A Critical Case review from State of Madhya Pradesh, India
Dr. Mukesh Yadav, B.Sc., M.B.B.S., M.D., LL.B., PGDHR
Prof. & HOD, Forensic Medicine & Toxicology
Muzaffarnagar Medical College, Muzaffarnagar, U.P.
Problem of recognition of medical degrees / diplomas awarded by the Government Medical Colleges is still persisting through out the India and drawing the attention not only of the Hon’ble Apex Court of India but also of the various High Courts. The present case report deals with the problem of the Government Medical Colleges of Madhya Pradesh. Dr. S.K. Neema, who completed his M.S. (Orthopedics) from G.R. Medical College, Gwalior, which is not recognised by the Medical Council of India, whose appointment for the post of Assistant Professor, Orthopedics was challenged by Dr. Omprakash Lakhwani on the ground that the course i.e. M.S. (Orthopedics) is not recognised by the Medical Council of India in G.R. Medical College, Gwalior from where Dr. S.K. Neema has obtained M.S.(Orthopedics) degree, hence, he is not eligible for appointment to the said post.
Hon’ble High Court has gone into the depth of the problem, their consequential effects on the medical student’s community, role of the various authorities, and directions to solve the problem. [Para 9] 
This paper deals with critical review of the problem based on recent six pages judgment delivered by the Justice, Subhash Samvatsar, at Jabalpur Bench, Gwalior, High Court of Judicature of Madhya Pradesh on May 13, 2008, in Writ Petition No. 2943 of 2004 in case of Dr. Omprakash Lakhwani v. State of Madhya Pradesh and Others.
Key Words: Recognition of Degree, High Court, Apex Court, Supreme Court, State Medical Council, University, State Government of M.P.
Brief facts of the case:
That said course M.S. (Ortho) is being run by G.R. Medical College, Gwalior for more than 25 years and the students who clear the said examination are being appointed by the State Government. [Para 6] 
Various government authorities like: the State of Madhya Pradesh, Medical Council of India, Madhya Pradesh Medical Council and G.R. Medical College, Gwalior have admitted that the course of MS (Orthopedics) is run in G.R. Medical College, Gwalior for large number of years. It was also contended that for recognition of the said course, the Medical Council of India had conducted inspections of the College whereby the Medical Council of India had recommended for recognition of the course of MS (Orthopedics) in G.R. Medical College, Gwalior. But till today, no recognition is granted by the Medical Council of India. [Para 10] 
However, the question before the Hon’ble High Court was what is its effect? Hon’ble High Court has gone into the depth of the problem, their consequential effects on the medical student’s community, role of the various authorities, and directions to solve the problem. [Para 9] 
This writ petition is filed by the petitioner (Dr. Omprakash Lakhwani) challenging the contractual appointment of respondent No.6 (Dr. S.K. Neema) to the post of Assistant Professor in the Department of Orthopedics in G.R. Medical College, Gwalior on the ground that his appointment is contrary to the rules framed by the Medical Council of India. [Para 1] 
Dr. Omprakash Lakhwani had obtained his MBBS degree from Jiwaji University, Gwalior in the year 1994. He had successfully completed three years post graduate course in Orthopedics from M.G.M. College, Indore in the year 2003. After completing his MS course in the year 2003, he applied for the post of Assistant Professor on contractual basis in pursuance of an advertisement issued by the Directorate of Medical Education, Madhya Pradesh. This advertisement was issued on July 22, 2004 inviting applications for various posts. Dr. Omprakash Lakhwani as well as Dr. S.K. Neema applied for the said post. After facing selection process, the selection committee found Dr. S.K. Neema to be more meritorious and appointed him as Assistant Professor in G.R. Medical College at Gwalior.
