Kerala High Court
Under Graduate Medical Education Board vs V.N. Public Health And Educaiton Trust on 29 October, 2025
Author: Anil K. Narendran
Bench: Anil K. Narendran
2025:KER:80819
IN THE HIGH COURT OF KERALA AT ERNAKULAM
PRESENT
THE HONOURABLE MR. JUSTICE ANIL K. NARENDRAN
&
THE HONOURABLE MR. JUSTICE MURALEE KRISHNA S.
WEDNESDAY, THE 29TH DAY OF OCTOBER 2025/7TH KARTHIKA, 1947
WA NO. 2466 OF 2025
AGAINST THE JUDGMENT DATED 08.10.2025 IN WP(C) NO.32178 OF 2025
OF THE HIGH COURT OF KERALA
APPELLANTS/RESPONDENTS 1 & 2:
1 UNDER GRADUATE MEDICAL EDUCATION BOARD
NATIONAL MEDICAL COMMISSION (NMC), POCKET-14, SECTOR-
8, DWARAKA, PHASE-1 NEW DELHI REPRESENTED BY ITS
PRESIDENT, PIN - 110077
2 NATIONAL MEDICAL COMMISSION
POCKET-14, SECTOR-8, DWARAKA PHASE-1, NEW DELHI
REPRESENTED BY ITS CHAIRMAN, PIN - 110077
BY SRI.A.R.L. SUNDARESAN, ADDL. SOLICITOR GENERAL OF
INDIA
SHRI.K.S. PRENJITH KUMAR, SC, NATIONAL MEDICAL
COMMISSION
RESPONDENT/PETITIONERS & THE 3RD RESPONDENT:
1 V.N. PUBLIC HEALTH AND EDUCATION TRUST
A2, JAWAHAR NAGAR COLONY, SALES TAX OFFICE ROAD,
KOZHIKODE, REPRESENTED BY ITS MANAGING TRUSTEE -
SECRETARY - V. ANILKUMAR, PIN - 673006
2 V.ANILKUMAR
AGED 56 YEARS
MANAGING TRUSTEE, VN PUBLIC HEALTH AND EDUCATIONAL
TRUST, JAWAHAR NAGAR COLONY, SALES TAX OFFICE ROAD,
KOZHIKODE, PIN - 673006
3 KERALA UNIVERSITY OF HEALTH SCIENCES
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W.A.No.2466 of 2025 2
MEDICAL COLLEGE P.O. THRISSUR REPRESENTED BY ITS
REGISTRAR, PIN - 680596
BY SHRI.P. SREEKUMAR (SR.)
SHRI.S. GANESH, SC, KERALA UNIVERSITY OF HEALTH
SCIENCES
ADV. SRI.S. VINOD BHATT FOR R1 AND R2
SMT.ANAGHA LAKSHMY RAMAN FOR R1 AND R2
THIS WRIT APPEAL HAVING BEEN FINALLY HEARD ON 21.10.2025,
THE COURT ON 29.10.2025 DELIVERED THE FOLLOWING:
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W.A.No.2466 of 2025 3
"C.R"
JUDGMENT
Anil K. Narendran, J.
The appellants, who are respondents 1 and 2 in W.P.(C)No.
32178 of 2025, have filed this writ appeal, invoking the provisions
under Section 5(i) of the Kerala High Court Act, 1958, challenging
the judgment dated 08.10.2025 of the learned Single Judge in that
writ petition.
2. W.P.(C)No.32178 of 2025 is one filed by the petitioners
(respondents 1 and 2 herein), namely, V.N. Public Health and
Educational Trust and its Managing Trustee, seeking a writ of
certiorari to quash Ext.P1 order dated 22.08.2025 of the 2nd
respondent National Medical Commission (2nd appellant herein), in
the appeal filed by Palakkad Institute of Medical Sciences, Walayar,
under Section 22(3) of the National Medical Commission Act,
2019, read with Section 9 of the Maintenance of Standards of
Medical Education Regulations, 2023, and Ext.P13 order dated
14.07.2025 of the 1st respondent Under Graduate Medical
Education Board (1st appellant herein), whereby the Board decided
to reduce 50 seats in Palakkad Institute of Medical Sciences, and
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granted conditional renewal of only 100 MBBS seats, for the
academic session 2025-26; a declaration that for the institutions
granted Letter of Permission (LoP) under the Establishment of
Medical College Regulations, 1999, read with the Minimum
Standard Requirements for 150 MBBS Admissions Annual
Regulations, 1999, and the Minimum Requirements for Annual
MBBS Admissions Regulations, 2020, yearly renewals till the grant
of Letter of Recognition is governed by said norms; a writ of
mandamus commanding the respondents (1st and 2nd appellants
and the 3rd respondent University) to permit the petitioners to
admit second batch of 150 MBBS students during the academic
session 2025-26; a writ of mandamus commanding the
respondents to grant LoP to the petitioners for 150 MBBS seats
during the academic session 2025-26; and a writ of mandamus
commanding the 3rd respondent Kerala University of Health
Sciences to grant order of Continuation of Provisional Affiliation for
150 MBBS seats during the academic session 2025-26.
3. In W.P.(C)No.32178 of 2025, the petitioners sought for
an interim order to permit them to admit the second batch of 150
MBBS students during the academic session 2025-26 and to direct
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the respondents to pass appropriate orders for the purpose
thereof, pending disposal of the writ petition. On 25.08.2025,
when the writ petition came up for admission as a 'today motion',
it was adjourned to 27.08.2025. On 27.08.2025, the petitioners
filed I.A.No.1 of 2025 for accepting an affidavit sworn to by the
2nd petitioner stating additional facts.
4. By the interim order dated 27.08.2025, the learned
Single Judge directed the respondents to permit the petitioners to
admit the second batch of 150 MBBS students, during the
academic session 2025-26. The 3rd respondent University was
directed to pass appropriate orders for that purpose, as early as
possible. On 09.09.2025, the petitioners filed I.A.Nos.2 and 3 of
2025 in W.P.(C)No.32178 of 2025. I.A.No.2 of 2025 was filed
seeking an order directing the respondents to pass orders in
compliance with the interim order dated 27.08.2025, within a time
limit to be stipulated by this Court, so as to enable the petitioners
to admit 150 students in the second round of counselling, in terms
of Ext.P22 revised NEET-UG Schedule-2025 issued by the 2nd
respondent National Medical Commission. I.A.No.3 of 2025 was
filed seeking an order to accept Ext.P22 as an additional
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document.
5. On 16.09.2025, when W.P.(C)No.32178 of 2025 came
up for consideration, the learned Single Judge directed the
respondents to get instructions as to why a contempt of court
action should not be taken against them for not complying with
the directions in the interim order dated 27.08.2025. Challenging
the interim order dated 27.08.2025 of the learned Single Judge in
W.P.(C)No.32178 of 2025, respondents 1 and 2 (appellants herein)
had approached this Court in W.A.No.2236 of 2025. The said writ
appeal was allowed by the judgment dated 22.09.2025, whereby
the interim order dated 27.08.2025 of the learned Single Judge
was set aside. By that judgment, both sides were directed to raise
appropriate legal and factual contentions before the learned Single
Judge in the pending writ petition.
