Ker HC | One-year mandatory internship for foreign medical graduate; HC holds residential internship in India is not mandatory if already done abroad

Kerala High Court

Kerala High Court: P.B.Suresh Kumar, J., held that the requirement for Medical students who had studied abroad to undergo CRRI for obtaining permanent registration under State Medical Register was inconsistent with prevailing provisions.

Background

The petitioner, an Indian citizen enrolled for obtaining medical qualification without obtaining Eligibility Certificate insisted in terms of Section 13(4B) of the Indian Medical Council Act, 1956, which she obtained later on in 2017. She graduated in 2019, thereupon, she underwent one year internship in the various teaching hospitals under the Dubai Health Authority.

The petitioner cleared the Screening Test in terms of Section 13(4A) of the IMC Act in order to become eligible to be enrolled in a State Medical Register in India as well and applied for permanent registration under State Medical Register. Her application for registration was rejected by the State Medical Council, the Council insisted on requirement of Compulsory Rotatory Residential Internship (CRRI) in any one of the medical institutions approved by the Medical Council of India for foreign medical graduates before granting permanent registration to them in terms of Ext.P21 decision taken by the State Medical Council on 20-10-2017 in order to ensure that they learn and gain clinical experience and exposure about the epidemiological and clinical profile of local community.

Analysis and Findings of the Court

In the backdrop of above, the Court was to address following questions:

  1. Whether a person who has not undertaken internship as part of the medical course undertaken by him/her abroad is eligible to appear in the Screening Test provided for under Section 13(4A) of the IMC Act?

Regulation 11 of Screening Test Regulations, 2002 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. Therefore, internship is not insisted for appearing in the Screening Test and the only requirement for appearing in the Screening Test is that the candidates should possess a primary medical qualification.

Noticing that the State Medical Council did not have a case that the petitioner did not possess a primary medical qualification as defined in the Regulations at the time when she applied for and cleared the Screening Test, the Bench held that the stand of the State Medical Council that only students who had completed internship as part of the medical course undertaken by them in the medical institution abroad were entitled to appear for the Screening Test was unsustainable.

  1. Whether a person who obtains Eligibility Certificate after taking admission in a medical institution abroad, be denied enrolment on a State Medical Register, if he/she satisfies all other eligibility criteria for the same?

On the issue that the petitioner had obtained Eligibility Certificate only after taking admission in the medical institution abroad, the Bench observed that the Council had no case that the petitioner would not have been issued Eligibility Certificate, had she applied for the same before taking admission for the medical course in the medical institution abroad.

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 eligible to appear for the Screening Test concerned. Noticing the fact that the petitioner was permitted by the competent authority i.e. Indian Medical Council to appear for Screening Test and the fact that she had cleared the Screening Test were not disputed by the State Medical Council,  the Bench remarked,

“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.”

Accordingly, the stand of the Council that the qualification obtained by the petitioner could not be regarded as one in accordance with the provisions of the IMC Act as she had not obtained Eligibility Certificate before taking admission, so as to become eligible to be enrolled as a medical practitioner in the State Medical Register was held to be unsustainable.

  1. Whether a person who obtains a medical qualification from a medical institution abroad and undertakes one year internship thereafter in the country of education and satisfies all other eligibility criteria for enrolment on a State Medical Register be insisted to undergo CRRI for the said purpose?

As per the IMC Act and Regulation 11 a person who obtains medical qualification granted by medical institutions outside India recognised for enrolment as medical practitioner in that country and who clears the Screening Test in terms of Section 13(4A) of the IMC Act, is entitled to be enrolled as a medical practitioner on any State Medical Register, if he has already undergone one year internship.

Since the fact that the petitioner had obtained a medical qualification granted by a medical institution in a country outside India recognised for enrolment as medical practitioner in that country and the fact that she had cleared the Screening Test were not in dispute, including the fact that the petitioner had completed one year internship after acquiring the primary medical qualification, the Bench held that the State Medical Council was obliged to grant permanent registration to the petitioner and they could not insist that the petitioner should undergo CRRI for the said purpose.

  1. Whether the State Medical Council is empowered to take decisions in the nature of Ext.P21?

Opining that a person who is entitled to registration in a State Medical Register in terms of the provisions of the IMC Act could not be denied registration by the State Medical Council, and the medical qualifications of foreign medical graduates who satisfy the requirements in the said provision are deemed to be recognised medical qualifications for the purpose of the IMC Act, the Bench was of the view that the requirement in terms of Ext.P21 that such medical graduates should undergo CRRI for claiming permanent registration was inconsistent with the requirement in terms of the IMC Act and also the Regulations.

“The IMC Act is one relatable to Entry 66 of List I of the Seventh Schedule to the Constitution and the TCMP Act is one relatable to Entries 25 and 26 of List III of the Seventh Schedule.   In other words, Ext.P21 decision of the State Medical Council being inconsistent with the provisions contained in the IMC Act, the same is invalid and unenforceable.”  

Conclusion

In the result, the writ petitions were 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. [Sadhiya Siyad v. State of Kerala, 2021 SCC OnLine Ker 3954, decided on 20-10-2021]


Kamini Sharma, Editorial Assistant has reported this brief.


Appearance by:

Counsel for the Petitioner: Santhosh Mathew, Arun Thomas, Jennis Stephen, Vijay V. Paul, Karthika Maria, Veena Raveendran, Anil Sebastian Pulickel and Divya Sara George

Counsel for the State: Titus Mani and N.Raghuraj, SC, TCMC & KNMC

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