Supreme Court Stays Inspection Order for Medical College: Board of Governors vs. National Institute of Medical Sciences (2019)

Date of the Judgment: April 01, 2019

Citation: 2019 INSC 289

Judges: L. Nageswara Rao, J. and M.R. Shah, J.

Can a High Court order an inspection of a medical college for increasing seats when the college is already barred from admitting students? The Supreme Court of India recently addressed this question, setting aside a High Court order that directed an inspection of a medical college. This case revolves around the powers of the Medical Council of India (MCI) and the procedures for granting recognition to medical courses. The Supreme Court bench, comprising Justices L. Nageswara Rao and M.R. Shah, delivered the judgment.

Case Background

The National Institute of Medical Sciences (NIMS) was established in 2004. In 2011, NIMS received permission to start M.D. (Radio Diagnosis) with one seat and M.S. (Orthopedics) with two seats. The permission was valid until the first batch of students appeared for their final exams. NIMS was required to apply for recognition of these qualifications under Section 11(2) of the Indian Medical Council Act, 1956, when the students were in their final year. NIMS applied for recognition on 18.07.2013. The Medical Council of India (MCI) conducted several inspections and found deficiencies. The MCI was not satisfied with the compliance reports submitted by NIMS. Consequently, the MCI decided that NIMS could not conduct Post Graduate courses in M.S. (Orthopedics) and M.D. (Radio Diagnosis) due to lack of clinical material, human resources, and infrastructure. However, the MCI decided to recognize the qualifications of students who had completed their courses during the academic years 2011-2012, 2012-2013, and 2013-2014.

On 07.03.2017, the MCI decided to restrain NIMS from applying to start the M.S. (Orthopedics) and M.D. (Radio Diagnosis) courses for five years. On 14.04.2017, the MCI recommended to the Union of India to notify the qualifications of students who completed the courses during 2011-2012, 2012-2013, and 2013-2014. The MCI also decided that admissions made by NIMS after 2014 were in violation of Regulations 6(2) and (3) of the Post Graduate Medical Education Regulations, 2000.

Timeline

Course of Proceedings

The First Respondent, NIMS, filed a Writ Petition in the High Court of Delhi questioning the proceedings dated 14.04.2017 of the Appellant, MCI, which refused to recognize certain courses and barred NIMS from admitting students for future academic years. NIMS later withdrew the petition with liberty to approach the court at a later stage. Subsequently, a corrigendum was issued by the Union of India to the notification dated 07.06.2017, removing the words “on or after 2014”. NIMS then filed another Writ Petition in the Delhi High Court questioning the corrigendum and seeking recognition for the Post Graduate courses from the academic year 2014-2015. The Delhi High Court issued notice but refused to grant interim relief. Following this, NIMS approached the High Court of Rajasthan seeking a direction to the MCI to conduct an inspection for enhancement of seats in M.S. (Orthopedics) and M.D. (Radio Diagnosis) courses for the academic year 2019-2020. The Rajasthan High Court directed the MCI to conduct an inspection and submit a report to the Union of India before 28.02.2019.

Legal Framework

The case primarily involves the interpretation and application of the Indian Medical Council Act, 1956 and the Post Graduate Medical Education Regulations, 2000. Section 11(2) of the Indian Medical Council Act, 1956 deals with the recognition of medical qualifications granted by any University or medical institution in India. It states that:

“The medical qualifications granted by any University or medical institution in India which are included in the First Schedule shall be recognised medical qualifications for the purposes of this Act.”

The Post Graduate Medical Education Regulations, 2000, specifically Regulation 6(2) and (3), deal with the requirements for starting and conducting Post Graduate medical courses. The MCI found that NIMS did not fulfill the requirements of the Regulations relating to clinical material, human resources, and infrastructure.

Arguments

Arguments by the Appellant (Board of Governors in Supersession of Medical Council of India):

• The MCI argued that the proceedings dated 14.04.2017 and the corrigendum dated 09.04.2018 clearly show that NIMS was restrained from making admissions to M.S. (Orthopedics) and M.D. (Radio Diagnosis) courses for five years. The ambiguity in the notification dated 07.06.2017 was clarified by the corrigendum.

• The MCI contended that the corrigendum recognized the courses only for students admitted in the academic years 2011-2012, 2012-2013, and 2013-2014. The note attached to the notification dated 07.06.2017 was not applicable to these courses.

• The MCI argued that NIMS had engaged in forum shopping by approaching the Rajasthan High Court, as earlier Writ Petitions were filed in the Delhi High Court. The decision taken by the Committee constituted under Section 20 of the Indian Medical Council Act, 1956, had become final as it was accepted by the MCI.

• The MCI also argued that the High Court’s direction for an inspection within one week would remove the surprise element essential for a fair assessment.