6. By the impugned judgment dated 08.10.2025, the
learned Single Judge allowed W.P.(C)No.32178 of 2025 and
directed the respondents (1st and 2nd appellants and the 3rd
respondent University) to permit the petitioners (respondents 1
and 2 herein) to admit the second batch of 150 MBBS students
during the academic session 2025-26. As the third round of the
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allotment process was over, the learned Single Judge ordered that
the petitioners shall be permitted to fill up the remaining seats,
i.e., 50 MBBS seats out of 150 seats, through stray vacancy
allotment. Paragraphs 24 to 27 and also the last paragraph of the
judgment dated 08.10.2025 of the learned Single Judge read
thus;
"24. It is therefore clear that the only relevant deficiency is
the alleged inadequacy of the faculty. Here, it is not disputed
that the petitioners satisfy the faculty requirement as per
MSR-2020. The Apex Court has directed the respondents
that MSR-2020 should be applied to the petitioners for the
academic year 2024-25. As per Ext.P8, if MSR-2020 is
applicable, the petitioners have to satisfy only phase-wise
requirements. The petitioners, therefore, legitimately
believed that they had time to increase the faculty. This is
evident from Ext.P19 reply given by the petitioner to the
University.
25. It must be kept in mind that the petitioners were given
LoP to start the MBBS Course only on 04.07.2024. They
have been conducting the Course as per MSR-2020 (though
MSMER-2023 had come into force by then) as per the
directions of the Apex Court. The MSR-2020 provided for
phase-wise requirements. In the circumstances, if the
petitioners have to increase the faculty as per MSMER-
2023, they should have been informed accordingly and
given a reasonable time for compliance.
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26. The respondents cannot simply state that all Medical
Colleges have to comply with MSMER-2023, because the
Hon'ble Apex Court had specifically directed to apply MSR-
2020 to the petitioner for the year 2024-25 as a special case
and under peculiar circumstances. In the circumstances of
the case, reducing the intake capacity of the College from
150 to 100 without giving the petitioners a breathing time
to come over to the MSMER-2023 can only be described as
highly arbitrary, offending Article 14.
27. I am not inclined to accept the defence of the NMC as
regards the availability of an alternate remedy, because in
view of the facts of the case and the timeline involved, the
appellate remedy will not be an efficacious alternate
remedy.
In the facts and circumstances of the case, the writ petition
is allowed. The respondents are directed to permit the
petitioner to admit the second batch of 150 MBBS students
during the academic session 2025-26. As the Round-3
allotment process is over, the petitioner shall be permitted
to fill up the remaining of the 150 MBBS seats through the
stray vacancy allotments."
7. Challenging the judgment dated 08.10.2025 of the
learned Single Judge, the appellants-respondents 1 and 2 are
before this Court in this writ appeal. By the order dated
17.10.2025, the operation of the impugned judgment of the
learned Single Judge was stayed for a period of one week. On
21.10.2025, while reserving the writ appeal for judgment, the said
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interim order was extended for a period of 10 days.
8. We heard arguments of the learned Additional Solicitor
General of India for the appellants, the learned counsel for
respondents 1 and 2-petitioners and the learned Senior Counsel
for the 3rd respondent University.
9. The learned Additional Solicitor General of India for the
appellants contended that the learned Single Judge allowed
W.P.(C)No.32178 of 2025 by the impugned judgment dated
08.10.2025 without properly appreciating the legal and factual
contentions raised by the appellants. Without setting aside
Ext.P13 order dated 14.07.2025 of the Under Graduate Medical
Education Board and Ext.P1 order dated 22.08.2025 of the
National Medical Commission, the learned Single Judge directed
the appellants and the 3rd respondent University to permit the
petitioners (respondents 1 and 2 herein) to admit second batch of
150 MBBS students in Palakkad Institute of Medical Sciences
during the academic session 2025-26. The direction contained in
Ext.P5 order dated 03.11.2023 of the Apex Court in W.P.(C)No.
1166 of 2023 was to conduct the inspection and complete the
process for grant of approval to Palakkad Institute of Medical
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Sciences, for the academic session 2024-25, on the parameters
that were prevailing for the academic session 2023-24. The said
direction issued by the Apex Court in exercise of its powers under
Article 142 of the Constitution of India was only for the academic
session 2024-25. For continuing the approval for the academic
session 2025-26, the medical institution has to comply with the
requirements of the Guidelines for Under Graduate Courses under
the Establishment of New Medical Institutions, Starting of New
Medical Courses, Increase of Seats for Existing Courses and
Assessment and Rating Regulations, 2023 (UG-MSR 2023) and not
the requirements of the Minimum Requirements for Annual MBBS
Admissions Regulations, 2020 (MSR 2020). In support of the said
contention, the learned ASGI referred to sub-section (2) of Section
61 of the National Medical Commission Act, 2019. UG-MSR 2023
notified on 16.08.2023, automatically replaced the previous
Regulations, i.e., MSR 2020. Therefore, all medical institutions,
regardless of the year of establishment, must comply with the
requirements of UG-MSR 2023 for continuing the approval for
MBBS course. The finding of the learned Single Judge in the
impugned judgment that, if the medical institution of the
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petitioners (respondents 1 and 2 herein) had to increase the
faculty as per the requirements of UG-MSR 2023, they should have
been informed accordingly and given a reasonable time for
compliance, is contrary to the mandatory requirements of UG-MSR
2023. Though MSR 2020 provided for phase-wise requirements,
UG-MSR 2023 requires a medical institution to meet the
requirements at the time of grant of approval for the first academic
session. The finding of the learned Single Judge that the action of
respondents 1 and 2 (the appellants herein) in reducing the annual
intake in the medical institution from 150 MBBS seats to 100
seats, without giving the petitioners a breathing time to come over
to UG-MSR 2023, is highly arbitrary and offending Article 14 of the
Constitution of India, is absolutely without any legal basis. The
learned ASGI relied on various decisions of the Apex Court to
contend that the medical education will be incomplete, unless a
medical institution can provide complete facilities as per the
applicable regulations for imparting training to the students
admitted in various disciplines. In view of the alternate remedy
provided in the regulations, the learned Single Judge went wrong
in entertaining the writ petition and exercising the extraordinary
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jurisdiction under Article 226 of the Constitution of India.
10. The learned Senior Counsel for the 3rd respondent
University contended that the learned Single Judge committed a
grave error in directing respondents 1 and 2 (the appellants
herein) and the 3rd respondent University to permit the petitioners
(respondents 1 and 2 herein) to admit second batch of 150 MBBS
students in Palakkad Institute of Medical Sciences, during the
academic session 2025-26, when the approval granted by the
Under Graduate Medical Education Board and the Consent of
Affiliation granted by the 3rd respondent University for that
academic session is for 100 MBBS seats. The learned Senior
Counsel adopted the arguments advanced by the learned ASGI on
the requirements of UG-MSR 2023 for continuing the approval for
the MBBS course in the medical institution in question. The learned
Senior Counsel placed reliance on the decision of the Apex Court
in V.N. Public Health and Educational Trust v. State of
Kerala [(2021) 17 SCC 189], wherein it was reiterated that the
decision taken by the Union of India based on the recommendation
of the expert body cannot be interfered with lightly and an
interference is permissible only when the medical institution
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demonstrates jurisdictional errors ex-facie perversity or mala
fides.
