Healthcare is a matter of national importance, a key to Swasth Bharat, and the resident doctors are crucial for the entire healthcare system

The matter of introducing 27 percent reservations for the Other Backward Classes (OBCs) and the Economically Weaker Sections (EWSs) in medical education both at Under Graduate (UG) and Post Graduate (PG) levels is at crucial stage of hearing before the Supreme Court. The medical students and the entire nation are waiting with bated breath for the judgement of the apex court as it is a matter of vital importance involving and intertwining social justice and quality medical education. 

A group of resident doctors has challenged before the Supreme Court the government notification providing the impugned reservations.   On July 29, 2021, the Union government had issued a notification introducing the above two new reservations for undergraduate and postgraduate medical and dental courses beginning from the current academic year 2021-22.   The notification reserves 27 per cent seats for the OBC and 10 percent seats for the EWS under All India Quota (AIQ).  The NEET-UG examination for admission to the MBBS course is conducted by the National Testing Agency, Ministry of Education while the National Board of Examination (NBE), Ministry of Health and Family Welfare conducts the NEET-PG examination for medical and dental courses in the country. 

The NEET-PG exam was supposed to be held in the month of January 2021 but was postponed to April 2021 and, in the meanwhile, owing to the evolving Covid-19 situation, the exam was further postponed to September 2021. The exam results came out in October.   The counselling was to start from the end of October itself but it could not start as the notification was challenged in the Supreme Court by some doctors and the matter is sub-judice.  The petitioners also challenged the reasonableness of the annual income ceiling of ?. 8 lakhfixed to determine EWS status.  Another important aspect is the fate of those candidates who have secured higher ranking in the order of merit but would be deprived of admission due to these two new reservations unless additional seats are created for them.

Although the resident doctors have called off the strike on the personal intervention of the Union Health Minister, the problem of inordinate delay in admissions and the inevitable denial of admission to meritorious students continues to be a cause of serious concern and worry.   The problem needs speedy and amicable resolution in view of the looming threat of yet another but far contagious wave of the pandemic and the possible enormous swell in patients. The resident doctors were protesting since November 27 against the multiple postponements of the NEET-PG 2021 counselling and the resultant delay in admission of the fresh batch of doctors in medical colleges.

The  All-India Quota (AIQ) scheme was introduced in 1986 under the Supreme Court's direction to provide for domicile-free merit-based opportunities to students from any state aspiring to study in a good medical college in any of the  states. The AIQ consists of 15 per cent of the total available UG seats and 50 per cent of the total available PG seats in government medical colleges.  Prior to 2007, there was no reservation in the AIQ scheme.  In 2007, the Supreme Court introduced 15 per cent reservation for the Scheduled Castes (SCs) and a 7.5 per cent quota for the Scheduled Tribes (STs) in the AIQ scheme.  When the Central Educational Institutions (Reservation in Admission) Act came into force in 2007, it provided for the first time 27 per cent reservation to the OBCs.  It was implemented by all the central medical educational institutions but not applied to the AIQ seats of the state medical and dental colleges. The 103rd Constitution Amendment made in 2019, provided for 10 per cent reservation for the EWS category in all central educational institutions. The number of seats in the medical and dental colleges was increased to accommodate this additional 10 per cent EWS reservation without affecting the seats of the unreserved category.

On a petition, the Madras High Court ruled in July 2020 that the OBCs were entitled to reservations in the AIQ seats and directed the Union Government to implement the same from the academic year 2021.  The Union Government vide their notification in July, 2021 decided to provide 27 per cent reservation for OBCs and 10 per cent reservation for EWS in the AIQ seats for all the UG and PG courses from the current academic year 2021-22. Given the enormous delay in holding NEET-PG-21 counselling, the government could have taken a decision to implement these reservations from the academic year 2022-23. But no popular government can afford dithering and prevaricating on a highly emotive and inflammable issue of social justice, more so when elections are round the corner.  The clarion call of social justice is seen as a potentially powerful tool to secure political power.  There were times when the politics of Mandal and Kamandal were at loggerheads but today a blend of both is perceived as sure recipe for electoral triumph. The report of Mandal Commission was pulled out of hibernation all of a sudden by then Prime Minister VP Singh as a counter-measure to save his government.  P V Narasimha Rao, short of a full parliamentary majority, introduced 10 percent reservation for the EWS apart from 27 percent reservations for the OBCs. The notification was challenged, and the Supreme Court in the famous Indra Sawhney vs Union of India, 1992, upheld 27 percent quota for the OBCs but struck down 10 percent reservation for the EWS.  However, with the passage of the 103rd Constitution Amendment, the reservation for the EWS has been constitutionally guaranteed, albeit some institutions of national excellence and pioneering research in matters of national and strategic importance have been kept beyond the ambit of reservations.

The resident doctors want NEET-PG-21 Counselling to start without further loss of time, which has been delayed unconscionably and inordinately for multiple reasons.  The academic session 2022-23 is only a few months away and given the severe constraints of infrastructure and faculty, approximately 90,000 PG students cannot be catered to by the system meant for 45,000 students per academic year. Besides causing avoidable mental agony and strain to the students, it will have adverse cascading effect on teaching and patient-treatment.  To overcome the shortage of teachers, the Medical Council of India (now Medical Commission under the new Act) increased the professor-teacher ratio from 1:2 to 1:3 from the academic session 2018-19.  The professors are already overburdened and the simultaneous running of two batches, under the circumstance, would pose formidable challenge.  Yet, the nation needs new batches of meritorious PG doctors. Healthcare is a matter of national importance, a key to Swasth-Bharat, and the resident doctors are so crucial for the entire healthcare system.  Hopefully, the judgement of the Supreme Court will resolve the matter amicably in the best and long-term interest of the nation as we can ill-afford strikes by our doctors.

(The writer is a member of Delhi Bar Council. The views expressed are personal.)