* THE HON’BLE SRI JUSTICE V.V.S.RAO AND THE HON’BLE SRI JUSTICE C.V.RAMULU + WRIT PETITION Nos.19238, 19239, 24645, 24774, 24795, 24796, 24797, 24798 and 24799 of 2006; WRIT PETITION Nos.4519 and 21046 of 2007; and WRIT PETITION Nos.483 and 4022 of 2008 % Dated 02-05-2008 # J.Sai Prasanna, D/o.S.Jeya Prakash Narayanan and others. … PETITIONERS VERSUS $ The Medical council of India, rep.by its Secretary, New Delhi, and others. … RESPONDENTS ! Counsel for the Petitioners:Sri P.V.S.Giridhar. ^Counsel for the Respondents: Sri A.R.S.Reddy, Asst.Solicitor General, Sri K.G.Krishna Murthy, Addl.SC, Sri Nagaraju Madireddy, Sri S.Niranjan Reddy. <GIST: >HEAD NOTE: ? Cases referred 1. (2005) 1 SCC 45 2. (2002) 3 SCC 696 3. AIR 1979 SC 193 4. AIR 1988 SC 1883 5. (2001) 7 SCC 358 6. (2002) 3 SCC 722 = AIR 2002 SC 1351 7. (2002) 7 SCC 273 = AIR 2002 SC 3240 8. (2003) 3 SCC 410 = AIR 2003 SC 843 9. (2004) 9 SCC 686 10.(2005) 2 SCC 271 = AIR 2005 SC 648 11.(2006) 3 SCC 434 = AIR 2006 SC 1489 12.(2007) 6 SCC 143 13.(2004) 5 SCC 409 = AIR 2004 SC 2258 14.(2007) 3 SCC 700 15(2000) 6 SCC 127 16.(1987) 1 SCC 424 17.AIR 1955 SC 166 18.AIR 1982 Raj 187 (FB) 19.(2001) 7 SCC 231 THE HON’BLE SRI JUSTICE V.V.S.RAO AND THE HON’BLE SRI JUSTICE C.V.RAMULU WRIT PETITION Nos.19238, 19239, 24645, 24774, 24795, 24796, 24797, 24798 and 24799 of 2006; WRIT PETITION Nos.4519 and 21046 of 2007; and WRIT PETITION Nos.483 and 4022 of 2008 .5.2008 Between: J.Sai Prasanna, D/o.S.Jeya Prakash Narayanan and others … Petitioners AND The Medical council of India, rep.by its Secretary, New Delhi, and others … Respondents THE HON’BLE SRI JUSTICE V.V.S.RAO AND THE HON’BLE SRI JUSTICE C.V.RAMULU WRIT PETITION Nos.19238, 19239, 24645, 24774, 24795, 24796, 24797, 24798 and 24799 of 2006; WRIT PETITION Nos.4519 and 21046 of 2007; and WRIT PETITION Nos.483 and 4022 of 2008 COMMON ORDER: (per Hon’ble Sri Justice V.V.S.Rao) Question for determination in these cases being the same, common order is a necessity. In all these cases, decision dated 10.2.2006 of Executive Committee of Medical Council of India (MCI) and Ad hoc committee dated 10.2.2006 not to grant registration to Bachelor of Medicine and Bachelor of Surgery (MBBS) students who have undergone part of training in an institution in India without obtaining permission from Government of India/MCI, is impugned as illegal and arbitrary and for a consequential direction to grant provisional registration and/or permanent registration under Indian Medical Council Act, 1956 (the Act, for brevity). The said decision of Executive Committee was communicated to all petitioners by different impeached communications sent by Additional Secretary to MCI. These cases can be divided into three groups. In first group, Indian students obtained MBBS degree awarded by International Medical and Technological University (IMTU), Dar-es-salaam, Tanzania. They passed screening test for foreign medical graduates conducted by National Board of Examinations (NBE) under aegis of MCI as per relevant provision in the Act. When they applied for temporary registration under Section 25(1) of the Act, same was denied on the ground that students completed part of the course in unrecognized Indian medical colleges. In second group, students after completing MBBS in Tanzania obtained provisional registration and after completion of internship, applied and got permanent registration from Andhra Pradesh Medical Council (State Council). MCI, however, while cancelling permanent registration, requested holders to surrender original permanent registration certificates. In third group, all the petitioners allegedly studied entire MBBS course in IMTU, Dar-es- salaam. They also passed screening test conducted by NBE, obtained provisional certificates and completed internship. When they applied for permanent registration, MCI asked for details as to whether students completed entire course in IMTU, Dar-es-salaam. Petitioners having procured evidence in support of the same, produced before MCI who did not pass any orders. The case of MCI in all writ petitions is one of justification. Core contention is that Vignan Educational Foundation (VEF), Bangalore, set up IMTU in Tanzania and even before recognition/accreditation was granted, VEF advertised seats, admitted students and those students prosecuted pre-clinical and para-clinical courses at Guntur. Those students later continued their course for period of 1½ year at Dar-es-salaam. As mandatory recognition/permission under Section 10A of the Act was not granted even if petitioners completed their clinical course/training in IMTU, Tanzania, registration cannot be granted. For ready reference, paragraphs 33 to 35 of counter affidavit in W.P.No.24645 of 2006 may be extracted. The averments of para 2 discloses that the petitioners have done both pre-clinical and para-clinical training in an institution at Guntur in Andhra Pradesh for a period of four years. The petitioners state that they have thereafter continued their education for a period of 1½ years at Dar-e- Salaam in Tanzania. This would clearly show that the petitioners cannot claim to have studied in a