11. The learned counsel for petitioners (respondents 1 and
2 herein) contended that the reasoning of the learned Single Judge
in the impugned judgment dated 08.10.2025 is neither perverse
nor patently illegal, and hence no interference is warranted in this
intra-court appeal filed under Section 5(i) of the Kerala High Court
Act, 1958. In view of the specific direction contained in Ext.P5
order dated 03.11.2023 of the Apex Court in W.P.(C)No.1166 of
2023, for continuing the approval of 150 MBBS seats in Palakkad
Institute of Medical Sciences, for the academic session 2025-26,
the petitioners are required only to comply with the requirements
of MSR 2020, which provides for phase-wise requirements. The
petitioners, vide Ext.P23 letter dated 19.09.2024 sought for a
clarification from the Under Graduate Medical Education Board as
to whether the requirements of MSR 2020 alone is applicable for
continuing approval for the academic session 2025-26 and for
admitting the second batch of 150 MBBS students, in view of the
direction contained in Ext.P5 order dated 03.11.2023 of the Apex
Court in W.P.(C)No.1166 of 2023. Without providing any
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clarification, the petitioners are required to comply with the
requirements of UG-MSR 2023, without providing any breathing
time to meet the said requirements. Therefore, the learned Single
Judge rightly allowed the writ petition by the impugned judgment
dated 08.10.2025. The learned counsel contended that the
requirements of UG-MSR 2023 regarding bed occupancy and
faculty position for 150 MBBS seats are not essential for imparting
medical education to MBBS students during the 1st and 2nd year
MBBS course and therefore, appellants and the 3rd respondent
University ought to have granted permission for admitting
students in the second batch of 150 MBBS seats, during the
academic session 2025-26, based on the undertaking given by the
petitioners in Ext.P12 reply dated 23.06.2025 to Ext.P11 show
cause notice dated 15.05.2025 issued by the Under Graduate
Medical Education Board. In Ext.P12 reply, the petitioners have
given an undertaking to comply with the requirements of UG-MSR
2023, within a period of one year, by recruiting additional faculty
and making all necessary infrastructures, and improving clinical
materials and other facilities. The learned counsel pointed out the
requirements of MSR 2020 and UG-MSR 2023 regarding bed
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occupancy and faculty requirements for a medical institution with
150 MBBS seats. After referring to the provisions under UG-MSR
2023, the learned counsel contended that the Under Graduate
Medical Education Board has ample power under the said
Regulations to grant sufficient time to medical institutions to meet
the requirements of the regulations, before imposing a penalty of
reducing the number of seats for the MBBS course.
12. In exercise of the powers conferred vide sub-section
(2) of Section 57 read with Sections 26, 28 and 29 of the National
Medical Commission Act, 2019, the National Medical Commission
made the Establishment of New Medical Institutions, Starting of
New Medical Courses, Increase of Seats for Existing Courses &
Assessment and Rating Regulations, 2023, in short the
Establishment of Medical institutions, Assessment and Rating
Regulations, 2023. The said Regulations came into force with
effect from 02.06.2023, the date of publication in the official
gazette. Section 2(b) defines 'Assessment' to mean the process of
evaluating a medical institution by the concerned authorities, as
being compliant with the applicable Regulations, guidelines/
standards, and/or orders and circulars issued by the NMC and
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other authorities, as the case may be, from time to time. Section
2(c) defines 'MARB' to mean the Medical Assessment and Rating
Board duly constituted under Section 16 of the National Medical
Commission Act, 2019. Section 2(e) defines 'Consent of Affiliation'
(in its abbreviated form CoA) to mean a letter in writing obtained
from a recognised University, issued in the name of the applicant,
agreeing to affiliate the medical institution for the award of the
necessary qualifications by the University. Section 2(f) defines
'Essentiality Certificate' (in its abbreviated form EC) to mean
written permission from the Central or concerned State
Government or the Union Territory administration, as the case
may be, for the establishment of a new medical institution. Section
2(i) defines 'MSR' to mean the Minimum Standards of
Requirements as notified either by UGMEB or PGMEB, as the case
may be, from time to time, which shall also include explanatory
notes, circulars, advisories, etc., issued by the corresponding
Boards or the Commission.
12.1. Section 4 of the Establishment of Medical Institutions,
Assessment and Rating Regulations, 2023 (for brevity, 'EMAR-
2023') deals with the mandate of permission. As per Section 4, no
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medical college or medical institution can be established, or new
medical course or courses can be started, unless it is granted
permission by the MARB in writing, in response to an application
submitted in this regard. As per the proviso to Section 4, any such
permission by the MARB may be issued subject to such conditions
as it may think fit to impose.
12.2. Section 10 of EMAR-2023 deals with eligibility criteria.
As per sub-section (a) of Section 10, no medical institution shall
be provided permission unless it satisfies the conditions pertaining
to, but not limited to, physical infrastructure, teaching staff,
clinical material and hospital as detailed in the MSRs notified from
time to time. As per sub-section (b) of Section 10, without
prejudice to anything stated in sub-section (a) above, the UGMEB
or PGMEB, as the case may be, shall from time to time publish the
MSR with such modifications or amendments required, keeping in
mind the overall objectives of the Act. As per sub-section (c) of
Section 10, notwithstanding anything stated above in Section 10,
all modified or amended MSRs shall have to be implemented.
12.3. Section 26 of EMAR-2023 deals with the submission of
annual disclosure reports. As per Section 26, all medical
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institutions shall furnish a Compulsory Annual Disclosure Report
to UGMEB and/or PGMEB in compliance with the norms specified
under the National Medical Commission Act, 2019 [Sections 24(i)
and 25(h)] in the prescribed format and prescribed fee, with a
copy to the MARB. As per the proviso to Section 26, the
compulsory annual disclosure report shall be made once all
students for the academic year are admitted to a given course and
not later than thirty days, to be calculated from the date of the
last student's admission. As per Section 27, notwithstanding
anything stated elsewhere, failure to submit the annual disclosure
report by the medical institution as indicated in Section 26 within
a notified period shall amount to non-compliance and shall result
in disciplinary proceedings under Chapter-V below. As per the
proviso to Section 27, medical Institutions can use the Annual
Disclosure as a form of self-appraisal and request the MARB for a
voluntary decrease of seats/courses and also seek restitution of
seats/courses appropriately.
12.4. As per Section 28 of EMAR-2023, it shall be the duty
of all medical institutions to follow the regulations and directions
issued by the MARB, both in letter and spirit, either within a
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specified time period or within a reasonable period of time,
wherever the timelines are applicable. As per Section 29, which
defines non-compliance, the acts or omissions enumerated in sub-
sections (a) to (i) of a medical institute shall amount to non-
compliance. Sub-section (a) of Section 29 deals with non-
compliance with any of the regulations and notifications of the
National Medical Commission issued from time to time. Sub-
section (c) of Section 29 deals with deficiency in infrastructure,
teaching staff, clinical material and others as prescribed by way of
MSR or otherwise by UGMEB and/or PGMEB. Section 29 of EMAR-
2023 reads thus;
"29. Non-compliance defined - following acts or omissions
of a medical institute shall amount to non-compliance.-
(a) Non-compliance with any of the regulations and
notifications of the National Medical Commission issued from
time to time.
(b) The medical institution has conducted in a manner which
is not in accordance with the objectives of the medical
institution and practices like ragging, exploiting students on
fees, etc.
(c) Deficiency in infrastructure, teaching staff, clinical
material and others as prescribed by way of MSR or
otherwise by UGMEB and/or PGMEB.
(d) Any act of misbehavior, non-cooperation, forbidding the
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inspection process, etc., with the assessors representing the
MARB or such other designated agency by the MARB in this
regard.
(e) Physical misbehavior by teaching staff with the students,
harassment of faculty and/or students by the management,
etc.
(f) False information declared for obtaining permission for
any of the schemes, including the establishment of a
medical institution. (g) Falsifying information or fabricating
evidence at the time of inspection by the MARB or
constituent autonomous boards or NMC-appointed third
parties.
