In a recent decision, the Madras High Court bench ruled that diploma holders are not permitted to operate a clinic anywhere in the state without a recommendation from the National Medical Commission (NMC), formerly the Medical Council of India (MCI), or the AYUSH Department. The HC bench of Justice M Dhandapani further defined “Registered Medical Practitioner” as “a person who possesses any of the Government recognised medical qualifications and who has been enrolled in the register of the respective Council viz., Medical, Dental, Siddha, Ayurveda, Unani or Homeopathic Councils or the Board of Indian Medicine” or “Doctor” as “means and includes a Residency”

The court made this statement as it was deliberating a petition by diploma holders asking it to step in and prevent the health department from interfering with their ability to establish primary healthcare clinics. The petitioners contended that they were qualified to manage primary health care clinics in rural areas after successfully completing the two-year Diploma in Community Medical Service and Essential Medicines Course. They further asserted that they never identified themselves as doctors and that there was no legal restriction on their ability to practice community medical services and essential drugs.

On the other hand, the government’s attorney argued that if the petitioners were qualified to operate a clinic, they would need to submit an application under the Tamil Nadu Clinical Establishments (Regulation) Act, 1997, and secure approval before opening one. The government’s representative contended that the petitioners were not permitted to operate a clinic anywhere in Tamil Nadu or in rural areas since they lacked the necessary authorization.

The attorney further emphasized that, pursuant to Rule 2(i) of the Tamil Nadu Clinical Establishments (Regulations) Rules, “doctor” in 2018 refers to and includes a Registered Medical Practitioner who provides consultations or treatment under AYUSH or Allopathy. Regarding this, the government’s attorney said that the petitioners are not permitted to operate a clinic or practice medicine until their qualifications have been approved by the Medical Council of India or the AYUSH Department.

The Tamil Nadu Clinical Establishments (Regulations) Rules, 2018’s pertinent clauses were also skimmed by the Madras High Court’s panel in order to review the definitions of physicians and licensed medical practitioners.

The Madras High Court bench’s earlier decision was also cited by the bench, according to the ruling. The HC bench noted, referring to the rules, that “the above said provisions makes it clear that Registered Medical Practitioner means a person who possesses any of the Government recognised medical qualifications and who has been enrolled in the register of the respective Council, viz., Medical, Dental, Siddha, Ayurveda, Unani or Homeopathic Councils or the Board of Indian Medicine or any such Council, Board or any other statutory body recognised by the Government of Tamil Nadu

In the decision, the bench remarked, “The petitioners are not permitted to operate a clinic anywhere in Tamil Nadu without approval from the Medical Council of India or the AYUSH Department.” As a result, neither the relief requested in these petitions nor the claim raised in the writ petitions may be considered.

The Madras High Court panel had emphasized last month that unqualified persons cannot claim any right to practice alternative medicine as the outcome can be devastating, refusing any relief to a total of 61 practitioners. By this, the court had mandated that the state take action against institutions and practitioners of medicine that were not recognized.

In the absence of any genuine medical certificates and without their names being registered with the Tamil Nadu Medical Council, the court had instructed the authorities not to permit the petitioners to continue their medical practice in alternative medicine or in any other type of medicine.

Madras High Court recently made an observation stating that candidates who secure a Post Graduate (PG) medical seat should consider it as a national resource and not waste it by discontinuing the course. The bench comprising Acting Chief Justice T. Raja and Justice D. Bharatha Chakravarthy made the observation while considering an appeal by the selection committee of the Directorate of Medical Education (DME) and the Dean of Madras Medical College (MMC) against a single-judge order passed by the HC in 2019.

The order had directed the DME and the Dean of MMC to return the MBBS degree certificate and transfer certificate to a student who had discontinued her PG medical course at Madras Medical College. The student had secured admission in 2019 in MD (Tuberculosis and Respiratory diseases) / Pulmonary Medicine UR/MD (Respiratory Medicine) on the basis of her score in NEET PG examination.

However, within two days of joining the course, the student had submitted a letter stating that she had to discontinue the course due to a sudden change of events in her personal life, namely the fixing of her marriage. The college insisted that she pay a discontinuation fee of Rs. 15 lakh in addition to the tuition fee before returning her educational documents.

The student challenged this decision in court, and the single-judge bench ruled that as per Clause 27(a), the liability to pay the discontinuation fee arises only if the discontinuation takes place after the cut-off date for admission. Since the discontinuation in this case had taken place before the cut-off date for admission, the bench directed the college to return the student’s documents.

However, the DME and the Dean of MMC appealed against this ruling, arguing that Clause 24(c) states that candidates under the All India Quota who discontinue the course after the last phase of counseling are liable to pay the discontinuation fee. The division bench of the High Court considered both sides’ arguments and finally upheld the single-judge bench’s decision.

Challenging this decision, the authorities of the medical college approached the Division bench of the High Court, where they argued that the petitioner cannot resign from their allotted seats or participate in any further counseling as per the decision of the Director General of Health Services. The authorities further pointed out that the State had all facilities including Professors for teaching PG students, who are limited in number. Therefore, if the petitioner vacates her seat in a casual manner, then the Clauses in the Prospectus cannot be read in the manner as read by the learned Single Judge.

The authorities also argued that even though Clause 24(c) expressly mentions candidates of All India Quota, there is no such express mention of AIQ students in Clause 27(a). Therefore, the authorities contended that the mention of the cut-off date can only be applicable to State Quota students and the petitioner, who got admission under the AIQ, is liable to pay the discontinuation fee of Rs 15 lakh once she vacates the seat after the last phase of counseling.

Despite finding force in the submissions made by the authorities, the Division Bench referred to Clause 27(a) of the Prospectus, which provides that if only the candidates who discontinue their course after the cut-off date, they have to pay the discontinuing fees; otherwise, they will only forfeit their tuition fees. The bench noted that a plain reading of the Prospectus does not make any difference between the State Quota or All India Quota, and hence, the student would not be liable to pay the discontinuation fees.

The bench also added that the student seemed to be a meritorious candidate who had to discontinue on account of personal reasons. The bench further disapproved of the practice of wasting precious medical seats and urged candidates to be more careful in planning their career and personal life, considering that a Post Graduation Medical seat is a national resource by itself.

The Madras High Court Division bench has passed an order in favour of the student, directing the Dean of the medical college to return her educational certificates. The court has also clarified that the benefits of ambiguity in the Prospectus should be in favour of the student, and candidates should be more careful in planning their career and personal life to avoid wastage of precious medical seats.

The court also observed that PG medical seats should be considered national resources and that meritorious candidates admitted to such seats should not waste them by discontinuing the course. The bench pointed out that there were other candidates who missed the seat by a fraction of marks and, therefore, advised students to be more careful in planning their career and personal life.

The Madras High Court’s ruling is significant as it underscores the importance of PG medical seats and the responsibility of students who secure them. The court’s observation that such seats are national resources should serve as a reminder to students that they should not take the admission process lightly and that they have a duty to make the most of the opportunity provided to them.