THE NATIONAL MEDICAL COMMISSIONversusPOOJA THANDU NARESH & ORS.

344                      [2022]REPORTS
               SUPREME COURT   17 S.C.R. 344             [2022] 17 S.C.R.


A                THE NATIONAL MEDICAL COMMISSION
                                       v.
                     POOJA THANDU NARESH & ORS.
                     (Civil Appeal Nos. 2950-2951 of 2022)
B                               APRIL 29, 2022
        [HEMANT GUPTA AND V. RAMASUBRAMANIAN, JJ.]
             Medical Education: Eligibility Requirement for Taking
      Admission in an Undergraduate Medical Course in a Foreign
      Medical Institution Regulations, 2002 – Online Clinical Training –
C
      Provisional registration declined on the ground that the student had
      not completed the ninth semester in part and tenth semester
      completely – Clinical training for tenth semester was done online –
      Whether the degree granted by the Foreign Institute even in respect
      of clinical training through online mode is binding on the Appellant-
D     Commission and whether the student has to be provisionally
      registered – Appellants argued that clinical training cannot be
      imparted through online mode as it is the actual training involving
      diagnosis and interactions with the patients – Respondents contended
      that acquiring primary medical qualification from the Foreign
      Medical Institute was acceptable for grant of registration as per
E
      Regn.2(c) read with Regn.2(e) – Held: Regn.4(3) makes it mandatory
      that a candidate should have studied for the medical course at the
      same institute located abroad for the entire duration of the course
      – Appellant is not bound to grant provisional registration to the
      student who has not completed the entire duration of the course
F     from the Foreign Institute including the clinical training – Without
      practical training, there cannot be any doctor who is expected to
      take care of the citizens of the country.
            Constitution of India: Right to Equality – Held: Certain
      students having been granted provisional registration will not confer
G     any right to the student to claim provisional registration so as to
      undergo the internship – There cannot be any equality in illegality.
            Disposing of the appeals, the Court
            HELD:1. The student admittedly has not completed clinical
      training which was part of the curriculum in the tenth semester,
H
                                      344
THE NATIONAL MEDICAL COMMISSION v. POOJA THANDU                          345
                 NARESH & ORS.

may be she has not completed part of clinical training in the ninth      A
semester as well as per the curriculum. [Para 14][356-B]
       2. The Eligibility Regulations are to ensure that a student
meets the minimum eligibility condition as per the Graduate
Medical Education Regulations, 1997, but after completing the
curriculum, a candidate has to qualify the Screening Test, provided      B
the entire duration of the course has been completed at the same
institute located abroad. The question to be examined is as to
whether the degree granted by the Foreign Institute even in
respect of clinical training is binding on the appellant and the
student has to be provisionally registered. The appellant is not
bound to grant provisional registration to the student who has           C
not completed the entire duration of the course from the Foreign
Institute including the clinical training. [Para 15][356-C-D]
       3. 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             D
undergone clinical training would be compromising with the health
of the citizens of any country and the health infrastructure at large.
[Para 16][356-E]
       4. The argument that certain students have been granted
provisional registration will not confer any right with the student      E
to claim provisional registration so as to undergo the internship.
There cannot be any equality in illegality. [Para 20][356-B]
       5. The Appellant is directed 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              F
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. [Para 25][359-B-C]
      Orissa Lift Irrigation Corporation Ltd. and Ors. v. Rabi           G
      Sankar Patro and Ors. (2018) 1 SCC 468: [2017] 13
      SCR 921 – relied on.



                                                                         H
346              SUPREME COURT REPORTS                         [2022] 17 S.C.R.


