Under Graduate Medical Education Board vs V.N. Public Health And Educaiton Trust on 29 October, 2025

[Cites 44, Cited by 0]

Kerala High Court

Under Graduate Medical Education Board vs V.N. Public Health And Educaiton Trust on 29 October, 2025

The appellants, who are respondents 1 and 2 in W.P.(C)No. 32178 of 2025, have filed this writ appeal, invoking the provisions under Section 5(i) of the Kerala High Court Act, 1958, challenging the judgment dated 08.10.2025 of the learned Single Judge in that writ petition.

2. W.P.(C)No.32178 of 2025 is one filed by the petitioners (respondents 1 and 2 herein), namely, V.N. Public Health and Educational Trust and its Managing Trustee, seeking a writ of certiorari to quash Ext.P1 order dated 22.08.2025 of the 2nd respondent National Medical Commission (2nd appellant herein), in the appeal filed by Palakkad Institute of Medical Sciences, Walayar, under Section 22(3) of the National Medical Commission Act, 2019, read with Section 9 of the Maintenance of Standards of Medical Education Regulations, 2023, and Ext.P13 order dated 14.07.2025 of the 1st respondent Under Graduate Medical Education Board (1st appellant herein), whereby the Board decided to reduce 50 seats in Palakkad Institute of Medical Sciences, and 2025:KER:80819 W.A.No.2466 of 2025 4 granted conditional renewal of only 100 MBBS seats, for the academic session 2025-26; a declaration that for the institutions granted Letter of Permission (LoP) under the Establishment of Medical College Regulations, 1999, read with the Minimum Standard Requirements for 150 MBBS Admissions Annual Regulations, 1999, and the Minimum Requirements for Annual MBBS Admissions Regulations, 2020, yearly renewals till the grant of Letter of Recognition is governed by said norms; a writ of mandamus commanding the respondents (1st and 2nd appellants and the 3rd respondent University) to permit the petitioners to admit second batch of 150 MBBS students during the academic session 2025-26; a writ of mandamus commanding the respondents to grant LoP to the petitioners for 150 MBBS seats during the academic session 2025-26; and a writ of mandamus commanding the 3rd respondent Kerala University of Health Sciences to grant order of Continuation of Provisional Affiliation for 150 MBBS seats during the academic session 2025-26.

3. In W.P.(C)No.32178 of 2025, the petitioners sought for an interim order to permit them to admit the second batch of 150 MBBS students during the academic session 2025-26 and to direct 2025:KER:80819 W.A.No.2466 of 2025 5 the respondents to pass appropriate orders for the purpose thereof, pending disposal of the writ petition. On 25.08.2025, when the writ petition came up for admission as a 'today motion', it was adjourned to 27.08.2025. On 27.08.2025, the petitioners filed I.A.No.1 of 2025 for accepting an affidavit sworn to by the 2nd petitioner stating additional facts.

4. By the interim order dated 27.08.2025, the learned Single Judge directed the respondents to permit the petitioners to admit the second batch of 150 MBBS students, during the academic session 2025-26. The 3rd respondent University was directed to pass appropriate orders for that purpose, as early as possible. On 09.09.2025, the petitioners filed I.A.Nos.2 and 3 of 2025 in W.P.(C)No.32178 of 2025. I.A.No.2 of 2025 was filed seeking an order directing the respondents to pass orders in compliance with the interim order dated 27.08.2025, within a time limit to be stipulated by this Court, so as to enable the petitioners to admit 150 students in the second round of counselling, in terms of Ext.P22 revised NEET-UG Schedule-2025 issued by the 2nd respondent National Medical Commission. I.A.No.3 of 2025 was filed seeking an order to accept Ext.P22 as an additional 2025:KER:80819 W.A.No.2466 of 2025 6 document.

5. On 16.09.2025, when W.P.(C)No.32178 of 2025 came up for consideration, the learned Single Judge directed the respondents to get instructions as to why a contempt of court action should not be taken against them for not complying with the directions in the interim order dated 27.08.2025. Challenging the interim order dated 27.08.2025 of the learned Single Judge in W.P.(C)No.32178 of 2025, respondents 1 and 2 (appellants herein) had approached this Court in W.A.No.2236 of 2025. The said writ appeal was allowed by the judgment dated 22.09.2025, whereby the interim order dated 27.08.2025 of the learned Single Judge was set aside. By that judgment, both sides were directed to raise appropriate legal and factual contentions before the learned Single Judge in the pending writ petition.

6. By the impugned judgment dated 08.10.2025, the learned Single Judge allowed W.P.(C)No.32178 of 2025 and directed the respondents (1st and 2nd appellants and the 3rd respondent University) to permit the petitioners (respondents 1 and 2 herein) to admit the second batch of 150 MBBS students during the academic session 2025-26. As the third round of the 2025:KER:80819 W.A.No.2466 of 2025 7 allotment process was over, the learned Single Judge ordered that the petitioners shall be permitted to fill up the remaining seats, i.e., 50 MBBS seats out of 150 seats, through stray vacancy allotment. Paragraphs 24 to 27 and also the last paragraph of the judgment dated 08.10.2025 of the learned Single Judge read thus;

"24. It is therefore clear that the only relevant deficiency is the alleged inadequacy of the faculty. Here, it is not disputed that the petitioners satisfy the faculty requirement as per MSR-2020. The Apex Court has directed the respondents that MSR-2020 should be applied to the petitioners for the academic year 2024-25. As per Ext.P8, if MSR-2020 is applicable, the petitioners have to satisfy only phase-wise requirements. The petitioners, therefore, legitimately believed that they had time to increase the faculty. This is evident from Ext.P19 reply given by the petitioner to the University.

25. It must be kept in mind that the petitioners were given LoP to start the MBBS Course only on 04.07.2024. They have been conducting the Course as per MSR-2020 (though MSMER-2023 had come into force by then) as per the directions of the Apex Court. The MSR-2020 provided for phase-wise requirements. In the circumstances, if the petitioners have to increase the faculty as per MSMER- 2023, they should have been informed accordingly and given a reasonable time for compliance.

2025:KER:80819 W.A.No.2466 of 2025 8

26. The respondents cannot simply state that all Medical Colleges have to comply with MSMER-2023, because the Hon'ble Apex Court had specifically directed to apply MSR- 2020 to the petitioner for the year 2024-25 as a special case and under peculiar circumstances. In the circumstances of the case, reducing the intake capacity of the College from 150 to 100 without giving the petitioners a breathing time to come over to the MSMER-2023 can only be described as highly arbitrary, offending Article 14.

27. I am not inclined to accept the defence of the NMC as regards the availability of an alternate remedy, because in view of the facts of the case and the timeline involved, the appellate remedy will not be an efficacious alternate remedy.

In the facts and circumstances of the case, the writ petition is allowed. The respondents are directed to permit the petitioner to admit the second batch of 150 MBBS students during the academic session 2025-26. As the Round-3 allotment process is over, the petitioner shall be permitted to fill up the remaining of the 150 MBBS seats through the stray vacancy allotments."

