M.Venkatesan v. Tamil Nadu Dr.M.G.R.Medical University

conducting M.Ch. (Paediatric Surgery) clinical and practicalexaminations afresh by cancelling the examination held on 10.8.2009in the Institute of Child Health, Egmore, Chennai. 2. After filing of the writ petition, the second respondentMedical Council of India was impleaded as per the order of this Courtdated 29.9.2009. Thereafter, the third respondent, another candidatewho had undergone the said M.Ch. (Paediatric Surgery) course in theInstitute of Child Health, Egmore, Chennai and who also participatedin the clinical examination held on 10.8.2009, filed a petition toimplead himself as a party and he has also been impleaded by order ofthis Court dated 15.10.2009.3. It is the case of the petitioner that as per the PostGraduate Medical Education Regulations,2000, out of minimum fourexaminers, two shall be the external examiners who are to be invitedfrom recognized universities from outside the State and such externalexaminers must have minimum six years of experience as recognizedPost-graduate Teachers. It is the case of the petitioner that afterhe took up the examination for which results were to be published on9.9.2009, he came to know that Dr.V.Ravindran of Annamalai Universitywas appointed as one of the external examiners, who is not qualifiedsince he is not a person coming from outside the State.3(a). That apart, it is the case of the petitioner that theAnnamalai University is not a recognized University for M.Ch.(Paediatric Surgery) course and hence, the appointment ofDr.V.Ravindran is illegal and the examination conducted on 10.8.2009for M.Ch. (Paediatric Surgery) is not valid. It is stated that thepetitioner has written to the Vice Chancellor of the Tamil NaduDr.MGR University, who has expressed his inability to interfere. Inthese circumstances, the present writ petition has been filed mainlyon the basis of the above said contention.4. In the counter affidavit filed by the first respondentUniversity, while the fact that the petitioner has written theexamination for M.Ch.(Paediatric Surgery) held in August, 2009 isadmitted, it is stated that in the practical examination for M.Ch.(Paediatric Surgery), four examiners were appointed viz., (i)Dr.Philip Chandran, Professor of Paediatric Surgery, ICH, Chennai, asConvenor, (ii) Dr.Jacob Chacko, Professor of Paediatric Surgery, CMC,Vellore, as Member, (iii) Dr.Kanishka Doss, Professor of PaediatricSurgery, St.John's Medical College and Hospital, Bangalore as Member,and (iv) Dr.Mohan Abraham, Professor of Paediatric Surgery, AmirthaInstitute of Medical Sciences, Cochin, as Member. 4(a). It is stated that Dr.Mohan Abraham, Professor ofPaediatric Surgery, Amirtha Institute of Medical Sciences, Cochin,expressed his inability to be an Examiner in the last minute due topersonal reasons and in those circumstances, the first respondent https://hcservices.ecourts.gov.in/hcservices/ University was forced to appoint an alternative Examiner to conductthe practical examination on 10.8.2009 since other three examinersalso accepted the appointment of examinership and made all thearrangements to conduct the practical examination. 4(b). It is stated that the Annamalai University is a separateentity and that the Tamil Nadu Dr.MGR University Act, 1987 isapplicable to the State of Tamil Nadu and under Section 2(r) of theabove said Act not extended to Annamalai University and therefore,treating Dr.V.Ravindran of Annamalai University as an Examineroutside the State as per the guidelines, he was appointed as one ofthe examiners for practical examination. 4(c). It is stated that Dr.V.Ravindran completed his M.Ch.(Paediatric Surgery) in Madurai Medical College in the year 1999 andfrom 1.12.1999 till date, he has been working in AnnamalaiUniversity. It is stated that he is working as a Lecturer in theDepartment of Paediatric Surgery from 1.12.1999 to 13.2.2003 and asReader in the same department from 14.2.2003 to 19.3.2006 and asProfessor from 19.3.2006 till date in Raja Muthiah Medical Collegeand Hospital, Annamalai university, Chidambaram, Tamil Nadu. It isstated that he is functioning as Head of the Department of PaediatricSurgery from 13.6.2008 till date. 4(d). It is the case of the first respondent University that allthe Post Graduate Examiners are recognized as post-graduate teachersholding post-graduate degree in the subjects concerned and therefore,Dr.V.Ravindran fulfils the condition for appointment as externalexaminer since he is a post-graduate teacher holding post-graduatedegree in the subject concerned and recognized as a post-graduateteacher in Annamalai University, Chidambaram and hence, hisappointment as external examiner is within the Regulations. 4(e). It is also stated that Dr.V.Ravindran, is working asProfessor and Head of the Department in the Department of PaediatricSurgery at Rajah Muthaiah Medical College and Hospital, AnnamalaiUniversity, Chidambaram and no fault can be found against him as anexternal examiner. According to the first respondent, the writpetition is not maintainable. It is admitted that the results of theexamination held in August, 2009 in respect of M.Ch. (PaediatricSurgery) is withheld due to the pendency of the writ petition and theinterim orders passed in the writ petition. 4(f). It is stated that no other candidate has questioned theappointment of Dr.V.Ravindran as external examiner and the writpetition affects the interests of third parties. It is also statedthat the appointment of Dr.V.Ravindran is one of the contingentcircumstances which is not prohibited by the Medical Council of Indiaby its Regulations. https://hcservices.ecourts.gov.in/hcservices/