A             Medical Council of India v. J. Saai Prasanna and Ors.
              (2011) 11 SCC 748 : 2011 (6) SCALE 400; Chandigarh
              Administration and Ors. v. Jagjit Singh and Ors. (1995)
              1 SCC 745 : [1995] 1 SCR 126 – referred to.
                                   Case Law Reference
B     (2011) 11 SCC 748                     referred to          Para 12
      [2017] 13 SCR 921                     relied on            Para 18
      [1995] 1 SCR 126                      referred to          Para 20
            CIVIL APPELLATE JURISDICTION: Civil Appeal Nos. 2950-
C     2951 of 2022.
             From the Judgment and Orders dated 29.07.2021 and 20.09.2021
      of the High Court of Judicature at Madras in W.P. No. 9703 of 2021.
            Vikas Singh, Sr. Adv., Gaurav Sharma, Dhawal Mohan, Prateek
      Bhatia, Advs. for the Appellant.
D
            Amit Anand Tiwari, AAG, Dr. Joseph Aristotle S., Ms. Mary Mitzy,
      Ms. Devyani Gupta, Ms. Tanvi Anand, V. Ramasubramaniam, T. Harish
      Kumar, Navneet Dugar, Subham Kothari, M. P. Parthiban, K. K. Mani,
      T. Archana, Vinaj Rajput, Advs. for the Respondents.
E             The Judgment of the Court was delivered by
              HEMANT GUPTA, J.
             1. The present appeals are directed against orders dated 29.7.2021
      and 20.9.2021 passed by the High Court of Judicature at Madras in the
      writ petitions filed for quashing the circulars issued by the Tamil Nadu
F     Medical Council on 12.11.2020 and 24.12.2020 and consequential orders
      of directing respondent No. 1/writ petitioner1 to undergo two months of
      Compulsory Rotatory Residential Internship,2 followed by one year of
      internship before granting permanent registration under the Indian Medical
      Council Act, 19563 (now repealed by the National Medical Commission
G     Act, 2019).
            2. The brief facts leading to the present appeals are that the student
      and other similarly situated students after qualifying the eligibility test
      1
        For short, the ‘student’
      2
        For short, the ‘CRRI’
      3
H       For short, the ‘Act’
THE NATIONAL MEDICAL COMMISSION v. POOJA THANDU                                 347
         NARESH & ORS. [HEMANT GUPTA, J.]

i.e. as per “The Eligibility Requirement for Taking Admission in an             A
Undergraduate Medical Course in a Foreign Medical Institution
Regulations, 20024 joined medical colleges in the People’s Republic of
China, such as Qingdao University Faculty of Medicine5. 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
                                                                                B
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           C
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
                                                                                D
Test in terms of the Screening Test Regulations, 20026. 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.
       3. The High Court in its order dated 29.7.2021 passed the following      E
directions:
        “i) The impugned circulars dated 12.11.2020 and 24.12.2020 passed
        by the third respondent, rejecting the claim of the petitioners are
        quashed, as far as the petitioners are concerned.
                                                                                F
        ii) The petitioners shall make their individual application to the
        third respondent for provisional registration for doing their CRRl
        along with the documents, as required by the second respondent,
        within a period of one week from the date of receipt of a copy of
        this order.
                                                                                G
        iii) On such application being made by the petitioners, the third
        respondent shall verify the original documents and consider their
        application for issuing certificate of provisional registration.
4
  For short, the ‘Eligibility Regulations’
5
  For short, the ‘Foreign Institute’
6
  For short, the ‘Screening Regulations’                                        H
348            SUPREME COURT REPORTS                          [2022] 17 S.C.R.


A           iv) The above said exercise shall be completed within two weeks
            from the date of receipt of the application from the petitioners.”
             4. Subsequently, writ petitions were listed under the caption “for
      clarification” and thereafter an order was passed by the High Court
      with the following directions:
B           “(a) the petitioners who submit their applications to the Tamil Nadu
            Medical Council shall be provisionally registered and they shall be
            permitted to undergo the internship (CRRI);
            (b) Taking into consideration the fact that the petitioners had not
            undergone the practical and clinical training during the MBBS
C           Course in physical form in the medical university where they had
            undergone the course, there shall be a direction to the effect that
            the petitioners will undergo the internship for a period of 14 months
            and the additional 2 months shall be utilized for providing practical
            and clinical training in the initial phase of their internship and
D           thereafter, the regular internship shall follow for a period of 12
            months (1 year). This Court is aware of the fact that this
            requirement goes beyond what is provided under clause 11 of the
            screening test regulations 2002. However, instead of making the
            students go back to the respective universities and complete the
            practical and clinical training which may be impossible in the
E           prevailing situation, it will be a better via-media to make them
            undergo the same in the initial phase of the internship for a period
            of 2 months. This will sufficiently satisfy the requirements for
            maintaining better quality in medical education and at the same
            time safeguarding the interest of the students;
F           (c) It is made clear that all these directions issued by this Court
            are peculiar to the given situation and this can never be taken as
            a precedent in future. The Tamil Nadu Medical Council shall
            ensure that the students who apply for provisional registration are
            possessing screening test passing certificate issued by the
G           concerned authority and only thereafter register them provisionally,
            and:
            (d) This Court expects that this order will be made applicable to
            all the students who are similarly placed and they are not made to
            knock the doors of this Court.”
H
THE NATIONAL MEDICAL COMMISSION v. POOJA THANDU                                 349
         NARESH & ORS. [HEMANT GUPTA, J.]