7. Challenging the judgment dated 08.10.2025 of the learned Single Judge, the appellants-respondents 1 and 2 are before this Court in this writ appeal. By the order dated 17.10.2025, the operation of the impugned judgment of the learned Single Judge was stayed for a period of one week. On 21.10.2025, while reserving the writ appeal for judgment, the said 2025:KER:80819 W.A.No.2466 of 2025 9 interim order was extended for a period of 10 days.

8. We heard arguments of the learned Additional Solicitor General of India for the appellants, the learned counsel for respondents 1 and 2-petitioners and the learned Senior Counsel for the 3rd respondent University.

9. The learned Additional Solicitor General of India for the appellants contended that the learned Single Judge allowed W.P.(C)No.32178 of 2025 by the impugned judgment dated 08.10.2025 without properly appreciating the legal and factual contentions raised by the appellants. Without setting aside Ext.P13 order dated 14.07.2025 of the Under Graduate Medical Education Board and Ext.P1 order dated 22.08.2025 of the National Medical Commission, the learned Single Judge directed the appellants and the 3rd respondent University to permit the petitioners (respondents 1 and 2 herein) to admit second batch of 150 MBBS students in Palakkad Institute of Medical Sciences during the academic session 2025-26. The direction contained in Ext.P5 order dated 03.11.2023 of the Apex Court in W.P.(C)No. 1166 of 2023 was to conduct the inspection and complete the process for grant of approval to Palakkad Institute of Medical 2025:KER:80819 W.A.No.2466 of 2025 10 Sciences, for the academic session 2024-25, on the parameters that were prevailing for the academic session 2023-24. The said direction issued by the Apex Court in exercise of its powers under Article 142 of the Constitution of India was only for the academic session 2024-25. For continuing the approval for the academic session 2025-26, the medical institution has to comply with the requirements of the Guidelines for Under Graduate Courses under the Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses and Assessment and Rating Regulations, 2023 (UG-MSR 2023) and not the requirements of the Minimum Requirements for Annual MBBS Admissions Regulations, 2020 (MSR 2020). In support of the said contention, the learned ASGI referred to sub-section (2) of Section 61 of the National Medical Commission Act, 2019. UG-MSR 2023 notified on 16.08.2023, automatically replaced the previous Regulations, i.e., MSR 2020. Therefore, all medical institutions, regardless of the year of establishment, must comply with the requirements of UG-MSR 2023 for continuing the approval for MBBS course. The finding of the learned Single Judge in the impugned judgment that, if the medical institution of the 2025:KER:80819 W.A.No.2466 of 2025 11 petitioners (respondents 1 and 2 herein) had to increase the faculty as per the requirements of UG-MSR 2023, they should have been informed accordingly and given a reasonable time for compliance, is contrary to the mandatory requirements of UG-MSR 2023. Though MSR 2020 provided for phase-wise requirements, UG-MSR 2023 requires a medical institution to meet the requirements at the time of grant of approval for the first academic session. The finding of the learned Single Judge that the action of respondents 1 and 2 (the appellants herein) in reducing the annual intake in the medical institution from 150 MBBS seats to 100 seats, without giving the petitioners a breathing time to come over to UG-MSR 2023, is highly arbitrary and offending Article 14 of the Constitution of India, is absolutely without any legal basis. The learned ASGI relied on various decisions of the Apex Court to contend that the medical education will be incomplete, unless a medical institution can provide complete facilities as per the applicable regulations for imparting training to the students admitted in various disciplines. In view of the alternate remedy provided in the regulations, the learned Single Judge went wrong in entertaining the writ petition and exercising the extraordinary 2025:KER:80819 W.A.No.2466 of 2025 12 jurisdiction under Article 226 of the Constitution of India.

10. The learned Senior Counsel for the 3rd respondent University contended that the learned Single Judge committed a grave error in directing respondents 1 and 2 (the appellants herein) and the 3rd respondent University to permit the petitioners (respondents 1 and 2 herein) to admit second batch of 150 MBBS students in Palakkad Institute of Medical Sciences, during the academic session 2025-26, when the approval granted by the Under Graduate Medical Education Board and the Consent of Affiliation granted by the 3rd respondent University for that academic session is for 100 MBBS seats. The learned Senior Counsel adopted the arguments advanced by the learned ASGI on the requirements of UG-MSR 2023 for continuing the approval for the MBBS course in the medical institution in question. The learned Senior Counsel placed reliance on the decision of the Apex Court in V.N. Public Health and Educational Trust v. State of Kerala [(2021) 17 SCC 189], wherein it was reiterated that the decision taken by the Union of India based on the recommendation of the expert body cannot be interfered with lightly and an interference is permissible only when the medical institution 2025:KER:80819 W.A.No.2466 of 2025 13 demonstrates jurisdictional errors ex-facie perversity or mala fides.

11. The learned counsel for petitioners (respondents 1 and 2 herein) contended that the reasoning of the learned Single Judge in the impugned judgment dated 08.10.2025 is neither perverse nor patently illegal, and hence no interference is warranted in this intra-court appeal filed under Section 5(i) of the Kerala High Court Act, 1958. In view of the specific direction contained in Ext.P5 order dated 03.11.2023 of the Apex Court in W.P.(C)No.1166 of 2023, for continuing the approval of 150 MBBS seats in Palakkad Institute of Medical Sciences, for the academic session 2025-26, the petitioners are required only to comply with the requirements of MSR 2020, which provides for phase-wise requirements. The petitioners, vide Ext.P23 letter dated 19.09.2024 sought for a clarification from the Under Graduate Medical Education Board as to whether the requirements of MSR 2020 alone is applicable for continuing approval for the academic session 2025-26 and for admitting the second batch of 150 MBBS students, in view of the direction contained in Ext.P5 order dated 03.11.2023 of the Apex Court in W.P.(C)No.1166 of 2023. Without providing any 2025:KER:80819 W.A.No.2466 of 2025 14 clarification, the petitioners are required to comply with the requirements of UG-MSR 2023, without providing any breathing time to meet the said requirements. Therefore, the learned Single Judge rightly allowed the writ petition by the impugned judgment dated 08.10.2025. The learned counsel contended that the requirements of UG-MSR 2023 regarding bed occupancy and faculty position for 150 MBBS seats are not essential for imparting medical education to MBBS students during the 1st and 2nd year MBBS course and therefore, appellants and the 3rd respondent University ought to have granted permission for admitting students in the second batch of 150 MBBS seats, during the academic session 2025-26, based on the undertaking given by the petitioners in Ext.P12 reply dated 23.06.2025 to Ext.P11 show cause notice dated 15.05.2025 issued by the Under Graduate Medical Education Board. In Ext.P12 reply, the petitioners have given an undertaking to comply with the requirements of UG-MSR 2023, within a period of one year, by recruiting additional faculty and making all necessary infrastructures, and improving clinical materials and other facilities. The learned counsel pointed out the requirements of MSR 2020 and UG-MSR 2023 regarding bed 2025:KER:80819 W.A.No.2466 of 2025 15 occupancy and faculty requirements for a medical institution with 150 MBBS seats. After referring to the provisions under UG-MSR 2023, the learned counsel contended that the Under Graduate Medical Education Board has ample power under the said Regulations to grant sufficient time to medical institutions to meet the requirements of the regulations, before imposing a penalty of reducing the number of seats for the MBBS course.