5. The Medical Council of India in its counter affidavit, whileexplaining about the statutory force of the Regulations framed by theMedical Council of India and the significance of medical education,especially post-graduate course and super speciality course, hasstated that the powers conferred under section 20 and 33 of theIndian Medical Council Act,1956, the regulations of the MedicalCouncil of India in relation to post-graduate medical courses, i.e.,"The Post Graduate Medical Education Regulations, 2000" was approvedby the Government of India on 22.5.2000 and published in the OfficialGazette on 7.10.2000. 5(a). The counter affidavit also refers to Regulation No.9,which speaks about the Selection of Post-graduate Students. Theeligibility requirement for candidates to register in the specialitysubjects in respect of M.Ch. is stated to be one that a candidatemust possess a recognized degree of M.S. or its equivalent recognizeddegree in the subject shown against him. It is also stated that thesaid Regulations cover the Post- graduate Medical Educationincluding super speciality courses after M.S. and M.D. 5(b). It is stated that as per the Regulations, out of fourexaminers, two shall be external examiners from recognizedUniversities outside the State and no person can be appointed asexternal examiner unless he/she is having minimum six years’experience as P.G. Teacher. Apart from referring to Regulation 14(1)of the Post-graduate Medical Education (Amendment) Regulations, 2008,which stipulates the above said condition, a reference is also madeto the guidelines for appointment of Post-graduate Examiners, whichcontemplate for the appointment of internal examiners with threeyears’ experience as recognized P.G. Teachers in the subjectconcerned and for external examiners, the guidelines stipulate forsix years’ experience as recognized P.G. Teachers in the concernedsubject. However, it is stated that the appointment of externalexaminers is the prerogative of the concerned University followingthe minimum guidelines or criteria prescribed by the Regulations. 5(c). It is also stated that for Post-graduate Super-specialityCourses in Medicine, more stringent qualifications are required thanthe graduate level. It is stated that M.Ch. Regulations are mandatoryin nature and any other State enactment or rules which areinconsistent with the Act and the regulations made thereunder by theMedical Council of India, are repugnant by virtue of Article 254 ofthe Constitution of India, as held by the Supreme Court inDr.Preeti Srivastava vs. State of Madhya Pradesh and others [(1999) 7SCC 120]. 6. The third respondent, who was impleaded and who was alsoanother candidate participated in the same examination, has statedthat the petitioner and the third respondent were doing M.Ch. coursein the Institute of Child Health, Egmore, Chennai. It is also https://hcservices.ecourts.gov.in/hcservices/ stated that apart from them, another candidate who joined in MadrasMedical College along with the petitioner and the third respondenthas abandoned the course and one other candidate admitted fromMadurai has failed to join the course. Therefore, in addition to thepetitioner and third respondent, two other candidates from CoimbatoreMedical College have taken up the theory examination on the same dayat the respective centres and as per the schedule, the petitioner andthe third respondent took up the clinical examination in theInstitute of Child Health, Madras Medical College, Chennai and thesaid clinical examination started from 8.00 a.m. and proceeded till6.00 p.m. and four examiners appointed by the first respondentUniversity questioned the candidate individually without reference toother examiners on various aspects involving Paediatric Surgery. 6(a). It is stated that the paediatric course involves handlingof infants from birth till 13 years’ old and the said examinationincluded one long case presentation and three short casepresentations and detailed discussion and also answering to examinersin respect of various questions put to them and the above saidprocess went for not less than 1½ hours that is, 15 minutes for eachof the cases. According to the third respondent, the examinationwas conducted in intensive manner and it was not a mere formality. 6(b). It is stated that the candidates from Coimbatore alsoparticipated in the clinical examination held on 11.8.2009 and theirresults were published on 9.9.2009 while the results of thepetitioner and the third respondent have not been released due to thependency of the case. It is the case of the third respondent thatexternal examiner means an examiner who is other than those workingin the first respondent University and therefore, the appointment ofDr.V.Ravindran of Annamalai University cannot be doubted. It isstated that his (Dr.V.Ravindran) specialization in PaediatricSurgery is unparalleled since he himself is qualified from MaduraiMedical College and he is a Professor and Head of the Department forthe past six years in Annamalai University and he is coaching thestudents undergoing the Post Graduate course in M.D. Paediatrics andM.S. and he has published many articles. 