Although Dr. Omprakash Lakhwani was also selected in the said selection, but he was placed lower in merit than Dr. S.K. Neema hence he was posted at Rewa Medical College. [Para 2] 
Contention of the learned counsel for Dr. Omprakash Lakhwani is that the course i.e. M.S. (Orthopedics) is not recognised by the Medical Council of India in G.R. Medical College, Gwalior from where Dr. S.K. Neema has obtained M.S.(Orthopedics) degree, hence, he is not eligible for appointment to the said post. [Para 3] 
Counsel for Dr. Omprakash Lakhwani has invited attention of the Hon’ble High Court to clause 6 of the advertisement according to which, it is necessary that a candidate must have a degree in the subject from the institution recognised by Medical Council of India. Thus, according to the advertisement, it is necessary that the candidate must have got a degree from the institution where the course is recognised by Medical Council of India. [Para 4] 
Counsel for Dr. Omprakash Lakhwani also invited attention of the Hon’ble High Court to the document which is a list issued by Madhya Pradesh Medical Council, Bhopal of various courses in various colleges in the State of Madhya Pradesh which are not recognised. As per the list, M.S. (Orth.) is not recognised in G.R. Medical College, Gwalior. Learned counsel has also invited attention of this Court to the schedule appended to the Indian Medical Council Act, 1956 to demonstrate that the subject of Orthopedics is not recognised in G.R. Medical College, Gwalior. [Para 8] 
Said course, is however, recognised in M.G.M. Medical College, Indore from where Dr. Omprakash Lakhwani obtained his degree in MS (Orthopedics). Thus, as per, Dr. Omprakash Lakhwani, Dr. S.K. Neema is not eligible to be appointed as Assistant Professor. [Para 5] 
After perusal of records it is virtually an admitted position that MS (Orthopedics) is not recognised in G.R. Medical College, Gwalior, still Dr. S.K. Neema is appointed against the post of Assistant Professor in the Department of Orthopedics. Parties, at the time of arguments, have admitted that said course is being run by G.R. Medical College, Gwalior for more than 25 years and the students who clear the said examination are being appointed by the State Government.
It was further contended by Shri R.D.Jain, learned Senior Advocate appearing on behalf of Dr. Omprakash Lakhwani that the illegality which is committed by the Authorities for long years cannot be permitted to be perpetuated. Hence, appointment of Dr. S.K. Neema be cancelled. [Para 7] 
Hon’ble High Court observed that there is no dispute to the fact, in the present case, that the course of MS (Orthopedics) is not recognised in G.R. Medical College, Gwalior. What is the effect of running courses and awarding unrecognized medical degrees / diplomas by the Government Medical Colleges?
Learned counsel appearing for the State of Madhya Pradesh, Medical Council of India, Madhya Pradesh Medical Council and G.R. Medical College, Gwalior have admitted that the course of MS (Orthopedics) is run in G.R. Medical College, Gwalior for large number of years. It is also contended that for recognition of the said course, the Medical Council of India had conducted inspections of the College whereby the Medical Council of India had recommended for recognition of the course of MS (Orthopedics) in G.R. Medical College, Gwalior. But till today, no recognition is granted by the Medical Council of India. [Para 10] 
Insensitivity of the Government:
Mayhem and chaos ruled the day in Government Hospitals of Madhya Pradesh as Junior Doctors went on strike following the Medical Council of India’s recommendations to derecognize 154 medical Post Graduate seats in the State. On Monday Junior Doctors of Bhopal, Jabalpur, Gwalior and Rewa went on strike. Junior Doctors in Indore are joined the strike on Tuesday. Patients queued up out side of the emergency ward of Government Hospitals while nurses assumed charge and major operations were postponed. The Government remained silent while patient waited for hours hoping for doctor to attend to them. 
Last year (2007) the MCI inspected Medical Colleges in MP and found the Institutions unsuitable to churn out quality doctors. Since 1996 MCI has been repeatedly observing that the basic infrastructure of Medical Colleges in the State did not match standard set by the Council. In March this year (2007), MCI recommended that 154 Post Graduate seats be derecognized. MP has five Government Medical Colleges. The MCI also asked the Centre to direct the colleges not admit fresher for 2007-2008 academic session, unless the State Government introduced the necessary infrastructural changes. Junior Doctors claim that doctors seeking jobs outside MP were facing discrimination as the validity of their degrees was being questioned. 
In fact, if State Government did make adequate changes in the existing Medical Colleges as per standard prescribed by MCI, their degree were valueless. “If the Medical Colleges are derecognized, then we are ‘fargy’ (fraud) doctors. It will not be right for fraud doctors to treat patients,” –Junior Doctor’s Association, President, Jeevan Singh Meena, argued. 
“We are not the ones to be blamed,” -Meena justified. “We had informed the Government 48 hours in advance. For the last nine years, the Government has been inactive. The State has not assured us that it will bring the Medical Colleges to the standard set by the MCI. If our degrees are not recognised who will give us job? Even this Government not employs us any longer.” 