12. In exercise of the powers conferred vide sub-section (2) of Section 57 read with Sections 26, 28 and 29 of the National Medical Commission Act, 2019, the National Medical Commission made the Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses & Assessment and Rating Regulations, 2023, in short the Establishment of Medical institutions, Assessment and Rating Regulations, 2023. The said Regulations came into force with effect from 02.06.2023, the date of publication in the official gazette. Section 2(b) defines 'Assessment' to mean the process of evaluating a medical institution by the concerned authorities, as being compliant with the applicable Regulations, guidelines/ standards, and/or orders and circulars issued by the NMC and 2025:KER:80819 W.A.No.2466 of 2025 16 other authorities, as the case may be, from time to time. Section 2(c) defines 'MARB' to mean the Medical Assessment and Rating Board duly constituted under Section 16 of the National Medical Commission Act, 2019. Section 2(e) defines 'Consent of Affiliation' (in its abbreviated form CoA) to mean a letter in writing obtained from a recognised University, issued in the name of the applicant, agreeing to affiliate the medical institution for the award of the necessary qualifications by the University. Section 2(f) defines 'Essentiality Certificate' (in its abbreviated form EC) to mean written permission from the Central or concerned State Government or the Union Territory administration, as the case may be, for the establishment of a new medical institution. Section 2(i) defines 'MSR' to mean the Minimum Standards of Requirements as notified either by UGMEB or PGMEB, as the case may be, from time to time, which shall also include explanatory notes, circulars, advisories, etc., issued by the corresponding Boards or the Commission.

12.1. Section 4 of the Establishment of Medical Institutions, Assessment and Rating Regulations, 2023 (for brevity, 'EMAR- 2023') deals with the mandate of permission. As per Section 4, no 2025:KER:80819 W.A.No.2466 of 2025 17 medical college or medical institution can be established, or new medical course or courses can be started, unless it is granted permission by the MARB in writing, in response to an application submitted in this regard. As per the proviso to Section 4, any such permission by the MARB may be issued subject to such conditions as it may think fit to impose.

12.2. Section 10 of EMAR-2023 deals with eligibility criteria. As per sub-section (a) of Section 10, no medical institution shall be provided permission unless it satisfies the conditions pertaining to, but not limited to, physical infrastructure, teaching staff, clinical material and hospital as detailed in the MSRs notified from time to time. As per sub-section (b) of Section 10, without prejudice to anything stated in sub-section (a) above, the UGMEB or PGMEB, as the case may be, shall from time to time publish the MSR with such modifications or amendments required, keeping in mind the overall objectives of the Act. As per sub-section (c) of Section 10, notwithstanding anything stated above in Section 10, all modified or amended MSRs shall have to be implemented.

12.3. Section 26 of EMAR-2023 deals with the submission of annual disclosure reports. As per Section 26, all medical 2025:KER:80819 W.A.No.2466 of 2025 18 institutions shall furnish a Compulsory Annual Disclosure Report to UGMEB and/or PGMEB in compliance with the norms specified under the National Medical Commission Act, 2019 [Sections 24(i) and 25(h)] in the prescribed format and prescribed fee, with a copy to the MARB. As per the proviso to Section 26, the compulsory annual disclosure report shall be made once all students for the academic year are admitted to a given course and not later than thirty days, to be calculated from the date of the last student's admission. As per Section 27, notwithstanding anything stated elsewhere, failure to submit the annual disclosure report by the medical institution as indicated in Section 26 within a notified period shall amount to non-compliance and shall result in disciplinary proceedings under Chapter-V below. As per the proviso to Section 27, medical Institutions can use the Annual Disclosure as a form of self-appraisal and request the MARB for a voluntary decrease of seats/courses and also seek restitution of seats/courses appropriately.

12.4. As per Section 28 of EMAR-2023, it shall be the duty of all medical institutions to follow the regulations and directions issued by the MARB, both in letter and spirit, either within a 2025:KER:80819 W.A.No.2466 of 2025 19 specified time period or within a reasonable period of time, wherever the timelines are applicable. As per Section 29, which defines non-compliance, the acts or omissions enumerated in sub- sections (a) to (i) of a medical institute shall amount to non- compliance. Sub-section (a) of Section 29 deals with non- compliance with any of the regulations and notifications of the National Medical Commission issued from time to time. Sub- section (c) of Section 29 deals with deficiency in infrastructure, teaching staff, clinical material and others as prescribed by way of MSR or otherwise by UGMEB and/or PGMEB. Section 29 of EMAR- 2023 reads thus;

"29. Non-compliance defined - following acts or omissions of a medical institute shall amount to non-compliance.-

(a) Non-compliance with any of the regulations and notifications of the National Medical Commission issued from time to time.

(b) The medical institution has conducted in a manner which is not in accordance with the objectives of the medical institution and practices like ragging, exploiting students on fees, etc.

(c) Deficiency in infrastructure, teaching staff, clinical material and others as prescribed by way of MSR or otherwise by UGMEB and/or PGMEB.

(d) Any act of misbehavior, non-cooperation, forbidding the 2025:KER:80819 W.A.No.2466 of 2025 20 inspection process, etc., with the assessors representing the MARB or such other designated agency by the MARB in this regard.

(e) Physical misbehavior by teaching staff with the students, harassment of faculty and/or students by the management, etc.

(f) False information declared for obtaining permission for any of the schemes, including the establishment of a medical institution. (g) Falsifying information or fabricating evidence at the time of inspection by the MARB or constituent autonomous boards or NMC-appointed third parties.

(h) Any attempt to bribe or pressurise or threaten assessors or officials of NMC.

(i) Any such act or omission as notified by the NMC in this regard."

12.5. Section 30 of EMAR 2023 deals with penalties. As per Section 30, for any of the non-compliance or intentional attempt of non-compliance act or omission by the medical institution, the MARB shall either penalise the medical college or medical institution as per sub-section (f) of Section 26 of the Act and/or conduct further enquiry into such incident or act, and wherever needed, provide an opportunity to rectify the same. As per Section 31, without prejudice to anything stated in Section 30 above, the imposition of the penalty may include one/more/all of the 2025:KER:80819 W.A.No.2466 of 2025 21 penalties enumerated in sub-sections (a) to (h). Sub-section (d) of Section 31 deals with reducing the number of students in the next or subsequent academic years to be admitted by the medical institution. As per the first proviso to Section 31, the medical institution may be granted a reasonable opportunity to rectify the deficiencies, and any further action shall be taken if it fails to meet the requisite norms. Section 31 of EMAR 2023 reads thus;

"31. Without prejudice to anything stated in Section 30 above, the imposition of the penalty may include one/more/all of the following.-

(a) Issuance of warning with accommodation of reasonable time for compliance or rectification, as the case may be, by the medical institution.

(b) Monetary penalty not exceeding INR one crore per every non-compliance committed by the medical institution.

(c) Withholding processing of application for any new scheme/s for that academic year or for a such number of years.

(d) Reducing the number of students in the next or subsequent academic years to be admitted by the medical institution.

(e) Stoppage of admission to one or more of the courses in the next or subsequent academic years.

(f) Recommending to NMC for withdrawal of recognition.

(g) Withholding and withdrawal of rating of the medical institution for a period up to five academic years.

2025:KER:80819 W.A.No.2466 of 2025 22

(h) Any attempt to pressurize MARB or NMC through individuals or agency will lead to immediate halt of the processing of the application/request by the medical Institution.

