Kerala High Court
Selbin Boban vs National Medical Commission on 27 June, 2025
Author: T.R. Ravi
Bench: T.R.Ravi
W.P.(C)No.34898 of 2022
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2025:KER:45786
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT
THE HONOURABLE MR. JUSTICE T.R.RAVI
FRIDAY, THE 27TH DAY OF JUNE 2025 / 6TH ASHADHA, 1947
WP(C) NO. 34898 OF 2022
PETITIONER:
SELBIN BOBAN
AGED 27 YEARS
S/O. BOBAN K. MATHEW, KOICKAKUNNEL HOUSE,
VATTAKKUNNU P.O., MEENADOM,
KOTTAYAM-686516.
BY ADV SRI.JAMES ABRAHAM (VILAYAKATTU)
RESPONDENTS:
1 NATIONAL MEDICAL COMMISSION,
DADA DEV MANDIR ROAD, DWARAKA,
PHASE-I, POCKET 14, SECTOR-8, NEW DELHI- 110077,
REPRESENTED BY ITS CHAIRPERSON.
2 THE REGISTRAR,
KERALA STATE MEDICAL COUNCIL,
COMBINED COUNCIL BUILDING, RED CROSS ROAD,
THIRUVANANTHAPURAM-695035.
3 KERALA STATE MEDICAL COUNCIL
REPRESENTED BY ITS PRESIDENT,
THE KERALA STATE MEDICAL COUNCIL,
COMBINED COUNCIL BUILDING, RED CROSS ROAD,
THIRUVANANTHAPURAM-695035.
ADDL.R4 & R5 IMPLEADED
ADDL.R4. UNION OF INDIA
REPRESENTED BY ITS SECRETARY,
MINISTRY OF EXTERNAL AFFAIRS, SOUTH BLOCK,
SECRETARIAT BUILDING, RAISINA HILL,
NEW DELHI - 110011
W.P.(C)No.34898 of 2022
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ADDL. R5 THE EMBASSY OF INDIA
PARAMARIBO (SURINAME), REPRESENTED BY THE
AMBASSADOR, 239, DR. SOPHIE REDMONDSTRAAT, POST BOX
NO. 1329, PARAMARIBO (SURINANE)
(ADDL.R4 AND R5 ARE IMPLEADED VIDE ORDER DATED
14-07-2023 IN IA.1/2023 IN WPC 34898/2022)
BY ADVS.
SHRI.TITUS MANI
SRI.N.RAGHURAJ (SR.)
SRI.JAMES ABRAHAM (VILAYAKATTU)
SHRI.K.S.PRENJITH KUMAR, SC, NATIONAL MEDICAL
COMMISSION
SHRI.VIVEK MENON
SHRI.V.GIRISHKUMAR, SENIOR PANEL COUNSEL
THIS WRIT PETITION (CIVIL) HAVING BEEN FINALLY HEARD
ON 08.04.2025, THE COURT ON 27.06.2025 DELIVERED THE
FOLLOWING:
W.P.(C)No.34898 of 2022
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T.R. RAVI, J.
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W.P.(C)No.34898 of 2022
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Dated this the 27th day of June, 2025
JUDGMENT
The prayers in the writ petition are; to quash Ext.P11, to declare that the petitioner is entitled to get permanent registration under Section 25(4) of the Indian Medical Council Act, 1956 ('the 1956 Act' for short) and for a direction to the 2 nd respondent to grant permanent registration under Section 25(4) of the 1956 Act or the provisions of Act 30 of 2019 to the petitioner.