On its part, State Medical Education Department has argued that the strike is unjustified because neither the MCI nor the Union Government has informed MP Government about derecognition. Principal Secretary, Medical Education, M. M. Upadhyay told reporters “we have spoken to the Union Government on this and have been assured to that as per rules the State Government will be consulted before the Centre takes any action on the MCI recommendations.” 
The department claimed that after the MCI’s recommendation in March, 2007 the State has recruited Assistant Professors in the faculties, considering construction of buildings and purchasing medical equipments and instruments. A budget of 73.73 crore has been allotted for the up gradation of Medical Colleges. 
Hon’ble High Court’s important observations:
In the present case, an advertisement was issued by the State for contractual appointment to the post of Assistant Professor and both – Dr. Omprakash Lakhwani and Dr. S.K. Neema– had applied. There is no dispute that the essential qualification for appointment to the post of Assistant Professor is having MS degree from an institution in the course recognised by the Medical Council of India. [Para 11] 
Hon’ble High Court after having heard learned counsel for the parties and observed that “I find that the Apex Court in the case of Dr.Arun Kumar Agrawal vs. the State of Bihar, AIR 1991 SC 1514  has considered the similar situation. In that case also, Patna Medical College and Hospital, Patna had issued advertisement and selection committed had made appointments after considering the merits of the candidates.
It was argued that the candidate who is selected did not fulfill criterion of passing post graduate degree from an institution where the said course was recognised and the Apex Court has held that whether the post graduate course is started by the University with the consent of Medical Council of India and where the State has recognised the said degree imparted by the University, plea raised that the candidate has obtained decree in such course which was not recognised in the institution has no value and dismissed the petition”. [Para 14] 
Hon’ble Court further observed that the Contention of Shri R.D. Jain, learned Senior Advocate for Dr. Omprakash Lakhwani is that, in that case, there was consent by the State Government and the Medical Council of India which is not present in the present case. Hence, the facts of the aforesaid case are quite distinguishable. [Para 15] 
On the question of Consent of the State Government and Medical Council of India:
Hon’ble High Court observed that in the present case, I find that Dr. S.K. Neema was a candidate from All India Quotas. He was allotted a seat in MS (Orthopedics) by Director of Medical Education on the basis of his merits. At the time of allotment of seat, the Director of Medical Education must have knowledge that said course is not recognized by Medical Council of India. Thus, the State Government had consented to the admission of Dr. S.K. Neema in G.R. Medical College, Gwalior. [Para 16] 
Hon’ble Court further added that apart from that, at the time of admission of Dr. S.K. Neema, the State Authorities were fully conscious of the fact that said course was not recognised and still Dr. S.K. Neema was appointed by the State. This clearly shows that there was implied consent by the State Government, firstly at the time of admission and secondly at the time of appointment in service. Now it cannot be said that the State Government had not consented to this fact. [Para 17, Page No.5] 
It is an admitted position that the course of MS (Orthopedics) is run for the last more than 25 years in G.R. Medical College and candidates who have cleared the said post graduate courses are being appointed by the State Government from time to time. Thus, in the present case, objection about not having consent of the State Government cannot be maintained. [Para 17] 
Comments about role of Madhya Pradesh Medical Council:
Hon’ble High Court made comments about the role of M.P. State Medical Council in the words that so far as Madhya Pradesh Medical Council is concerned, it cannot be presumed that they are not aware of this illegality. It is true that illegality cannot be permitted to be perpetuated, all the same, it is the Respondents Authorities which are indulging in continuing such illegality and the innocent students who come from outside the State and getting admission are made to suffer without any fault on their part. [Para 18] 
Hon’ble High Court concluded that considering this aspect of the matter, I find that the judgment of the Apex Court in the case of Dr.Arun Kumar Agrawal  is fully applicable in the present case and there is no illegality in the appointment of Dr. S.K Neema. At the most, it can be said that there is some irregularity in his appointment for which Dr. S.K Neema cannot be held to be responsible. [Para 19] 