medical institution outside India. The medical institution where the petitioners have studies for a majority part of their course is in India and the same was established without obtaining the approval under Section 10A of the Indian Medical Council Act. The same cannot therefore be treated as an education availed in a proper medical institution within India for the petitioners to claim any benefit from such course of study. A medical institution would necessarily mean institution where the students are imparted training and education. Merely because the sites of Head Office of the institution, is in a different country it would not automatically mean that the medical institution is located outside India. It would be mandatory that the entire institution where training and education is imparted, has to be outside India for the purpose of Sections 12 & 13 of the Act. In the admitted facts of the case that the petitioners have studied a major part of their course in India they cannot be treated as students of a medical institution outside India. It is therefore incorrect to contend that MBBS degree obtained by the petitioners is a recognized qualification for the purposes of the Indian Medical Council Act or that the same is to be recognized by the Medical Council of India after conducting a screening test. In reply to para 3 it is submitted that the petitioners are not entitled to appear for the screening test inasmuch as the petitioners have availed training and education in an unrecognized institution in India and the petitioners are therefore not eligible for being entitled to appear for the screening test and claim any provisional registration thereafter. The medical institution (being the campus at Guntur) where the petitioners have studied cannot also be stated to be a medical institution outside India for the petitioners to claim the benefit of Section 13(4A) & 13(4B). This Court has heard submissions of Sri E.Manohar, Senior Advocate, appearing for petitioners in first group of cases. M/s.P.V.S.Giridhar, V.Srinivas, M.V.Rajaram and Ms.A.Anasuya, supplemented the submissions of lead Counsel. Learned Standing Counsel for MCI opposed and refuted the submissions made on behalf of petitioners. Two points would arise for consideration. First, whether Section 13(4A) read with Section 25 of the Act disentitle petitioners for grant of provisional/permanent registration? And second point is whether Regulation 11 of Screening Test Regulations, 2002 (Screening Regulations, for brevity) enables MCI to refuse provisional/permanent registration to an MBBS graduate who is qualified in screening test? In Re Point No.1 (i) Legal context The Act is legislation in the occupied field leaving negligible or little role to federal States. It is an act intended to deal with matters connected with medical profession and medical education. The Act was amended in 1964, 1990, 2001 and 2004. Sections 10A, 10B and 10C of the Act were inserted by IMC (Amendment) Act 1993. Section 10A(1) prohibits establishment of a medical college and/or prohibits opening of new courses or increasing admission capacity unless previous permission of Central Government is obtained. Sub-sections (2) to (8) of Section 10A of the Act contain detailed procedure for applying and obtaining previous permission from Central Government and necessary factors to be taken into consideration for approving or disproving the scheme for obtaining permission. Section 10B of the Act speaks of adverse consequences of establishing medical college without previous permission. No medical qualification granted by an unrecognized medical college can be recognised for the purpose of the Act. Sections 11 to 14 of the Act form one set of provisions dealing with recognition of medical qualifications granted by Universities or medical institutions in India and outside India. These provisions have to be read along with Schedule-I, Schedule-II and Schedule-III. Schedule-I contains lengthy list of Graduate, Post Graduate (PG) and Super-specialty medical qualifications granted by Universities or medical institutions in India. As per Section 11(1) of the Act, these degrees shall be recognized as medical qualifications for the purpose of the Act. Schedule-II contains list of medical qualifications granted by medical institutions by an Authority outside India with which MCI has entered into a scheme of reciprocity. Schedule-III contains Part-I and Part-II. Part-I contains recognized medical qualifications granted by medical institutions not included in Schedule-I whereas Part-II contains medical qualifications granted by medical institutions outside India not included in Schedule-II. Schedule III is explained in Section 13 of the Act. Section 13 of the Act as extracted below prior to 2001 amendment contained five sub-sections. They read as under. (13) Recognition of medical qualification granted by certain medical institutions whose qualifications are not included in the first or second schedule (1) The medical qualifications granted by medical institutions in India which are not included in the First Schedule and which are included in Part I of