2. The petitioner acquired the Doctor of Medicine degree, equivalent to MBBS, from American International Medical University, Saint Lucia and passed the screening test prescribed under the Indian Medical Council Act, 1956 and Screening test Regulation, 2002 and claims to be entitled to get permanent registration under Section 25(4) of Indian Medical Council Act. It is contended that the American International Medical University, Saint Lucia, is one of the Accredited Universities and is listed in the World Directory of Medical Schools published by the World Health W.P.(C)No.34898 of 2022 -4- 2025:KER:45786 Organization, and on the official website of the then Medical Council of India (MCI), it is listed as an approved/recognised University. The Indian Medical Council Act, 1956, was repealed by Act 30 of 2019, i.e., the National Medical Commission Act, 2019. This Act contains a saving clause, under which all medical qualifications recognised before the new Act's commencement were treated as recognised qualifications under Act 30 of 2019. The petitioner claims that after ascertaining the University's credibility on the official website of the erstwhile Medical Council of India, he applied and pursued the Doctor of Medicine course in the said university. He claims that the certificate issued by the said University has been confirmed by the Indian Embassy. It is contended that the petitioner had been exempted from the requirement of obtaining an eligibility certificate from the 1st respondent, under Section 13(4B) of the Indian Medical Council Act, 1956, as per the Indian Medical Council (Amendment) Second Ordinance, 2013. The petitioner relies on the entry in his passport to submit that he underwent a regular course of study at Saint Lucia. When there was a delay in consideration of his application for provisional registration, the petitioner approached this Court by filing W.P.(C). No.12454/2020 and based on the directions issued W.P.(C)No.34898 of 2022 -5- 2025:KER:45786 by this Court on 16.7.2020, he was granted provisional registration. The petitioner submits that he has thereafter completed his internship at the General Hospital, Kottayam, and is entitled to get permanent registration for which he had applied on 20.11.2021. By judgment dated 15.7.2022 in W.P. No. 12454/2020, this Court directed the 2nd respondent to decide on the application, after due verification of the documents. The 2nd respondent rejected the application for permanent registration, by Ext.P11, stating that the petitioner has acquired his qualification through an off-campus mode and he has not undergone a regular course of study in the University. The petitioner relies on Ext.P13 letter and contends that he had undergone a regular course. It is submitted that he attended his pre-clinical course fully at the University itself in a regular mode of classes, and his clinical course was done in various Medical Colleges within India and America, affiliated to the University.
3. Ext.P11 order refers to a decision of the Modern Medicine Council not to grant registration to those foreign medical graduates who had undergone the course in an off-campus education method, and to consider only those foreign medical W.P.(C)No.34898 of 2022 -6- 2025:KER:45786 graduates who graduated from foreign medical institutions approved by the MCI, through a regular course of study, for registration. The petitioner relies on Ext.P2 and submits that the American International Medical University is recognised by the MCI; hence, the decision in Ext.P12 and the decision dated 10.10.2019 does not apply to the petitioner, as he completed his medical degree as a regular course from a recognised University approved by the MCI. The counsel for the petitioner relies on the decision of the Hon'ble Supreme Court in Medical Council of India v. J. Saai Prasanna & Ors. [2011 (11) SCC 748], and Exhibit P12 judgment of this Court, and submits that the petitioner is entitled to get permanent registration under Section 25(4) of the 1956 Act. It is also submitted that after issuing the eligibility certificate, clearing the screening test, and completing his internship based on the provisional registration granted by the 2 nd respondent, the respondents are estopped from refusing to grant permanent registration. The counsel referred to Regulation 11 of the Screening Test Regulation, 2002, which reads thus:
"11. The Prescribed Authority shall intimate the result of the Screening Test to the candidates as wel as to the Secretary, Medical Council of India and the State Medical W.P.(C)No.34898 of 2022 -7- 2025:KER:45786 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 Medical Council for provisional registration/permanent registration along with the requisite registration fee in favour of Secretary, Medical Council of India or State Medical Council. The Medical Council of India or State Medical Councils shall issue provisional registration to such successful candidates, who are yet to undergo one year internship in an approved institution and issue permanent registration to such eligible candidates who have already undergone one year internship, as the case may be."
4. The counsel for the petitioner relied on the decision of a Division Bench of this Court in Travancore Cochin Council of Modern Medicine v. Leeba Mary Eapen & Ors. [2021 SCC OnLine Ker 1272], to submit that once the petitioner had cleared the Screening Test, permanent registration cannot be refused. The judgment in Praveen Kumar M. & Ors. v. Union of India & Ors. [2012 (4) KHC 413], affirmed by a Division Bench in appeal, is also relied on for the above contention.