Perusal of Schedules to the Indian Medical Council Act, 1956 clearly indicates that the medical qualifications which are recognized by the Universities and Medical Institutions in India have been mentioned. According to the First Schedule qualification Doctor of Medicine in Pathology in abbreviation from M.D. (Path.) has been recognized in the Rani Durgavati Vishwa Vidhyalya, Jabalpur. Thus, it was incumbent upon the respondent No. 1 University to have awarded only that degree which is recognized one and to amend the degree from that of M.D. (Pathology and Microbiology) to M.D. (Pathology) as this is the only change in nomenclature of the degree. For the fault of University, the students cannot be made to suffer. Since they have acquired qualifications, degrees in M.D. (Pathology and Microbiology) should be amended as the Schedule to Act of 1956 does not recognize the degree in M.D (Pathology and Microbiology). The petitioner and such other similar students are being deprived of their right to education and other fundamental rights enshrined under Articles 14, and 21 of the Constitution of India which make it clear that the petitioner and such other students cannot be dealt with in such an arbitrary manner. [Para 8] 
The respondents are bound to act within the purview of Medical Council Act, 1956. I find no rhyme or reason in the explanation offered by the Rani Durgavati Vishwa Vidyalya in not amending nomenclature of the degree of M.D. (Pathology and Microbiology). If the degree is not amended, it may be detrimental to the students who have passed out the examination by making hard efforts to obtaining the degree and their qualification would go in waste. In such circumstances, the decision was taken by Devi Ahilya Vishwa Vidyalya, Indore and by notification Annexure A-8; the said University has recalled its order and amended the degree. Therefore, same action ought to have been taken by the respondent No. 1 University to amend the degree of the students who have been taken by the University to amend the degree of the student who have passed prior to 1997 when it has decided to amend it prospectively. Though the University realized the situation and its mistake and they have passed the resolutions in this respect in 1997 the student of 1990 to 1996 are being still awarded by the degree with nomenclature on the basis of same course as M.D. (Pathology and Microbiology). The action taken is discriminatory. Right to Education is a fundamental right. Under Article 21 of the Constitution of India no one can be deprived of fruits of his hard labour in pursuit of degree in question by prescribing a wrong nomenclature. Medical Council had indicated it’s willing to treat degree as one in M.D. in Pathology as same course which should have been enough for University to amend it and act like Devi Ahilya University, India. [Para 8] 
Summary and Conclusions:
It is not disputed that there are number of courses which are not recognised by the Medical Council of India. Students are admitted to such courses as per the allotment made by the Director of Medical Education in spite of the fact that the Director of Medical Education is fully aware of the fact that said courses are not recognised by the Medical Council of India. Medical Council of India and the Madhya Pradesh Medical Council are also watching this illegality for number of years as silent spectators and thus, all these Authorities are playing with the career of the students which cannot be permitted to be done. If the Medical Council of India and Madhya Pradesh Medical Council permitted to watch the game as silent spectators and continue the illegality in admissions, then the very purpose of establishing these Authorities will be frustrated. In such a situation, it is for the aforesaid Authorities to see that in future, no candidate is allotted seat in post graduate degree course in the Institutions which are not recognised. Therefore, they are directed not to admit any student in future against any course which is not recognised by the Medical Council of India in a particular Institution. [Para 20, Page No.5, 6] 
In the result, Hon’ble High Court dismissed the said petition with the directions issued to be followed in future. [Para 21, Page No. 6] 
Dr. Omprakash Lakhwani v. State of Madhya Pradesh and others, Writ Petition No.2943 of 2004, High Court of Judicature of Madhya Pradesh: Jabalpur Bench at Gwalior, Date of disposal: May 13, 2008.
The Indian Medical Council Act, 1956, Schedules.
The Minimum Qualifications for Teachers in Medical Institutions Regulations, 1998.
Dr.Arun Kumar Agrawal vs. the State of Bihar, AIR 1991 SC 1514.
‘Jr doctors stop work in MP’, The Times of India, December 15, 2007.
Dr. Harish Bajaj v. Rani Durgavati Vishwa Vidyalaya, Jabalpur and Others, AIR 2003 Madhya Pradesh 114-117, Writ Petition No. 30 of 2002, dated 10-05-2002.
Dr. B.L. Asawa v. State of Rajasthan and Others, Rajasthan High Court in D.B. Civil Appeal No. 247 of 1974), decided on March 5, 1982.
Om Prakash and Others v. State of U.P. and Others, Writ Petition No. 1563 (M/B) of 2005, Order dated April 22, 2005 of Lucknow Bench, Allahabad High Court.
Dr. Mukesh Yadav & Others v. Union of India & Others, Writ No.124 of 2008, Supreme Court of India.
Dr. Ms. Swapnil Sandhya & Others v. Union of India & Others, W.P. (Civil) 3065/2002, Disposed on March 12, 2008 in the High Court of Delhi at New Delhi.
Medical Council of India v. State of Karnataka and Others, AIR 1998 SC 2423.