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Rajasthan High Court - Jaipur

Somya Saxena D/O Alok Saxena vs National Medical Commission on 18 October, 2022

Author: Ashok Kumar Gaur

Bench: Ashok Kumar Gaur

        HIGH COURT OF JUDICATURE FOR RAJASTHAN
                    BENCH AT JAIPUR

                  S.B. Civil Writ Petition No.13465/2022
Somya Saxena D/o Alok Saxena, Aged About 25 Years, Resident
of B-212, Vaishali Nagar, Jaipur, Rajasthan.
                                                                      ----Petitioner
                                      Versus


1.      National Medical Commission, Through Chairman, Pocket-
        14, Sector- 8, Dwarka Phase-1, New Delhi-110077.
2.      SMS Medical College, through its Principal, JLN Marg,
        Jaipur.
3.      Sri Devaraj URS Medical College, through its Principal,
        Tamaka, Kolar, Karnataka 563101.
                                                                   ----Respondents


For Petitioner(s)           :     Mr.Abhimanyu Singh Yaduvanshi, Adv.
For Respondent(s)           :     Mr.Angad Mirdha, Adv.



         HON'BLE MR. JUSTICE ASHOK KUMAR GAUR

                                       Order
18/10/2022

           This writ petition has been filed by the petitioner for

seeking a direction to allow her to complete her MBBS internship

from any medical institute in Jaipur and prays that National

Medical Commission Compulsory Rotating Internship Regulations,

2021 may not be made applicable to the petitioner for the purpose

of completing her internship after passing of final examination of

MBBS.

           The facts in brief as pleaded in the writ petition are:-

           (a)     The    petitioner        appeared         in    NEET   UG   2016

Examination, having secured the requisite merit and rank and




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thereafter, got admission in Sri Devaraj Urs Medical College, Kolar,

Karnataka.


           (b) The petitioner completed her final year of MBBS

Course and on completion of her MBBS Course, the petitioner was

required to undergo one year compulsory rotating internship and

as per Graduate Medical Regulations, 1997, the students can

complete their Compulsory Internship of one year at any

recognized medical college and hospital in India.

           (c) The petitioner has pleaded in the writ petition that

after admission in the College for MBBS Course, she was

diagnosed with Idiopathic Thrombocytopenic Purpura in May, 2019

and the petitioner started undergoing treatment in the same

College where she was pursuing her MBBS Course. The petitioner

has pleaded that her medical condition deteriorated and as such,

her platelets counts dropped down to 10,000 while the Normal

Range is 1.5 Lakh to 4.5 Lakh and she also developed increase in

bleeding tendencies when she stayed at Kolar and as such, the

petitioner had to receive prolonged immunosuppressive therapy

i.e. physical as well as psychological adverse effects and at several

times, multiple single donor platelets transfusions, was also done

after hospitalization of the petitioner.

           (d) The petitioner has pleaded that after National

Medical Commission Act, 2019 was enacted, the Medical Council of

India was replaced by 'National Medical Commission' and the

newly constituted body i.e. National Medical Commission has

framed    Compulsory       Rotating        Internship            Regulations,   2021

(hereafter 'the CRI Regulations') for regulating the internships.

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           (e)   The petitioner has pleaded that a request was

made by her before the Authorities by sending an E-mail on

05.01.2022, wherein the petitioner through her father made a

request that she was suffering from serious ailment and as such,

after consulting to the various Doctors, it was advised that the

petitioner was required to stay at Jaipur for undergoing her

treatment and further on account of College of the petitioner being

situated at Kolar, she was developing complications in her ailment

and as such, the petitioner who was to pursue her medical career

was required to complete her CRMI from any institute in Jaipur.

           (f) The petitioner has pleaded that her request was

turned down by the respondents by issuing impugned order dated

11.01.2022. The said impugned order dated 11.01.2022, makes a

reference of Section 1(c) of Schedule-II i.e. Eligibility criteria for

completion of CRMI under the heading "Indian Medical Graduates"

in the National Medical Commission (Compulsory Rotating Medical

Internship) Regulations, 2021 and All Indian Medical Graduates

are required to complete their entire period of compulsory rotating

internship training (CRMI) in the Institution, where they have

pursued and completed their Bachelor of Medicine and Bachelor of

Surgery (MBBS).

           (g) The petitioner has pleaded in her writ petition that

after receipt of order dated 11.01.2022, she again sent her

request to the respondents by way of E-mail, however, the

respondents did not take any action on the requests made by the

petitioner and as such, she has been constrained to file the

present writ petition.