5. A counter-affidavit has been filed by the respondents 2 and 3. It is contended that the prayer for a declaration that the petitioner is entitled to get permanent registration under Section W.P.(C)No.34898 of 2022 -8- 2025:KER:45786 25(4) of the 1956 Act is not maintainable since the said Act was repealed by Section 60 of the National Medical Commission Act, 2019. Consequently, it is submitted that the third prayer in the writ petition has become infructuous. It is submitted that Section 35 of the Act provides for an appeal from every decision of the Council, particularly its orders under Sections 25, 28, and 33 of the Act. The petitioner is thus having an efficacious, alternative remedy by way of an appeal against the Ext.P11 order before the Government. Reliance is placed on the decision of a learned Single Judge of this Court in Union Bank of India & Ors. v. K.J.Jose & Ors. [2022 (2) KHC 739] in support of the above contention. The respondents assert that the petitioner had completed his medical degree through an off-campus mode and has not undergone a regular course of study at the University. It is pointed out that the petitioner admittedly underwent part of his studies in India, which shows that he had not undergone the regular mode of studies as in India. The conflict in the pleadings on this aspect, is pointed out by referring to Ext.P13 letter. It is submitted that at the time of consideration of the application for provisional registration submitted on 01.10.2019, the petitioner was informed about the decision of the Council, taken at the meeting held on W.P.(C)No.34898 of 2022 -9- 2025:KER:45786 09.03.2018, not to consider the applications for temporary/ permanent registration of medical graduates who had obtained foreign medical degree through off campus mode. It is stated that after the judgment of this Court in W.P.(C)No. 12454/2020, the Council verified the petitioner's application and the documents he submitted and it was found that he had completed the medical course in different colleges and thus had not undergone a regular course of study in the University in which he had taken admission. Accordingly, the Council decided not to grant permanent registration to the petitioner and issued Exhibit P11 order/proceedings. It is contended that the provisions of the Indian Medical Council Act, 1956, will not apply to the petitioner since it was repealed by Section 60 of the National Medical Commission Act, 2019. It is submitted that the petitioner's contention that he had undergone a regular course cannot be decided based on Ext.P7, since it is truncated. It is submitted that mere entry and exit visas, stamped from a country (St. Lucia), cannot be considered conclusive to prove that the petitioner has undergone a regular course of study there. Regarding Ext.P13, it is submitted that, admittedly, the first phase of the course was completed on the St.Lucia campus, and part of the studies were W.P.(C)No.34898 of 2022 -10- 2025:KER:45786 completed by him from the SRM Medical College Hospital and Research Centre and Christian Medical College, Vellore, in India, while Ext.P13 speaks of completion of the Clinical Science phase in various hospitals in Caribbean islands and other affiliated hospitals in the UK and the USA. According to the respondents, the National Medical Council or its Predecessor Council does not allow the transfer of House Surgency to any other hospital except where they studied for medical graduation. It is contended that medical education in India does not permit distant or Off-campus education, as the medical profession requires more skill and on hand experience than any other profession, and any deficiency in service will adversely affect public health. It is submitted that before giving registration to a medical graduate to practice, the Council is bound to ensure that the said person is eligible and equipped for medical practice in India. Reference is made to the decision of the Hon'ble Supreme Court in Orissa Lift Irrigation Corporation Ltd. v. Rabi Sankar Patro & Ors. (C.A.No. 17869-17870 of 2017), wherein the Apex Court has deprecated the practice of conferring degrees in engineering undertaken through the distance education mode. It is submitted that the Health Sector is much more vital than the technical education field, W.P.(C)No.34898 of 2022 -11- 2025:KER:45786 as it involves human health and life, which is all the more reason not to permit persons who have obtained their medical degrees through off off-campus mode to practice medicine in the State of Kerala. It is contended that permanent registration is granted in terms of the provisions of Section 24 of the 2021 Act, and not in terms of Section 25(4) of the Indian Medical Council Act. It is contended that the doctrine of promissory estoppel cannot be applied in the case of the petitioner, merely for the fact that he had passed the FMG examination, and that the dictum laid down by the Hon'ble Supreme Court in the decision reported in Saai Prasanna (supra) is not applicable. It is submitted that the judgment of the Hon'ble Supreme Court in National Medical Commission v. Pooja Thandu Naresh [(2022) 13 SCC 56], governs the issue.
6. The Deputy Solicitor General has filed a statement. It is stated that the Joint Secretary, CPV Division of the Ministry of External Affairs, by an email dated 07.08.2023, has addressed the Ambassador, Paramaribo, in the following manner:
"The Mission is doing attestation of the signature of competent authorities of a foreign Government. In this case it was the signature of Saint Lucia authority only. The W.P.(C)No.34898 of 2022 -12- 2025:KER:45786 diplomatic Missions are not the competent authorities to extend recognition or approval for educational qualifications. The degree in respect of Shri Selbian Boban was attested keeping the above position in view.
The Mission, is separately sending a note verbale to St. Lucian authorities seeking a clarification whether enrolment as a medical practitioner in the country is permitted or not. However, we know as a matter of fact that Saint Lucia does not permit students coming out of such universities to automatically get a licence to practise. They have to pass some exams external to the University to get a licence".
It is also submitted that the St. Lucian authorities, vide their diplomatic note, had clarified that students who have completed their studies at the AIMU must successfully pass the Caribbean Association of Medical Councils Examination (CAMC) and an internship at a local medical facility before being able to practice in St. Lucia or the CARICOM.