6(c). It is stated that the petitioner having participated inthe examination conducted by the four examiners, as per the statutoryregulations, cannot question the validity of the examinationconducted and the same is for extraneous reasons especially when thewrit petitioner has not alleged any mala fide, fraud or irregularityagainst the examiners. It is also stated that even if theappointment of Dr.V.Ravindran is assumed to be irregular, that cannotaffect the entire examination process, especially when other threeexaminers are competent who have given their valuation and hence, theexamination conducted by the four examiners should be approved. https://hcservices.ecourts.gov.in/hcservices/

7. By taking note of the contention of the learned counsel forthe petitioner and the learned counsel appearing for the respondents,the material points to be decided and discussed in this case are, asto whether the concerned Regulations passed by the Medical Council ofIndia regarding the appointment of Examiners especially withreference to external examiners for M.Ch. Course are mandatory andwhether the appointment of one of the external examiners vitiates theentire examination on the ground that he is not qualified.8. On the face of it, there is no difficulty to conclude that byhierarchy of judgements of the Supreme Court, the Regulations ofMedical Council of India in respect of medical education includingexaminations are having statutory binding effect. In cases whereexaminations are conducted against the provisions of Medical Councilof India, especially when the examinations are relating to post-graduate and super-speciality courses, the violations of suchstatutory regulations cannot be permitted at any cost, for, inrespect of super-speciality courses, while admitting or at the timeof examinations, the sole criterion shall be the merit and meritalone and therefore, violation of any statutory regulations either inrespect of appointment of examiners or otherwise will certainlyaffect the very conduct of the examinations, which, in my consideredview, cannot be rectified for the reason that such violation cannotbe at any stretch of imagination presumed to be a mere proceduralviolation. Therefore, if the appointment of examiners is not withinthe statutory requirements, certainly this Court cannot substituteits view to say that the majority of the examiners have beenappointed as per the statutory requirements and therefore, the non-following of the requirements in respect of one or two examinersshould not affect the conduct of the examinations. Such a view isoutside the jurisdiction of this Court, since in the academicmatters, especially relating to examinations, particularly withreference to super-speciality courses in Medicine, the scope ofinterference by this Court is very limited. 9. When merit alone is the criteria for getting admission tosuper-speciality courses, there is no scope to hold that whileconducting examinations for super-speciality courses, there can beviolation of statutory rules. When the rules are framed by theMedical Council of India, especially relating to post-graduate andsuper-speciality courses, it is presumed that the rules have beenframed keeping in view the goal of maintaining high standard andmerit in such examinations. 10. Now, coming to the relevant rules framed by the MedicalCouncil of India, it is stated that Post-graduate Medical EducationRegulations, 2000 were framed by the Medical Council of India. It istrue that there are no separate regulations in respect of super-speciality courses framed by the Medical Council of India, but areading of the Regulations shows that the said Regulations of 2000 https://hcservices.ecourts.gov.in/hcservices/ are applicable not only to the post-graduate courses in medicaleducation, but also to the super-speciality courses. The goal of thesaid Regulations regarding post-graduate medical education is toproduce competent specialists or medical teachers as enumeratedunder regulation No.3 which is as follows:"3. GOALS AND GENERAL OBJECTIVES OF POSTGRADUATE MEDICALEDUCATION PROGRAMME TO BE OBSERVED BY POSTGRADUATE TEACHINGINSTITUTION.3.1. GOALThe goal of postgraduate medical education shall be toproduce competent specialities and/or Medical teachers.i.Who shall recognise the health needs of the community,and carry out professional obligations ethically andin keeping with the objectives of the national healthpolicy.ii.Who shall have mastered most of the competencies,pertaining to the speciality, that are required to bepracticed at the secondary and the tertiary levels ofthe health care delivery system;iii.who shall be aware of the contemporary advance anddevelopments in the discipline concerned;iv.who shall have acquired a spirit of scientificinquiry and is oriented to the principles of researchmethodology and epidemiology; andv.who shall have acquired the basic skills in teachingof the medical and paramedical professions;"3.2 GENERAL OBJECTIVES OF POST-GRADUATE TRAINING EXPECTEDFROM STUDENTS AT THE END OF POSTGRADUATE TRAINING.At the end of the postgraduate training in thediscipline concerned the student shall be able to;i.Recognise the importance to the