New Delhi: The Supreme Court has suggested a uniform national policy on compulsory rural service for medical students, asking the Centre to consider whether a common framework can govern mandatory service requirements for medical graduates across India.
The Bench comprising Justice P.S. Narasimha and Justice Alok Aradhe observed on August 7 while hearing a plea challenging Karnataka's requirement that certain medical graduates complete compulsory public rural service before obtaining the No-Objection Certificate (NOC) needed for permanent medical registration.
The Solicitor General told the Court that he would seek instructions from the Centre on the possibility of formulating a pan-India policy.
The Bench then adjourned the matter for three weeks and directed that it be listed thereafter.
Justice Narasimha described compulsory rural service as an important policy issue and suggested that medical students should be subject to a uniform approach.
Justice Narasimha emphasised the role of public investment in medical education, arguing that medical training itself constitutes a resource for the state. He said:
It's a very important policy because no medical education is complete without States' subsidy at any point of time. Even if we don't think about States' subsidies, the technique of medicine or the science of medicine is a resource and that State must be entitled to challenge it.
The Court's suggestion does not, however, amount to an order creating a nationwide compulsory rural service programme.
Instead, the Solicitor General has been asked to obtain instructions from the Centre on whether such a national policy on compulsory service for doctors and medical students can be formulated.
The case will be taken up again after three weeks.
The case before the Supreme Court arises from Karnataka's statutory framework governing compulsory service by candidates who have completed medical courses.
The Karnataka Compulsory Service by Candidates Completed Medical Courses Act, 2012, enacted as Karnataka Act 26 of 2015, provides for compulsory service following specified medical courses. The legislation was introduced with the objective of ensuring the availability of medical personnel in government primary health centres and government hospitals.
The statutory framework has been amended over the years. India Code records amendments to the Act and rules, including changes notified in 2023, 2024, 2025 and 2026. Therefore, the current requirements need to be read with the applicable amendments rather than solely with the original 2015 rules.
The present Supreme Court proceedings concern a challenge arising from Karnataka's July 28, 2023 notification, which extended the compulsory-service requirement to candidates admitted to private seats in private or deemed universities, according to the case reporting.
The petitioners, who studied on private seats in private or deemed universities, argued that their higher education costs distinguish them from students on government seats under Article 14 of the Constitution, and therefore they should not be subject to the same compulsory rural service requirement.
They challenged the requirement to submit an undertaking or affidavit for rural service before receiving the NOC needed for permanent registration. They have asked the Supreme Court to direct the Commissionerate of Health and Family Welfare Services to issue the NOC and the Karnataka Medical Council to process their permanent registration.
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The Supreme Court had previously examined the issue in May 2024, when it questioned why students from private medical institutions should be exempt from rural service.
During the earlier proceedings, the Bench questioned whether studying at a private medical institution should by itself exempt a medical student from serving in rural areas.
The Court's earlier observations brought the issue of private medical college students and compulsory rural service into sharper focus.
The latest proceedings also echo the Supreme Court's 2019 judgment in Association of Medical Super Speciality Aspirants and Residents v. Union of India, which upheld compulsory bonds for postgraduate and super-speciality medical courses while highlighting the need for a uniform policy on compulsory service for doctors trained in government institutions.
The 2019 judgment did not establish a nationwide rural-service system but called for greater uniformity in state-level service requirements.
If the Centre develops a national compulsory rural service policy for doctors, it could bring greater uniformity across government and private medical institutions. The framework could potentially address:
Eligibility: Which MBBS, postgraduate and super-speciality graduates would be covered
Service duration: How long doctors would be required to serve
Rural postings: How doctors would be allocated to underserved areas
Private-seat students: Whether government and private-seat students would follow the same rules
Medical registration: Whether rural service would remain linked to permanent registration
Service bonds: Common rules for compulsory service bonds and their enforcement
Exemptions: Circumstances in which doctors could be exempted from the requirement
The Supreme Court has not yet ordered a nationwide compulsory rural service programme.
The Bench has instead asked the Solicitor General to obtain instructions from the Centre on the possibility of formulating a uniform policy.
The matter will be listed after three weeks.
(Rh/ARC/MSM)