Provided that the medical institution may be granted a reasonable opportunity to rectify the deficiencies, and any further action shall be taken if it fails to meet the requisite norms.

Provided further that, the MARB or the Commission may also initiate criminal proceedings for furnishing false information, or fabrication of false documents as per the criminal law in force at that time."

12.6. Section 32 of EMAR 2023 deals with an appeal to the Commission. As per Section 32, a medical institution or any such aggrieved person may file an appeal before the Commission with appropriate fees as specified against any orders passed or decision taken by the MARB, which shall comprise the following, (a) disapproval of a scheme; (b) where no decision is taken within six months of applying or request to the MARB for approval of any of the schemes; (c) imposition of penalty as per Section 31 of these Regulations. As per the proviso to Section 32, such an appeal to the Commission is filed within fifteen days of passing an order or decision taken by the MARB. Section 33 deals with an appeal to the Central Government. As per Section 33, where an applicant is 2025:KER:80819 W.A.No.2466 of 2025 23 aggrieved by the decision of the Commission under Section 15 or where the Commission fails to give its decision within forty-five days from the date of receipt of such an appeal, a second appeal may be filed before the Central Government within thirty days from the date of such order or lapse of time, as the case may be.

13. In exercise of the powers conferred by the National Medical Commission Act, 2019, and particularly by Sections 10, 24, 25 and 57, the National Medical Commission made the Maintenance of Standards of Medical Education Regulations, 2023 (for brevity, 'MSMER 2023') to ensure smooth compliance with its functions in general and particularly to maintain a high quality and high standards in medical education. MSMER 2023 came into force with effect from 21.09.2023, the date of publication in the official gazette. Section 3(f) of MSMER 2023 defines 'MSR' to mean the Minimum Standards Requirements as notified by the Post Graduate Medical Education Board (PGMEB) or the Under Graduate Medical Education Board (UGMEB), as such or by way of guidelines, and which shall also include explanatory notes, circulars, advisories, etc., issued from time to time.

13.1. Chapter II of MSMER 2023 deals with the Annual 2025:KER:80819 W.A.No.2466 of 2025 24 Disclosure Report and its evaluation. Section 4 deals with the mandate of annual disclosures. As per sub-section (1) of Section 4, after its establishment, the medical college or medical institution is obligated to furnish an Annual Disclosure Report to the corresponding Board, satisfying such conditions provided under the notified MSRs by UGMEB or PGMEB and regulations of the National Medical Commission (NMC), as the case may be. Section 4 of MSMER 2023 reads thus;

"4. Mandate of Annual Disclosure.- 1) After its establishment, the medical college or medical institution is obligated to furnish an Annual Disclosure Report to the corresponding Board, satisfying such conditions provided under the notified MSRs by UGMEB or PGMEB and regulations of NMC, as the case may be.

2) Without prejudice to anything stated above, the concerned Board may seek such additional information with regard to the Annual Disclosure Report, as and when deemed necessary for their assessment and otherwise from the concerned medical institution or concerned agencies having or exercising control over that medical college or medical institution.

3) It shall be the duty of the medical college or medical institution or the concerned agency or agencies exercising control over such medical college or medical institution to furnish the information (including additional information) to 2025:KER:80819 W.A.No.2466 of 2025 25 the concerned Board in the prescribed mode."

13.2. Section 5 of MSMER 2023 deals with the evaluation of the report. As per sub-section (1) of Section 5, keeping in mind the overall objectives of the National Medical Commission Act, the respective Board (PGMEB or UGMEB) may undertake the evaluation of the Annual Disclosure Report for verifying whether the medical college or medical institution fulfils the required conditions prescribed by way of MSRs or NMC Regulations, as the case may be, which shall include the matters enumerated in sub- sections (i) to (vii). The required conditions include the availability of the required number of qualified faculty for actual teaching and research, and to undertake necessary student learning activities on a regular and continued basis [sub-section (ii)]; availability of adequate clinical material in terms of number of patients of different specialties, variety of patients to fulfil all round training of students, number of variety of procedures, surgeries, laboratory investigations, radiological investigations and other relevant investigations [sub-section (iii)]; and other parameters related to standards of medical education that may be added from time to time by the respective boards or NMC [sub-section (vii)]. As per 2025:KER:80819 W.A.No.2466 of 2025 26 sub-section (4) of Section 5, if the applicant fails to submit such information or clarify or provide additional documents, etc., as mandated by the respective Board within such prescribed time, including any additional time provided by the respective Board, it shall be deemed as non-compliance with the Regulations and shall attract a penalty. Section 5 of MSMER 2023 reads thus;

"5. Evaluation of Report.- 1) Keeping in mind the overall objectives of the Act, the respective Board (PGMEB or UGMEB) may undertake the evaluation of the Annual Disclosure Report for verifying whether the medical college or medical institution fulfils the required conditions prescribed by way of MSRs or NMC Regulations, as the case may be, which shall include -

(i) verification of physical infrastructure;

(ii) availability of required number of qualified faculty for actual teaching and research and to undertake necessary student learning activities on a regular and continued basis;

(iii) availability of adequate clinical material in terms of number of patients of different specialties, variety of patients to fulfil all round training of students, number of variety of procedures, surgeries, laboratory investigations, radiological investigations and other relevant investigations;

(iv) assessment of the teaching methodology adopted;

(v) the methods and modes of assessment, grading of the students;

(vi) review of feedback from students;

2025:KER:80819 W.A.No.2466 of 2025 27

(vii) other parameters related to standards of medical education that may be added from time to time by the respective boards or NMC.

2) Without prejudice to (1) above or elsewhere in these Regulations, at its sole discretion, the respective Board may seek any additional information or clarification or additional documents, etc., from the medical college or medical institution while considering the Annual Disclosure Report referred above.

3) The Medical College shall furnish such information or clarification or additional documents, etc., sought under sub-section (2) above at the earliest, but not later than 30 days from the date of receipt of communication from the respective Board, or such additional time to be provided by the respective Board on specific request from the applicant in that regard.

Provided, the medical college or medical institution shall adhere to the prescribed format or pro-forma, while furnishing of information or clarification or additional documents, etc., as required by the concerned Board.

4) If the applicant fails to submit such information or clarify or provide additional documents, etc., as mandated by the respective Board within such prescribed time, including any additional time provided by the respective Board, it shall be deemed as non-compliance with the Regulations and shall attract penalty."

13.3. Section 6 of MSMER 2023 deals with joint or independent evaluation. Sub-section (1) of Section 6 provides 2025:KER:80819 W.A.No.2466 of 2025 28 that, notwithstanding anything stated elsewhere in these Regulations, any of the Board (other than corresponding Board) individually or collectively, may cause to evaluate the accuracy and/or truth and/or veracity of the averments made out in the Annual Disclosure Report from the medical college or medical institution. Sub-section (4) of Section 6 provides that, after such inspection under this Regulation, if the concerned Board or Boards contemplate any remedial measure or action, etc., such measure or action shall be intimated to the medical college or medical institution, through the concerned Board (UGMEB or PGMEB). Provided it shall be the administrative responsibility of the concerned Board to oversee that such measure or action intimated are duly complied with by the medical college or medical institution. Section 6 of MSMER 2023 reads thus;

"6. Joint or Independent Evaluation.- 1) Notwithstanding anything stated elsewhere in these Regulations, any of the Board (other than the corresponding Board), individually or collectively, may cause to evaluate the accuracy and/or truth and/or veracity of the averments made out in the Annual Disclosure Report from the medical college or medical institution.

