidates in admission to postgraduate medical courses. Heavy reliance is placed upon the decision of this Court in the case of Pre-PG Medical Sangharsh D Committee v. Dr. Bajrang Soni11; g) that Regulation 9 of the Post Graduate Medical Education Regulations, 2000 cannot expressly or impliedly take away the power of the State Government under Entry 25, List III to provide either reservation or weightage in marks for all the in-service candidates and in no way providing such reservation for all in-service candidates, would be lowering the standard prescribed by MCI since eligible candidates would have met the minimum qualification marks set out in the NEET entrance test and moreover the admission would take place based on inter se merits of the in-service candidates; h) that the power of the State Government to provide for reservation or separate channel of entry for in-service candidates at the postgraduate level so long as the minimum standards of qualification is maintained has been held to be constitutionally valid by this Court in catena of decisions;

11 (2001) 8 SCC 694 H

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A i) that even otherwise providing reservation for in-service candidates in postgraduate diploma courses (as per Regulation 9(VII)) only and not providing any specific provision for reservation for in-service candidates in postgraduate degree courses is absolutely arbitrary and colourable exercise of power. It is submitted that there B is no logic and reason to provide for reservation only in postgraduate diploma courses and not in postgraduate degree courses. It is submitted that not providing for any reservation for in-service candidates in postgraduate degree courses is discriminatory and violative of Article C 14 of the Constitution of India; j) that any interpretation of Regulation 9, which allows for reservation for in-service candidates in diploma courses but prohibits a separate source of entry for in-service candidates in degree courses therefore is wholly arbitrary D and without any application of mind inasmuch as it completely fails to consider that the need to adequately staff rural healthcare is not only at a basic level but more so at a specialised level since the shortage of staff in specialised healthcare is even more acute and serious; E k) that in case Regulation 9 is understood to not provide a separate channel of entry for in-service candidates seeking admission to degree courses, then the same would be ultra vires Section 20 of the Indian Medical Council Act, 956 inasmuch as Section 20 only mandates that MCI prescribes the standards of postgraduate F medical education, i.e., prescribes the minimum qualification marks but does not in any way empower MCI to impede the well-recognised right of the States to create a separate channel for persons it may deem fit; G 4.8 If it is understood that MCI Regulations, 2000 provide for any reservation for in-service candidates in postgraduate degree courses and do not provide a separate channel of entry for in-service candidates, then the same would be ultra vires to Section 33 of the Indian Medical Council Act, 1956 inasmuch as it would be beyond the scope and ambit of the MCI to make any provision for separate channel of entry for in-service candidates;

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 619 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

4.9 The MCI Regulations, 2000 do not and cannot take away the powers of the respective States to make special provision for in-service candidates, looking to the need and requirement of the particular State in exercise of the power under Entry 25 of List III of the Constitution. It is submitted that “institutional preference” for postgraduate medical admissions is held to be permissible by this Court B in catena of decisions. It is submitted that therefore once the “institutional preference” for postgraduate medical admissions within the State quota is held to be permissible, similarly providing a separate channel for in-service candidates in the form of certain percentage by way of reservation, looking to the specific need and requirement of the State and that too within the State quota is certainly permissible and C the MCI Regulations, 2000 cannot take away the powers/authority of the concerned States to make special provision for in-service candidates for postgraduate medical admissions within the State quota and without compromising the merits, namely, following the minimum eligibility criteria framed by the MCI; D 4.10 Learned counsel appearing on behalf of some of the in- service candidates working with the State of West Bengal, in addition, has made the following submissions: a) that the Indian Medical Council Act, 1956 has been enacted for the sole purpose of coordination and E determination of standards in exercise of the power of the Union Legislature under Entry 66 of List I of Schedule VII. The power of regulating “Education” as such is prescribed in Entry 25 of List III giving concurrent power to both States and the Union. The entire gamut of admission is not covered under Entry F 66 of List I of Schedule VII excluding Entry 25 of List III, though Entry 25 of List III is subjected to Entry 66 of List I; b) that there is no conflict between the power of the Union and the States. The occupied field of Union Legislation G is only related to minimum standards of medical education and the State has provided for in-service quota without impinging the prescribed minimum standards; c) that the power of the State in providing reservation has to be tested within the Constitutional framework and the H

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A State has not travelled beyond its powers in providing quota for the in-service doctors in postgraduate medical admission and the same has been provided within the framework of the Constitution of India; d) that the power of the State under Entry 6 of List II of B Schedule VII to legislate in the subject matter of public health and hospital is exclusive. The State of West Bengal has enacted the West Bengal Health Services Act, 1990 under such exclusive legislative power. Under Section 21 of the said Act, the State has the Rule making power and in exercise of that power the State C has enacted the West Bengal Health Service and the West Bengal Medical Education Service and the West Bengal Health and Public Administrative Service Rules,