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          Learned counsel for the petitioner Mr.Abhimanyu Singh

Yaduvanshi has made following submissions :-


1.   Section 49 of the National Medical Commission Act, 2019

(hereinafter read as 'the Act of 2019) provides that the student

who was studying for a degree course in any medical institution

before commencement of the Act of 2019, shall continue to so

study and complete his course for such degree in accordance with

the syllabus and studies as existed before such commencement of

the Act and as such, student is deemed to have completed his

course of study under the new Act i.e. the Act of 2019 and

accordingly will be awarded degree under the new Act of 2019.

2.   Learned counsel submitted that Section 49 contains a non

obstante clause and since the petitioner was already studying in a

degree course i.e. MBBS and course of study included internship

and as such, the respondents have acted arbitrarily in making

reference of the Regulations of 2021.

3.   The Regulations of 2021 have been framed by virtue of

power conferred by Section 57 of the National Medical Commission

Act, 2019 and such regulation if runs contrary to Section 49 of the

Act, the provisions of Act will prevail over the regulations and

requirement of completing compulsory rotating internship from

the same Institution, should either be declared bad or such

condition should be read down by this Court.

4.   The medical condition of the petitioner does not allow to

pursue MBBS Course from the College, where she was admitted in

2016 and if the petitioner is forced to go to the same College,

during the study period before completion of her internship, then




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her right to pursue the MBBS Course will be curtailed by the

respondents on baseless grounds.

5.   Learned counsel submitted that the erstwhile regulations

permitted completion of internship at different College, from

medical institute where a person had pursued the MBBS Course

and accordingly SMS Medical College had also reserved 50% seats

in the internship, for such candidates passing their MBBS Course

from other States.

6.        Learned counsel submitted that the past practice was

meant to meet the exigencies, where a candidate who completed

the internship in Home State and the same curriculum, training

period followed by the College situated in the State of Rajasthan

and no prejudice was caused on account of passing internship

from any College in Jaipur in the State of Rajasthan.

7.        Learned counsel for the petitioner submitted that there

is an apparent discrimination between the students who are

studying MBBS Course in India and the Foreign Students who are

acquiring their qualification of MBBS Course from outside of India,

as later, are exempted from doing their compulsory rotating

internship, whereas, the petitioner is asked to do his internship

from the same College.

          Learned counsel appearing for the respondent-National

Medical Commission Mr.Angad Mirdha submitted that the writ

petition filed by the petitioner is devoid of any merit and on the

ground of delay and laches, the writ petition itself may not be

entertained by this Court.

          Learned counsel for the respondent submitted that the

petitioner had approached the respondent on 05.01.2022 and her

representation was rejected by them on 11.01.2022 and she has

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approached this Court by filing the present writ petition in the

Month of September, 2022.

            Learned counsel submitted that the petitioner has also

appeared in MBBS Final Examination in the Month of February,

2022 and she waited for considerable time to approach this Court

and if the petitioner had any grievance, she ought to have

approached the Court of law immediately after issuance of

impugned order.

            Learned counsel, on the merits of the matter, submitted

that the regulations which have been framed by the Commission

are absolutely in consonance with the object for which the

National Medical Commission Act, was promulgated.

            Learned counsel submitted that the right which is

claimed by the petitioner as per Section 49 of the Act of 2019, is

not attracted in the present case.

            Learned counsel submitted that the internship is a part

of the complete curriculum of MBBS course having duration of five

and a half year. Learned counsel submitted that the petitioner had

already completed her academic course of MBBS of four and a half

year and requirement of internship cannot be said to be still

studying in the course, as has been canvassed before this Court

by interpreting Section 49 of the Act.

            Learned     counsel        for    the      NMC        Mr.Angad       Mirdha

submitted    that   the    Regulations         of     2021        have    been    made

applicable to the MBBS Course and as per Schedule-II, the

eligibility criteria for completion of internship has been provided in

sub-Clause (iii)(c), where All India Medical Graduates are required

to complete their entire period of compulsory rotating internship in



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the Institution where they have pursued and completed their

Bachelor of Medicine and Bachelor of Surgery (MBBS).

           Learned counsel submitted that the very purpose of

introducing the Regulations of 2021, was to ensure that all the

candidates who were doing their MBBS Course, were required to

complete their period of compulsory rotating internship and as

such, the complete curriculum has been provided for completing

the internship by allotting different subjects for different duration.

           Learned counsel submitted that the past experience of

the Authorities is that candidates after appearing in MBBS Final

Examination were not undertaking the internship period with full

dedication and sincerity and in fact, the candidates were also

trying to prepare for their Post Graduate career and as such, the

internship was given a back seat by all these candidates and as

such, now by virtue of Regulations of 2021, all the MBBS

Candidates   will be required to pursue and complete their

compulsory rotating internship training.

           Learned counsel for the respondent-NMC submitted

that the Schedule-II of the Regulations of 2021 was put to

challenge before the Madras High Court in the case of Aravinth

R.A. Vs. The Secretary to the Government of India & Ors. in

Writ Petition Nos.3667 and 3670 of 2022 and the Madras

High Court has dismissed those petitions after imposing cost on

the petitioners therein.