      5. Some of the statutory provisions of the Act relevant for the           A
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                B
      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      C
      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 sub-section
      (3), be eligible to get admission to obtain medical qualification
      granted by any medical institution in any foreign country without         D
      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 sub-section (4-A):
             Provided that an Indian citizen who has acquired the medical       E
      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           F
      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.”
       6. The Eligibility Regulations and the Screening Regulations were        G
published in the Government of India Gazette on the same date i.e.,
18.2.2002. It is not disputed that the student has qualified the eligibility
test which made her eligible to undergo the medical course in the Foreign
Institute. The relevant provisions of the Eligibility Regulations read as
under:
                                                                                H
350            SUPREME COURT REPORTS                               [2022] 17 S.C.R.


A           “9. After verification, as required, if the candidate is found to fulfil
            the eligibility criteria, the Council shall issue an Eligibility Certificate
            in the prescribed format to the candidate certifying that he/she is
            eligible to join a medical institution outside India to obtain a primary
            medical qualification. The certificate shall indicate that on return
            after obtaining the foreign primary medical qualification, the
B
            candidate shall have to undergo a screening test, subject to
            fulfilment of the conditions prescribed in the Screening Test
            Regulations, 2002, and that passing this test shall only entitle him
            to provisional/permanent registration by the Medical Council of
            India or the State Medical Councils.
C                 Provided that he/she has studied for the medical course at
            the same institute located abroad for the entire duration of the
            course from where he/she has obtained the degree.
            10. In case the candidate does not fulfil any of the qualifying
            criteria the Council may reject his application for issue of Eligibility
D           Certificate giving the reasons therefore.
            11. The issue of a eligibility certificate to a candidate shall not
            entitle him to any right, whatsoever, other than to take admission
            in an undergraduate medical course in a foreign medical institute.”

E           7. Some of the relevant conditions of the Screening Regulations
      read as thus:
            “2. (c) “Permanent Registration” means registration for the
            purpose of enrolment on any State Medical Register or Indian
            Medical Register after obtaining the Primary Medical qualification
F           followed by completion of such practical training as prescribed
            either in India or abroad as per the provisions of the Act;
                       xx                           xx                           xx
            (f) “Primary Medical qualification” means a medical qualification
            awarded by any medical institution outside India which is a
G           recognized qualification for enrolment as medical practitioner in
            the country in which the institution awarding the said qualification
            is situated and which is equivalent to MBBS in India;
                       xx                           xx                           xx

H
THE NATIONAL MEDICAL COMMISSION v. POOJA THANDU                              351
         NARESH & ORS. [HEMANT GUPTA, J.]

    (g) “Provisional Registration” means provisional registration in a       A
    State Medical Register or Indian Medical Register for the purpose
    of undergoing practical training in India as prescribed and for no
    other purpose by an Indian citizen possessing any primary medical
    qualification but has not undergone such practical training after
    obtaining that qualification as may be required by the rules or
                                                                             B
    regulations in force in the country granting the qualification;
              xx                         xx                         xx
    4. Eligibility criteria. – No person shall be allowed to appear in the
    screening test unless –
              xx                         xx                         xx       C

    (3) he/she has studied for the medical course at the same institute
    located abroad for the entire duration of the course from where
    he/she has obtained the degree:
           Provided in cases where Central Government is informed            D
    of condition of war, civil unrest, rebellion, internal war or any such
    situation wherein life of Indian citizen is in distress and such
    information has been received through the Indian Embassy in that
    country then the Council shall relax the requirement of obtaining
    medical education from the same institute located abroad in
    respect of which communication has been received from the Indian         E
    Embassy in that country.
              xx                         xx                         xx
    5. The purpose.—The purpose of conducting the screening test
    shall be only to determine the eligibility or otherwise of a candidate
                                                                             F
    for his or her registration with the Medical Council of India or any
    State Medical Council and qualifying the same shall not confer
    any other right, whatsoever, on a candidate.
              xx                         xx                         xx
    11. The Prescribed Authority shall intimate the result of the            G
    Screening Test to the candidates as well as to the Secretary,
    Medical Council of India and the State Medical Councils. The
    unsuccessful candidates shall also be appropriately informed. The
    candidates who qualify the Screening Test may apply to the
    Secretary, Medical Council of India, New Delhi or to any State
                                                                             H
352                 SUPREME COURT REPORTS                         [2022] 17 S.C.R.


