TAMIL NADU MEDICAL OFFICERS ASSOCIATION & Ors. v. UNION OF INDIA & Ors.

Judgment

– 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. 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 583 B C D E F G H 584 SUPREME COURT REPORTS [2020] 8 S.C.R. 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 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. Disposing of the matters, the Court HELD: PER M. R. SHAH, J.

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 A B C D E F G H TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. UNION OF INDIA & OTHERS 585 said standards and therefore when it comes to prescribe the 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 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 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 (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 – 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/ 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 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 A B C D E F G H 586 SUPREME COURT REPORTS [2020] 8 S.C.R. A B C D E F G H (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 ; 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, 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]

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- 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 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 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/ ST/OBC and as per the prevailing laws in the States. If that be TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. UNION OF INDIA & OTHERS 587 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 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. [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/ 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 A B C D E F G H 588 SUPREME COURT REPORTS [2020] 8 S.C.R. A B C D E F G H 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 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 (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.

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 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. UNION OF INDIA & OTHERS 589

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 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 A B C D E F G H 590 SUPREME COURT REPORTS [2020] 8 S.C.R. 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]

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- 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]

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 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] A B C D E F G H TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. UNION OF INDIA & OTHERS 591

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.

#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] A B C D E F G H 592 SUPREME COURT REPORTS [2020] 8 S.C.R. A B C D E F G H 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 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 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 TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. UNION OF INDIA & OTHERS 593 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. A B C D E F G H 594 SUPREME COURT REPORTS [2020] 8 S.C.R.

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] 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 : [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 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- 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]

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 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] A B C D E F G H TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. UNION OF INDIA & OTHERS 595 West U.P. Sugar Mills Association & Ors v. State of 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 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 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 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 & 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. 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 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 A B C D E F G H 596 SUPREME COURT REPORTS [2020] 8 S.C.R. A B C D E F G 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- 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]

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 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. UNION OF INDIA & OTHERS 597 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]

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 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 A B C D E F G H 598 SUPREME COURT REPORTS [2020] 8 S.C.R. A B C D E F G H 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] 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 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) 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 [1970] 1 SCR 413 referred to referred to [2001] 1 Suppl. SCR 506 referred to [2018] 3 SCR 551 referred to [1999] 4 Suppl. SCR 364 referred to [2016] 3 SCR 579 followed [1963] Supp (1) SCR 112 relied on [1964] 6 SCR 368 [1999] 1 Suppl. SCR 249 [2004] 2 SCR 775 (1971) 2 SCC 293 [1984] 3 SCR 942 [1986] 3 SCR 345 relied on relied on relied on relied on relied on relied on Para 2 Para 3.11 Para 4.7(f) Para 8.2 Para 8.4 Para 10.1 Para 10.1 Para 10.1 Para 10.1 Para 10.1 Para 10.2 Para 10.2 Para 10.2 TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. UNION OF INDIA & OTHERS 599 [1996] 2 Suppl. SCR 184 [2001] 2 Suppl. SCR 79 [2003] 5 Suppl. SCR 152 [2019] 12 SCR 848 [2001] 1 SCR 490 [2003] 1 Suppl. SCR 797 [2015] 1 SCR 884 [2016] 6 SCR 571 (2016) 10 SCC 726 [1991] 2 Suppl. SCR 267 [1996] 2 Suppl. SCR 331 [2019] 12 SCR 1011 [1987] 2 SCR 468 [1981] SCR 197 [2015] 1 SCR 884 [2016] 6 SCR 571 relied on relied on relied on relied on relied on relied on relied on referred to relied on relied on relied on relied on relied on relied on Para 10.2 A Para 10.2 Para 10.2 Para 10.2 Para 14.1 Para 14.2 Para 14.3 Para 14.4 Para 15.2 Para 15.2 Para 15.2 Para 15.3 Para 15.4 Para 15.6 held not good law Para 18.1 held not good law Para 18.1 In the judgment of Aniruddha Bose, J. [2016] 6 SCR 571 [2015] 1 SCR 884 [1964] 6 SCR 368 [1970] 1 SCR 413 [2016] 3 SCR 579 Not affirmed referred to referred to referred to followed [1963] 1 Suppl. SCR 112 referred to [1999] 1 Suppl. SCR 249 referred to [2019] 12 SCR 848 (1971) 2 SCC 293 [2001] 1 SCR 490 relied on relied on relied on Para 12 Para 12 Para 16 Para 16 Para 16 Para 18 Para 20 Para 23 Para 28 Para 28 B C D E F G H 600 SUPREME COURT REPORTS [2020] 8 S.C.R. A [2001] 2 Suppl. SCR 79 [2003] 1 Suppl. SCR 797 [1992] 1 SCR 335 [2001] 1 Suppl. SCR 506 [2012] 10 SCR 204 [1999] 3 SCR 594 [1978] 2 SCR 1 [1973] 1 SCR 822 relied on relied on relied on relied on relied on relied on relied on relied on (2020) SCC Online SC 380 relied on [2004] 2 Suppl. SCR 238 relied on [1994] 2 SCR 644 [1956] SCR 393 relied on relied on Para 28 Para 28 Para 29 Para 29 Para 29 Para 35 Para 35 Para 35 Para 36 Para 36 Para 36 Para 36 CIVIL ORIGINAL JURISDICTION : Writ Petition (Civil) No. 196 of 2018. [Under Article 32 of the Constitution of India] With 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, 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, 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. B C D E F G H TAMIL NADU MEDICAL OFFICERS ASSOCIATION & ORS. v. UNION OF INDIA & OTHERS 601 Makker, Gaurav Sharma, Ankit Anandraj Shah, Saurabh Rajpal, Govind 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. The Judgments of the Court were delivered by M. R. SHAH, J.

#1. Leave & permission granted in the respective special leave petitions.

#2. After considering the judgment rendered by a three Judge Bench of this Court in the case of State of U.P. v. Dinesh Singh Chauhan1, 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.

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 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.

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 mentioned: “(i) The decision in Dinesh Singh Chauhan1 has not considered the entries in the legislative lists of the