           Learned counsel submitted that the said judgment of

the Madras High Court was challenged before the Apex Court and

the Apex Court in the case of Aravinth R.A. Vs. Secretary to

the Government of India Ministry of Health and Family

Welfare and Others in Civil Appeal Nos.3585-3586/2022

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decided on 02.05.2022, has discussed the relevant provisions of

Regulations and after considering the importance of the provisions

contained in the regulations, the said provisions have been

upheld.

            Learned     counsel         submitted          that    the   provisions

contained   in   National      Medical       Commission           (Foreign   Medical

Graduate Licentiate) Regulations, 2021 and the present National

Medical Commission (Compulsory Rotating Medical Internship),

Regulations, 2021 are having the similar provisions and as such,

judgment passed by the Apex Court does not leave any room of

doubt that the Authorities does have power to introduce such

regulations.

            Learned counsel for the respondent further submitted

that after issuance of Regulations of 2021, several queries were

raised by the different Authorities and the candidates, and the

Authorities while answering the Frequently Asked Questions

(FAQs), have made it very clear that the CRMI Regulations, 2021

have come into force with effect from 18 th November, 2021 and

internships for Indian/Foreign Medical Graduates can only be done

from a Medical College or Institution approved/recognised by the

Commission and listed by the Undergraduate Medical Education

Board under the provisions of Section 35 of the Act.

            Learned counsel submitted that any intern who has to

complete internship, is not even allowed for any transfer during

the internship period and as such, counsel refers to answer of

Question No.10 of the said FAQs, wherein it has been clarified that

All Indian Medical Graduates shall complete their entire period of

compulsory rotating internship training (CRMI) in the institution,

where they have pursued and completed their Bachelor of

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Medicine and Bachelor of Surgery [Regulation 1 (c) of Schedule-

II].

           Learned counsel submitted that after challenge being

unsuccessful in the Apex Court, certain candidates again filed the

petition before the Delhi High Court and the Court, in the case of

Likhitha Yanmandala Vs. National Medical Commission &

Anr. in W.P. (C) No.87/2022 and other connected writ

petitions, has dismissed the petitions and have found that the

National Medical College (Foreign Medical Graduate Licentiate)

Regulations, 2021 are valid and no illegality can be attached to

these regulations.

           Learned counsel for the respondent submitted that the

petitioner who has pursued the course after admission in the

College at Kolar in Karnataka for almost four and a half year, has

now turned around and want to complete her internship from

Jaipur and if the petitioner survived for a period of four and a half

year, it is unimaginable that the petitioner would not be treated in

the same Government Medical College, where she has already

completed her MBBS Course.

           Learned counsel submitted that the disease which the

petitioner is allegedly suffering from, is not such a disease which

can only be treated at Jaipur and cannot be treated at any other

place including the place where she was studying.

           Learned counsel for the respondent submitted that the

importance of internship cannot be lost sight of only on account of

lame excuses put forward by the candidates by taking a plea of

medical treatment and ailment and if such kind of permission is

granted by this Court, then it will be impossible for the Authorities

to ensure that candidates who have completed their MBBS Course

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by passing the academic examination, also do compulsory rotating

medical internship.

          I have heard the submissions made by learned counsel

for the parties and perused the material available on record.

          The extract of the Act, relevant to decide the present

controversy is reproduced, as follows:-


           Section 49. (1) Notwithstanding anything
           contained in this Act, any student who was
           studying for a degree, diploma or certificate in
           any medical institution immediately before the
           commencement of this Act shall continue to so
           study and complete his course for such degree,
           diploma or certificate, and such institution shall
           continue     to    provide    instructions    and
           examination for such student in accordance
           with the syllabus and studies as existed before
           such commencement, and such student shall
           be deemed to have completed his course of
           study under this Act and shall be awarded
           degree, diploma or certificate under this Act.

           Schedule-II
           1. Indian Medical Graduates
           (a) The applicant should have successfully
           completed the MBBS Course of any University
           from a College or Institution approved and
           recognised by the Commission and listed by
           the Undergraduate Medical Education Board
           under the provisions of Section 35 of the Act.

           (b) xx xx xx xx

           (c) All Indian Medical Graduates shall complete
           their entire period of compulsory rotating
           internship training (CRMI) in the institution
           where they have pursued and completed their
           Bachelor of Medicine and Bachelor of Surgery
           (MBBS).



          This Court, on perusal of the provisions contained in the

Regulations of 2021, finds that Regulation (3) provides that

Compulsory Rotating Medical Internship shall be an integral part of

undergraduate medical education degree.