2015. That as per Note of the Rule 3 of the said Rules, the State is empowered to make reservation in the seats D of the medical courses of the State Universities for its officers under West Bengal Health Service. The Government Order dated 18.04.2013 provides reservation of 40% of the State quota in the postgraduate medical seats for the in-service doctors. Such Note is a part of the Statute; E e) that 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 F get more specialized health care facility. Such action of the State is indeed 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 G Constitution of India; f) that the power of the State under Entry 6 of List II of Schedule VII is exclusive and the same is not subject to any other entry of the List I. The Court cannot give an interpretation which may make such independent entry subject to any entry of List I which was not the intention of the framers of the Constitution of India;

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 621 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

g) that the State can fix a separate source of admission as the in-service doctors are distinct class. The classification has sufficient nexus with the laudable object of meeting the requirement of qualified postgraduate doctors for the public health service; h) that the observations made by this Court in the case of B Sudhir N (supra) that Regulation 9 is a complete code by itself is required to be considered with reference to the context and the controversy in the said case. It is submitted that the observations in the case of Sudhir N (supra) that Regulation 9 is a complete code in itself may not be construed with respect to providing C reservation and/or making special provision like providing separate source of entry for in-service candidates within the State quota and subject to fulfilling all other eligibility criteria fixed and provided by the MCI. It is submitted that in that sense the observations made by this Court D in Dinesh Singh Chauhan (supra) that as held by this Court in Sudhir N (supra) that Regulation 9 is a complete code in itself including the reservation may not be accepted and is not a good law; i) it is further submitted that even as provided under E Regulation 9(IV) of the MCI Regulations, 2000, the reservation of seats shall be fixed as per the prevailing laws in the State. Therefore, by giving restrictive meaning to the term “reservation” as only constitutional reservation, it would be putting words to the legislation which is otherwise unambiguous and includes all kinds F of reservation including that of in-service; 4.11 It is submitted by the learned counsel appearing on behalf of the State of West Bengal that if Regulation 9(IV) is considered to be limited only to reservations in favour of SC/ST/OBC, then the proviso is not in the form of an exception as it is independently dealing with in- G service doctors. The proviso then becomes substantive provision and is more concerned with the marks to be allocated which is the concern of Regulation 9(III). This proviso confers a discretion on the State to provide for weightage in marks for services rendered in remote or difficult areas. The proviso was required because Regulation 9(III) H

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A prescribes for the obtaining of minimum marks in the NEET exam. The States could not have relaxed or tinkered with the marking system. Therefore, proviso enables the State by conferring a discretion to provide for weightage. The proviso has nothing to do with the reservation in the postgraduate degree courses and it will not negate the States power to make reservation; B 4.11.1 Regulation 9(VII) provides that 50% of the seats in postgraduate diploma courses shall be reserved for medical officers in the government service. Firstly, this Regulation merely deals with diploma courses and has no relevance to postgraduate degree courses. Secondly, this provision makes it an obligation on the part of the State C to reserve 50% seats for in-service doctors. The State, is therefore, left with no discretion and is bound to make such reservations in diploma courses. This provision would not negate the discretionary power of the State Government to make reservation for in-service doctors. 4.11.2 Regulation 9 contains no specific clause or expression which would indicate that the field of making reservations for in-service doctors in the postgraduate degree courses has been covered. Hence, Regulation 9 is not a complete and exhaustive code; 4.11.3 That by making Regulation 9(IV) and 9(VII), the intention is not to exclude reservation for in-service candidates in postgraduate degree courses. If the language in the provision was instead of ‘may be given’, ‘shall be given’, the proviso could have become mandatory. Consciously such mandatory language is not used in the proviso. However, if the mandatory language in the nature of ‘shall be given’ was used, then the only way the States could have recognised the in- F service candidates entitlement to postgraduate courses would have been by way of granting incentive as provided therein. Since the language does not indicate that such course is mandatory and is only an enabling provision, the State Rules/Act or directions issued by the respective State Governments providing for reservation for in-service candidates in postgraduate degree courses is not incompatible with the proviso to G clause IV of Regulation 9. It is submitted that unless there is express or implied prohibition of reservation of seats, contained in the MCI Regulations, for in-service candidates in admission to postgraduate degree courses, no incompatibility between the two arises.