concerned specialityin the context of the health needs of the communityand the national priorities in the health section.ii.Practice the speciality concerned ethically and instep with the principles of primary health care.iii.Demonstrate sufficient understanding of the basicsciences relevant to the concerned speciality.iv.Identify social, economic, environmental, biologicaland emotional determinants of health in a given case,and take them into account while planning therapeutic,rehabilitative, preventive and primitivemeasure/strategies.v.Diagnose and manage majority of the conditions in thespeciality concerned on the basis of clinicalassessment, and appropriately selected and conductedinvestigations.vi.Plan and advise measures for the prevention andrehabilitation of patients suffering from disease and https://hcservices.ecourts.gov.in/hcservices/ disability related to the speciality.vii.Demonstrate skills in documentation of individualcase details as well as morbidity and mortality raterelevant to the assigned situation.viii.Demonstrate empathy and humane approach towardspatients and their families and exhibit interpersonalbehaviour in accordance with the societal norms andexpectations.ix.Play the assigned role in the implementation ofnational health programme, effectively andresponsibly.x.Organise and supervise the chosen/assigned health careservices demonstrating adequate managerial skills inthe clinic/hospital or the field situation.xi.Develop skills as a self-directed learner, recognisecontinuing education needs; select and use appropriatelearning sources.xii.Demonstrate competence in basic concepts of researchmethodology and epidemiology, and be able tocritically analyze relevant published researchliterature.xiii.Develop skills in using educational methods andtechniques as applicable to the teaching ormedical/nursing students, general physicians andparamedical health workers.xiv.Function as an effective leader of a health teamengaged in health care, research or training." 11. Regulation No.7 relates to the nomenclature of post-graduatecourses provided in the schedule annexed to the said Regulations. Under Regulation No.10, while explaining about the period of trainingfor Doctor of Medicine (MD) and Master of Surgery (MS), which arepost-graduate courses, it deals with the Doctor of Medicine andMaster of Chirurgiae (M.Ch.), which are super-speciality courses forwhich the period of training is mentioned as follows:"10. PERIOD OF TRAINING(1) .....(2) Doctor of Medicine (D.M.) / Master Chirurgiae(M.Ch.)The period of training for obtaining these degreesshall be three completed year (including the examinationperiod) after obtaining M.D./M.S. Degrees, or equivalentrecognised qualification in the required subject;Provided that where an institution on the date ofcommencement for these Regulation, is imparting five yeartraining in Neurology and Neuro-Surgery, such institutionshall continue to have five year training course." https://hcservices.ecourts.gov.in/hcservices/ Therefore, for obtaining super-speciality degrees in medicine, theduration of course is three years after obtaining M.D. and M.S.degrees. While speaking about examinations in Regulation No.10, itsays as follows:"EXAMINATIONS...... The examination for M.S., M.D., D.M., M.Ch.,shall be held at the end of 3 academic years (six academicterms) and for diploma at the end of 2 academic years (fouracademic terms). ...." 12. Likewise, Regulation 11.3, while speaks about Bed Strengthin Clinical Departments in respect of super-speciality and M.Ch.courses it states as follows:"11. Departmental training Facilities:-11.1 and 11.2. xxxx11.3. Bed Strength in Clinical DepartmentsA department to be recognised for trainingof Post Graduate students, shall have not less than 60(sixty) beds each of General Medicine, General Surgery,Obstetrics and Gynaecology, 30(thirty) beds each for othersincase of M.D./M.S. and diploma and 20 (twenty) beds eachin case of D.M./M.Ch.Explanation:- A unit shall consist of 30 beds forMD/MS and 20 beds for DM/M.Ch. respectively." 13. Similarly, while speaking about Training Programme underRegulation 13, the implementation of the said programme also coversDoctor of Medicine (DM) and M.Ch. and the said regulation is asfollows:"13. TRAINING PROGRAMME13.1to 13.7 xxxx13.8. Implementation of the training programmes for theaward of various Post Graduate degree and diplomas shallinclude the following:-(a) Doctor of Medical (M.D.)/Master of Surgery (M.S.)(i) Basic Medical SciencesLectures, Seminars, Journal Clubs, GroupDiscussions, Participation in laboratory and experimentalwork, and involvement in research studies in the concerned https://hcservices.ecourts.gov.in/hcservices/ speciality and exposure to the applied aspects of thesubject relevant to clinical specialities.(ii) Clinical disciplinesIn service training, with the students beinggiven graded responsibility in the management and treatmentof patients entrusted to their care; participation inSeminars, Journal clubs, Group Discussions, ClinicalMeetings, Grand rounds, and Clinico – PathologicalConferences; practical training in Diagnosis and medical andSurgical treatment; training in the Basic Medical Sciences,as well as in allied clinical specialities.