2) When such evaluation as enumerated under sub-section (1) is undertaken, it shall be the duty of the concerned 2025:KER:80819 W.A.No.2466 of 2025 29 medical college or medical institution to provide all necessary support to the concerned Board or Boards as the case may be, in their course of evaluation, which shall also include disclosure of documents, providing additional evidence as the case may be, providing oral statements etc.

3) Without prejudice to anything stated above, the concerned Board or Boards conducting evaluation under this provision, shall mandatorily share such conduct of an evaluation and its outcome to other Boards and NMC at the earliest but not exceeding seven days.

4) After such inspection under this Regulation, if the concerned Board or Boards contemplate any remedial measure or action etc., such measure or action shall be intimated to the medical college or medical institution, through the concerned Board (UGMEB or PGMEB). Provided it shall be the administrative responsibility of the concerned Board to oversee that such measure or action intimated are duly complied with by the medical college or medical institution."

13.4. Section 7 of MSMER 2023 deals with the consequence of compliance. As per sub-section (1) of Section 7, if the medical college or medical institution is found to be successfully meeting requirements as prescribed for the UGMEB or PGMEB, as the case may be, the concerned Board shall provide a renewal certificate for continuation of the course/s and admission of students thereof for the next/coming Academic Year. As per sub-section (2) of 2025:KER:80819 W.A.No.2466 of 2025 30 Section 7, any deficiency noted will attract penalties with or without the decision above.

13.5. Section 8 of MSMER 2023 deals with penalties. As per sub-section (1) of Section 8, where the respective Board has reason to believe that a medical institution has failed to comply with any statutory provision, regulations framed thereunder or has not complied with the Minimum Standards of Requirements as prescribed by their respective Boards, or has conducted themselves in any manner which is not in accordance with the goals of medical education and practice, the Board shall either penalize the medical college or medical institution and/or conduct further enquiry into such act and wherever needed provide an opportunity to rectify the same. As per sub-section (2) of Section 8, without prejudice to anything stated at Section 8.1 above, the imposition of the penalty may include one/more/all of the matters enumerated in sub-sections (a) to (j). The penalty provided under sub-section (2) of Section 8 includes reducing the number of students in the next or subsequent academic years to be admitted by the medical institution. Section 8 of MSMER 2023 reads thus;

"8. Penalties.- 1) Where the respective Board has reason to 2025:KER:80819 W.A.No.2466 of 2025 31 believe that a medical institution has failed to comply with any statutory provision, regulations framed thereunder or has not complied with the Minimum Standards of Requirements as prescribed by their respective Boards, or has conducted themselves in any manner which is not in accordance with the goals of medical education and practice, the Board shall either penalize the medical college or medical institution and/or conduct further enquiry into such act and wherever needed provide an opportunity to rectify the same.

2) Without prejudice to anything stated at Section 8.1 above, the imposition of the penalty may include one/more/ all of the following.-

(a) Issuance of warning with direction to rectify/comply, as the case may be, by the medical institution;

(b) Monetary penalty not exceeding INR one crore per violation or act of omission by the medical institution;

(c) Monetary penalty not exceeding Rupees five lakh for the faculty/Head of the Department (HoD)/Dean/Director/ doctor submitting false declaration/documents/records (including patients' records). Further, they can also be charged or penalized for misconduct under the Registered Medical Practitioner (Professional Conduct) Regulations in vogue;

(d) Withholding the accreditation process;

(e) recommending to MARB for withholding processing of application(s) for any new course, including increase of seats in the existing course for that academic year or for such number of years;

2025:KER:80819 W.A.No.2466 of 2025 32

(f) Reducing the number of students in the next or subsequent academic years to be admitted by the medical institution;

(g) Stoppage of admission to one or more of the courses in the next or subsequent academic years. h. Recommending to NMC for withdrawal of permission;

(h) Recommending to NMC for withdrawal of permission;

(i) Withholding and withdrawal of accreditation for a period up to five academic years;

(j) Any attempt to pressurize UGMEB, PGMEB or NMC through individuals or agency will lead to immediate halt of the processing of all applications/requests by the medical institution.

Provided that the medical institution, may be granted a reasonable opportunity to rectify the deficiencies and any further action shall be taken if it fails to meet the requisite norms.

Provided further that the UGMEB, PGMEB or the NMC may also initiate criminal proceedings for furnishing false information, or fabrication of false documents as per the criminal law in force at that time."

13.6. Section 9 of MSMER 2023 deals with appeal to the National Medical Commission. As per Section 9, a medical college or medical institution or any such aggrieved person may file an appeal before the Commission with an appropriate fee as specified against any order. As per the proviso to Section 9, such an appeal is to be filed within sixty days of the passing of such an order or 2025:KER:80819 W.A.No.2466 of 2025 33 lapse of time, as the case may be. Section 10 deals with an appeal to the Central Government. As per Section 10, where an applicant/medical college or medical institution is aggrieved by the decision of the Commission or where the Commission fails to give its decision within forty-five days from the date of receipt of such an appeal, a second appeal may be filed before the Central Government within thirty days from the date of such order or lapse of time, as the case may be. The decision of the Central Government in this regard shall be final.

14. In exercise of the powers conferred vide sub-section

(a), (d) and (e) of Section 24 read with Sections 26,28 and 29 of the National Medical Commission Act, 2019, the Under Graduate Medical Education Board (UGMEB) issued the Guidelines for Under Graduate Courses under the Establishment of New Medical Institutions, Starting of New Medical Courses, Increase of Seats for Existing Courses and Assessment and Rating Regulations, 2023 (for brevity, UG-MSR 2023). The said Regulations came into force with effect from 16.08.2023, the date of publication in the official gazette.

14.1. The objective of UG-MSR 2023 is to prescribe for a 2025:KER:80819 W.A.No.2466 of 2025 34 medical college and medical institution approved for admission of MBBS students annually, the minimum requirements of accommodation in the college and its associated teaching hospitals, staff (teaching and technical) and equipment in the college departments and hospitals. Chapter I of UG-MSR 2023 provides that the said regulations shall be applicable for medical colleges being established from the academic session 2024-25 onwards. As per UG-MSR 2023, applications for establishing new undergraduate medical education colleges shall be allowed only for 50/100/150 seats. Only such colleges meeting these requirements shall be eligible for continuing their admission of permitted/recognised number of MBBS students from the academic year 2024-25.

14.2. Schedule I of UG-MSR 2023 deals with accommodation in the medical college and its associated teaching hospitals. As per Para.B.I., the teaching hospital building shall conform to the existing national building norms and various local authority regulations for hospitals, taking into consideration the requirements of the hospital as a service provider, including administration, registration, records storage, out-patient and 2025:KER:80819 W.A.No.2466 of 2025 35 inpatient areas, operating theatres, CSSD, ICUs, Radiology and laboratory services, emergency areas, etc. The teaching hospital shall provide for the minimum requirements as prescribed in UG- MSR 2023. Para.B.I.2. deals with indoor beds occupancy. The bed strength shall be as shown in the table in Para.B.I.2. The beds (OPD/DAY) required for 150 MBBS seats capacity are 1,200. The average occupancy of indoor beds shall be a minimum of 80% per annum.

