New Delhi: The Supreme Court Wednesday struck down domicile-based reservations in post-graduate (PG) medical admissions under the state quota, declaring them “unconstitutional” for violating the Right to Equality under Article 14 of the Constitution.
The judgement eliminates the practice of reserving 50 percent of PG medical seats in state-run colleges for residents of a state. For instance, a student from Haryana who completed their MBBS in Punjab was previously eligible for PG seats under both Punjab’s state quota (institutional preference) and Haryana’s domicile quota.
“If such a reservation is permitted then it would be an invasion of the fundamental rights of several students, who are being treated unequally simply for the reasons that they belong to a different state in the Union! This would be a violation of the equality clause in Article 14 of the Constitution and would amount to a denial of equality before the law,” the SC said.
In other words, the three-judge bench of Justices Hrishikesh Roy, Sudhanshu Dhulia, and S.V.N Bhatti asserted that state quota seats must be filled solely based on merit as determined by the National Eligibility-cum-Entrance Test (NEET).
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Two parts of the state quota
Dr Dhruv Chauhan, national coordinator of the Indian Medical Association Junior Doctors’ Network (IMA JDN), welcomed the Supreme Court’s decision.
He explained that the state quota for postgraduate medical admissions was divided into two parts.
“The first was ‘institutional preference’, which was reserved for students who had completed their MBBS degree from the same state where they were applying for postgraduate courses,” he said.
The second part, he added, was ‘domicile-based reservation’, where a portion of the seats is reserved for candidates who are permanent residents of that particular state.
A three-judge SC bench removed the latter, with Justice Sudhanshu Dhulia saying, “We are all domiciled in the territory of India. We are all residents of India. Our common bond as citizens and residents of one country gives us the right not only to choose our residence anywhere in India, but also gives us the right to carry on trade and business or a profession anywhere in India. It also gives us the right to seek admission in educational institutions across India.”
However, the judgment does not affect domicile-based reservations that have already been granted.
Clarity on policy in Chandigarh
Referencing an order by the Punjab and Haryana High Court on a series of petitions filed in 2019, the Supreme Court also provided clarity on the reservation policy for 50 percent of the state quota seats in Chandigarh. It ruled that candidates who completed their MBBS from the Government Medical College and Hospital (GMCH), Chandigarh, are eligible for institutional preference.
Additionally, those who studied in Chandigarh for five years, whose parents lived there for five years, or who own immovable property in the Union Territory could qualify under the UT pool. Of the 64 available PG seats, 32 were rightly allocated based on institutional preference.
However, the Supreme Court upheld the High Court’s finding that the remaining 32 seats had been wrongly allocated based on residence criteria, thereby striking down domicile-based reservations in PG medical admissions.
Several doctors voiced support for the Supreme Court’s decision. Dr. Sudhir Kumar, a neurologist at Apollo Hyderabad, called it a progressive step. “If we aim to compete with the world’s leading healthcare systems, it is crucial that the best doctors are given the opportunity to pursue MD, MS, DM, or MCh courses at the medical colleges of their choice based on their all-India rank in the NEET-PG entrance,” he told ThePrint.
“Merit should never be compromised. It creates a level-playing field,” said Dr. Rohan Krishnan, national chairman and co-founder FAIMA Doctors Association. “These reservations often take away opportunities from candidates who, despite completing their MBBS in remote areas, aspire to join prestigious institutions for further studies.”
Pushback from the South
Tamil Nadu strongly opposed the Supreme Court’s ruling, with Health Minister Ma. Subramanian announcing that the state government will soon file a review petition after consulting legal experts.
Doctors from southern states have also voiced concerns, arguing that the verdict undermines regional rights and social justice.
Dr. G.R. Ravindranath, general secretary of the Doctors’ Association for Social Equality (DASE), called the ruling “highly condemnable” and “regrettable”. He contended that it goes against constitutional principles, social justice, reservation policies, and the interests of Tamil Nadu and other states.
“In India, states were formed based on linguistic identities. Every state has the right to develop its own education system, language, skills, economy, and culture. This judgment is against the linguistic framework of India,” he said. “The Supreme Court’s stance that there should be no regional or state-based domicile reservation is detrimental to the federal structure of the country.”
According to data shared by the Union Health Ministry in response to a Lok Sabha question in February 2024, India had 70,645 postgraduate medical seats in the 2023-2024 academic session.
Karnataka, with a population of 6.76 crore (according to UIDAI data), offers the highest number of PG medical seats at 6,402, followed by Maharashtra with 6,043 seats for a population of 12.63 crore.
Dr. Jason Philip, a senior urologist at the Government Kalaignar Centenary Hospital in Chennai, expressed his disappointment on social media platform ‘X’, highlighting Tamil Nadu’s extensive investment in healthcare infrastructure.
He argued that Tamil Nadu’s PG medical training system ensures that doctors, after gaining expertise, return to their hometowns and villages to serve rural and semi-rural communities, calling it a “winning model”. He pointed out that the state has pioneered advanced medical treatments, including robotic surgery, laser procedures, state-of-the-art operating theatres, free bone marrow transplants, and cadaver transplants.
Dr. Philip alleged that the Supreme Court’s ruling could allow students from other states to receive training in Tamil Nadu’s premier institutions—funded by Tamil taxpayers—only to leave and practice in corporate hospitals elsewhere, particularly in states that have invested little in healthcare. He equated this to the “misappropriation of Tamil Nadu’s resources”.
(Edited by Sanya Mathur)