(b) Doctor of Medicine (D.M.) / Magister Chirurgiae(M.Ch.)The training programme shall be on the samepattern as for M.D./M.S. in clinical disciplines; practicaltraining including advanced Diagnostic, Therapeutic andLaboratory techniques, relevant to the subject ofspecialisation. For M.Ch. candidates,there shall beparticipation in surgical operations." 14. The crucial regulation which relates to the examinations isRegulation 14. Regulation 14.1 speaks about examiners, Regulation14.2 deals with Doctor of Medicine and M.Ch. The Regulation 14 is asfollows:"14. EXAMINATIONS.The examinations shall be organised on the basis ofgrading or marking system to evaluate and certify candidateslevel of knowledge, skill and competence at the the end ofthe training and obtaining a minimum of 50% marks in theoryas well as practical separately shall be mandatory forpassing the whole examination. The examination for M.S.,M.D., M.Ch. Shall be held at the end of 3 academic years(six academic terms) and for diploma at the end of 2academic years (four academic terms). The academic termsshall mean six months training period.(1) EXAMINERS(a) All the Post Graduate Examiners shall berecognised Post Graduate Teachers holding recognised PostGraduate qualifications in the subject concerned.(b) For all Post Graduate Examinations, theminimum number of Examiners shall be four, out of which atleast two (50%) shall be External Examiners, who shall beinvited from other recognised universities from outside the https://hcservices.ecourts.gov.in/hcservices/ State. Two sets of internal examiners may be appointed onefor M.D./M.S. And one for diploma.(c) Under exceptional circumstances, examinationsmay be held with 3 (three) examiners provided two of themare external and Medical Council of India is intimated thejustification of such action prior to publication of resultfor approval. Under no circumstances, result shall bepublished in such cases without the approval of MedicalCouncil of India.(d) In the event of there being more than onecentre in one city, the external examiners at all thecentres in that city shall be the same. Where there is morethan one centre of examination, the University shall appointa Supervisor to co-ordinate the examination on its behalf.(e) The examining authorities may follow theguidelines regarding appointment of examiners given inAppendix II.(2) Number of candidates.The maximum number of candidates to be examined inClinical/practical and Oral on any day shall not exceedeight for M.D./M.S. Degree, eight for diploma and three forD.M./M.Ch. Examinations.(3)Number of examinationsThe university shall conduct not more than twoexaminations in a year, for any subject with an interval ofnot less than 4 and not more than 6 months between the twoexaminations.(4) Doctor of Medicine (M.D.)/Master of Surgery (M.S.) M.D./M.S. Examinations, in any subject shall consistof Thesis, Theory Papers and clinical/Practical and Oralexaminations.(a) ThesisEvery candidate shall carry out work on anassigned research project under the guidance of a recognisedPost Graduate Teacher, the result of which shall be writtenup and submitted in the form of a Thesis.Work for writing the Thesis is aimed atcontributing to the development of a spirit of enquiry,besides exposing the candidate to the techniques ofresearch, critical analysis, acquaintance with the latestadvances in medical science and the manner of identifyingand consulting available literature. Thesis shall besubmitted at least six months before the theoretical and https://hcservices.ecourts.gov.in/hcservices/ clinical/practical examination.The thesis shall be examined by a minimum ofthree examiners; one internal and two external examiners,who shall not be the examiners for Theory and Clinical; andon the acceptance of the thesis by two examiners, thecandidate shall appear for the final examination.(b) Theory(i)There shall be four theory papers.(ii)Out of these one shall be of Basic MedicalSciences and one shall be of recentadvances.(iii)The theory examinations shall be heldsufficiently earlier than the Clinical andPractical examination, so that the answerbooks can be assessed and evaluated beforethe start of the Clinical/Practical and Oralexamination.Provided that after five years from thecommencement of these regulations, thereshall be one theory paper of 'multiplechoice questions'; unless anyinstitution wants to have such paperearlier.(c) Clinical/Practical and Oral(i)Clinical examination for the subjects inClinical Sciences shall be conducted to testthe knowledge and competence of thecandidates for undertaking independent workas a specialist/Teacher, for whichcandidates shall examine a minimum one longcase and two short cases.(ii)Practical examination for the subjects inBasic Medical Sciences shall be conducted totest the knowledge and competence of thecandidates for making valid and relevantobservations based on theexperimental/Laboratory studies and hisability to perform such studies as arerelevant to his subject.(iii)The oral examination shall be thoroughand shall aim at assessing the candidateknowledge and competence about the subject,investigative procedures, therapeutictechnique and other aspects of thespeciality, which form a part of the https://hcservices.ecourts.gov.in/hcservices/ examination.A candidate shall secure not less than50% marks in each head of passing whichshall include (1) Theory, (2) Practicalincluding clinical and viva voceexamination.II. Doctor of Medicine (D.M.)