7. Heard Sri James Abraham (Vilayakattu) for the petitioner, Sri K.S. Prenjith Kumar, Standing Counsel for the 1 st respondent, Sri N.Raghuraj, Senior Advocate, instructed by Sri Vivek Menon for respondents 2 and 3 and Sri V. Girish Kumar, Central Government Counsel for respondents 4 and 5. W.P.(C)No.34898 of 2022 -13-
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8. Section 25 of the 1956 Act reads thus;
"25. Provisional registration.--(1) A citizen of India possessing a medical qualification granted by a medical institution outside India included in Part II of the Third Schedule, who is required to undergo practical training as prescribed under sub-section (3) of Section 13, shall, on production of proper evidence that he has selected for such practical training in an approved institution, be entitled to be registered provisionally in a State Medical Register and shall be entitled to practice medicine in the approved institution for the purposes of such training and for no other purpose. (2) A person who has passed the qualifying examination of any University or medical institution in India for the grant of a recognised medical qualification shall be entitled to be registered provisionally in a State Medical Register for the purpose of enabling him to be engaged in employment in a resident medical capacity in any approved institution, or in the Medical Service of the Armed Forces of the Union, and for no other purpose, on production of proper evidence that he has been selected for such employment.
(3) The names of all persons provisionally registered under sub-section (1) or sub-section (2) in a State Medical Register shall be entered therein separately from the names of other persons registered therein.
(4) A person registered provisionally as aforesaid who has completed practical training referred to in sub-section (1) or who has been engaged for the prescribed period in employment in a resident medical capacity in any approved institution or in the Medical Service of the Armed Forces of W.P.(C)No.34898 of 2022 -14- 2025:KER:45786 the Union, as the case may be, shall be entitled to registration in the State Medical Register under section 15."
9. The Council is constituted in terms of Section 3 of the Kerala State Medical Practitioners Act, 2021 (hereinafter referred to as the 2021 Act). Section 24 of the 2021 Act states the eligibility for registration. It reads thus:
"24. Eligibility for registration.-- (1) Every holder of a recognized qualification of Modern Medicine acquired by a regular mode of education attending theory of medical science and sufficient number of days of practical training from recognized institution, is eligible to be registered as medical practitioner under this Act.
(2) No person shall be eligible for registration under sub-
section (1), if he is subject to any of the disqualifications mentioned in clauses (a) to (d) of section 11."
10. Respondents 2 and 3 contend that the petitioner admittedly underwent part of his studies in India, which would show that he had not acquired the Medical Degree through the regular mode of studies as in India. Hence, the rejection of the petitioner's application for permanent registration is contended to be legally correct. Reliance is placed on the statement filed by the DSGI on behalf of respondents 4 and 5, wherein it is stated that the Saint Lucian authorities vide their diplomatic note had clarified that students who have completed their studies at the AIMU must W.P.(C)No.34898 of 2022 -15- 2025:KER:45786 successfully pass the Caribbean Association of Medical Councils Examination (CAMC) and an internship at a local medical facility before being able to practice in Saint Lucia or the CARICOM. The respondents submit that admittedly, the petitioner has not completed all the requirements for being able to practice in St. Lucia or CARICOM.
11. In Saai Prasanna (supra), in paragraph 15, the Hon'ble Supreme Court held as follows;
"15. The second contention of MCI is also untenable. It is true that if the primary medical qualification of the candidate was not a recognized qualification for enrolment as medical practitioner in the country in which the institution awarding the said qualification is situated, such candidates will not entitled to take part in the screening test examination in India. In this case the High Commission of India in Tanzania has confirmed the following: (i) that Tanzania Medical Council has recognized the curriculum and medical degree of MBBS of International Medical & Technological, University Dar-es-Salaam, Tanzania as equivalent to MD degree in Tanzania; and (ii) that the medical degrees offered to the said International Medical & Technological University, Tanzania are recognized by Medical Council of Tanzania and the MBBS graduates of the said university are eligible for registration as Medical practitioners by the Medical Council of Tanzania under the provisions of the Medical Practitioners & Dentists Act, Cap 152 of the Laws of Tanzania. Therefore, the question of such primary degree not being recognized in India for the purpose of sitting in the screening test W.P.(C)No.34898 of 2022 -16- 2025:KER:45786 examination does not arise."
12. On facts, the Court held that the qualification which the respondents before the Hon'ble Supreme Court possessed made them eligible for registration as medical practitioners by the Medical Council, Tanzania as per the laws of Tanzania and the question of such primary degree not being recognised in India to sit in the screening test examination does not arise. Going by the statement filed by the DSGI, and the above observations of the Hon'ble Supreme Court, the qualification of the petitioner is not sufficient to permit him to practice in Saint Lucia.