the Third Schedule shall also be recognised medical qualifications for the purposes of this the Act. (2) The medical qualifications granted to a citizen of India:- (a) before the 15th day of August, 1947, by medical institutions in the territories now forming part of Pakistan, and, (b) before the 1st day of April, 1937, by medical institutions in the territories now forming part of Burma, which are included in part 1 of the Third Schedule shall also be recognised medical qualifications for the purposes of this the Act. (3) The medical qualifications granted by medical institutions outside India, which are included in Part II of the Third Schedule shall also be recognised medical qualifications for the purposes of this The Act, but no person possessing any such qualification shall be entitled to enrolment on any State Medical Register unless he is a citizen of India and has undergone such practical training after obtaining that qualification as may be required by the rules or regulations in force in the country granting the qualification, or if he has not undergone any practical training in that country he has undergone such practical training as may be prescribed. (4) The Central Government, after consulting the Council, may, by notification in the Official Gazette, amend Part II of the Third Schedule so as to include therein any qualification granted by a medical institution outside India, which is not included in the Second Schedule: (5) Any medical institution in India which is desirous of getting a medical qualification granted by it included in Part I of the Third Schedule may apply to the Central Government to have such qualification recognised and the Central Government, after consulting the Council, may by notification in the Official Gazette, amend Part I of the Third Schedule so as to include such qualification therein, and any such notification may also direct that an entry shall be made in the last column of Part-I of the Third Schedule against such medical qualification declaring that it shall be a recognised medical qualification only when granted after a specified date. Section 13 of the Act takes care of recognition of medical qualifications, which are not included either in Schedule-I or Schedule- II. Mainly these qualifications include qualifications granted by medical institutions in Pakistan and Burma prior to 15.8.1947 and 01.4.1937 respectively. These are included in Part-I of Schedule-III. Sub-section (3) of Section 13 of the Act recognises medical qualifications included in Part-II of Schedule-III. These medical qualifications essentially are those granted by medical institutions outside India. Sub-sections (4) and (5) of Section 13 of the Act enable any medical institution to apply to Central Government for inclusion either in Part-II or Part-I of Schedule-III in which Central Government may, after consulting MCI, can notify qualifications to be included and recognised for the purpose of the Act. Recognition of a medical qualification under the Act gives right for enrolment in Indian Medical Register and/or State Medical Register. Be it noted, Section 21 of the Act contemplates MCI to maintain Indian Medical Register, which shall contain names of all persons with recognized medical qualifications who are for the time being enrolled on any State Medical Register. Unless and until medical practitioner is permanently registered in State/Indian Medical Register, such person cannot practice medicine as medical practitioner in any part of India (Sections 25 and 27 of the Act). Therefore, recognition of a medical qualification and registration of in State/Indian Medical Register is alone fruitful logical end for a person who obtains medical qualifications. (ii) 2001 Amendment The Act was amended by IMC (Amendment) Act, 2001 (Central Act No.34 of 2001) with effect from 03.09.2001. Sub-sections (4A), (4B) and (4C) were introduced in Section 13. The amendment also inserted two provisos after Section 13(4) and clause (ma) in Section 33 of the Act, which confers power of making regulations of IMC. Section 33(ma) was inserted so as to specify the power of making regulations with reference to a new field which has been brought into existence by inserting Section 13(4A) and (4B). Before noticing the provisions, which are inserted in Section 13, it is necessary to briefly refer to events (as noticed by Supreme Court in Sanjeev Gupta v Union of India[1]), leading to such amendment. In 1981, as requested by Government of India, MCI recognised medical qualifications granted by medical institutions in erstwhile States of USSR. These were included in second schedule of the Act. After disintegration of USSR, serious doubts cropped up regarding the standards of medical education offered by large number of institutions in various States of USSR. It was found that large number of institutions without recognition or before such recognition being granted offered courses. A number of Indian students joined such medical institutions and completed the course. This led to difficulties for MCI in recognising their degrees and registration as medical practitioners. This