/Magistrer of Chirurgiae(M.Ch.)The examination shall consist of: Theory andClinical/Practical and Oral.(a) TheoryThere shall be four theory papers, one paperout of these shall be on Basic Medical Sciences, and anotherpaper on Recent Advances. The theory examination will beheld sufficiently earlier than the Clinical and Practicalexamination, so that the answer books can be assessed andevaluated before the start of the clinical/practical andoral examination.(b) Clinical/Practical and OralPractical examination shall consist ofcarrying out special investigate techniques for Diagnosisand Therapy. M.Ch. candidates shall also be examined insurgical procedures. Oral examination shall becomprehensive to test the candidate's overall knowledge ofthe subject.A candidate shall secure not less than 50%marks in each head of passing which shall include (1) Theory(2) Practical including clinical and viva voce examination.III Post Graduate DiplomaDiploma examination in any subject shall consistof Theory, Clinical and Oral.(a) TheoryThere shall be three theory papers. Onepaper out of these shall be on Basic Medical Sciences. Theexamination shall be held sufficiently earlier than theclinical examination, so that the answer books can beassessed before the start of the clinical examination.(b) Clinical and OralClinical examination for the subject inclinical Science shall be conducted to test/aimed atassessing the knowledge and competence of the candidate forundertaking independent work as a Specialist/Teacher forwhich a candidate shall examine a minimum of one long case https://hcservices.ecourts.gov.in/hcservices/ and two short cases.The oral examination shall be thorough andshall aim at assessing the candidate's knowledge andcompetence about the subject, investigate procedures,therapeutic technique and other aspects of the speciality,which shall form a part of the examination. The candidate shall secure not less than 50%marks in each head of passing which shall include (1) Theory(2) Practical including clinical and viva voceexaminations." 15. At this stage, a reference has to be made to RegulationNo.14 in respect of super-speciality courses regarding clinical,practical and oral examinations, wherein it is specifically statedthat apart from examining M.Ch. candidates in surgical procedures,oral examination shall be comprehensive to test the candidates’knowledge on the subject. The term ‘overall knowledge of thesubject’ is relevant since the examiner examines the candidate inrespect of his super-speciality knowledge in the subject. In theabsence of a separate clause for examiners to be appointed for super-speciality courses, in the admitted position, Regulation 14(1)applies to the super-speciality examiners also. 16. From the reading of the said Regulation, the followingpoints are clear: (i)there should be minimum four examiners out of whom 50% shall beexternal examiners;(ii) the appointment of 50% external examiners which is amandatory requirement as per the statutory regulations shall befrom recognized Universities “outside the State”; and (iii) even in exceptional cases where three examiners can conductthe examinations, the presence of two external examiners ismandatory and in respect of absence of one of the internalexaminers, the question of exemption can be considered by theMedical Council of India before publication of results. Therefore, it is clear that regarding two external examiners, themandatory requirement is that they should be from outside the Stateand the external examiners cannot be dispensed with under anycircumstance and even the Medical Council of India, which isempowered to consider the exigency of situation relating to internalexaminer. https://hcservices.ecourts.gov.in/hcservices/

17. In the Schedule to the Post-graduate Examination, Guidelineson appointment of post-graduate examiners, which is captioned as‘super-speciality/subjects in which post-graduate degree and diplomacan be awarded by the Indian Universities and the eligibilityrequirements for candidates for registration of the same’ in Clause-C, in respect of super-speciality courses viz., Doctor of Medicine(D.M.) and M.Ch. (Master of Chirurgie), it is stated as follows:"C. D.M.(Doctor of Medicine) for which candidates mustpossess recognised degree of M.D. (or its equivalentrecognised degree) in the subject shown against them.S.No.Area of SpecialisationPrior Requirement1CardiologyMD (Medicine)MD(Paediatrics)2Clinical HaematologyMD (Medicine)MD(Pathology)MD (Paediatrics)MD (Biochemistry)3Clinician PharmacologyMD (Pharmacology)4EndocrinologyMD (Medicine)MD (Paediatrics)MD (Biochemistry)5ImmunologyMD (Medicine)MD (Pathology)MD (Microbiology)MD (Paediatrics)MD (Biochemistry)MD (Physiology)6Medical GastroenterologyMD (Medicine)MD (Paediatrics)7Medical GeneticsMD/MS in any subject8Medical OncologyMD (Medicine)MS (Radiotherapy)MD (Paediatrics)9NeonatologyMD (Paediatrics)10NephrologyMD (Medicine)MD (Paediatrics) https://hcservices.ecourts.gov.in/hcservices/ S.No.Area of SpecialisationPrior Requirement11NeurologyMD (Medicine)MD (Paediatrics)12Neuro-radiologyMD (Radio-Diag.)D.M.Ch.