(h) Any attempt to bribe or pressurise or threaten assessors
or officials of NMC.
(i) Any such act or omission as notified by the NMC in this
regard."
12.5. Section 30 of EMAR 2023 deals with penalties. As per
Section 30, for any of the non-compliance or intentional attempt
of non-compliance act or omission by the medical institution, the
MARB shall either penalise the medical college or medical
institution as per sub-section (f) of Section 26 of the Act and/or
conduct further enquiry into such incident or act, and wherever
needed, provide an opportunity to rectify the same. As per Section
31, without prejudice to anything stated in Section 30 above, the
imposition of the penalty may include one/more/all of the
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penalties enumerated in sub-sections (a) to (h). Sub-section (d)
of Section 31 deals with reducing the number of students in the
next or subsequent academic years to be admitted by the medical
institution. As per the first proviso to Section 31, the medical
institution may be granted a reasonable opportunity to rectify the
deficiencies, and any further action shall be taken if it fails to meet
the requisite norms. Section 31 of EMAR 2023 reads thus;
"31. Without prejudice to anything stated in Section 30
above, the imposition of the penalty may include
one/more/all of the following.-
(a) Issuance of warning with accommodation of reasonable
time for compliance or rectification, as the case may be, by
the medical institution.
(b) Monetary penalty not exceeding INR one crore per every
non-compliance committed by the medical institution.
(c) Withholding processing of application for any new
scheme/s for that academic year or for a such number of
years.
(d) Reducing the number of students in the next or
subsequent academic years to be admitted by the medical
institution.
(e) Stoppage of admission to one or more of the courses in
the next or subsequent academic years.
(f) Recommending to NMC for withdrawal of recognition.
(g) Withholding and withdrawal of rating of the medical
institution for a period up to five academic years.
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(h) Any attempt to pressurize MARB or NMC through
individuals or agency will lead to immediate halt of the
processing of the application/request by the medical
Institution.
Provided that the medical institution may be granted a
reasonable opportunity to rectify the deficiencies, and any
further action shall be taken if it fails to meet the requisite
norms.
Provided further that, the MARB or the Commission may also
initiate criminal proceedings for furnishing false information,
or fabrication of false documents as per the criminal law in
force at that time."
12.6. Section 32 of EMAR 2023 deals with an appeal to the
Commission. As per Section 32, a medical institution or any such
aggrieved person may file an appeal before the Commission with
appropriate fees as specified against any orders passed or decision
taken by the MARB, which shall comprise the following, (a)
disapproval of a scheme; (b) where no decision is taken within six
months of applying or request to the MARB for approval of any of
the schemes; (c) imposition of penalty as per Section 31 of these
Regulations. As per the proviso to Section 32, such an appeal to
the Commission is filed within fifteen days of passing an order or
decision taken by the MARB. Section 33 deals with an appeal to
the Central Government. As per Section 33, where an applicant is
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aggrieved by the decision of the Commission under Section 15 or
where the Commission fails to give its decision within forty-five
days from the date of receipt of such an appeal, a second appeal
may be filed before the Central Government within thirty days
from the date of such order or lapse of time, as the case may be.
13. In exercise of the powers conferred by the National
Medical Commission Act, 2019, and particularly by Sections 10,
24, 25 and 57, the National Medical Commission made the
Maintenance of Standards of Medical Education Regulations, 2023
(for brevity, 'MSMER 2023') to ensure smooth compliance with its
functions in general and particularly to maintain a high quality and
high standards in medical education. MSMER 2023 came into force
with effect from 21.09.2023, the date of publication in the official
gazette. Section 3(f) of MSMER 2023 defines 'MSR' to mean the
Minimum Standards Requirements as notified by the Post
Graduate Medical Education Board (PGMEB) or the Under
Graduate Medical Education Board (UGMEB), as such or by way of
guidelines, and which shall also include explanatory notes,
circulars, advisories, etc., issued from time to time.
13.1. Chapter II of MSMER 2023 deals with the Annual
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Disclosure Report and its evaluation. Section 4 deals with the
mandate of annual disclosures. As per sub-section (1) of Section
4, after its establishment, the medical college or medical
institution is obligated to furnish an Annual Disclosure Report to
the corresponding Board, satisfying such conditions provided
under the notified MSRs by UGMEB or PGMEB and regulations of
the National Medical Commission (NMC), as the case may be.
Section 4 of MSMER 2023 reads thus;
"4. Mandate of Annual Disclosure.- 1) After its
establishment, the medical college or medical institution is
obligated to furnish an Annual Disclosure Report to the
corresponding Board, satisfying such conditions provided
under the notified MSRs by UGMEB or PGMEB and
regulations of NMC, as the case may be.
2) Without prejudice to anything stated above, the
concerned Board may seek such additional information with
regard to the Annual Disclosure Report, as and when
deemed necessary for their assessment and otherwise from
the concerned medical institution or concerned agencies
having or exercising control over that medical college or
medical institution.
3) It shall be the duty of the medical college or medical
institution or the concerned agency or agencies exercising
control over such medical college or medical institution to
furnish the information (including additional information) to
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the concerned Board in the prescribed mode."
13.2. Section 5 of MSMER 2023 deals with the evaluation of
the report. As per sub-section (1) of Section 5, keeping in mind
the overall objectives of the National Medical Commission Act, the
respective Board (PGMEB or UGMEB) may undertake the
evaluation of the Annual Disclosure Report for verifying whether
the medical college or medical institution fulfils the required
conditions prescribed by way of MSRs or NMC Regulations, as the
case may be, which shall include the matters enumerated in sub-
sections (i) to (vii). The required conditions include the availability
of the required number of qualified faculty for actual teaching and
research, and to undertake necessary student learning activities
on a regular and continued basis [sub-section (ii)]; availability of
adequate clinical material in terms of number of patients of
different specialties, variety of patients to fulfil all round training
of students, number of variety of procedures, surgeries, laboratory
investigations, radiological investigations and other relevant
investigations [sub-section (iii)]; and other parameters related to
standards of medical education that may be added from time to
time by the respective boards or NMC [sub-section (vii)]. As per
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sub-section (4) of Section 5, if the applicant fails to submit such
information or clarify or provide additional documents, etc., as
mandated by the respective Board within such prescribed time,
including any additional time provided by the respective Board, it
shall be deemed as non-compliance with the Regulations and shall
attract a penalty. Section 5 of MSMER 2023 reads thus;
"5. Evaluation of Report.- 1) Keeping in mind the overall
objectives of the Act, the respective Board (PGMEB or
UGMEB) may undertake the evaluation of the Annual
Disclosure Report for verifying whether the medical college
or medical institution fulfils the required conditions
prescribed by way of MSRs or NMC Regulations, as the case
may be, which shall include -
(i) verification of physical infrastructure;
(ii) availability of required number of qualified faculty for
actual teaching and research and to undertake necessary
student learning activities on a regular and continued basis;
(iii) availability of adequate clinical material in terms of
number of patients of different specialties, variety of
patients to fulfil all round training of students, number of
variety of procedures, surgeries, laboratory investigations,
radiological investigations and other relevant investigations;
(iv) assessment of the teaching methodology adopted;
(v) the methods and modes of assessment, grading of the
students;
(vi) review of feedback from students;
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(vii) other parameters related to standards of medical
education that may be added from time to time by the
respective boards or NMC.