13. In Praveen Kumar (supra), a learned Single Judge of this Court considered the denial of provisional registration since students studied in Off-Campus Centres of the Foreign Medical Centres in India. This Court considered Regulation 4(3) of the Screening Test Regulations 2002, which stipulates that a candidate who has studied for the Medical Course in an institution located abroad should undergo the entire duration of the course in that institution, was introduced only with effect from 16.04.2010, and held that the Medical Council of India cannot be heard to contend that the said stipulation will have retrospective effect and govern the rights of students like the petitioners who had completed their W.P.(C)No.34898 of 2022 -17- 2025:KER:45786 studies before the calendar year 2010 commenced. The said situation does not arise in this case since the petitioner completed the course much after 2010. In the said case, the learned Single Judge had relied on the decision in Saai Prasanna (supra). After referring to the said decision, this Court noted that in the case of persons who have obtained medical qualification from the Medical Institutions outside India, the question as to where the course of study was undergone is not relevant, and that the course of study could be in that country or if the norms of the Medical Council of that country so permitted, the course of study could be partly in that country and partly in another country including India, and once that country recognises the medical qualification granted by the institution in that country for enrolment as a medical practitioner in that country, and if such medical degree holder passes the screening test in India, the Medical Council of India cannot refuse to recognise such a degree.
14. In Rohit Naresh Agarwal v. Union of India [W.P. (C)No.1655/2013 & connected cases], the High Court of Delhi considered a challenge to Clause 4(3) of the Screening Test Regulations, 2002 and held that the Regulation is ultra vires the Act and liable to be set aside. The Regulation was thereafter W.P.(C)No.34898 of 2022 -18- 2025:KER:45786 amended in 2016 by adding a proviso to Clause 4(3), permitting the Council to relax the requirement regarding study at the same institute located abroad for the entire duration of the course. The judgment of the High Court of Delhi was challenged by the Medical Council of India in Civil Appeal No.11321 of 2013 before the Hon'ble Supreme Court and the Hon'ble Supreme Court held that it does not find any error in the decision rendered by the High Court in declaring Regulation 4(3) of the Screening Test Regulations, 2002 as ultra vires. A learned Single Judge of this Court had considered the issue in W.P.(C)No.39576/2018 and by judgment dated 21.08.2019, dismissed the writ petition. The petitioners before the Court were holders of a Medical Degree from various Universities in China and Nepal, and the question considered was whether they had the necessary qualification to practice in the country from which they acquired their Medical Degrees, and it was held that they could not.
15. The issue again came up before a Division Bench of this Court in Leeba Mary Eapen (supra). This Court held as follows:
"30. In our considered opinion, when the said provisions of the Regulations, 2002 and the Foreign Medical Institution Regulations, 2002 as discussed above are read together, a candidate who secures an eligibility certificate and acquires a W.P.(C)No.34898 of 2022 -19- 2025:KER:45786 primary foreign medical qualification, and passes the screening test, entitles him to provisional/permanent registration by the Medical Council of India or the State Medical Council, as of right. This we say because, Section 13(4A) clearly specifies that a person who is a citizen of India and obtains medical qualification granted by any medical institution outside India shall not be entitled to be enrolled on any medical register maintained by a State Medical Council, etc. unless he qualifies the screening test in India prescribed for such purpose and thereafter such foreign medical qualification shall be deemed to be the recognised medical qualification for the purposes of the Act, 1956 for that person. As we have pointed out earlier, the writ petitioner has satisfied the conditions deliberated above in terms of the Act, 1956 and both the Regulations of 2002. Therefore, it is clear that by virtue of the said provisions, a right is conferred on the writ petitioner who satisfied the conditions of law for the purpose of registration in any of the registers maintained by the statutory authorities for the purpose, and post qualification accordingly, the qualification secured by the person from abroad, by virtue of the statutory fiction contained under Section 13(4A) shall be a recognised qualification under the Act, 1956. That apart, the definition of provisional registration contained under the Regulations of 2002 makes it clear that it is done for the purpose of undergoing practical training in India as prescribed, by those persons who have not undergone such practical training after obtaining the qualification as may be required by the rules or regulations in force in the country granting the qualification, which by itself is a mechanism to W.P.(C)No.34898 of 2022 -20- 2025:KER:45786 regulate and control the practice of medicine. The documents produced by the petitioner and discussed above would make it clear that they are satisfying the requirements of the provisions of law in the Indian context, which were taken note of by the learned Single Judge while analysing the situations."
16. The above judgment was challenged by the Travancore Cochin Medical Council before the Hon'ble Supreme Court in SLP No.7293 of 2021, and the operation of the judgment was stayed by order dated 30.06.2021. However, SLP No.7293 of 2021 has thereafter been dismissed by the Hon'ble Supreme Court by judgment dated 31.10.2023, observing that the Court is not inclined to interfere with the judgment and order of the High Court.