(MASTER OF CHIRURGIE) for which candidates mustpossess recognised degree of M.S. (or its equivalentrecognised degree) in the subjects shown against them.S.No.Area of SpecialisationPrior Requirement1Cardio vasuclar & Thoracic SurgeryMS (Surgery)2UrologyMS (Surgery)3Neuro-SurgeryMS (Surgery)4Paediatrics SurgeryMS (Surgery)5Plastic & Reconstructive SurgeryMS (Surgery)6Surgical GastroenterologyMS (Surgery)7Surgical OncologyMS (Surgery)MS (ENT)MS (Orthopaedics)MD (Obst. & Gynae.)8Endocrine SurgeryMS (General Surgery)9Gynaecological OncologyMD/MS (Obst. & Gynae)10Vasuclar SurgeryMS (Surgery)18. Thus, the clause makes it clear that for M.Ch. degree orother super-speciality D.M. degree, the prior requirement is post-graduate degree in Surgery, Medicine, etc. and for specialization ofPaediatric Surgery, for the grant of M.Ch. degree, the basicqualification required is M.S.(Surgery). The guidelines regardingappointment of post-graduate examiners are given in the Appendix I,as amended by the Post-graduate Medical Education (Amendment)Regulations, 2008 which were brought in by the Medical Council ofIndia by virtue of powers under Section 33 of the Indian MedicalCouncil Act, 1956, and the guidelines came into effect from20.1.2008 and the same are as follows: "10(i). In Appendix (II), point no.1, under theheading "GUIDELINES ON APPOINTMENT OF POSTGRADUATEEXAMINERS" shall be substituted by the following:'No person shall be appointed as an internal examinerin any subject unless he/she has three years experience asrecognised PG teacher in the concerned subject. For https://hcservices.ecourts.gov.in/hcservices/ external examiners, he/she should have minimum six years ofexperience as recognised PG teacher in the concernedsubject."19. The said mandated provision along with the requirements ofpost-graduate degree holders for obtaining super-speciality degreeseither D.M. or M.Ch. should be construed to mean that in respect ofinternal examiners and external examiners, the required years ofexperience are three years and six years respectively in theconcerned subject and they should be treated as ‘recognised super-speciality teachers’ in the concerned subject. A reading of thatclause in the Appendix to the Guidelines in respect of external andinternal examiners for super-speciality courses with experience asP.G. Teachers in the concerned subject would make the distinctionbetween P.G. courses and Super-speciality Courses fallacious.Therefore, on a harmonious reading keeping in view the maintenance ofhighly sophisticated academic standard in super-speciality courses,it is clear that the examiners of super-speciality courses shall bethe recognized super-speciality teachers in the concerned subject andit cannot be read as the post-graduate teachers in the subjectconcerned. 20. A combined reading of the entire Regulations as they standtoday show that the Regulations create a nebulous situation, sincethe Medical Council of India has not thought of having a concretespecialized regulations for examinations in respect of super-speciality courses which creates a necessity of making the followinginferences: (i)in respect of super-speciality courses there should beminimum four examiners out of whom 50% viz., two shallnecessarily be external examiners, who shall be fromoutside the State and as against the mandate of twoexternal examiners from recognized Universities fromoutside the State, even if one is not appointed from arecognized University outside the State, the same should betreated as a violation of mandatory requirements of theMedical Council of India; (ii)in respect of two internal examiners in exigentcircumstances, if there is shortage of one internalexaminer, that can be approved by the Medical Council ofIndia on the basis of reasons given and the absence of therequirement of two internal examiners would not vitiate theresult of the examination; (iii)in respect of external examiners for super-specialitycourses, such examiners shall be from recognizedUniversities outside the State and they shall have theminimum six years’ experience as recognized super-speciality teachers in the concerned subject and that isthe mandatory requirement, the violation of which wouldinvalidate the examination; and https://hcservices.ecourts.gov.in/hcservices/ (iv)in respect of internal examiners for super-specialitycourses, the examiners must have three years’ experience assuper-speciality teachers in the concerned subject. 21. The above said inferences are the culmination of the readingof the entire Regulation which stands as on date. The contention ofMr.AR.L.Sundaresan, learned senior counsel appearing for the firstrespondent University that the term, ‘outside the State’ should bein fact read as ‘outside the University area’, cannot be accepted forthe reason that the Regulation 14(1)(b) uses the words, ‘externalexaminers who shall be invited from other recognized Universitiesfrom outside the State’. The term ‘other recognized universities’read with ‘outside the State’ shows the impossibility ofconstruction of including other recognized Universities within theState in the matter of appointment of external examiners. 