2) Without prejudice to (1) above or elsewhere in these
Regulations, at its sole discretion, the respective Board may
seek any additional information or clarification or additional
documents, etc., from the medical college or medical
institution while considering the Annual Disclosure Report
referred above.
3) The Medical College shall furnish such information or
clarification or additional documents, etc., sought under
sub-section (2) above at the earliest, but not later than 30
days from the date of receipt of communication from the
respective Board, or such additional time to be provided by
the respective Board on specific request from the applicant
in that regard.
Provided, the medical college or medical institution shall
adhere to the prescribed format or pro-forma, while
furnishing of information or clarification or additional
documents, etc., as required by the concerned Board.
4) If the applicant fails to submit such information or clarify
or provide additional documents, etc., as mandated by the
respective Board within such prescribed time, including any
additional time provided by the respective Board, it shall be
deemed as non-compliance with the Regulations and shall
attract penalty."
13.3. Section 6 of MSMER 2023 deals with joint or
independent evaluation. Sub-section (1) of Section 6 provides
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that, notwithstanding anything stated elsewhere in these
Regulations, any of the Board (other than corresponding Board)
individually or collectively, may cause to evaluate the accuracy
and/or truth and/or veracity of the averments made out in the
Annual Disclosure Report from the medical college or medical
institution. Sub-section (4) of Section 6 provides that, after such
inspection under this Regulation, if the concerned Board or Boards
contemplate any remedial measure or action, etc., such measure
or action shall be intimated to the medical college or medical
institution, through the concerned Board (UGMEB or PGMEB).
Provided it shall be the administrative responsibility of the
concerned Board to oversee that such measure or action intimated
are duly complied with by the medical college or medical
institution. Section 6 of MSMER 2023 reads thus;
"6. Joint or Independent Evaluation.- 1) Notwithstanding
anything stated elsewhere in these Regulations, any of the
Board (other than the corresponding Board), individually or
collectively, may cause to evaluate the accuracy and/or
truth and/or veracity of the averments made out in the
Annual Disclosure Report from the medical college or
medical institution.
2) When such evaluation as enumerated under sub-section
(1) is undertaken, it shall be the duty of the concerned
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medical college or medical institution to provide all
necessary support to the concerned Board or Boards as the
case may be, in their course of evaluation, which shall also
include disclosure of documents, providing additional
evidence as the case may be, providing oral statements etc.
3) Without prejudice to anything stated above, the
concerned Board or Boards conducting evaluation under this
provision, shall mandatorily share such conduct of an
evaluation and its outcome to other Boards and NMC at the
earliest but not exceeding seven days.
4) After such inspection under this Regulation, if the
concerned Board or Boards contemplate any remedial
measure or action etc., such measure or action shall be
intimated to the medical college or medical institution,
through the concerned Board (UGMEB or PGMEB). Provided
it shall be the administrative responsibility of the concerned
Board to oversee that such measure or action intimated are
duly complied with by the medical college or medical
institution."
13.4. Section 7 of MSMER 2023 deals with the consequence
of compliance. As per sub-section (1) of Section 7, if the medical
college or medical institution is found to be successfully meeting
requirements as prescribed for the UGMEB or PGMEB, as the case
may be, the concerned Board shall provide a renewal certificate
for continuation of the course/s and admission of students thereof
for the next/coming Academic Year. As per sub-section (2) of
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Section 7, any deficiency noted will attract penalties with or
without the decision above.
13.5. Section 8 of MSMER 2023 deals with penalties. As per
sub-section (1) of Section 8, where the respective Board has
reason to believe that a medical institution has failed to comply
with any statutory provision, regulations framed thereunder or has
not complied with the Minimum Standards of Requirements as
prescribed by their respective Boards, or has conducted
themselves in any manner which is not in accordance with the
goals of medical education and practice, the Board shall either
penalize the medical college or medical institution and/or conduct
further enquiry into such act and wherever needed provide an
opportunity to rectify the same. As per sub-section (2) of Section
8, without prejudice to anything stated at Section 8.1 above, the
imposition of the penalty may include one/more/all of the matters
enumerated in sub-sections (a) to (j). The penalty provided under
sub-section (2) of Section 8 includes reducing the number of
students in the next or subsequent academic years to be admitted
by the medical institution. Section 8 of MSMER 2023 reads thus;
"8. Penalties.- 1) Where the respective Board has reason to
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believe that a medical institution has failed to comply with
any statutory provision, regulations framed thereunder or
has not complied with the Minimum Standards of
Requirements as prescribed by their respective Boards, or
has conducted themselves in any manner which is not in
accordance with the goals of medical education and
practice, the Board shall either penalize the medical college
or medical institution and/or conduct further enquiry into
such act and wherever needed provide an opportunity to
rectify the same.
2) Without prejudice to anything stated at Section 8.1
above, the imposition of the penalty may include one/more/
all of the following.-
(a) Issuance of warning with direction to rectify/comply, as
the case may be, by the medical institution;
(b) Monetary penalty not exceeding INR one crore per
violation or act of omission by the medical institution;
(c) Monetary penalty not exceeding Rupees five lakh for the
faculty/Head of the Department (HoD)/Dean/Director/
doctor submitting false declaration/documents/records
(including patients' records). Further, they can also be
charged or penalized for misconduct under the Registered
Medical Practitioner (Professional Conduct) Regulations in
vogue;
(d) Withholding the accreditation process;
(e) recommending to MARB for withholding processing of
application(s) for any new course, including increase of
seats in the existing course for that academic year or for
such number of years;
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(f) Reducing the number of students in the next or
subsequent academic years to be admitted by the medical
institution;
(g) Stoppage of admission to one or more of the courses in
the next or subsequent academic years. h. Recommending
to NMC for withdrawal of permission;
(h) Recommending to NMC for withdrawal of permission;
(i) Withholding and withdrawal of accreditation for a period
up to five academic years;
(j) Any attempt to pressurize UGMEB, PGMEB or NMC
through individuals or agency will lead to immediate halt of
the processing of all applications/requests by the medical
institution.
Provided that the medical institution, may be granted a
reasonable opportunity to rectify the deficiencies and any
further action shall be taken if it fails to meet the requisite
norms.
Provided further that the UGMEB, PGMEB or the NMC may
also initiate criminal proceedings for furnishing false
information, or fabrication of false documents as per the
criminal law in force at that time."
13.6. Section 9 of MSMER 2023 deals with appeal to the
National Medical Commission. As per Section 9, a medical college
or medical institution or any such aggrieved person may file an
appeal before the Commission with an appropriate fee as specified
against any order. As per the proviso to Section 9, such an appeal
is to be filed within sixty days of the passing of such an order or
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lapse of time, as the case may be. Section 10 deals with an appeal
to the Central Government. As per Section 10, where an
applicant/medical college or medical institution is aggrieved by the
decision of the Commission or where the Commission fails to give
its decision within forty-five days from the date of receipt of such
an appeal, a second appeal may be filed before the Central
Government within thirty days from the date of such order or lapse
of time, as the case may be. The decision of the Central
Government in this regard shall be final.
14. In exercise of the powers conferred vide sub-section
(a), (d) and (e) of Section 24 read with Sections 26,28 and 29 of
the National Medical Commission Act, 2019, the Under Graduate
Medical Education Board (UGMEB) issued the Guidelines for Under
Graduate Courses under the Establishment of New Medical
Institutions, Starting of New Medical Courses, Increase of Seats
for Existing Courses and Assessment and Rating Regulations, 2023
(for brevity, UG-MSR 2023). The said Regulations came into force
with effect from 16.08.2023, the date of publication in the official
gazette.