was subject of indepth enquiry by Government of India and MCI. Ultimately the executive committee of MCI in its meeting on 17.09.1997 took decision with regard to modalities for granting registration to those students coming back from various medical institutions from erstwhile States of USSR. Inter alia it was decided that (i) students who complete their medical degree courses of less than six years duration from institutions in erstwhile USSR shall not be eligible for registration; (ii) students successfully completing six years clinical courses in MCI recognised institute on or after 01.07.1997 shall have to undergo one year internship after obtaining qualification and only such students shall be eligible for permanent registration under Section 13(3) of the Act. On condition that they shall also satisfy other criteria laid down by MCI; and (iii) students who are initially admitted in an institution not recognised by MCI later on migrated and obtained degrees in a recognized institute in erstwhile USSR will not be eligible for any kind of registration in India. Students who took initial admission in non-recognised institutions but later migrated to USSR for study filed writ petitions in different High Courts. Delhi and Allahabad High Courts allowed writ petitions. Aggrieved by which, MCI preferred civil appeals before apex Court. During pendency of appeal before Supreme Court, the Act was amended with effect from 03.09.2001 inserting sub-sections (4A) to (4C) and clause 33(ma). To be in tune with this, sub-section (3) was also slightly modified. In exercise of their powers under Section 33(ma), MCI promulgated Screening Regulations. Brief legislative history referred to hereinabove would show that before 2001 Amendment introduced Section 13(4A), Government of India and MCI faced difficulties in recognising medical degrees granted by institutions in USSR. In those instances, students studied part of the course in unrecognized medical institutions in India and then migrated to complete the course in USSR. The amendment was intended to redress grievance of such category of students. This was also taken notice of by Supreme Court in Medical Council of India v Indian Doctors from Russia Welfare Associations[2]. (iii) Submissions of learned counsel Learned counsel for petitioners submit that sub-section 13(4A) deals with one class of persons who obtained medical qualifications granted by any medical institution abroad. Therefore, MCI cannot again introduce sub-classification among those students; one class who completed entire course in medical institutions abroad and obtained medical qualification granted by them and second class of those students who have undergone training in unrecognised institutions in India and then migrated to medical institutions outside the country for completing course and obtaining medical qualification. According to learned counsel, the plain meaning of Section 13(4A) does not permit any such sub-classification nor did legislature intend to divide students who obtained medical qualifications from outside Indian Medical Institutions into two categories. They also submit that Section 13(4A) read with Screening Regulations is a special code, which applies to medical qualifications granted by institutions outside India and the other provisions for recognition of medical qualifications contained in Sections 11, 12, 13(1) and 13(3) cannot be read into Section 13(4A). They would urge that when Section 13(4A) creates a fiction for deemed recognition of citizen qualifying in screening test, MCI cannot ignore fiction and introduce other irrelevant elements as no discretion is left to MCI. They conclude that the action of MCI is therefore ultra vires. Learned standing counsel for MCI vehemently opposes such interpretation. According to him, Section 13(4A) should be interpreted not textually giving its plain meaning but contextually and purposively. He submits that IMTU was set up by VEF, Bangalore, as per MoU between them and Government of Tanzania. Even before accreditation was granted by Higher Education Accreditation Council of Tanzania, Vignan commenced their campus at IMTU at Guntur, admitted students and conducted pre and para medical courses without obtaining prior permission under Section 10A of the Act. Such students, according to him, did not fall within the category of students under Section 13(4A). He, however, does not dispute that the medical qualification granted by IMTU, which is recognised University, is one such qualification which can be recognised subject to Section 13(4A). (iv) Principles of interpretation First, however, we may deal with principles of interpretation. The golden rule of interpretation of primary legislation and/or secondary legislation is literal interpretation. The script of the Act and the provision would help understand the spirit of the statute and the purport of the provision. Giving different meaning ignoring plain language of Section in the Act and reading something by supplying ‘words and phrases’ is not the function of the Court. Indeed, it is not warranted. If the meaning of the language is plain, the