A               Medical Council for provisional registration/permanent registration
                along with the requisite registration fee in favour of Secretary,
                Medical Council of India or the State Medical Council. The
                Medical Council of India or the State Medical Councils shall issue
                provisional registration to such successful candidates, who are
                yet to undergo one year internship in an approved institution and
B
                issue permanent registration to such eligible candidates who have
                already undergone one year internship, as the case may be.”
            8. A notification notifying the National Medical Commission
      (Foreign Medical Graduate Licentiate) Regulations, 2021 7 dated
      18.11.2021 has been published. Relevant provisions of the said
C     Regulations read thus:
                “5. Applicability of these regulations. – (1) Notwithstanding
                anything contained in regulation 4, these regulations shall not be
                applicable –

D               (a) To foreign medical graduates who have acquired a foreign
                medical degree or primary qualification, as the case may be, prior
                to the coming into force of these regulations;
                (b) to candidates who are pursuing their education in foreign
                institutions prior to the coming into force of these regulations; and
E               (c) to such foreign medical graduates who are specifically
                exempted by the Commission or the Central Government, as the
                case may be, by notification.
                (2) The foreign medical graduates who have acquired a foreign
                medical degree or primary qualification, as the case may be, and
F               the candidates who are pursuing their education in foreign
                institutions, prior to the coming into force of these regulations,
                shall be governed by the erstwhile applicable regulations.
                            xx                        xx                       xx
                                         SCHEDULE-I
G                                       (See regulation 4)
      CRITERIA TO RECOGNISE FOREIGN MEDICAL GRADUATES
      APPLYING FOR LICENCE OR PERMANENT REGISTRATION
                     TO PRACTICE IN INDIA
      7
H         For short, the ‘2021 Regulations’
THE NATIONAL MEDICAL COMMISSION v. POOJA THANDU                                353
         NARESH & ORS. [HEMANT GUPTA, J.]

      1. The guiding principle for licensing a foreign medical graduate        A
      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.
      2. Eligibility for primary medical qualification in a country outside
      India:                                                                   B
      (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               C
      (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    D
      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.”                                 E
      9. The appellant had issued a clarification on 4.3.2022 that the
2021 Regulations are not applicable to foreign medical graduates who
have acquired a foreign medical degree or primary qualification, as the
case may be, prior to 18.11.2021. However, it further prescribes as under:
      “6. Taking into the consideration all the relevant provisions of         F
      NMC’s Regulations and circumstances, the Commission decided
      to issue the detailed guidelines/process which is required to be
      followed by State Medical Councils for grant of registration of
      FMGs till further instructions from the Commission or
      implementation of NExT Exam, whichever occurs earlier. State
                                                                               G
      Medical Councils should ensure the following conditions/criteria
      while processing the case for grant of registration of FMGs:
      (i) The medical qualification/degree must be registerable to practice
      medicine in their respective jurisdiction of the country in which
      the medical degree is awarded and at par with the license to
                                                                               H
354               SUPREME COURT REPORTS                          [2022] 17 S.C.R.


