In a very significant, stimulating and straight forward judgment titled The National Medical Commission vs Pooja Thandu Naresh & Ors. in Civil Appeal Nos. 2950-2951 of 2022 (arising out of SLP (Civil) Nos. 2536-2537 of 2022), the Supreme Court as recently as on April 29, 2022 has held in no uncertain terms that the National Medical Commission is not bound to grant provisional registration to the student who has not completed the entire duration of the course from the Foreign Institute including the clinical training. (Para 15). The Apex Court has also minced just no words to make it absolutely clear that granting provisional registration to complete internship to a student who has not undergone clinical training would be compromising with the health of the citizens of any country and the health infrastructure at large. It was also made clear that the decision of the National Medical Commission not to grant provisional registration cannot be said to be arbitrary and qualifying in the Screening Regulations is no proof of the clinical experience, if any, gained by the students.
The brief facts leading to the present appeals are that the student and other similarly situated students after qualifying the eligibility test i.e. as per “The Eligibility Requirement for Taking Admission in an Undergraduate Medical Course in a Foreign Medical Institution Regulations, 2002 (For short, the ‘Eligibility Regulations’) joined medical colleges in the People’s Republic of China, such as Qingdao University Faculty of Medicine (For short, the ‘Foreign Institute’) . It is the stand of the students that they have undergone nine semesters of their academic course including clinical training on the campus. However, due to the outbreak of COVID-19 pandemic, the clinical training for the subjects of Ophthalmology, Otorhinolaryngology and Nuclear Medicine in the 10th Semester was done online and that they have been granted degree of Bachelor of Medicine & Bachelor of Surgery (MBBS) after qualifying in all the subjects as per the teaching plan till May, 2020 by the Foreign Institute. According to the student, some of her fellow students have been granted provisional registration by the Tamil Nadu Medical Council but she has been declined such provisional registration which led to filing of number of writ petitions before the High Court. The argument is that since she has been declared qualified by the Foreign Institute, the only requirement before provisional registration is qualifying in the Screening Test in terms of the Screening Test Regulations, 2002 (For short, the ‘Screening Regulations’). As she has qualified such Screening Test, therefore, the condition in the statute read with the Screening Regulations stands satisfied. Hence, the decision of the Medical Council not to grant provisional registration is not justified in law.”
Some of the statutory provisions of the Act relevant for the purpose of the present appeals read thus:
“13. (4-A) A person who is a citizen of India and obtains medical qualification granted by any medical institution in any country outside India recognised for enrolment as medical practitioner in that country after such date as may be specified by the Central Government under sub-section (3), shall not be entitled to be enrolled on any Medical Register maintained by a State Medical Council or to have his name entered in the Indian Medical Register unless he qualifies the screening test in India prescribed for such purpose and such foreign medical qualification after such person qualifies the said screening test shall be deemed to be the recognised medical qualification for the purposes of this Act for that person.
(4-B) A person who is a citizen of India shall not, after such date as may be specified by the Central Government under subsection (3), be eligible to get admission to obtain medical qualification granted by any medical institution in any foreign country without obtaining an eligibility certificate issued to him by the Council and in case any such person obtains such qualification without obtaining such eligibility certificate, he shall not be eligible to appear in the screening test referred to in subsection (4-A):
Provided that an Indian citizen who has acquired the medical qualification from foreign medical institution or has obtained admission in foreign medical institution before the commencement of the Indian Medical Council (Amendment) Act, 2001 shall not be required to obtain eligibility certificate under this sub-section but, if he is qualified for admission to any medical course for recognised medical qualification in any medical institution in India, he shall be required to qualify only the screening test prescribed for enrolment on any State Medical Register or for entering his name in the Indian Medical Register.””
CRITERIA TO RECOGNISE FOREIGN MEDICAL GRADUATES APPLYING FOR LICENCE OR PERMANENT REGISTRATION TO PRACTICE IN INDIA
- The guiding principle for licensing a foreign medical graduate to practice in India is to ensure that the Foreign Medical Graduate fulfils the requirements of education and training equivalent or commensurate with that of an Indian medical graduate.
- Eligibility for primary medical qualification in a country outside India:
(i) Duration of course and training in subjects leading to primary medical qualification:
(a) Any person who pursue the foreign medical degree should have undergone a course of theory, practical and clinical training equivalent to Bachelor of Medicine and Bachelor of Surgery ( MBBS) of India; and
(b) Should have been completed internship of twelve months in addition to such course referred to in clause (a), in the same foreign institution where the primary medical qualification has been obtained, along with hands-on training in clinical subjects including but not limited to Community Medicine, General Medicine, Psychiatry, Paediatrics, General Surgery, Anaesthesia, Obstetrics and Gynaecology, Orthopaedics, Otorhinolaryngology, Ophthalmology, Dermatology, Emergency or Casualty services, lab services and their sub-specialties.”
No doubt, the pandemic has thrown new challenges to the entire world including the students but granting provisional registration to complete internship to a student who has not undergone clinical training would be compromising with the health of the citizens of any country and the health infrastructure at large.”
It cannot be glossed over that the Bench then specifies in para 17 that, “The students had taken admission in medical colleges outside India for the reason that they could not get admission in the medical colleges in India. China alone has a number of Institutes offering medical courses conducted in English language. The Act and the Screening Regulations are framed in such a way that the course completed by the students is treated to be valid in India provided that the medical qualification is recognised for enrolment of the medical practitioner in that country. Obviously, none of the Indian students are going to practice medicine in the foreign country, therefore, the grant of degree to the Indian students has no corresponding obligation that such students actually practice medicine in that country. In other words, the medical course is permitted to be completed abroad to practice in India only on the basis of an endorsement that the completion of such medical course entitles them to practice in the said foreign country. The courses are designed in such a way to attract students to undertake admission in the Foreign Institutes so that such students, become eligible to practice medicine in India. The very framework of the Regulations was compromising the interests of the Indian nationals and the health infrastructure in India. However, the malice has been corrected by the 2021 Regulations but such Regulations are not applicable to the students who have taken admission in the Foreign Institutes prior to 18.11.2021.”
It is worth noting that the Bench then holds in para 25 that, “Therefore, we direct the appellant
- i) to frame a scheme as a one time measure within two months to allow the student and such similarly situated students who have not actually completed clinical training to undergo clinical training in India in the medical colleges which may be identified by the appellant for a limited duration as may be specified by the appellant, on such charges which the appellant determines.
- ii) It shall be open to the appellant to test the candidates in the scheme so framed in the manner within next one month, which it considers appropriate as to satisfy that such students are sufficiently trained to be provisionally registered to complete internship for 12 months.”
Finally, the Bench then concludes by holding aptly in para 26 that, “With the aforesaid directions, the appeals stand disposed of.”
In sum, the Apex Court has made it indubitably clear that the medical student who has not undergone clinical training of foreign MBBS course can’t be granted provisional registration by NMC. It merits no reiteration that the NMC must definitely follow strictly what the Apex Court has ruled so very clearly in this learned judgment. There can be just no denying or disputing it!
About the author