17. In Sadhiya Siyad v. State of Kerala & Ors. [2021 KHC 5832], a learned Single Judge of this Court considered the entitlement for registration with the Travancore Cochin Medical Council to practice Medicine in terms of the Travancore Cochin Medical Practitioners Act, 1953. Paragraph 21 of the judgment reads thus;
"21. That apart, Section 13(4B) of the IMC Act itself provides that in case any person obtains any medical qualification without obtaining Eligibility Certificate, he shall not be W.P.(C)No.34898 of 2022 -21- 2025:KER:45786 eligible to appear for the Screening Test. In other words, going by the said provision, the consequence of omission to obtain Eligibility Certificate is only that the candidate concerned will not be eligible to appear for the Screening Test. As far as the present case is concerned, the fact that the petitioner was permitted by the competent authority to appear for Screening Test and the fact that she has cleared the Screening Test are not disputed by the State Medical Council. True, the State Medical Council, while considering applications for registration, both provisional and permanent, has the power to verify whether the candidate has obtained Eligibility Certificate, but that does not mean that the State Medical Council is empowered to adjudicate the right of a person to obtain Eligibility Certificate and to appear for the Screening Test, ignoring the decisions taken by the Medical Council of India in this regard. As such, according to me, if it is found that a candidate has appeared for the Screening Test without there being any eligibility for the same, the State Medical Councils can only bring the said fact to the notice of the Medical Council of India to initiate appropriate proceedings for recalling the result of the Screening Test. I take this view for the reason that in terms of the provisions of the IMC Act, it is for the Medical Council of India to consider whether a particular candidate is eligible to obtain Eligibility Certificate and appear for the Screening Test. If it is held that the State Medical Councils are empowered to adjudicate the eligibility of a candidate to appear for the Screening Test in which he has been qualified, the State Medical Councils will be able to nullify the results of the Screening Test collaterally, which would, in turn, affect the W.P.(C)No.34898 of 2022 -22- 2025:KER:45786 sanctity of the statutory Screening Test. In other words, once a candidate qualifies the Screening Test, the State Medical Council cannot reject the application for registration preferred by him on the ground that he was not eligible to appear for the Screening Test. It is all the more so since Section 13(4A) of the IMC Act provides that a person who obtains medical qualification granted by any medical institution outside India recognised for enrolment as a medical practitioner in that country shall be entitled to be enrolled on any State Medical Register, if he clears the Screening Test. Yet another reason for arriving at the said conclusion is that, as noted earlier, Regulation 11 of the Regulations also provides that candidates who qualify the Screening Test may apply to any State Medical Council for provisional or permanent registration and the State Medical Councils shall issue provisional registration to such candidates, who are yet to undergo one year internship in an approved institution and issue permanent registration to such eligible candidates who have already undergone one year internship, as the case may be. In other words, if a candidate satisfies all the requirements for enrolling as a medical practitioner on a State Medical Register in India in accordance of the provisions of the IMC Act and the Regulations made thereunder, he cannot be denied registration by a State Medical Council. If the petitioner satisfies all the requirements for enrolling as a medical practitioner on a State Medical Register in accordance with the provisions of the IMC Act as also the regulations made thereunder, the State Medical Council cannot deny enrolment to her on the ground that she has obtained Eligibility W.P.(C)No.34898 of 2022 -23- 2025:KER:45786 Certificate after taking admission to the medical institution abroad and was consequently not eligible to appear for the Screening Test. As far as the case on hand is concerned, the petitioner satisfies all the eligibility criteria for registration in accordance with the provisions of the IMC Act and the regulations made thereunder and as such, she cannot be denied registration on the said ground. Question (ii), in the circumstances, is answered in favour of the petitioner."
18. The following directions were issued by the learned Single Judge in the last paragraph of the said judgment;
"In the result, the writ petitions are disposed of directing the State Medical Council to permit the petitioner to apply for the permanent registration, and if applied, grant permanent registration to the petitioner without insisting her to undergo CRRI, if the application of the petitioner is otherwise in order. This shall be done within two months. It is made clear that this judgment will not preclude the State Medical Council from bringing to the notice of the National Medical Commission the requirement, if any, for the foreign medical graduates to undergo internship afresh to get acclimatized with the diseases and requirements of treatment peculiar to the State in order to bring in force appropriate statutory amendments."
