the The Supreme Court on April 29 said that without practical training, there can be no doctor supposed to take care of the citizens of the country. Based on this reasoning, the court ordered the National Medical Commission [NMC] to mentor a clinical training program for students enrolled in foreign universities abroad, who had to return to India during the pandemic, without physically completing their mandatory clinical training. The NMC objected to online clinical training, which some students said was adequate, on the grounds that it would water down standards.
A division bench consisting of Judges Hemant Gupta and V. Ramasubramanian was considering whether a degree issued by a foreign institute without clinical training is binding on the National Medical Council and whether such a student can be provisionally enrolled.
After qualifying for the eligibility test under the Eligibility Requirements for Admission to an Undergraduate Medical Course at a Foreign Medical Institution Regulations 2002, respondents joined medical schools in the People’s Republic of China. Students have completed nine semesters of their academic course, including clinical training.
However, due to the outbreak of the COVID-19 pandemic, clinical training for Ophthalmology, Otorhinolaryngology and Nuclear Medicine subjects in their tenth semester was conducted online and , therefore, they obtained Bachelor of Medicine and Bachelor of Surgery (MBBS) degrees after qualification in all subjects according to the teaching plan till May 2020 by the foreign institute.
Later, a few of the classmates of the Respondents were granted provisional registration by the Medical Council of Tamil Nadu, but it was denied the same. This led to petitions being filed in the Madras High Court.
By way of order, the High Court ordered the Medical Council of Tamil Nadu to provisionally register the applicants who submit their applications and further allow them to undergo the compulsory rotating residential course. On appeal, the NMC asked the Supreme Court:
NMC submitted the following during the hearing:
- Under the terms of the legal provisions, the student must follow the medical course in the same institute located abroad for “the entire duration”.
- The semester dates and the departure date of the students from China show that the students had not completed the ninth semester partially and the tenth semester completely; therefore, students are not eligible for provisional registration to undertake a one-year internship in order to qualify for registration as a professional under the Indian Medical Council Act 1956.
- Clinical training cannot be delivered through the online mode as it is the actual training involving diagnosis and interactions with patients. No online clinical training can meet the requirement of the Screening Regulations.
What the court observed
The Supreme Court observed that the NMC is not required to grant provisional registration to students who have not completed the full course of a foreign institute, including clinical training.
“There is no doubt that the pandemic has brought new challenges to the whole world, including students, but granting provisional registration to complete an internship to a student who has not undergone clinical training would be compromising the health of citizens. of any country and the large health infrastructure.”
The court also ruled that the granting of degrees to Indian students does not have a corresponding requirement that these students actually practice medicine in the countries where they complete their studies. The bench found:
“Students had been admitted to medical colleges outside India on the grounds that they could not be admitted to medical colleges in India. China alone has a number of institutes offering medical courses taught in English. The screening act and regulations are designed in such a way that the course taken by the students is considered valid in India provided that the medical qualification is recognized for the doctor’s registration in that country. Obviously, none of the Indian students are going to practice medicine in the foreign country, therefore, granting a degree to Indian students has no corresponding obligation that these students actually practice medicine in that country.
With respect to the students’ assertion that they completed clinical training in an online mode, the court noted that in Orissa Lift Irrigation Corp. ltd. against Rabi Sankar Patro & Ors. (2017) where the degree in the discipline of engineering was conferred through the online method through a distance learning course, it was observed that the ‘practical work’ forms the backbone of a such education, which is a practical approach involving the actual application of the principles taught in theory. The bench held:
“[W]Without practical training, there can be no doctor who is supposed to take care of the citizens of the country. Accordingly, the applicant’s decision not to grant provisional registration cannot be described as arbitrary.
The training was also offended by the position of the tribunal de grande instance according to which an internship lasting two months, instead of three months, would suffice for provisional registration outside the 12-month internship.
The bench found: “Courts are not experts in deciding an academic program or clinical training requirement that students may have to meet.”
Although this is the case, the court was of the view that young talent could not be wasted. Thus, the court issued the following instructions to alleviate the pandemic-related issues facing students with foreign medical degrees:
- The NMC should develop a program as a one-time measure within two months to enable students who have not actually completed their clinical training to pursue clinical training in India at medical colleges that can be identified by the caller for a limited time that may be specified by the caller, on charges that the caller determines.
- It would be open to NMC to test the candidates in the program thus supervised in such manner in the following month as it deems appropriate to ensure that these students are sufficiently trained to be provisionally registered for a 12-month internship.