Following a rash of scandals relating to admission into the country’s 176 government and 205 private medical colleges and universities, in 2012 the Central government replaced the system of state governments and consortia of private colleges conducting admission tests with a National Eligibility-cum-Entrance Test (NEET). Inevitably the constitutional validity of NEET was contested by state governments and private medical colleges. In July 2013, the Supreme Court upheld the validity of NEET which was again appealed. In April this year, the apex court unequivocally upheld its judgement of July 2013 abolishing all entrance tests other than NEET. But although the issue of uneven admissions into medical colleges countrywide has been resolved and the first full-fledged NEET exam was conducted (by the Central Board of Secondary Education — CBSE) on May 1, the issue of reservations or affirmative action for scheduled castes, scheduled tribes and other backward classes in postgraduate medical education in government colleges (despite being repeatedly upheld in undergrad medical programmes) remains a grey area. In January 2014, the Uttar Pradesh cabinet decreed reservation of 30 percent capacity in postgraduate programmes of state government medical colleges for in-service doctors with service records in rural areas. The rationale of this reservation was that this initiative would motivate MBBS students to serve in severely understaffed rural health centres of the state. On August 16, a three judge bench headed by Chief Justice T.S. Thakur struck down the state government’s 2014 cabinet decision (State of UP & Ors. vs. Dr. Dinesh Singh Chauhan) on the ground that it violated the provisions of the Medical Council of India (MCI) Post Graduate Medical Education Regulations, 2000. The court held that although some marks could be given to eligible in-service candidates based on the length of service in remote and/or difficult areas, reservation of capacity was unconstitutional. The apex court’s decision has finally drawn the curtain on an issue which has agitated postgrad medical aspirants in the state. The August 16 order makes it clear that Regulation 9 (IV) of the MCI regulations mandates reservation of seats as per the constitutional scheme (for scheduled castes, scheduled tribes or other backward class candidates) and not for in-service medical officers. The three judge bench also clarified that its proviso for granting weightage in postgrad entrance exams conducted under NEET should be at the rate of 10 percent per year spent in rural service and capped at 30 percent. This should not be interpreted as providing a 30 percent seats reservation for in-service candidates. While the verdict clarifies the status of admissions into postgrad programmes in the state next year, the state government needs to devise other incentives to persuade MBBS graduates to serve their three-year residency programmes in the state’s 3,692 primary and 515 community health centres where there’s a shortage of over 1,000 doctors. “While it is understandable that young doctors do not want to confine themselves to villages, there has to be some mechanism to ensure that they pay for their highly subsidised undergrad medical education in…