19. Senior Counsel appearing for the Council submitted that the learned Single Judge had, in the above judgment, assumed that the Screening Test was conducted by the Medical Council of India and that, in fact, it is conducted by the National Board of W.P.(C)No.34898 of 2022 -24- 2025:KER:45786 Examination. The said contention is not very relevant since the Test is conducted under the Screening Test Regulation, 2002, which lays down the necessary criteria.
20. In Pooja Thandu Naresh (supra) relied on by the Senior Counsel, the Hon'ble Supreme Court was considering a challenge to the judgment of the High Court of Madras, whereby the writ petitioners were directed to undergo two months of Compulsory Rotatory Residential Internship, followed by one year of internship, before granting permanent registration under the Indian Medical Council Act, 1956. That was a case in which, after qualifying the eligibility test, students joined Colleges in the Republic of China and completed nine semesters of their academic course, including clinical training on the campus. Due to the 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 were 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. They qualified in the Screening Test and sought provisional registration, which was not granted. After extracting the provisions in the Screening Test W.P.(C)No.34898 of 2022 -25- 2025:KER:45786 Regulation regarding Permanent Registration, Provisional Registration, Primary Medical qualification, Eligibility criteria, and the Criteria to recognise Foreign Medical Graduates applying for Licence or permanent registration for practice in India, contained in Schedule I issued under Regulation 4, and the clarification issued on 4.3.2022 that the 2021 Regulations are not applicable to students who acquired a foreign medical degree prior to 18.11.2021, the Apex Court in paragraphs 13,14,15,17,19,20 and 22 held as follows:
"13. We have heard the learned counsel for the parties and find that the reliance on the judgment of this Court in Medical Council of India [Medical Council of India v. J. Saai Prasanna, (2011) 11 SCC 748] 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 [J. Sai Prasanna v. Medical Council of India, 2008 SCC OnLine AP 221], Regulation 4(3) of the Screening Test Regulations was inserted to make 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. 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.
14. The fact is that the student has admittedly not W.P.(C)No.34898 of 2022 -26- 2025:KER:45786 completed clinical training, which was part of the curriculum in the tenth semester; maybe 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 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 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.
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17. The students had taken admission in medical colleges outside 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 Test 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 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 W.P.(C)No.34898 of 2022 -27- 2025:KER:45786 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 the basis of an endorsement that the completion of such medical course 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 practise medicine in India. The very framework of the Regulations was compromising the interests of the Indian nationals and the health 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.
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 provisional registration will not confer any right on 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 in Chandigarh Admn. v. Jagjit Singh [Chandigarh Admn. v. Jagjit Singh, (1995) 1 SCC 745].
22. However, the fact remains that the students were permitted to undergo a medical course abroad and that they have completed their curriculum according to the certificate granted by such a Foreign Institute. Therefore, such national resources cannot be permitted to be wasted, which will W.P.(C)No.34898 of 2022 -28- 2025:KER:45786 affect the lives of young students who have taken admission in foreign institutes as part of their career prospects. Therefore, the services of the students should be used to augment the 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 the charges for imparting such training, as may be notified by the appellant."
21. Unlike before the Hon'ble Supreme Court, in the case on hand, the petitioner completed his first phase in the University and the second phase, as permitted by the laws relating to the foreign University, was completed in different Colleges spread out outside the Caribbean. The only objection put forward is that the second phase was not completed on the same University campus. The petitioner was permitted to take the Screening Test, granted provisional registration based on the successful completion of the Screening Test, and thereafter, he completed the internship at Kottayam Medical College. The case of the petitioner is to be considered in the light of the observations of the Apex Court in paragraph 22 of the judgment extracted above. The petitioner has a foreign medical degree granted by a recognised University. He has undergone the Screening Test as well as an internship after W.P.(C)No.34898 of 2022 -29- 2025:KER:45786 the provisional registration. He is hence entitled to permanent registration, entitling him to practice in India. The above conclusion is also in consonance with the decisions of this Court, in Praveen Kumar (supra), Sadhiya Siyad (supra), and in Leeba Mary Eapen (supra), which has been confirmed by the Hon'ble Supreme Court.
The petitioner is entitled to succeed. The writ petition is allowed. Ext.P11 is quashed. It is declared that the petitioner is entitled to get permanent registration under the provisions of the Indian Medical Council Act, 1956, the National Medical Commission Act, 2019, and the Kerala State Medical Practitioners Act 2021. The 2nd respondent is directed to grant permanent registration under the provisions of the Indian Medical Council Act, 1956, the National Medical Commission Act, 2019, and the Kerala State Medical Practitioners Act 2021, to the petitioner, within one month from the date of receipt of a copy of this judgment.