A              practice medicine given to citizen of that country.
               (ii) Documentary evidence certifying successful completion of
               physical training or internship during the medical qualification
               equivalent to MBBS, if conducted in foreign institute.
               (iii) Copy of passport with VISA and immigration details.
B
               (iv) Foreign medical Graduate Examination (FMGE) conducted
               by National Board of Examination (NBE) should be cleared by
               the candidates seeking registration in India.
                          xx                       xx                         xx”
C            10. It is admitted by the student that she has not undergone the
      practical and clinical training in the physical form, though she has
      undergone the course through online mode for the entire duration,
      therefore, she satisfies the requirement under Regulation 4(3) of the
      Screening Regulations.
D            11. The argument of Mr. Vikas Singh, learned senior counsel for
      the appellant, is that in terms of the statutory Regulations, the student
      has to study the medical course in the same institute located abroad for
      the “entire duration”. It has been argued that as per the dates of the
      semester and the date of departure of student from China, it shows that
      the student has not completed the ninth semester in part and tenth semester
E
      completely, therefore, the student is not eligible for provisional registration
      to undergo one year internship so as to be eligible for registration as a
      professional under the Act. The argument is that clinical training cannot
      be imparted through online mode as it is the actual training involving
      diagnosis and interactions with the patients. There cannot be any online
F     clinical training which will satisfy the requisite condition of the Screening
      Regulations.
             12. Mr. S. Nagamuthu, learned senior counsel for the respondent-
      student relied upon a judgment of this Court reported as Medical Council
      of India v. J. Saai Prasanna & Ors.8 to contend that the student is
G     eligible for provisional registration. It was contended that the action of
      the Tamil Nadu Medical Council is completely arbitrary and discriminatory
      as some students have been granted provisional registration not only by
      the Tamil Nadu Medical Council but also by the Medical Council of
      different States. Therefore, declining of provisional registration to the
H     8
          (2011) 11 SCC 748
THE NATIONAL MEDICAL COMMISSION v. POOJA THANDU                                355
         NARESH & ORS. [HEMANT GUPTA, J.]

student leads to heartburn amongst the student who has not been granted        A
provisional registration. Mr. Nagamuthu referred to a note filed on behalf
of the appellant before the High Court to contend that the stand of the
appellant was that acquiring primary medical qualification from the Foreign
Medical Institute was acceptable for grant of registration. It was also
contended that as per Note V(2), the Screening Regulations grant an
                                                                               B
opportunity to the candidate to either complete his practical training/
internship in the country from where he has acquired the Foreign Medical
Qualification or in India. Relevant part of the Note reads thus:
      “V. (1)            xxx                                          xxx
      (2) Further Regulation 2{c) read with 2(e) of the Eligibility            C
      Requirement For Taking Admission in an Undergraduate Medical
      Course in a Foreign Medical Institution Regulations, 2002 and
      similarly, Regulation 2(c) read with 2(g) of the Screening Test
      Regulation, 2002, further grants an opportunity to the candidate to
      either complete his practical training I internship in the Country
      ‘from where he has acquired the Foreign Medical Qualification            D
      or in India. This is further clarified by Regulation 11 of the
      Screening Test Regulation, 2002.
      xx                          xx                         xx
      VIII.      xx               xx                         xx                E
      The National Medical Commission vide its notice dated 30.09.2020.
      allowed Indian Medical Graduates to undergo only online classes
      of theory subjects which shall be supplemented by practical and
      Clinical training in physical form as per the MBBS Curriculum as
      and when the Medical Colleges gets re-opened. In order to bring          F
      Foreign medical Graduates at par with Indian Medical Graduates,
      the Candidates are required to reproduce Certificate of successful
      completion of theory as well as practical and Clinical training during
      the course of MBBS having being done in physical form in the
      Medica~ University and its affiliated Hospital.”
                                                                               G
       13. We have heard learned counsel for the parties and find that
the reliance on the judgment of this Court in Medical Council of India
is not applicable to the facts of the present case as after the judgment of
the Andhra Pradesh High Court delivered on 2.5.2008, Regulation 4(3)
of the Screening Regulations was inserted to make it mandatory that a
                                                                               H
356             SUPREME COURT REPORTS                          [2022] 17 S.C.R.


A     candidate should have studied for the medical course at the same institute
      located abroad for the entire duration of the course. Though, this Court
      has delivered judgment after the amendment but the student had obtained
      the degree prior to the amendment of the Regulations. Therefore, such
      judgment would not be relevant in the present matter.
B            14. The fact is that the student has admittedly not completed
      clinical training which was part of the curriculum in the tenth semester,
      may be she has not completed part of clinical training in the ninth semester
      as well as per the curriculum.
             15. The Eligibility Regulations are to ensure that a student meets
C     the minimum eligibility condition as per the Graduate Medical Education
      Regulations, 1997, but after completing the curriculum, a candidate has
      to qualify the Screening Test, provided the entire duration of the course
      has been completed at the same institute located abroad. The question
      to be examined is as to whether the degree granted by the Foreign
      Institute even in respect of clinical training is binding on the appellant
D     and the student has to be provisionally registered. We find that the
      appellant 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.
             16. No doubt, the pandemic has thrown new challenges to the
E     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.
             17. The students had taken admission in medical colleges outside
F     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
G     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
H
THE NATIONAL MEDICAL COMMISSION v. POOJA THANDU                                  357
         NARESH & ORS. [HEMANT GUPTA, J.]

