Supreme Court decision impacts state medical admissions

Source: The post Supreme Court decision impacts state medical admissions has been created, based on the article “Over-centralisation threatens federal health policy” published in “The Hindu” on 6th March 2025.

UPSC Syllabus Topic: GS Paper2- Polity-challenges pertaining

to the federal structure And Issues relating to development and management of Social Sector/Services relating to Health

Context: The article criticizes the Supreme Court’s decision to strike down domicile-based reservations in post-graduate medical admissions, arguing that it undermines State health planning, discourages investment in medical colleges, and increases central control over medical education, worsening regional disparities.

For detailed information on Reservations in super-speciality courses read this article here

Why did the Supreme Court strike down domicile-based reservations in post-graduate medical admissions?

1. Constitutional Violation: The Supreme Court struck down domicile-based reservations as it found them to violate Article 14 of the Constitution, which ensures equality before the law.
2. Precedent Reliance: The decision relied on the Pradeep Jain vs Union of India (1984) case, which sets a precedent for ensuring equal opportunities in medical admissions across states.
3. Meritocracy Emphasis: The Court aimed to uphold meritocracy, arguing that admissions should be based solely on merit to maintain educational standards and fairness.

4.Distinction Overlooked: Critics argue that the Court overlooked the crucial distinction between undergraduate (MBBS) and post-graduate medical education, the latter being essential for replenishing the state’s specialist workforce.

How did the ruling impact State investments in medical education?

1. The ruling discourages States from investing in medical colleges, fearing that specialists trained there might leave.
2. States allocate significant funds for medical education to retain a local specialist workforce, crucial for public health.
3. Without domicile quotas, States might deprioritise medical college funding, risking infrastructure decline.
4. Central institutions like AIIMS and JIPMER have autonomy in admissions, but State colleges lack similar control.
5. The Economic Survey 2024-25 noted that domicile quotas help retain specialists, supporting local healthcare access and reducing disparities.

What are the risks of excessive centralisation in medical education?

1. The Court’s decision promotes centralisation in medical education, limiting States’ ability to address local health needs.
2. Public health is a State responsibility under the Constitution, and medical colleges are part of this infrastructure.
3. Critics argue that centralisation could widen healthcare disparities and weaken the States’ role in managing public health.
4. The Economic Survey 2024-25 highlighted that domicile-based reservations help retain specialists in their home States, ensuring better healthcare access.

Does the judgment overlook structural issues in medical education?

1. Yes, the judgment overlooks structural issues in medical education.
2. NEET PG 2023 results exposed flaws, with qualifying percentiles reduced to zero to fill seats.
3. Cases like Jagdish Saran (1982) and Neil Aurelio Nunes (2022) highlighted that merit should consider social equity.
4. Domicile-based reservations help retain local doctors, addressing specialist shortages.
5. Prioritizing merit without addressing inequalities risks deepening regional healthcare disparities and undermining State health planning.

Why is there a need to reconsider the verdict?

1. Impact on State Investment: States may reduce funding for medical colleges without domicile quotas, fearing specialists might migrate. This could worsen regional health disparities.
2. Healthcare Challenges: Shortages of specialists and rising non-communicable diseases require policies retaining local doctors.
3. Proven Models: Tamil Nadu’s model links quotas to public service mandates, ensuring local healthcare benefits.
4. Merit System Flaws: In 2023, NEET PG’s qualifying percentile was lowered to zero to fill seats, revealing flaws in the merit-based system.

Question for practice:

Evaluate whether the Supreme Court’s decision to strike down domicile-based reservations in post-graduate medical admissions effectively balances meritocracy with the need to address regional healthcare disparities.