55. Learned counsel appearing on behalf of the Medical Council H of India has made the following submissions against the power of the

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 623 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

States to make reservation of seats for in-service candidates in Post- A graduate Degree Courses and also in favour of validity of the Regulation 9 of the MCI Regulations, 2000: 5.1. MCI has framed a comprehensive scheme for admission to Post-graduate Medicine (Degree and Diploma) Courses in the form of Regulation 9 of the MCI Regulations, 2000. The scheme envisaged under Regulation 9 for admission to Post-graduate Medicine (Degree and Diploma) is to be read as a whole. The Regulation 9 when read as a whole show that it is in-service doctors, i.e. doctors who have served in remote and difficult or rural areas notified by the State Government, are given the maximum benefit under the said scheme as compared to other candidates. The benefit given to the in-service doctors is in the form of; (1) reservation in Post-graduate diploma courses; and (2) grant of incentive marks in terms of Regulation 9(IV) of MCI Regulations, 2000. The option of availing incentive marks for Post-graduate degree courses or seeking reservation in post-graduate degree courses is only available to in-service candidates and the said option is not available to a non-service candidate; 5.2. Indian Medical Council Act, 1956 and the Regulation framed thereunder are traceable to Entry 66 of List I of Schedule VII of the Constitution of India and Entry 66 of List 1 provides for “Co-ordination and Determination of Standards” in the field of higher and technical education or research. The standard, criteria, manner and basis of granting admission in medicine courses fall within the exclusive domain of the Medical Council of India. Regulation 9(IV) prescribes the criteria for determination of merit on the basis of which admissions to be granted to students in post-graduate degree courses; F 5.3. The power of the State under Entry 25 of List III to make laws is subject to Entry 66 of List I of Schedule VII of the Constitution. The primacy will have to be given to Legislation framed by the Parliament or delegated legislation made in exercise of powers conferred under such Legislation on matters under Entry 25 of List III, over the Legislation/delegated legislation framed by the State Legislature or G authority designated by the State Legislature; 5.4. As held by this Court in the case of Preeti Srivastava v. State of M.P.12 under the Indian Medical Council Act, 1956, the Medical 12 (1999) 7 SCC 120 H

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A Council of India is empowered to prescribe, inter alia, standards of post- graduate medication education. It is further observed that in exercise of its powers under Section 20 r/w Section 33 of the Indian Medical Council Act, the MCI has framed the Regulations which govern post- graduate medical education. These Regulations therefore, are binding and the States cannot in the exercise of power under Entry 25 of the B List III, make rules and regulations which are in conflict with or adversely impinge upon the Regulations framed by the Medical Council of India for post-graduate medical education. Heavy reliance is placed upon para 52 and 53 of the said decision; 5.5. That in the case of Modern Dental College and Research C Centre (Supra) this Court has also further observed that exercise of powers by the State Legislature on any matter under Entry 25 of List III is circumscribed by the power under Entry 66 of List I and the latter shall have primacy over the former. Reliance is placed upon paras 102 and 104 of the said decision. D 6.0. Now, so far as submission on behalf of the respective petitioners on conversion of seats of Post-graduate Diploma Course into seats of Post-graduate Degree pursuant to the Notification dated 12.07.2018, it is vehemently submitted that as such when the reference was made to a Larger Bench and even in the original writ petition conversion of seats was not the issue much less any basis for the said reference. It is submitted that therefore, the issue of conversion of seats is a separate and distinct issue and a separate cause of action, which is sought to be clubbed with the present petition. It is submitted that however as submissions have been made on this aspect, it is submitted as under: A. Conversion of seats from post-graduate diploma to degree is optional and not mandatory. No College/ Institution was compelled or forced to opt for such conversion; G B. The provisions for conversion was introduced as over the past years the students, medical colleges, State Government and other stake holders have complained about the scarcity of seats in the post-graduate degree courses which is the most preferred choice of students; H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 625 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

C. To give an option to the States where the requirement A of doctors post-graduate degrees is more to avail the benefit of conversion; D. This provision was not meant to take away or do away with the in-service reservation in post-graduate diploma courses. If any State/Government Medical College B wants more diploma holders then it can retain those seats. 6.1. Now so far as submission on behalf of the respective petitioners and the respective States that on conversion of post-graduate diploma seats into degree seats in-service candidates are deprived of C reservation in diploma courses, it is submitted that as such Government Medical Colleges and other Medical Institutions in the State of Tamil Nadu and other States have consciously and unconditionally chosen to opt for conversion of seats. In fact, this conversion of seats helps the in-service doctors also as there are a greater number of seats in post- graduate degree courses for which they can compete; D