14.1. The objective of UG-MSR 2023 is to prescribe for a
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medical college and medical institution approved for admission of
MBBS students annually, the minimum requirements of
accommodation in the college and its associated teaching
hospitals, staff (teaching and technical) and equipment in the
college departments and hospitals. Chapter I of UG-MSR 2023
provides that the said regulations shall be applicable for medical
colleges being established from the academic session 2024-25
onwards. As per UG-MSR 2023, applications for establishing new
undergraduate medical education colleges shall be allowed only
for 50/100/150 seats. Only such colleges meeting these
requirements shall be eligible for continuing their admission of
permitted/recognised number of MBBS students from the
academic year 2024-25.
14.2. Schedule I of UG-MSR 2023 deals with accommodation
in the medical college and its associated teaching hospitals. As per
Para.B.I., the teaching hospital building shall conform to the
existing national building norms and various local authority
regulations for hospitals, taking into consideration the
requirements of the hospital as a service provider, including
administration, registration, records storage, out-patient and
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inpatient areas, operating theatres, CSSD, ICUs, Radiology and
laboratory services, emergency areas, etc. The teaching hospital
shall provide for the minimum requirements as prescribed in UG-
MSR 2023. Para.B.I.2. deals with indoor beds occupancy. The bed
strength shall be as shown in the table in Para.B.I.2. The beds
(OPD/DAY) required for 150 MBBS seats capacity are 1,200. The
average occupancy of indoor beds shall be a minimum of 80% per
annum.
14.3. Schedule II of UG-MSR 2023 deals with staff
requirements. In Para.A, under the heading 'General Remarks', it
is stated that since the emphasis in medical education is on
practical instruction and demonstration in small groups and to
encourage students for self-directed learning, the number of
teachers must be as mentioned in the requirements in Schedule
II, so as to enable instructions to be imparted effectively. The
regulations in Schedule II cover the minimum requirements of
under graduate medical education, as per the annual MBBS
student intake and the minimum patient load indicated therein.
The faculty requirement for MBBS admissions is provided in the
table in Schedule II. As per the said table, the total staff strength
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for 150 MBBS seats is Professor - 19, Associate Professor - 40,
Assistant Professor - 55 (total 114), Tutor/Demonstrator - 32 and
Senior Resident Doctors - 58.
15. On the other hand, as per the Minimum Requirements
for Annual MBBS Admissions Regulations, 2020 (for brevity, 'MSR
2020') made by the National Medical Commission, in exercise of
the powers conferred by section 57 of the National Medical
Commission Act, 2019, which came into force on 29.10.2020 on
publication in the official gazette, which was applicable for medical
colleges established from the academic session 2021-22 onwards,
every medical college and medical institution and its associated
teaching hospital shall have the required areas, accommodation
for the staff and equipment for each department, as given in
Schedules I, II and III respectively annexed with MSR 2020.
15.1. Annexure II to MSR 2020 deals with the requirements
to be fulfilled by the applicant colleges for obtaining the Letter of
Intent and Letter of Permission for the establishment of a new
medical college and yearly renewals for 150 MBBS admissions
annually. The requirement as per Annexure II of OPD (patients/
day) is as follows; LoP (1st Batch) - 600, 1st renewal (2nd Batch) -
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600, 2nd renewal (3rd Batch) - 750, 3rd renewal (4th Batch) - 900;
4th renewal (5th Batch) - 1200 and Recognition - 1200. The
requirement of bed occupancy is as follows; 60% for 1st Batch, 2nd
Batch and 3rd Batch and it is 75% for 4th Batch, 5th Batch and
Recognition. The requirement, as per Annexure II(A), of Faculty
and Residents for 150 MBBS admission annually, is as follows;
Faculty: LoP - 54, 1st renewal - 78, 2nd renewal - 83, 3rd renewal -
116; 4th renewal - 116 and Recognition - 116; Tutor/
Demonstrator/Senior Resident Doctors: LoP - 43, 1st renewal - 58,
2nd renewal - 62, 3rd renewal - 76; 4th renewal - 76 and Recognition
- 76; Statistician: LoP - 0, 1st renewal - 1, 2nd renewal - 1, 3rd
renewal - 1; 4th renewal - 1 and Recognition - 1.
16. As already noticed hereinbefore, the challenge made in
W.P.(C)No.32178 of 2025 was against Ext.P13 order dated
14.07.2025 of the 1st appellant Under Graduate Medical Education
Board, whereby the Board decided to reduce 50 seats in Palakkad
Institute of Medical Sciences, and to grant conditional renewal of
only 100 MBBS seats, for the academic session 2025-26. By
Exts.P1 order dated 22.08.2025 of the 2nd appellant National
Medical Commission, the appeal filed by Palakkad Institute of
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Medical Sciences, against Ext.P13 order dated 14.07.2025 of the
1st appellant Under Graduate Medical Education Board, invoking
the provisions under Section 22(3) of the National Medical
Commission Act, 2019, read with Section 9 of MSMER 2023, was
disposed of by upholding Ext.P13 order, thereby confirming the
renewal of approval of 100 MBBS seats, for the academic session
2025-26. By Ext.P1 order, the 2nd appellant Commission directed
Palakkad Institute of Medical Sciences to strictly adhere to
compliance under UG-MSR 2023, and rectify the deficiencies
before the next renewal for the academic session 2026-27.
17. By Ext.P9 public notice dated 01.11.2024 issued by the
1st appellant Under Graduate Medical Education Board, all medical
colleges/institutions having a valid LoP for MBBS admission were
directed to fill the details/data of respective colleges/institutions
on the portal of the 2nd appellant National Medical Commission for
annual declaration, as required under the provisions of the
National Medical Commission Act, 2019 and various regulations
issued by the Commission from time to time. In Ext.P9
notification, it was provided that the submission of a duly
completed Annual Declaration Form of each college/institution on
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the portal of the Commission is mandatory for the annual renewal
of permission of UG-MBBS seats. No seat shall be permitted in
case the college/institution fails to submit the Annual Declaration
within the specified time period. Ext.P9 public notice was followed
by Ext.P10 public notice dated 24.04.2025 issued by the 1st
appellant Under Graduate Medical Education Board.
18. The document marked as Ext.P11 is a show cause
notice dated 15.05.2025 issued by the 1st appellant Under
Graduate Medical Education Board, pointing out various
deficiencies in Palakkad Institute of Medical Sciences, based on
the evaluation of the Annual Declaration Form as per UG-MSR
2023 and MSMER 2023. In the said show cause notice, the 1st
appellant Board has pointed out the provisions contained in
Section 8 of MSMER 2023, which deal with penalties for violation
or any act of omission by the medical institution.