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           Regulation 4 provides that no medical medical graduate

shall be eligible to permanent registration to practice medicine in

India unless he undergoes the compulsory rotating internship in

India as provided in Schedule-II.

           Regulation 5 provides that the overall duration of

compulsory rotating medical internship shall not be less than

twelve months and institutions, or hospitals from where it may be

undergone shall be such as specified in Schedule 1 and shall be

completed within a period of two years from the date of qualifying

credentials to pursue compulsory rotating medical internship.

           Regulation 6 further provides for quality of internship

and as per sub-Clause (a) all the essential (practical) aspects of

medicine in the areas specified in the Schedule III and IV are

completed during the internship: and (b) the entire course                 of

internship is done under active supervision of the mentor duly

qualified in that respect, and the mentor has duly issued

certificate in that respect, as per the proforma provided in

Schedule IV.

           This Court finds that in Schedule II, as per Regulation

4, certain requirements need to be fulfilled to be eligible for CRMI

for Indian Medical Graduates, wherein it has been provided that

they will have to complete the MBBS Course of any University

from a College or institution approved and recognized by the

Commission and listed by the Undergraduate Medical Education

Board under the provisions of Section 35 of the Act.

           The provision contained in Clause 1(c) of Schedule-II

provides that All Indian Medical Graduates should complete their

entire period of compulsory rotating internship training (CRMI) in



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the institution where they have pursued and completed their

Bachelor of Medicine and Bachelor of Surgery (MBBS).

             This Court, considering the facts of the case, which

have come on record, finds that the petitioner has done her MBBS

Course from a College situated in Karnataka and now she wants to

avail the facility of completing her internship from the College,

which is not situated in Karnataka but in Rajasthan (Home State).

             The very purpose of providing compulsory rotating

internship from the same College, will be frustrated, if the

candidates will be allowed to complete their rotating internship

from any other medical institute.

             This Court finds that the notification dated 18.11.2021,

had made it clear that any candidate who has to complete the

internship, has to go to the same College or institution from which

he or she has pursued MBBS Course. There is no provision or any

window left open for any candidate to now complete internship

from   any    other   institution      and      accordingly,      the   Authorities

considering the provisions of the Regulations, rejected the

candidature of the petitioner, while passing the impugned order

dated 11.01.2022.

             The submission of learned counsel for the petitioner

that the regulations which have been framed by the Commission, are in fact, not in consonance with the main provisions of the Act and as such, Section 49 of the Act of 2019 protected the career of those students, who were pursuing their MBBS Course, as per old regulations and now by virtue of making the regulations applicable with effect from 18.11.2021, the candidates like petitioner have been deprived to complete their course, suffice it to say by this Court that as far as Section 49 of the Act is concerned, the same (Downloaded on 21/10/2022 at 09:48:03 PM) (13 of 14) [CW-13465/2022] provides for the situation where students who are already undergoing the degree course before commencement of the Act of 2019 and shall continue to do so, study and syllabus has been protected by virtue of having saving clause as provided in Section

49. The interpretation placed by counsel for the petitioner regarding Section 49 that the petitioner since has completed the MBBS Course and passing the internship from the same medical institute will not be a part of said course, cannot be accepted by this Court.

This Court finds that any candidate who has already joined the internship prior to 18.11.2021, only such candidates can claim that they will not be bound by the regulations, which have been made by the respondents.

This Court further finds that the Madras High Court though was considering the National Medical Commission (Foreign Medical Graduate Licentiate) Regulation, 2021, however, the regulations which were put to challenge were in respect of Foreign Students, who have done their MBBS Course from other Colleges in different parts of the World, however, they were asked to do their internship in India by virtue of regulations framed by the National Medical Commission. The Apex Court has upheld those regulations and found that candidates are required to undergo their compulsory rotating internship in India as per the regulations framed by the Commission.

This Court finds that the medical grounds which have been taken by the petitioner to permit her to pursue internship in any medical college at Jaipur, result into a situation where the Regulations of 2021 do not provide any window to any candidate (Downloaded on 21/10/2022 at 09:48:03 PM) (14 of 14) [CW-13465/2022] for pursuing the course in any College, except the College where they have passed the MBBS Course and as such, grant of such prayer will be in contravention of provisions contained in Regulations of 2021.

This Court further finds that the petitioner has already pursued her MBBS Course for four and a half year from the College situated in Karnataka, it is highly improbable that the petitioner cannot complete the internship from the very same College.

It goes without saying that ailment of the petitioner needs to be cured and if proper facilities are available at any medical College or Hospital, the same can always be availed by her.

This Court finds no force in the present writ petition and the petition being devoid of merits, stands dismissed.

(ASHOK KUMAR GAUR), J Himanshu Soni/2 (Downloaded on 21/10/2022 at 09:48:03 PM) Powered by TCPDF (www.tcpdf.org)