Supreme Court Medical PG Quota Unconstitutionality Case

In April 2025, the Supreme Court of India heard a landmark challenge to the central government's newly implemented domicile-based reservation policy for postgraduate medical seats. The petitioners, including the SC Advocate-on-Record Association and resident doctors' federations, argued that the National Medical Commission's quota system, which reserved 50% of PG seats for state domicile holders within state-run institutions, violated Articles 14, 15(1), and the basic structure principle of merit-based national integration. The Union of India defended the policy as a valid exercise of protective discrimination under Article 15(3) and Directive Principles to address regional healthcare disparities. The five-judge constitution bench struck down the domicile reservation as unconstitutional, mandating a purely All-India merit pool for superspecialty courses while allowing limited state preference for broad-specialty seats with a ceiling of 30%. The ruling fundamentally restructured India's PG medical admission framework.

The Supreme Court's 3:2 majority verdict declared domicile-based postgraduate medical reservation unconstitutional for superspecialty (DM/MCh) courses, mandating a single All-India merit list. For broad-specialty (MD/MS) courses, the court allowed state domicile reservation up to a ceiling of 30% of total seats, with the remaining 70% to be filled purely on All-India Rank. The National Medical Commission was directed to amend its regulations within three months.

1. Whether domicile-based reservations in PG medical admissions violate the right to equality under Article 14 and the freedom to practice any profession under Article 19(1)(g). 2. Whether state-level domicile quotas compromise the "national character" of medical institutions and the concept of a single citizenship. 3. The extent to which meritocracy can be diluted to achieve regional healthcare distribution goals. 4. The constitutional validity of the National Medical Commission's authority to impose blanket reservation caps without parliamentary legislation.

The judgment triggered widespread protests from state governments and regional political parties, especially in southern states which had historically high domicile quotas. Medical student bodies largely welcomed the decision, anticipating greater mobility and merit recognition. The ruling is expected to significantly alter the migration patterns of medical graduates, potentially exacerbating the urban-rural specialist divide. Several states indicated they would file a review petition or seek a legislative override through a constitutional amendment.