19. On receipt of Ext.P11 show cause notice, the Principal
of Palakkad Institute of Medical Sciences submitted Ext.P12 reply
dated 23.06.2025, with an undertaking to comply with the
requirements of UG-MSR 2023, within one year, by recruiting
additional faculty, making all necessary infrastructures, and
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improving clinical materials and facilities as required. In Ext.P12,
it was pointed out that the Apex Court in Ext.P5 order dated
03.11.2023 in W.P.(C)No.1166 of 2023 directed the 2nd appellant
Commission to go by the parameters that were available during
the academic session 2023-24, while permitting the petitioners to
establish the medical college. After considering Ext.12 compliance
report, the 1st appellant Board issued Ext.P13 order dated
14.07.2025, whereby it was decided to reduce 50 seats and grant
conditional renewal of only 100 MBBS seats in Palakkad Institute
of Medical Sciences. In Ext.P13 order, the 1st appellant Board
made it clear that the said decision is taken in the interest of
maintaining the quality of medical education and to ensure that
institutions operate within the framework of the prescribed
statutory norms. By Exts.P1 order dated 22.08.2025 of the 2nd
appellant Commission, the appeal filed against Ext.P13 order of
the 1st appellant Board was disposed of, by upholding Ext.P13
order, thereby confirming the renewal of approval of 100 MBBS
seats, during the academic session 2025-26. By Ext.P1 order, the
2nd appellant Commission directed Palakkad Institute of Medical
Sciences to strictly adhere to compliance under UG-MSR 2023,
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and rectify the deficiencies before the next renewal for the
academic session 2026-27.
20. The contention of respondents 1 and 2-petitioners is
that in view of Ext.P5 order dated 03.11.2023 of the Apex Court
in W.P.(C)No.1166 of 2023, the petitioners are entitled for
consideration of their request for permission to admit the second
batch of 150 MBBS students in Palakkad Institute of Medical
Sciences, during the academic session 2025-26, with reference to
the parameters prevailing for the academic session 2023-24, i.e.,
MSR 2020 and not with reference to the parameters in UG-MSR
2023. In Ext.P12 reply report dated 23.06.2025, the petitioners
gave an undertaking to comply with the requirements of UG-MSR
2023, within a period of one year.
21. In paragraph 4 of Ext.P3 order dated 09.05.2023 of the
Apex Court in the Civil Appeal No.3597 of 2023, arising out of
SLP(C)No.16139 of 2022, the Apex Court declined to accept the
contention made on behalf of V.N. Public Health and Educational
Trust, the 1st respondent herein, that faculty can be engaged in
the college only after the permission is granted. In the said order,
the Apex Court stated that, in academic matters and particularly
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in the field of medical education, no relaxation can be granted
insofar as the norms and requirements prescribed by law are
concerned. A reading of Ext.P5 order dated 03.11.2023 of the
Apex Court in W.P.(C)No.1166 of 2023 would show that the
relaxation in terms of the said order, which was one issued by the
Apex Court in exercise of the powers under Article 142 of the
Constitution of India, is applicable only for the academic session
2024-25 and not thereafter. The exception carved out by the said
order was with reference to testing the infrastructure for issuance
of LoP, whereafter annual renewals have to be on fulfillment of the
parameters prescribed in UG-MSR 2023, read with MSMER 2023.
22. In State of Punjab v. Rafiq Masih [(2014) 8 SCC
883] a Three-Judge Bench of the Apex Court affirmed the view
taken in Indian Bank v. ABS Marine Products (P) Ltd.
[(2006) 5 SCC 72] holding that the directions issued under
Article 142 do not constitute a binding precedent unlike Article 141
of the Constitution of India. The directions of the Court under
Article 142 of the Constitution, while moulding the relief, that relax
the application of law or exempt the case in hand from the rigour
of the law, in view of the peculiar facts and circumstances, do not
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comprise the ratio decidendi and therefore lose its basic premise
of making it a binding precedent.
23. In Manohar Lal Sharma v. Medical Council of India
[(2013) 10 SCC 60], a decision relied on by the learned ASGI,
in the context of Indian Medical Council Act, 1956 and the
regulations made thereunder, the Apex Court held that
deficiencies pointed out in the inspection conducted by a team of
inspectors, which are fundamental and very crucial in nature,
cannot be ignored in the interest of medical education and the
student community. The Medical Council of India and the college
authorities have to bear in mind that what is prescribed in the
Regulations is the minimum. If the Medical Council of India dilutes
the minimum standards, it will be doing violence to the statutory
requirements. The Medical Council of India is duty-bound to cancel
the request if fundamental and minimum requirements are not
satisfied, or else the college will be producing half-baked and poor-
quality doctors, who would do more harm to society than service.
On the facts of the case at hand, the Apex Court found that the
infirmities pointed out by the inspection team are serious
deficiencies and the Board of Governors of the Medical Council of
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India rightly declined approval for renewal of permission for the
third batch of 150 MBBS students, for the academic session 2013-
14.
24. In Medical Council of India v. Kalinga Institute of
Medical Sciences [(2016) 11 SCC 530], the Apex Court held
that medical education must be taken very seriously and when an
expert body certifies that the facilities in a medical college are
inadequate, the courts are not equipped to take a different view
in the matter, except for very cogent jurisdictional reasons such
as malafides of the inspection team, ex facie perversity in the
inspection report, jurisdictional error on the part of Medical Council
of India, etc. Under no circumstances should the High Court
examine the report as an appellate body, which is not a function
of the High Court.
25. In V.N. Public Health and Educational Trust v.
State of Kerala [(2021) 17 SCC 189], a decision relied on by
the learned Senior Counsel for the 3rd respondent University, on
the issuance of an essentiality certificate by the State
Government, for the academic session 2021-22, to respondents 1
and 2 herein for establishing Palakkad Institute of Medical
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Sciences, a Three-Judge Bench of the Apex Court reiterated the
law laid down in Medical Council of India v. KMCT Medical
College [(2018) 9 SCC 766] that the decision taken by the
Union of India based on the recommendation of the expert body
cannot be interfered with lightly, and interference is permissible
only when the college demonstrates jurisdictional errors, ex facie
perversity or mala fides. In the said decision, the Three-Judge
Bench relied on another decision in Medical Council of
India v. S.R. Educational and Charitable Trust [(2020) 17
SCC 717]. In the said decision, the High Court has ordered an
inspection, and, if the deficiencies are found to exist, then the
Medical Council of India and the Government of India have been
given liberty to take an appropriate decision. The Apex Court
found that such orders may ruin the entire career of the students.
Once permission to admit students is granted, it should not be
such a conditional one. Considering the deficiencies, it would be
against the efficacious medical education and would amount to
permitting the unequipped medical college to impart medical
education without proper infrastructure and faculty. The patients
serve as the object of teaching by such an approach. Ultimately,
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the interests of society would suffer, and half-baked doctors
cannot be left loose on society like drones and parasites to deal
with the lives of patients in the absence of proper educational
training. It would be dangerous and against the right to life itself,
in case unequipped medical colleges are permitted to impart
substandard medical education without proper facilities and
infrastructure.
26. The learned Senior Counsel for the 3rd respondent
University pointed out the observation made by the Three-Judge
Bench in paragraph 37 of the decision in V.N. Public Health and
Educational Trust [(2021) 17 SCC 189], which reads thus;
"37. In the case at hand, the essentiality certificate was first
issued in the year 2004, and over 17 years later, the
appellant College is not in a position to secure the requisite
permissions from the MCI. It is quite apparent that the
appellant institution has long been trying to escape its
responsibility and fill up the lacuna through the judicial
process by getting orders from the High Court for consent
of affiliation and consideration of its belated, half-baked
applications before the MCI. In both the inspections in 2015
and 2020, it was found that the appellant institution lacks
proper facilities. Even though the Appellant claims to be
running a hospital since 2006, neither adequate amenities
nor infrastructure on inspection was found to be in
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existence. This lackadaisical attitude is a testament to the
fact that the appellant has no real interest in running a
hospital in that place and has no ground to call foul upon
rejection of EC, CoA, or its applications before MCI."