22. Further, in the absence of the definition of ‘State’ in theRegulations, it is apposite to use the meaning of the term, ‘State’in Article 1(2) of the Constitution of India which is as follows: "Article 1(2). The States and the territories thereof shallbe as specified in the First Schedule."23. The Medical Council of India Regulations is based on theterritorial classification and the same is explained in respect ofState of Tamil Nadu in Schedule I, Clause-7 of the Constitution ofIndia as follows:"7. Tamil Nadu: The territories which immediately beforethe commencement of this Constitution were either comprisedin the Province of Madras or were being administered as ifthey formed part of that Province and the territoriesspecified in section 4 of the States ReorganisationAct,1956, [and the Second Schedule to the Andhra Pradesh andMadras (Alteration of Boundaries) Act,1959,] but excludingthe territories specified in sub-section (1) of section 3and sub-section (1) of section 4 of the Andhra StateAct,1953, and [the territories specified in clause (b) ofsub-section (1) of section 5, section 6 and clause (d) ofsub-section (1) of section 7 of the States ReorganisationAct,1956 and the territories specified in the First Scheduleto the Andhra Pradesh and Madras (Alteration of Boundaries)Act,1959."Therefore, the term, ‘State’ being defined on territorial basis,there is no scope to construe the term, ‘outside the State’ as‘outside the University area’ by any stretch of imagination. 24. On the facts of the present case, it may be true thatAnnamalai University may not be within the University area of TamilNadu Dr.MGR Medical University, but still it is one of the recognized https://hcservices.ecourts.gov.in/hcservices/ Universities within the State of Tamil Nadu and cannot be treated asa recognized University outside the State. Therefore, applying thesaid yardstick to the undisputed facts of the case as enumeratedabove, I am of the considered view that the appointment of one of theexternal examiners viz., Dr.V.Ravindran, who is the Professor andHead of the Department of Paediatrics in Annamalai University doesnot comes within the definition of the term, ‘external examiner fromoutside the State’. In addition to that, admittedly, in theAnnamalai University no M.Ch. Course is conducted and therefore, hecannot be termed as a super-speciality teacher in Paediatric Surgery,which is the concerned subject, as per the guidelines stated above.On that account also, he cannot be termed as a qualified examiner forconducting the examination. 25. For the reasons stated above, I am of the view that eventhe Medical Council of India cannot grant approval for such anappointment on the basis of any exigent situation, since the samecannot be rectified as a procedural irregularity. In cases ofprocedural violations, especially regarding qualifications ofexaminers in super-speciality courses which are mandatory in nature,it is not possible to accept the contention that the requirement ofqualifications can be given a go by under emergent circumstances.26. Further, the contention that clinical examination wasconducted for the whole day as a long drawn process with acutespecifications from the examiners in testing the quality of studentsand therefore, there is no possibility for undermining the quality ofparticipated students for the whole day, has no answer for statutoryviolations which relate to the quality of super-speciality coursesand the successful candidate is going to be a highly sophisticatedprofessional to serve the needy patients with practical approach.There cannot be any compromise formula in that regard. In such adetailed examination, there is no scope for presumption of abilityunless the examiner himself is competent and qualified as per thestatutory regulations which are sine quo non for his academic andpractical knowledge to examine the super-speciality candidates. 27. It is true that the third respondent just as any othercandidate had also undergone the ordeal of examination for the wholeday, but as stated above, there cannot be a compromise formula onthe basis of existing Regulations of the Medical Council of India ason date. Unless and until the Medical Council of India takes effortsto frame a self-contained regulations for the purpose of admissionand examinations for super-speciality courses in Medicine which isin dire need, there is possibility of recurrence of events like thepresent instance. 28. In such view of the matter, the writ petition stands allowedand the examination in clinical M.Ch. (Peadiatric Surgery) conductedby the first respondent on 10.8.2009 in the Institute of Child https://hcservices.ecourts.gov.in/hcservices/ Health, Egmore, Chennai, stands cancelled with direction to the firstrespondent to take immediate steps to conduct fresh examination inrespect of the said subject by appointing necessary external andinternal examiners as per the statutory regulations enumerated aboveand such exercise shall be completed by the first respondentUniversity within a period of eight weeks from the date of receiptof copy of the order and thereafter the process of examinationincluding the declaration of results shall be completed. No costs.Connected miscellaneous petition is closed.khSd/Asst. Registrar/true copy/Sub Asst.RegistrarTo1. The Registrar Tamil Nadu Dr.M.G.R.Medical University P.B.No.1200 No.69, Anna Salai Guindy, Chennai 600 032.2. The Secretary Medical Council of India Sec.8, Pocket 14, Dwaraka 1,New Delhi 110 077.1 cc To Mrs.A.Gandhimathi, Advocate, SR.634871 cc To Mr.V.Selvaraj, Advocate, SR.636791 cc To Mr.V.P.Raman, Advocate, SR.63787P.D.Order in W.P.No.17012 of 2009PA (CO)SS (03.12.2009)