14.3. Schedule II of UG-MSR 2023 deals with staff requirements. In Para.A, under the heading 'General Remarks', it is stated that since the emphasis in medical education is on practical instruction and demonstration in small groups and to encourage students for self-directed learning, the number of teachers must be as mentioned in the requirements in Schedule II, so as to enable instructions to be imparted effectively. The regulations in Schedule II cover the minimum requirements of under graduate medical education, as per the annual MBBS student intake and the minimum patient load indicated therein. The faculty requirement for MBBS admissions is provided in the table in Schedule II. As per the said table, the total staff strength 2025:KER:80819 W.A.No.2466 of 2025 36 for 150 MBBS seats is Professor - 19, Associate Professor - 40, Assistant Professor - 55 (total 114), Tutor/Demonstrator - 32 and Senior Resident Doctors - 58.

15. On the other hand, as per the Minimum Requirements for Annual MBBS Admissions Regulations, 2020 (for brevity, 'MSR 2020') made by the National Medical Commission, in exercise of the powers conferred by section 57 of the National Medical Commission Act, 2019, which came into force on 29.10.2020 on publication in the official gazette, which was applicable for medical colleges established from the academic session 2021-22 onwards, every medical college and medical institution and its associated teaching hospital shall have the required areas, accommodation for the staff and equipment for each department, as given in Schedules I, II and III respectively annexed with MSR 2020.

15.1. Annexure II to MSR 2020 deals with the requirements to be fulfilled by the applicant colleges for obtaining the Letter of Intent and Letter of Permission for the establishment of a new medical college and yearly renewals for 150 MBBS admissions annually. The requirement as per Annexure II of OPD (patients/ day) is as follows; LoP (1st Batch) - 600, 1st renewal (2nd Batch) -

2025:KER:80819 W.A.No.2466 of 2025 37 600, 2nd renewal (3rd Batch) - 750, 3rd renewal (4th Batch) - 900; 4th renewal (5th Batch) - 1200 and Recognition - 1200. The requirement of bed occupancy is as follows; 60% for 1st Batch, 2nd Batch and 3rd Batch and it is 75% for 4th Batch, 5th Batch and Recognition. The requirement, as per Annexure II(A), of Faculty and Residents for 150 MBBS admission annually, is as follows; Faculty: LoP - 54, 1st renewal - 78, 2nd renewal - 83, 3rd renewal - 116; 4th renewal - 116 and Recognition - 116; Tutor/ Demonstrator/Senior Resident Doctors: LoP - 43, 1st renewal - 58, 2nd renewal - 62, 3rd renewal - 76; 4th renewal - 76 and Recognition

- 76; Statistician: LoP - 0, 1st renewal - 1, 2nd renewal - 1, 3rd renewal - 1; 4th renewal - 1 and Recognition - 1.

16. As already noticed hereinbefore, the challenge made in W.P.(C)No.32178 of 2025 was against Ext.P13 order dated 14.07.2025 of the 1st appellant Under Graduate Medical Education Board, whereby the Board decided to reduce 50 seats in Palakkad Institute of Medical Sciences, and to grant conditional renewal of only 100 MBBS seats, for the academic session 2025-26. By Exts.P1 order dated 22.08.2025 of the 2nd appellant National Medical Commission, the appeal filed by Palakkad Institute of 2025:KER:80819 W.A.No.2466 of 2025 38 Medical Sciences, against Ext.P13 order dated 14.07.2025 of the 1st appellant Under Graduate Medical Education Board, invoking the provisions under Section 22(3) of the National Medical Commission Act, 2019, read with Section 9 of MSMER 2023, was disposed of by upholding Ext.P13 order, thereby confirming the renewal of approval of 100 MBBS seats, for the academic session 2025-26. By Ext.P1 order, the 2nd appellant Commission directed Palakkad Institute of Medical Sciences to strictly adhere to compliance under UG-MSR 2023, and rectify the deficiencies before the next renewal for the academic session 2026-27.

17. By Ext.P9 public notice dated 01.11.2024 issued by the 1st appellant Under Graduate Medical Education Board, all medical colleges/institutions having a valid LoP for MBBS admission were directed to fill the details/data of respective colleges/institutions on the portal of the 2nd appellant National Medical Commission for annual declaration, as required under the provisions of the National Medical Commission Act, 2019 and various regulations issued by the Commission from time to time. In Ext.P9 notification, it was provided that the submission of a duly completed Annual Declaration Form of each college/institution on 2025:KER:80819 W.A.No.2466 of 2025 39 the portal of the Commission is mandatory for the annual renewal of permission of UG-MBBS seats. No seat shall be permitted in case the college/institution fails to submit the Annual Declaration within the specified time period. Ext.P9 public notice was followed by Ext.P10 public notice dated 24.04.2025 issued by the 1st appellant Under Graduate Medical Education Board.

18. The document marked as Ext.P11 is a show cause notice dated 15.05.2025 issued by the 1st appellant Under Graduate Medical Education Board, pointing out various deficiencies in Palakkad Institute of Medical Sciences, based on the evaluation of the Annual Declaration Form as per UG-MSR 2023 and MSMER 2023. In the said show cause notice, the 1st appellant Board has pointed out the provisions contained in Section 8 of MSMER 2023, which deal with penalties for violation or any act of omission by the medical institution.

19. On receipt of Ext.P11 show cause notice, the Principal of Palakkad Institute of Medical Sciences submitted Ext.P12 reply dated 23.06.2025, with an undertaking to comply with the requirements of UG-MSR 2023, within one year, by recruiting additional faculty, making all necessary infrastructures, and 2025:KER:80819 W.A.No.2466 of 2025 40 improving clinical materials and facilities as required. In Ext.P12, it was pointed out that the Apex Court in Ext.P5 order dated 03.11.2023 in W.P.(C)No.1166 of 2023 directed the 2nd appellant Commission to go by the parameters that were available during the academic session 2023-24, while permitting the petitioners to establish the medical college. After considering Ext.12 compliance report, the 1st appellant Board issued Ext.P13 order dated 14.07.2025, whereby it was decided to reduce 50 seats and grant conditional renewal of only 100 MBBS seats in Palakkad Institute of Medical Sciences. In Ext.P13 order, the 1st appellant Board made it clear that the said decision is taken in the interest of maintaining the quality of medical education and to ensure that institutions operate within the framework of the prescribed statutory norms. By Exts.P1 order dated 22.08.2025 of the 2nd appellant Commission, the appeal filed against Ext.P13 order of the 1st appellant Board was disposed of, by upholding Ext.P13 order, thereby confirming the renewal of approval of 100 MBBS seats, during the academic session 2025-26. By Ext.P1 order, the 2nd appellant Commission directed Palakkad Institute of Medical Sciences to strictly adhere to compliance under UG-MSR 2023, 2025:KER:80819 W.A.No.2466 of 2025 41 and rectify the deficiencies before the next renewal for the academic session 2026-27.

