'Like Learning Swimming Without Entering Water' : NMC Opposes Relaxations For Foreign Medical Graduates Without Clinical Training
A medical student who has not undergone clinical training was like someone who has learned the theory of swimming but has never entered the water, and as such, such students should not be allowed to treat Indian patients under any circumstances, Advocate Gaurav Sharma, appearing on behalf of the National Medical Council, told the Supreme Court on Friday. "Because of a lack of training...
A medical student who has not undergone clinical training was like someone who has learned the theory of swimming but has never entered the water, and as such, such students should not be allowed to treat Indian patients under any circumstances, Advocate Gaurav Sharma, appearing on behalf of the National Medical Council, told the Supreme Court on Friday.
"Because of a lack of training and practice, the medical council does not consider them fit to treat Indian patients. There are human lives involved. We are not against these students but are more concerned about the common people they will treat if allowed. We cannot take even one per cent risk when it comes to Indian patients," he submitted before the bench hearing a batch of petitions filed by foreign medical graduates who were repatriated before completing their clinical training for China or the Philippines because of the stringent COVID-19 travel restrictions in the countries, or from Ukraine, following the Russian invasion. The aggrieved students had moved the top court praying to be accommodated within the Indian medical education architecture as an extraordinary, humanitarian measure. The Division Bench, comprising Justices B.R. Gavai, and Vikram Nath, was invited to issue appropriate directions to, inter alia, the National Medical Council and the Union of India in order to ameliorate the situation of the students, who as the Additional Advocate-General for Tamil Nadu, Amit Anand Tiwari pithily said, were in a 'Catch-22' dilemma – neither able to return to the countries where they were enrolled in foreign medical institutions for reasons beyond their control nor being inducted in the healthcare system of their own country. While refraining from issuing a writ of mandamus in light of its own limitations and admitted lack of expertise, the court, on Friday, urged the centre to 'find out a solution' in consultation with the National Medical Council. Justice Gavai, while pronouncing the order on behalf of the bench, also said that the government might consider constituting a committee of experts to look for an equitable solution, considering the fact that these students could be a national asset when the country was already facing a dearth of doctors. Justice Gavai also said, "If no solution is found at this stage, their entire careers will be left in a lurch and their families will be made to suffer."
Senior Advocate S. Nagamuthu, appearing on behalf of the medical students sent back from China due to the strict COVID-19 travel restrictions in the country, vehemently argued that despite a Bench led by Justice Hemant Gupta allowing repatriated Indian students of the batch 2015-20 to undergo clinical training in India and get provisionally registered, the states of Kerala and Tamil Nadu had refused to extend similar relief to students of the batch 2016-21 who were hit by the same travel curbs. He submitted, "This court has held that the order passed in the other batch would also be applicable to our case. Therefore, the students who joined the medical course in China in 2016 should be given the same benefits. Several state medical councils have complied. Only Kerala and Tamil Nadu have refused. This is when we are covered by two judgements of this court." The reason why the current petitioners were unable to avail of the benefits of the scheme prepared by the government in pursuance of the court order was because they had completed only seven semesters physically and were in their penultimate years, while the scheme covered only students in their final year, the senior counsel explained. Justice Gavai asked Sharma, "Have you granted the benefit to these students?" Sharma replied, "After the second year, every day, a medical student, under the guidance of a professor or an associate professor, is supposed to gain practical knowledge in hospitals. For one and a half years, that is, three semesters, these students have not studied. Nothing has happened in this duration." He also pointed out that this was in stark contrast to the students of the previous batch, who were the beneficiaries of the earlier court order. Sharma said, "The previous batch missed only three months. Even then, they were directed to undergo one year of additional training." Any relaxation in the policy would be patently dangerous, and the situation could be remedied just as well if the students went back to China, Sharma asserted.
The Tamil Nadu law officer suggested that the repatriated students in their penultimate year be allowed to provisionally register with additional clinical training. Countering Sharma's remark about 'going back to China', Tiwari said, "They cannot go back now because they have completed their course. Here also, they are not allowed. This is a Catch-22 situation." He added, "This is a human situation which needs to be addressed soon." Nagamuthu also chimed in, "These students are neither here, nor there. Even in the earlier case, the court accepted that the time and money of these students should not go to waste."
Addressing Additional Solicitor-General Aishwarya Bhati, appearing for the Union of India, Justice Gavai said, "Madam, we only request you to consider this on humanitarian grounds and find a way out. We request the highest authority in the central government to address this human problem keeping in mind the career of the students. We are restricting this to only those students who have completed seven or eight semesters by June 2022. We do not want to issue a mandamus because we know our limitations." He added, "Leaving it to the National Medical Council would be no good, since we know how adamant they are." Bhati responded, "You are aware that physicians in India are well respected because of the strict guidelines that we follow." Justice Gavai countered, "I hope you remember Ahmedabad."
Then, Justice Gavai proceeded to dictate, "…Though we find that this is a fit case wherein some solution which must be evolved by the experts in the field, we refrain ourselves from issuing any directions. However, we request the Union of India, i.e the Ministry of Health, the Ministry of External Affairs and the Ministry of Home in consultation with the National Medical Commissions to find a solution to address this human problem. We are sure that the Union of India will give due importance to our suggestion and find out a solution so that the career of students, who are undisputedly an asset to the nation and particularly when there is a dearth of doctors in the country, will be positively addressed."
Earlier, in April, a Division Bench of the apex court had directed the National Medical Council to frame a scheme to allow students of the batch 2015-20 who were unable to undergo their clinical training to complete it in medical colleges identified by the council, while hearing an appeal against a Madras High Court direction to allow such a student to be provisionally registered.
Case Title
Abin Philip George & Ors. v. National Medical Commission [WP (C) No. 1038/2022] and other connected matters