intention of the legislation has to be determined with regard to the language used. The golden rule, however, is not without exceptions. If statutory provision is open to more than one interpretation or its grammatical and literal meaning leads to absurdities, then only the Court has to ignore the text and search purpose and context elsewhere to understand legislative intention of making such provision. Even while doing so, the Court has to presume that the legislature never intended to be unreasonable, unfair and ignore constitutional principle of equality. ( S e e Chief Justice of Andhra Pradesh v L.V.A.Dikshitulu[3] and Kehar Singh v State (Delhi Administration)[4]). In District Mining Officer v Tata Iron & Steel Company[5], after referring to relevant precedents, the apex Court reiterated the principle. We feel it apposite to excerpt the following. If a statutory provision is open to more than one interpretation the Court has to choose that interpretation which represents the true intention of the Legislature. This task very often raises the difficulties because of various reasons, inasmuch as the words used may not be scientific symbols having any precise or definite meaning and the language may be an imperfect medium to convey one’s thought or that the assembly of Legislatures consisting of persons of various shades of opinion purport to convey a meaning which may be obscure. It is impossible even for the most imaginative Legislature to forestall exhaustively situations and circumstances that may emerge after enacting a statute where its application may be called for. Nonetheless, the function of the Courts is only to expound and not to legislate. Legislation in a modern State is actuated with some policy to curb some public evil or to effectuate some public benefit. The legislation is primarily directed to the problems before the Legislature based on information derived from past and present experience. It may also be designed by use of general words to cover similar problems arising in future. But, from the very nature of things, it is impossible to anticipate fully the varied situations arising in future in which the application of the legislation in hand may be called for, and, words chosen to communicate such indefinite referents are bound to be in many cases lacking in clarity and precision and thus giving rise to controversial questions of construction. The process of construction combines both literal and purposive approaches. In other words the legislative intention i.e., the true or legal meaning of an enactment is derived by considering the meaning of the words used in the enactment in the light of any discernible purpose or object which comprehends the mischief and its remedy to which the enactment is directed. (emphasis supplied) That golden rule of literal interpretation ordinarily is preferable to context and purposive interpretation is well settled and is axiomatic. Supreme Court in a number of cases reiterated that the language of the statutes is the key. It is determinative of purpose and intent of legislation. When the language is plain, two meanings cannot be ascribed. Court should also be cautious while dealing with amendment of legislation because such amendment is not always decisive to know the intention as to whether such amendment was intended to alter the entire law or it was intended to meet a particular historical event (See Harbhajan Singh v Press Council of India[6], Union of India v Hansoli Devi[7], Easland Combines, Coimbatore v Collector of Central Excise[8], Prakash Nath Khanna v Commissioner of Income Tax[9], Nathi Devi v Radha Devi Gupta[10], Bombay Dyeing and Manufacturing Company Limited v Bombay Environmental Action Group[11], Promoters & Builders Association of Pune v Pune Municipal Corporation[12] and Ramesh Mehta v Sanwal Chand Singhvi[13]). In a recent Judgment in National Insurance Company v Laxmi Narain Dhut[14], after referring to Joint registrar of Cooperative Societies v T.A.Kuttappan[15], Reserve Bank of India v Peerless General Finance and Investment Company Limited[16], Chief Justice of A.P v L.V.A.Dikshitulu (supra), Kehar Singh v State (Delhi Administration) and District Mining Officer v Tata Iron & Steel Company (supra), Supreme Court laid down as under. "Golden Rule" of interpretation of statutes is that statutes are to be interpreted according to grammatical and ordinary sense of the word in grammatical or liberal meaning unmindful of consequence of such interpretation. It was the predominant method of reading statutes. More often than not, such grammatical and literal interpretation leads to unjust results which the Legislature never intended. The golden rule of giving undue importance to grammatical and literal meaning of late gave place to 'rule of legislative intent'. The world over, the principle of interpretation according to the legislative intent is accepted to be more logical. .. When the law to be applied in a given case prescribes interpretation of statute, the Court has to ascertain the facts and then interpret the law to apply to such facts. Interpretation cannot be in a vacuum or in relation