6.2. It is submitted that any reservation for in-service candidates in post-graduate degree course at this stage will give unfair advantage to in-service candidates over other candidates by increasing their seat share in the said degree courses; E 6.3. That the Government Medical Colleges/Private Medical Colleges/Deemed Universities are keen to secure permission from Government of India for post graduate degree courses only, since post graduate diploma courses is not the preferred choice of the students. In any case, the data in the table given below indicates that not all post graduate diploma seats across the Country have not been converted to post-graduate degree course. Many States have not opted for conversion of seats in their medical colleges; 6.4. It is important to take into consideration that if 30% reservation of seats in post-graduate degree courses is reserved for in-service candidates in State quota, then a major chunk of these seats, particularly seats in clinical subjects will be reserved for in-service candidates only; 6.5. Now so far as submission on behalf of in-service candidates that diploma seats for which reservation of in-service candidates is permitted under Regulation 9(VIII) of MCI Regulations, upon H

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A conversion into post-graduate degree seats, will continue to be reserved for in-service candidates, it is submitted that the said contention is devoid of merit and liable to be rejected since once the seats in post- graduate diploma courses are converted to post-graduate degree courses then the nature and colour of the said seat itself changes and it will be governed by Regulation 9 (IV) and not Regulation 9(VIII) of the MCI B Regulations. It is submitted that grievance of the petitioners, if any, as a result of conversion is because of the action of their State Governments in applying for conversion of seats; 6.6. There is clear cut distinction in post-graduate diploma seats and post-graduate degree courses and both serve different purposes. C The conversion of post-graduate diploma seats into post-graduate degree courses is only an enabling provision which gives discretion to the State Government/Medical Institutes to opt for such conversion. It is not in any manner intended to do away with the reservation in post-graduate diploma courses under Regulation 9(VIII) of the MCI Regulations, D 2000; 6.7. Regulation 9(IV) of the MCI Regulations, 2000 serve a large public interest and it is an objective way of determining merit. Regulation 9(IV) of the Regulations based on the objective consideration, rational, reasonableness and balances the competing interest of in-service candidates and non-service (direct) candidates as well as the interest of State to have doctors serving in remote and difficult or rural areas of the State and at the same time also ensuring that there is no compromise of merit; 6.8. It is submitted that therefore, as there is already provision for in-service candidates in Regulation 9 framed by the MCI framed in exercise of powers under Section 20 r/w 33 of the India Medical Council Act 1956 and the MCI Act has been enacted by the Central Government under Entry 66 of list I and even otherwise Entry 25 of List III empowers the Union also to enact the law and therefore, also in view of MCI Regulations, 2000 which were found place before the G Parliament and ascent of the President, State cannot have the power on the same subject under Entry 25 of List III and any law by the State shall be repugnant to Central Act. 7.0. Shri Aman Lekhi, learned ASG appearing on behalf of the Union of India has made the following submissions: H

TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. 627 UNION OF INDIA & OTHERS [M. R. SHAH, J.]

7.1. That the decision of this Court in the case of Dinesh Singh A Chauhan (supra) is a correct law. That the said decision is consistent with the Article 246 r/w Entry No. 66 of List I and Entry 25 of List III of 7th schedule of the Constitution; it would not be correct to say, as mentioned in the Referral Order, that the Legislative Entries were not considered in judgment of Dinesh Singh Chauhan (supra). As such B in para 24, this Court has specifically approved the judgment in the case of Preeti Srivastav (supra) and has specifically referred Entry 66 of List I and has clearly held that Central Legislation and Regulations must prevail; that the judgment in the case of Dinesh Singh Chauhan( supra) does not digress from the law laid down by the Constitution Benches. C Apart from the fact that the judgment in the case of R. Chitralekha vs. State of Mysore13, specifically negative the contentions raised by the petitioner, it is to be noted that the said decision was prior to deletion of entry 11 List II and insertion of Entry 25 List III in the 7th Schedule of the Constitution; D 7.2. It is submitted that at the time when the judgment in the case of R. Chitralekha (supra) was passed there was no Entry 25 in List III (which came after the 42nd Amendment) and the two Entries which were relevant for controversy in the said case were Entry 66 of List I which has not been amended till now, and Entry 11 of List II. E The State therefore, had the power under Article 246(3) read with Entry 11 to legislate in respect of ‘education’ subject to Entry 66 of List I. The expression ‘education’ was held in Gujarat University v. Krishna Ranganath Mudholkar14 (para 23) to be wide important and include all matters related to imparting and regulating education. Admittedly, there was no Central Enactment or regulation framed under Entry 66 F of List I which was to be considered by this Hon’ble Court in the case of R. Chitralekha (supra); 7.3. That prior to the deletion of entry 11 of List II and insertion of Entry 25 of List III, the Union Parliament could not deal with the issue of imparting and regulating of the education which vested G exclusively in the State Legislature. The power of State Legislature relating to ‘education’ was taken away only to the extent Entry 11 of List II was made subject to relevant entries in the List I including Entry 13

(1964) 6 SCR 368

14 AIR 1963 SC 703 = 1963 Supp (1) SCR 112 H

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