20. The contention of respondents 1 and 2-petitioners is that in view of Ext.P5 order dated 03.11.2023 of the Apex Court in W.P.(C)No.1166 of 2023, the petitioners are entitled for consideration of their request for permission to admit the second batch of 150 MBBS students in Palakkad Institute of Medical Sciences, during the academic session 2025-26, with reference to the parameters prevailing for the academic session 2023-24, i.e., MSR 2020 and not with reference to the parameters in UG-MSR 2023. In Ext.P12 reply report dated 23.06.2025, the petitioners gave an undertaking to comply with the requirements of UG-MSR 2023, within a period of one year.

21. In paragraph 4 of Ext.P3 order dated 09.05.2023 of the Apex Court in the Civil Appeal No.3597 of 2023, arising out of SLP(C)No.16139 of 2022, the Apex Court declined to accept the contention made on behalf of V.N. Public Health and Educational Trust, the 1st respondent herein, that faculty can be engaged in the college only after the permission is granted. In the said order, the Apex Court stated that, in academic matters and particularly 2025:KER:80819 W.A.No.2466 of 2025 42 in the field of medical education, no relaxation can be granted insofar as the norms and requirements prescribed by law are concerned. A reading of Ext.P5 order dated 03.11.2023 of the Apex Court in W.P.(C)No.1166 of 2023 would show that the relaxation in terms of the said order, which was one issued by the Apex Court in exercise of the powers under Article 142 of the Constitution of India, is applicable only for the academic session 2024-25 and not thereafter. The exception carved out by the said order was with reference to testing the infrastructure for issuance of LoP, whereafter annual renewals have to be on fulfillment of the parameters prescribed in UG-MSR 2023, read with MSMER 2023.

22. In State of Punjab v. Rafiq Masih [(2014) 8 SCC 883] a Three-Judge Bench of the Apex Court affirmed the view taken in Indian Bank v. ABS Marine Products (P) Ltd. [(2006) 5 SCC 72] holding that the directions issued under Article 142 do not constitute a binding precedent unlike Article 141 of the Constitution of India. The directions of the Court under Article 142 of the Constitution, while moulding the relief, that relax the application of law or exempt the case in hand from the rigour of the law, in view of the peculiar facts and circumstances, do not 2025:KER:80819 W.A.No.2466 of 2025 43 comprise the ratio decidendi and therefore lose its basic premise of making it a binding precedent.

23. In Manohar Lal Sharma v. Medical Council of India [(2013) 10 SCC 60], a decision relied on by the learned ASGI, in the context of Indian Medical Council Act, 1956 and the regulations made thereunder, the Apex Court held that deficiencies pointed out in the inspection conducted by a team of inspectors, which are fundamental and very crucial in nature, cannot be ignored in the interest of medical education and the student community. The Medical Council of India and the college authorities have to bear in mind that what is prescribed in the Regulations is the minimum. If the Medical Council of India dilutes the minimum standards, it will be doing violence to the statutory requirements. The Medical Council of India is duty-bound to cancel the request if fundamental and minimum requirements are not satisfied, or else the college will be producing half-baked and poor- quality doctors, who would do more harm to society than service. On the facts of the case at hand, the Apex Court found that the infirmities pointed out by the inspection team are serious deficiencies and the Board of Governors of the Medical Council of 2025:KER:80819 W.A.No.2466 of 2025 44 India rightly declined approval for renewal of permission for the third batch of 150 MBBS students, for the academic session 2013-

14.

24. In Medical Council of India v. Kalinga Institute of Medical Sciences [(2016) 11 SCC 530], the Apex Court held that medical education must be taken very seriously and when an expert body certifies that the facilities in a medical college are inadequate, the courts are not equipped to take a different view in the matter, except for very cogent jurisdictional reasons such as malafides of the inspection team, ex facie perversity in the inspection report, jurisdictional error on the part of Medical Council of India, etc. Under no circumstances should the High Court examine the report as an appellate body, which is not a function of the High Court.

25. In V.N. Public Health and Educational Trust v. State of Kerala [(2021) 17 SCC 189], a decision relied on by the learned Senior Counsel for the 3rd respondent University, on the issuance of an essentiality certificate by the State Government, for the academic session 2021-22, to respondents 1 and 2 herein for establishing Palakkad Institute of Medical 2025:KER:80819 W.A.No.2466 of 2025 45 Sciences, a Three-Judge Bench of the Apex Court reiterated the law laid down in Medical Council of India v. KMCT Medical College [(2018) 9 SCC 766] that the decision taken by the Union of India based on the recommendation of the expert body cannot be interfered with lightly, and interference is permissible only when the college demonstrates jurisdictional errors, ex facie perversity or mala fides. In the said decision, the Three-Judge Bench relied on another decision in Medical Council of India v. S.R. Educational and Charitable Trust [(2020) 17 SCC 717]. In the said decision, the High Court has ordered an inspection, and, if the deficiencies are found to exist, then the Medical Council of India and the Government of India have been given liberty to take an appropriate decision. The Apex Court found that such orders may ruin the entire career of the students. Once permission to admit students is granted, it should not be such a conditional one. Considering the deficiencies, it would be against the efficacious medical education and would amount to permitting the unequipped medical college to impart medical education without proper infrastructure and faculty. The patients serve as the object of teaching by such an approach. Ultimately, 2025:KER:80819 W.A.No.2466 of 2025 46 the interests of society would suffer, and half-baked doctors cannot be left loose on society like drones and parasites to deal with the lives of patients in the absence of proper educational training. It would be dangerous and against the right to life itself, in case unequipped medical colleges are permitted to impart substandard medical education without proper facilities and infrastructure.

26. The learned Senior Counsel for the 3rd respondent University pointed out the observation made by the Three-Judge Bench in paragraph 37 of the decision in V.N. Public Health and Educational Trust [(2021) 17 SCC 189], which reads thus;

"37. In the case at hand, the essentiality certificate was first issued in the year 2004, and over 17 years later, the appellant College is not in a position to secure the requisite permissions from the MCI. It is quite apparent that the appellant institution has long been trying to escape its responsibility and fill up the lacuna through the judicial process by getting orders from the High Court for consent of affiliation and consideration of its belated, half-baked applications before the MCI. In both the inspections in 2015 and 2020, it was found that the appellant institution lacks proper facilities. Even though the Appellant claims to be running a hospital since 2006, neither adequate amenities nor infrastructure on inspection was found to be in 2025:KER:80819 W.A.No.2466 of 2025 47 existence. This lackadaisical attitude is a testament to the fact that the appellant has no real interest in running a hospital in that place and has no ground to call foul upon rejection of EC, CoA, or its applications before MCI."

27. By Ext.P9 public notice dated 01.11.2024 issued by the 1st appellant Under Graduate Medical Education Board require all medical colleges/institutions having a valid LoP for MBBS admission to fill the details/data of respective college/institution on the portal of National Medical Commission for annual declaration, as required under the provisions of National Medical Commission Act, 2019 and the regulations issued by the National Medical Commission from time to time. In Ext.P11 show cause notice dated 15.05.2025 issued by the 1st appellant Board, various deficiencies in Palakkad Institute of Medical Sciences were pointed out, based on the evaluation of the Annual Declaration Form as per UG-MSR 2023 and MSMER 2023.

