New Delhi : The Supreme Court on Friday indicated that India may need a uniform national policy on compulsory rural service for medical graduates, observing that medical education carries a larger responsibility towards nation-building and that states invest substantial public resources in training doctors.

A Bench of Justice P.S. Narasimha and Justice Alok Aradhe made the observations while hearing a writ petition challenging the Karnataka Government’s requirement that medical graduates complete one year of compulsory rural service before becoming eligible for permanent registration with the Karnataka Medical Council.

Supreme Court Favors a Pan-India Policy

During the hearing, Justice P.S. Narasimha described the issue as an important policy matter and suggested that the Centre consider framing a uniform nationwide framework for compulsory rural service instead of allowing different states to follow varying rules.

The Court noted that medical education, irrespective of whether it is pursued in a government or private institution, is supported by public infrastructure and state resources in several ways. Therefore, doctors also have an obligation to contribute to public healthcare, particularly in underserved rural areas.

Justice Narasimha observed that medical education cannot be viewed solely as a private investment because states subsidize the healthcare ecosystem at multiple levels. He remarked that trained medical professionals are valuable national resources whose services can be utilized for the larger public good.

Centre Asked to Consider National Framework

Solicitor General Tushar Mehta, appearing for the Union Government, sought time to obtain instructions from the Centre regarding the feasibility of a nationwide policy.

Accepting the request, the Bench directed:

“Learned Solicitor General asked to adjourn the case for three weeks in order to take instructions in need for formulating a policy. List after three weeks.”

The matter will now be heard again after three weeks.

Background: Karnataka’s Compulsory Rural Service Law

The case challenges the Karnataka Compulsory Service Training by Candidates Completed Medical Courses Act, 2012, along with the 2015 Rules framed under the Act.

Under the existing law, candidates completing:

• MBBS,
• Postgraduate (Degree or Diploma), and
• Super-speciality courses

through government medical colleges or government quota seats in private/deemed universities are required to complete one year of compulsory rural service.

Only after completing this service are candidates issued a No Objection Certificate (NOC), which is necessary for obtaining permanent registration with the Karnataka Medical Council.

However, through a notification dated July 28, 2023, Karnataka extended this requirement to students admitted on private seats in private and deemed universities, leading to the present legal challenge.

What the Petitioners Argued

The petitioners contended that students studying on private seats pay significantly higher tuition fees and therefore constitute a distinct category under Article 14 of the Constitution, which guarantees equality before law.

According to them, imposing compulsory rural service on privately funded students is arbitrary and unconstitutional because they do not receive the same level of direct government financial support as students admitted under government quota.

They have sought directions from the Supreme Court to:

• Direct the Commissionerate of Health and Family Welfare Services to issue the required NOC without insisting on compulsory rural service.
• Direct the Karnataka Medical Council to grant permanent medical registration without requiring completion of the mandatory service.

Previous Supreme Court View

The petitioners also relied upon the Supreme Court’s judgment in Association of Medical Super Speciality Aspirants & Residents vs Union of India, where the Court upheld the validity of compulsory service bonds for postgraduate and super-speciality admissions.

While upholding such bonds, the Court had also observed that different states followed widely varying conditions and suggested that the Union Government and the then Medical Council of India consider evolving a uniform policy on compulsory service across the country.

The present proceedings revive that recommendation, with the Supreme Court once again indicating that a standardized national framework may help eliminate disparities between states and provide greater clarity for medical graduates.

Why This Case Matters

The outcome of this case could have significant implications for MBBS, postgraduate, and super-speciality medical students across India, particularly those studying in private medical colleges.

If the Centre decides to formulate a nationwide policy, it could bring uniformity to compulsory rural service requirements, replacing the existing state-specific rules that often differ in duration, applicability, and bond conditions.

The Supreme Court’s observations also reignite the broader debate on balancing the country’s need for doctors in rural and underserved regions with the rights and career aspirations of medical graduates.

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