27. By Ext.P9 public notice dated 01.11.2024 issued by the
1st appellant Under Graduate Medical Education Board require all
medical colleges/institutions having a valid LoP for MBBS
admission to fill the details/data of respective college/institution
on the portal of National Medical Commission for annual
declaration, as required under the provisions of National Medical
Commission Act, 2019 and the regulations issued by the National
Medical Commission from time to time. In Ext.P11 show cause
notice dated 15.05.2025 issued by the 1st appellant Board, various
deficiencies in Palakkad Institute of Medical Sciences were pointed
out, based on the evaluation of the Annual Declaration Form as
per UG-MSR 2023 and MSMER 2023.
28. Section 10 of MSMER 2023 deals with an appeal to the
Central Government. As per Section 10, where an applicant/
medical college or medical institution is aggrieved by the decision
of the Commission or where the Commission fails to give its
decision within forty-five days from the date of receipt of such an
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appeal, a second appeal may be filed before the Central
Government within thirty days from the date of such order or lapse
of time, as the case may be. The decision of the Central
Government in this regard shall be final.
29. Instead of challenging Ext.P1 order dated 22.08.2025
of the 2nd appellant National Medical Commission, by invoking the
statutory remedy provided under Section 10 of MSMER 2023,
before the Central Government, by filing an appeal, the petitioners
(respondents 1 and 2 herein) have chosen to challenge the said
order by filing a writ petition before this Court on 24.08.2025.
30. In Commissioner of Income Tax v. Chhabil Das
Agarwal [(2014) 1 SCC 603] the Apex Court held that non-
entertainment of a writ petition under Article 226 of the
Constitution of India when an efficacious alternative remedy is
available is a rule and self-imposed limitation. It is essentially a
rule of policy, convenience and discretion rather than a rule of law.
Undoubtedly, it is within the discretion of the High Court to grant
relief under Article 226 of the Constitution of India, despite the
existence of alternative remedy. However, High Court must not
interfere if there is an adequate efficacious alternative remedy
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available to the petitioner and he has approached the High Court
without availing the same, unless he has made out an exceptional
case warranting such interference or there exists sufficient ground
to invoke the extraordinary jurisdiction under Article 226.
31. When a statutory remedy by way of an appeal to the
Central Government is provided under Section 10 of MSMER 2023
against Ext.P1 order dated 22.08.2025 of the 2nd appellant
National Medical Commission, instead of invoking the
extraordinary jurisdiction of this Court under Article 226 of the
Constitution of India, the petitioners (respondents 1 and 2 herein)
ought to have availed that statutory remedy. The timeline involved
in the matter is not a sufficient ground or an exceptional
circumstance for invoking the extraordinary jurisdiction under
Article 226 of the Constitution of India against Ext.P1 order passed
by the 2nd appellant National Medical Commission. Therefore, the
finding of the learned Single Judge that the appellate remedy
provided under Section 10 of MSMER 2023 will not be an
efficacious alternative remedy cannot be sustained in law.
32. As already noticed hereinbefore, as per sub-section (a)
of Section 10 of EMAR 2023, no medical institution shall be
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provided permission unless it satisfies the conditions pertaining
to, but not limited to, physical infrastructure, teaching staff,
clinical material and hospital as detailed in the MSRs notified from
time to time. Sub-section (b) of Section 10 empowers the UGMEB
or PGMEB, as the case may be, to publish from time to time, the
MSR with such modifications or amendments required, keeping in
mind the overall objectives of the National Medical Commission
Act. The mandate of sub-section (c) of Section 10 is that
notwithstanding anything stated above in Section 10, all modified
or amended MSRs shall have to be implemented.
33. The mandate of Section 28 of EMAR 2023 is that it shall
be the duty of all medical institutions to follow the regulations and
directions issued by Medical Assessment and Rating Board
(MARB), both in letter and spirit, either within a specified time
period or within a reasonable period of time, wherever the
timelines are applicable. In view of the provisions under Section
29, which defines non-compliance, the acts or omissions
enumerated in sub-sections (a) to (i) of a medical institute shall
amount to non-compliance. Sub-section (a) of Section 29 deals
with non-compliance with any of the regulations and notifications
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of the National Medical Commission issued from time to time. Sub-
section (c) of Section 29 deals with deficiency in infrastructure,
teaching staff, clinical material and others as prescribed by way of
MSR or otherwise by UGMEB and/or PGMEB.
34. In view of the provisions contained in Section 30 of
EMAR 2023, for any of the non-compliance or intentional attempt
of non-compliance act or omission by the medical institution, the
MARB shall either penalise the medical college or medical
institution as per sub-section (f) of Section 26 of the Act and/or
conduct further enquiry into such incident or act, and wherever
needed, provide an opportunity to rectify the same. In view of the
provisions contained in Section 31, the imposition of the penalty
may include one/more/all of the penalties enumerated in sub-
sections (a) to (h). Sub-section (d) of Section 31 provides for
reducing the number of students in the next or subsequent
academic years to be admitted by the medical institution.
35. The argument of the learned counsel for the petitioners
(respondents 1 and 2 herein) is that, in view of the first proviso to
Section 31 of EMAR 2023, the medical institution ought to have
been granted a reasonable opportunity to rectify the deficiencies,
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and any further action shall be taken if it fails to meet the requisite
norms.
36. On the aforesaid argument advanced by the learned
counsel for the petitioners (respondents 1 and 2 herein), we notice
that the mandate of Section 28 of EMAR 2023 require all medical
institutions to follow the regulations and directions issued by the
MARB, both in letter and spirit, either within a specified time
period or within a reasonable period of time, wherever the
timelines are applicable. As already noticed hereinbefore at
paragraphs 14.2 and 14.3, there is no phase-wise minimum
requirement in UG-MSR 2023, as in the case of MSR 2020, as
noticed hereinbefore at paragraphs 15 and 15.1. In view of the
provisions contained in UG-MSR 2023, read with the provisions
contained in EAMR 2023, all medical institutions have to comply
with the requirements of UG-MSR 2023, at the time of
establishment itself. When such a provision is there in UG-MSR
2023 and EMAR 2023, the 1st appellant Under Graduate Medical
Education Board or the 2nd appellant National Medical Commission
cannot be found fault with in not accepting the request of the
medical institution in question to meet the requirements by
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appointing additional faculties and providing infrastructure, within
a period of one year.
37. It is not in dispute that the petitioners (respondents 1
and 2 herein) could not comply with the requirements of UG-MSR
2023 read with EMAR 2023 for the academic session 2025-26,
which had resulted in the conditional renewal for the said
academic session being reduced to the second batch with 100
MBBS seats. In such circumstances, this Court in exercise of the
extraordinary jurisdiction of this Court under Article 226 of the
Constitution of India cannot issue a writ of mandamus
commanding the appellants and the 3rd respondent University to
permit the medical institution in question to admit students in 150
MBBS seats in the second batch, during the academic session
2025-26, over and above 100 MBBS seats in respect of which
conditional renewal has been granted by the appellants, since no
mandamus can be issued directing the statutory authorities to do
something contrary to the statute. See: Bhaskara Rao A.B. v.
CBI [(2011) 10 SCC 259]. Therefore, the direction contained in
the judgment of the learned Single Judge cannot be sustained in
law.
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In the above circumstances, this writ appeal is allowed by
setting aside the judgment dated 08.10.2025 of the learned Single
Judge in W.P.(C)No.32178 of 2025, and the writ petition is
dismissed for the reasons stated hereinbefore.
Sd/-
ANIL K. NARENDRAN, JUDGE
Sd/-
MURALEE KRISHNA S., JUDGE
bkn/-