Sd/-
T.R.RAVI JUDGE dsn W.P.(C)No.34898 of 2022 -30- 2025:KER:45786 APPENDIX OF WP(C) 34898/2022 PETITIONER'S EXHIBITS Exhibit P1 TRUE COPY OF THE RELEVANT EXTRACT OF THE WORLD DIRECTORY OF MEDICAL SCHOOLS SHOWING AMERICAN INTERNATIONAL MEDICAL UNIVERSITY, SAINT LUCIA.
Exhibit P2 TRUE COPY OF THE RELEVANT PAGES OF LIST OF
APPROVED UNIVERSITIES SHOWING AMERICAN
INTERNATIONAL MEDICAL UNIVERSITY, SAINT LUCIA DOWNLOADED AND PRINTED FROM THE OFFICIAL WEBSITE OF MEDICAL COUNCIL OF INDIA.
Exhibit P3 TRUE COPY OF THE LETTER DATED 18.7.2013 ISSUED BY THE AMERICAN INTERNATIONAL MEDICAL UNIVERSITY, SAINT LUCIA TO THE PETITIONER.
Exhibit P4 TRUE COPY OF THE MBBS CERTIFICATE DATED
31.12.2018 ISSUED BY THE AMERICAN
INTERNATIONAL MEDICAL UNIVERSITY, SAINT
LUCIA.
Exhibit P5 TRUE COPIES PUBLIC NOTICES ISSUED IN THE
OFFICIAL WEBSITE OF THE 1ST RESPONDENT
GRANTING EXEMPTION TO OBTAIN ELIGIBILITY
CERTIFICATE.
Exhibit P6 TRUE COPY OF THE SCREENING TEST RESULT DATED
7.9.2019 ISSUED BY THE NATIONAL BOARD OF
EXAMINATIONS TO THE PETITIONER.
Exhibit P7 TRUE COPY OF RELEVANT PAGES OF PASSPORT
Exhibit P8 A TRUE COPY OF THE CERTIFICATE OF PROVISIONAL
REGISTRATION DATED 27.7.2020.
Exhibit P9 A TRUE COPY OF THE CRRI COMPLETION
CERTIFICATE DATED 26.10.2021 ISSUED BY THE
GENERAL HOSPITAL, KOTTAYAM.
Exhibit P10 A TRUE COPY OF THE JUDGMENT DATED 15.7.2022
IN W.P. NO. 12454/2020.
Exhibit P11 A TRUE COPY OF THE ORDER NO. C2-25310/2021/MC
DATED 2.9.2022.
Exhibit P12 A TRUE COPY OF THE DECISION OF MODERN
MEDICINE COUNCIL HELD ON 20.9.2019 AND
ENGLISH TRANSLATION OF THE SAME.
Exhibit P13 TRUE COPY OF THE LETTER DATED 29.1.2020 SENT
BY THE AMERICAN INTERNATIONAL MEDICAL
UNIVERSITY TO THE 2ND RESPONDENT.
Exhibit P14 A TRUE COPY OF THE OFFICIAL TRANSCRIPT ISSUED
BY THE AMERICAN INTERNATIONAL MEDICAL
W.P.(C)No.34898 of 2022
-31-
2025:KER:45786
UNIVERSITY, WHICH IS ATTESTED BY THE EMBASSY OF INDIA.
Exhibit P15 A TRUE COPY OF CERTIFICATE DATED 25.4.2016 ISSUED BY THE SRM MEDICAL COLLEGE HOSPITAL & RESEARCH CENTRE TAMILNADU Exhibit P16 A TRUE COPY OF CERTIFICATE DATED 9.5.2016 ISSUED BY THE CHRISTIAN MEDICAL COLLEGE, VELLORE.
Exhibit P17 A TRUE COPY OF THE RELEVANT PAGE DOWNLOADED FROM THE WEBSITE OF THE MEDICAL COUNCIL OF INDIA SHOWING THE REGISTRATION DETAILS OF PERSON WHO ACQUIRED DOCTOR OF MEDICINE FROM AMERICAN INTERNATIONAL MEDICAL UNIVERSITY, SAINT LUCIA, WEST INDIES.
Exhibit P18 A TRUE COPY OF THE RELEVANT PAGE DOWNLOADED FROM THE WEBSITE OF THE MEDICAL COUNCIL OF INDIA SHOWING THE REGISTRATION DETAILS OF PERSON WHO ACQUIRED DOCTOR OF MEDICINE FROM AMERICAN INTERNATIONAL MEDICAL UNIVERSITY, SAINT LUCIA, WEST INDIES RESPONDENT EXHIBITS EXHIBIT.R2[A] TRUE COPY OF THE MINUTES OF MODERN MEDICINE COUNCIL DATED.2.9.2022