The road to a medical education in India is anything but smooth. One is not talking about the actual years of study and residency, but of making it to the portals of a decently equipped and staffed college. The competition is fierce. The National Eligibility-cum-Entrance Test draws 16 lakh candidates for 88,000 MBBS seats, the preparation starts years ahead robbing the aspirants of the joys of childhood, coaching factories such as the ones in Kota proliferate, tensions mount, deaths by suicide increase, heartbreaks exceed exultation. And then there is the overarching shadow of reservations, the undoubted major premise in the prospectus. Starting with the advent of the Constitution in 1950 for a 10-year period, reservations have continued uninterrupted at an ever-increasing pace owing to a combustion of unrealised aspirations, increasing awareness of historical wrongs, political expediency and vote banks. As much as we have wanted to move away from a caste-based society, we have become even more wired into one where caste predominantly dictates reservation, and reservation determines accessibility to education and employment.
Courts and quotas
The courts have struggled to balance the competing demands of preference and unrestricted competition cast as merit. Initially the judiciary’s bent towards equality made it view reservations and quotas through a less-than-welcoming lens. Later on, it recognised that substantive equality does mandate a catch-up philosophy to bring the less fortunate up to levels where competition can be had on more equal terms. Courts have moved up the percentage scale of what they considered permissible, and come around to the halfway mark of 50%, the common negotiating point of resolution. The Supreme Court used a simple explanation to justify this stoppage point: reservations are an exception to the rule of equality, an exception cannot exceed the norm, ergo stop at 50%. It seems to have held on to this principle enunciated in the Balram (1972), Indra Sawhney (1992) and Maratha reservation (2021) cases.
How long more, one has to see, because the court is getting besieged by States which have a higher percentage of the population in the catchment area for reservation and see both social justice and electoral benefit converge in higher reservation points. Thus, there have been attempts to provide reservation to students of rural schools, students of State Board schools, etc. The latest is Tamil Nadu’s attempt to secure a 7.5% preference for governmental school students in an across-the-board horizontal reservation on the ground of a cognitive gap irremediable by (or some may say caused by) years of schooling in such schools; the Madras High Court is now testing its constitutional correctness. But one may take it that as long as ground conditions remain, the battle for increased reservations will continue and this will be the dominant player in determining who gets into, or is excluded from, medical colleges.
It needn’t be this way. We have become conditioned to the condition and mentality of shortages in education, and our courts have responded correspondingly with the jurisprudence of scarcity, perpetually grappling with large volumes of students chasing low numbers of seats, and in so doing balancing past wrongs against present denials, an exercise which can never be satisfactory. But rarely has the court taken it upon itself to ask the broader question: why are we consigned to be perpetually in this state of scarcity? Isn’t there a legal right for Indians to have a medical education system which is accessible and affordable, which can accommodate the youngsters who want to make this their profession? The country needs doctors, teachers need jobs, students need education. Every end of the triangle connects, but there is a yawning gap in the middle made up of enabling policy and action. The right to health and to a good education is part of the right to life, under our expanded conceptualisation of Fundamental Rights.
Turn around the dismal situation
The Prime Minister’s recent observations occasioned by the plight of the Indian medical students returning from Ukraine are on point. Why can’t we provide education to our students instead of them having to go abroad, he asked. Their travails arise not just out of the current situation; apparently, they are driven to seek unregulated agents to obtain indifferent quality education abroad with uneven chances of fitment into the medical system here. His query can well be the galvanising point for turning around the dismal medical education scheme. It does not take much to open up the field for investment and employment of capital and talent. Restrictive rules limiting entrants should be pruned; why should only trusts or societies provide education? The more the restrictions, the more the ways to circumvent them. Focus on enabling and mandating quality infrastructure and capable teachers and keeping standards high. Have a sensible pricing policy, realise that investments need returns, and that there are students who are willing to pay. Don’t drive the commercials into the black market by unreasonable and unnecessary restrictions. Mandate scholarships as the social commitment of the institution. Calibrate a policy of reservation, total and partial scholarships with freedom to run the institution and make a reasonable profit. Let not the government appropriate the seats of private institutions; instead, it can focus on running its own colleges better. Structure tax benefits which will make it viable to start and run medical colleges, and allow minority institutions too to avail of the benefits of Section 80G of the Income Tax Act for donations to its colleges with perhaps a requirement that some, not excessive, seats are for general allotment. Beyond a wholesome regulation, let market forces operate to obtain the benefits of pricing and quality. Give up the substratum of power of officialdom, tailor policy and implementation to meet real needs, create the supply for the demand, and focus on capacity building of institutions and individuals. That’s good Atmanirbhar Bharat.
Sriram Panchu is a Senior Advocate at the Madras High Court. Email: srirampanchu@gmail.com