28. Section 10 of MSMER 2023 deals with an appeal to the Central Government. As per Section 10, where an applicant/ medical college or medical institution is aggrieved by the decision of the Commission or where the Commission fails to give its decision within forty-five days from the date of receipt of such an 2025:KER:80819 W.A.No.2466 of 2025 48 appeal, a second appeal may be filed before the Central Government within thirty days from the date of such order or lapse of time, as the case may be. The decision of the Central Government in this regard shall be final.

29. Instead of challenging Ext.P1 order dated 22.08.2025 of the 2nd appellant National Medical Commission, by invoking the statutory remedy provided under Section 10 of MSMER 2023, before the Central Government, by filing an appeal, the petitioners (respondents 1 and 2 herein) have chosen to challenge the said order by filing a writ petition before this Court on 24.08.2025.

30. In Commissioner of Income Tax v. Chhabil Das Agarwal [(2014) 1 SCC 603] the Apex Court held that non- entertainment of a writ petition under Article 226 of the Constitution of India when an efficacious alternative remedy is available is a rule and self-imposed limitation. It is essentially a rule of policy, convenience and discretion rather than a rule of law. Undoubtedly, it is within the discretion of the High Court to grant relief under Article 226 of the Constitution of India, despite the existence of alternative remedy. However, High Court must not interfere if there is an adequate efficacious alternative remedy 2025:KER:80819 W.A.No.2466 of 2025 49 available to the petitioner and he has approached the High Court without availing the same, unless he has made out an exceptional case warranting such interference or there exists sufficient ground to invoke the extraordinary jurisdiction under Article 226.

31. When a statutory remedy by way of an appeal to the Central Government is provided under Section 10 of MSMER 2023 against Ext.P1 order dated 22.08.2025 of the 2nd appellant National Medical Commission, instead of invoking the extraordinary jurisdiction of this Court under Article 226 of the Constitution of India, the petitioners (respondents 1 and 2 herein) ought to have availed that statutory remedy. The timeline involved in the matter is not a sufficient ground or an exceptional circumstance for invoking the extraordinary jurisdiction under Article 226 of the Constitution of India against Ext.P1 order passed by the 2nd appellant National Medical Commission. Therefore, the finding of the learned Single Judge that the appellate remedy provided under Section 10 of MSMER 2023 will not be an efficacious alternative remedy cannot be sustained in law.

32. As already noticed hereinbefore, as per sub-section (a) of Section 10 of EMAR 2023, no medical institution shall be 2025:KER:80819 W.A.No.2466 of 2025 50 provided permission unless it satisfies the conditions pertaining to, but not limited to, physical infrastructure, teaching staff, clinical material and hospital as detailed in the MSRs notified from time to time. Sub-section (b) of Section 10 empowers the UGMEB or PGMEB, as the case may be, to publish from time to time, the MSR with such modifications or amendments required, keeping in mind the overall objectives of the National Medical Commission Act. The mandate of sub-section (c) of Section 10 is that notwithstanding anything stated above in Section 10, all modified or amended MSRs shall have to be implemented.

33. The mandate of Section 28 of EMAR 2023 is that it shall be the duty of all medical institutions to follow the regulations and directions issued by Medical Assessment and Rating Board (MARB), both in letter and spirit, either within a specified time period or within a reasonable period of time, wherever the timelines are applicable. In view of the provisions under Section 29, which defines non-compliance, the acts or omissions enumerated in sub-sections (a) to (i) of a medical institute shall amount to non-compliance. Sub-section (a) of Section 29 deals with non-compliance with any of the regulations and notifications 2025:KER:80819 W.A.No.2466 of 2025 51 of the National Medical Commission issued from time to time. Sub- section (c) of Section 29 deals with deficiency in infrastructure, teaching staff, clinical material and others as prescribed by way of MSR or otherwise by UGMEB and/or PGMEB.

34. In view of the provisions contained in Section 30 of EMAR 2023, for any of the non-compliance or intentional attempt of non-compliance act or omission by the medical institution, the MARB shall either penalise the medical college or medical institution as per sub-section (f) of Section 26 of the Act and/or conduct further enquiry into such incident or act, and wherever needed, provide an opportunity to rectify the same. In view of the provisions contained in Section 31, the imposition of the penalty may include one/more/all of the penalties enumerated in sub- sections (a) to (h). Sub-section (d) of Section 31 provides for reducing the number of students in the next or subsequent academic years to be admitted by the medical institution.

35. The argument of the learned counsel for the petitioners (respondents 1 and 2 herein) is that, in view of the first proviso to Section 31 of EMAR 2023, the medical institution ought to have been granted a reasonable opportunity to rectify the deficiencies, 2025:KER:80819 W.A.No.2466 of 2025 52 and any further action shall be taken if it fails to meet the requisite norms.

36. On the aforesaid argument advanced by the learned counsel for the petitioners (respondents 1 and 2 herein), we notice that the mandate of Section 28 of EMAR 2023 require all medical institutions to follow the regulations and directions issued by the MARB, both in letter and spirit, either within a specified time period or within a reasonable period of time, wherever the timelines are applicable. As already noticed hereinbefore at paragraphs 14.2 and 14.3, there is no phase-wise minimum requirement in UG-MSR 2023, as in the case of MSR 2020, as noticed hereinbefore at paragraphs 15 and 15.1. In view of the provisions contained in UG-MSR 2023, read with the provisions contained in EAMR 2023, all medical institutions have to comply with the requirements of UG-MSR 2023, at the time of establishment itself. When such a provision is there in UG-MSR 2023 and EMAR 2023, the 1st appellant Under Graduate Medical Education Board or the 2nd appellant National Medical Commission cannot be found fault with in not accepting the request of the medical institution in question to meet the requirements by 2025:KER:80819 W.A.No.2466 of 2025 53 appointing additional faculties and providing infrastructure, within a period of one year.

37. It is not in dispute that the petitioners (respondents 1 and 2 herein) could not comply with the requirements of UG-MSR 2023 read with EMAR 2023 for the academic session 2025-26, which had resulted in the conditional renewal for the said academic session being reduced to the second batch with 100 MBBS seats. In such circumstances, this Court in exercise of the extraordinary jurisdiction of this Court under Article 226 of the Constitution of India cannot issue a writ of mandamus commanding the appellants and the 3rd respondent University to permit the medical institution in question to admit students in 150 MBBS seats in the second batch, during the academic session 2025-26, over and above 100 MBBS seats in respect of which conditional renewal has been granted by the appellants, since no mandamus can be issued directing the statutory authorities to do something contrary to the statute. See: Bhaskara Rao A.B. v. CBI [(2011) 10 SCC 259]. Therefore, the direction contained in the judgment of the learned Single Judge cannot be sustained in law.

2025:KER:80819 W.A.No.2466 of 2025 54 In the above circumstances, this writ appeal is allowed by setting aside the judgment dated 08.10.2025 of the learned Single Judge in W.P.(C)No.32178 of 2025, and the writ petition is dismissed for the reasons stated hereinbefore.

Sd/-

ANIL K. NARENDRAN, JUDGE Sd/-

MURALEE KRISHNA S., JUDGE bkn/-

Unlock Advanced Research with PRISMAI

Kerala High Court