Arguments by the First Respondent (National Institute of Medical Sciences):

• NIMS argued that there was no complaint of lack of infrastructure and facilities, as the college had been running Under Graduate courses since 2004. Permission was granted to start Post Graduate courses, and seats were enhanced for other courses.

• NIMS submitted that from 2014, the MCI had been harassing the institute by not accepting compliance reports. Admissions to the PG courses after 2014 were regularly intimated to the MCI.

• NIMS argued that the MCI’s recommendation to restrain admissions for five years was not accepted by the Union of India. The notification dated 07.06.2017 stated that students trained “on or after 2014” were also entitled to a recognized medical qualification. The note to the notification indicated that recognition was for a maximum of five years, after which it had to be renewed.

• NIMS contended that it was situated in Jaipur, and there was no bar on filing a Writ Petition in the Rajasthan High Court. The institute had approached the High Court because the last date for granting permission was 28.02.2019 and the application for enhancement of seats had not been considered by the MCI.

Issues Framed by the Supreme Court

The Supreme Court did not explicitly frame issues in this case. However, the core issue before the court was whether the High Court was correct in directing an inspection of the medical college for enhancement of seats, especially when there was a dispute regarding the bar on admissions imposed by the Medical Council of India (MCI).

Treatment of the Issue by the Court

The following table demonstrates as to how the Court decided the issues:

Authorities

The Supreme Court relied on the following authorities:

Judgment

How each submission made by the Parties was treated by the Court?

How each authority was viewed by the Court?

• The Court cited Manohar Lal Sharma v. Medical Council of India [2013] 10 SCC 60 to emphasize the importance of surprise inspections, stating that “Surprise inspection naturally contemplates no notice, if the notice is given in advance, it would not be a surprise inspection and will give room for the College to hoodwink the assessors by springing a surprise, by making perfect what was imperfect.”
• The Court cited Royal Medical Trust v. Union of India [2015] 10 SCC 19 to reiterate that there must be a surprise element in the inspection conducted by the MCI.

What weighed in the mind of the Court?

The Supreme Court’s decision was primarily influenced by procedural irregularities and the need to maintain the integrity of the inspection process. The Court emphasized that the High Court should not have ordered an inspection without giving the Medical Council of India (MCI) a chance to be heard. The Court also highlighted the importance of surprise inspections in ensuring a fair assessment of medical colleges. The fact that the matter was already pending before the Delhi High Court also weighed heavily in the Court’s decision to set aside the High Court’s order.

The Court’s reasoning was based on the following points:

• The High Court did not consider the existing bar on admissions imposed on NIMS by the MCI.
• The High Court did not provide an opportunity for the MCI to be heard before issuing the order.
• The direction to conduct the inspection within one week would negate the surprise element necessary for a fair assessment.
• The matter was already pending before the Delhi High Court, and any further directions should have been sought there.

The Supreme Court stated, “The High Court failed to examine the notification dated 07.06.2017 and the corrigendum dated 09.04.2018 before passing the impugned order.”

The Court also noted, “No useful purpose will be served by an inspection before the adjudication of the dispute relating to the bar imposed on the First Respondent from making admissions to the M.S. (Orthopedics) and M.D. (Radio Diagnosis) courses.”

The Court further observed, “The direction to conduct an inspection within a period of one week ought not to have been passed by the High Court as the surprise element of the inspection would not be there.”

Key Takeaways

• High Courts should not order inspections of medical colleges without considering existing restrictions or bars on admissions.
• It is essential to provide all parties, especially regulatory bodies like the MCI, an opportunity to be heard before issuing orders.
• Surprise inspections are crucial for ensuring the integrity of the assessment process for medical colleges.
• When a matter is already pending before one High Court, any related directions should be sought from the same court to avoid conflicting orders.

Directions

The Supreme Court set aside the interim direction of the High Court to conduct an inspection of the First Respondent-Institute. The appeal was allowed.

Development of Law

The ratio decidendi of this case is that High Courts should not order inspections of medical colleges without considering existing restrictions or bars on admissions, without giving the regulatory authority a hearing, and without considering the need for surprise inspections. This case reinforces the importance of procedural fairness and the integrity of the inspection process in the context of medical education.

Conclusion

The Supreme Court’s judgment in Board of Governors vs. National Institute of Medical Sciences sets aside the Rajasthan High Court’s order for an inspection of NIMS. The Supreme Court emphasized the importance of procedural fairness, the need for a hearing for all parties, and the necessity of surprise inspections. The Court also highlighted that when a matter is already pending before one High Court, related directions should be sought from the same court. This ruling ensures that regulatory bodies like the MCI are not bypassed and that the inspection process remains fair and effective.