the basis of an endorsement that the completion of such medical course           A
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
                                                                                 B
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.
       18. The students claim to have completed clinical training through
online mode. The online mode for practical training has come up for
consideration before this Court in a judgment reported as Orissa Lift            C
Irrigation Corporation Limited v. Rabi Sankar Patro & Ors.9 wherein
the degree in the discipline of engineering was being conferred by online
method as part of distance education course. Earlier, it was Engineering
Degree by online mode and now Degree in Medicine and Surgery by
online mode. This Court held that the practicals form the backbone of            D
such education which is hands-on approach involving actual application
of principles taught in theory. It was held as under:
         “48. Technical education leading to the award of degrees in
         Engineering consists of imparting of lessons in theory as well as
         practicals. The practicals form the backbone of such education          E
         which is hands-on approach involving actual application of principles
         taught in theory under the watchful eyes of Demonstrators or
         Lecturers. Face to face imparting of knowledge in theory classes
         is to be reinforced in practical classes. The practicals, thus,
         constitute an integral part of the technical education system. If
         this established concept of imparting technical education as a          F
         qualitative norm is to be modified or altered and in a given case to
         be substituted by distance education learning, then as a concept
         the AICTE ought to have accepted it in clear terms. What
         parameters ought to be satisfied if the regular course of imparting
         technical education is in any way to be modified or altered, is for     G
         AICTE alone to decide. The decision must be specific and
         unequivocal and cannot be inferred merely because of absence
         of any Guidelines in the matter. No such decision was ever
         expressed by AICTE. ......”
9
    (2018) 1 SCC 468                                                             H
358                SUPREME COURT REPORTS                       [2022] 17 S.C.R.


A           19. Therefore, without practical training, there cannot be any
      Doctor who is expected to take care of the citizens of the country. Hence,
      the decision of the appellant not to grant provisional registration cannot
      be said to be arbitrary.
            20. The argument that certain students have been granted
B     provisional registration will not confer any right with the student to claim
      provisional registration so as to undergo the internship. There cannot be
      any equality in illegality. Reference may be made to a judgment of this
      Court reported as Chandigarh Administration v. Jagjit Singh10.
            21. The argument that if a student has a right, then such right can
C     be enforced independent of the order passed by the courts is not tenable.
      Qualifying in the Screening Regulations is no proof of the clinical
      experience, if any, gained by the students. The Screening examination is
      based upon Optical Mark Reader (OMR) answers and has no correlation
      with any practical training. We do not find that in terms of the Screening
      Regulations, the students are entitled to the provisional registration.
D
             22. However, the fact remains that the students were permitted
      to undergo medical course abroad and that they have completed their
      curriculum according to the certificate granted by such Foreign Institute.
      Therefore, such national resource cannot be permitted to be wasted
      which will affect the life of young students, who had taken admission in
E     the foreign Institutes as part of their career prospects. Therefore, the
      services of the students should be used to augment health infrastructure
      in the country. Thus, it would be necessary that the students undergo
      actual clinical training of such duration and at such institutes which are
      identified by the appellant and on such terms and conditions, including
F     the charges for imparting such training, as may be notified by the appellant.
             23. We are unable to agree with the High Court that instead of
      three months of clinical training in China, two months training would be
      sufficient for provisional registration apart from the 12 months of
      internship. The Courts are not expert in deciding an academic curriculum
G     or the requirement of the clinical training which may be required to be
      satisfied by the students.
            24. Mr. Vikas Singh submitted that the pandemic and the crisis in
      the Ukraine has thrown new challenges for the appellant and that the

      10
H          (1995) 1 SCC 745
THE NATIONAL MEDICAL COMMISSION v. POOJA THANDU                                   359
         NARESH & ORS. [HEMANT GUPTA, J.]

appellant shall take a holistic view as to how to safeguard the interests         A
of the Indian students who were studying abroad and at the same time,
not compromising with the quality of medical education expected from
them in India.
       25. Therefore, we direct the appellant
       i)     to frame a scheme as a one time measure within two months           B
              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            C
              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          D
              complete internship for 12 months.
       26. With the aforesaid directions, the appeals stand disposed of.

Bibhuti Bhushan Bose and Amarendra Kumar                   Appeals disposed of.
(Assisted by : Ajay, LCRA)                                                        E




                                                                                  F




                                                                                  G




                                                                                  H