Section 23(3)(b) in The Rajasthan Medical Rules, 1957
(b)When a seat of particular electorate remains unfilled by the operation of this sub-rule or becomes vacant by the refusal of the elected candidates to serve, such refusal being signified before his name is published in the Rajasthan Gazette under rule 25, the seat may be filled by that one among the other candidates willing to accept office who has received the highest number of votes among unsuccessful candidates of the electorate affected at the election. If there is no unsuccessful candidate, a fresh election shall be held to fill the vacancy thus created.