‘Given the shortage of older experts, the dominance quota ensures an estimated supply of doctors familiar with the state’s health care scenario’. Photo Credit: Getty Image/ISTOCKPhoto
Recently the decision of the Supreme Court, Dr. In Tanvi Bahl vs Shrey Goyal (2025), which reduced the horrific-based reservation in postgraduate medical entry into the concerned medical colleges in states, symbolizing a significant change in India’s medical education policy. The ruling, assuming that such reservation violates Article 14 of the Constitution, destroys a mechanism that states have long been relieved to ensure a stable medical workforce friendly to public health requirements. While maintaining meritocracy, it calls the medical education policies and complex relations between the state public health plan wrong. By complicating a centralization prejudice in India’s medical education structure, it risks to disintegrate the state’s investment in government medical colleges – transforms competitive federalism down into a race.
Grobing quota in state health planning
Growning-based reservation in postgraduate medical courses perform an important task in aligning state investment in medical education with retention of health care personnel. State medical students allocate enough resources to train, hoping that these graduates will contribute to the local health care system. Given the shortage of older experts, the domicile quota ensures an estimated supply of doctors familiar with the state’s health care scenario. The court’s dependence on Pradeep Jain vs. Union of India (1984) ignores the required difference between graduation and postgraduate education to abolish the post-graduate reservation. Unlike MBBS programs, where students acquire basic knowledge, post-graduate courses are primary channels, through which the states recreate their expert workforce. Removal of domicile quota disrupts this pipeline, causing state to rapidly depend on external recruitment – a procedure with unpredictory and disabilities.
By reducing the domicile quota, the decision weakens the incentive to invest in medical education for states. A well -working system of competitive federalism encourages states to develop strong institutions to attract and maintain talent. However, if the state cannot ensure that their investment translates into a local expert workforce, then their encouragement to fund medical education is reduced. Without reservation, state medical college can destroy funding, leading to a decline in infrastructure and deteriorating regional health care inequalities. It is unlike Premier Central Institutions such as All India Institute of Medical Sciences (AIIMS), Postgraduate Institute of Medical Education and Research (PGIMER), and Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), which is given autonomy. State Medical College-Sugar India’s public health architecture is even more important-now a uniform privilege, deprived states have been denied in planning their long-term health services.
Article 21 of the Indian Constitution guarantees the right to life, including access to adequate health care, while public health state lives under legislative capacity. Medical colleges are not only institutions of higher education; They are also an important part of the state’s health infrastructure. It is a limited perspective to see them as a center for the production of medical graduates. A comprehensive, system-based approach highlights the relationship between the right to life, the right to public health and medical education. Given the role of the state government’s medical colleges in maintaining public health, it is necessary to recognize the state government’s need for autonomy in the selection process at undergraduate, post-graduate and super-specialty levels. This ensures that medical education aligns with local health care needs, suggests that these institutions work more objective than the alone academics. Excessive centralization, inadvertently operated by court decisions, prevents states from preparing policies favorable to their public health needs and socio-economic conditions. Legislative assemblies and judiciary should accept that the government medical colleges are an integral part of the infrastructure of state health care.
Full ability decline
The court urge on a rigid meritocratic framework urge the structural inequalities inherent in India’s medical entry system. Analysis of National Eligibility cum Entrance Test (Post Graduate), or NEET-PG shows the results how qualifications are assessed, including examples where the candidates with negative marks are eligible for percentage-based cutoffs.
A recent 2023 example watched the National Medical Commission, following the instructions of the Ministry of Health, reduced the qualifying percentage for NEET PG and reduced super specialty examinations up to zero to zero to fill the vacant seats. If graduation entry recognizes regional and socio-economic inequalities, postgraduate entry is very rare except for such ideas. In addition, the decision eliminates a narrow conception of qualification that disregards its social context. As is mentioned in decisions on medical education in matters like Jagdish Saran and ORS VS Union of India and ORS (1982), Pradeep Jain (1984), Neel Oralo Nuns and ORS VS Union of India (2022). Inequality. Candidates are more likely to live and serve in their home states-as the Economic Survey is accepted by 2024-25-Adivas-based reservation increases health care and reduces regional inequalities-aligned with a wide, more inclusive definition of practicing.
Need to reconsider
While the court’s verdict follows Pradeep Jain and the exemplary from the Constitution Bench, it is the property of revaluation. The original outline, which attracted a rigid line between graduation and postgraduate entry, was designed in a separate health care scenario. Today, maintaining experts within state health systems is putting more pressure than ever, especially in the light of crisis such as Covid-19 epidemic and increasing burden of non-communicable diseases. Instead of ending the outstanding quota, a more balanced approach will integrate these reservations with public service obligations. For example, Tamil Nadu’s Medical Education Framework Kota connects quota to the service mandate in public institutions, ensuring that state investment gives tangible health care benefits. Such models deserve more judicial and policy views rather than outright dismissal.
The ruling refers to a well -worthy of intent but flawed application that ignores the functional realities of public health regime and blur the line between constitutional interpretation and detailed policy design. By strengthening centralized control over medical entry, it risk weakening state investment, increasing regional inequalities and eradicating competitive federalism. Rethinking of this decision is mandatory to ensure that states maintained the autonomy necessary to structure their medical education policies in alignment with their health care preferences. Contrary to court concerns that the domicile quota creats a serious national risk, the over-sensitizing threatens the federal health policy. If India aims to create a strong and durable health care system, judicial theory must develop to adjust the complex interaction between medical education, federalism and public health policy.
Prannv Dhawan is a lawyer located in NCR and a legal researcher. Yazini PM is a doctor who is currently following his post-graduation in pharmacology in Chennai, and Dravida is a spokesperson of Munnetra Kajgam (DMK). Vignesh Karthik KR Royal is the Netherlands Institute of Southeast Asian and Caribbean Studies, a postdotoral research of Indian and Indonesian politics, and the author of the upcoming book, Dravidian route: Dravidian Munnetra Kazgam (DMK) and infection politics in South India (2025)
Published – March 06, 2025 12:16 AM IST