Over-Centralisation in Medical Education

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The Supreme Court's ruling against domicile-based reservations in medical education undermines States' ability to plan healthcare policies and threatens federalism.

The Supreme Court's judgment in Dr. Tanvi Behl vs Shrey Goyal (2025) struck down domicile-based reservations for post-graduate medical courses, impacting States' capacity to retain trained healthcare professionals. States invest in medical education, expecting graduates to serve local healthcare needs, but the ruling disrupts this pipeline, worsening specialist shortages.

Domicile quotas help States plan long-term healthcare, ensuring an adequate workforce. The judgment misinterprets the distinction between undergraduate and post-graduate education, where the latter is crucial for workforce replenishment. Removing domicile quotas could drive specialists toward central institutions, neglecting State-run colleges and hospitals.

India’s public health infrastructure depends on medical colleges, making their governance essential. Excessive centralisation in admissions curtails State autonomy in addressing public health needs. Rigid meritocracy disregards socio-economic inequalities, as seen in NEET-PG results, where coaching and financial disparities skew outcomes.

Tamil Nadu's medical education model balances access and public service, demonstrating that domicile quotas aid healthcare distribution. The ruling weakens States' role in shaping their healthcare workforce and promotes competitive federalism at the cost of public health.

A reconsideration is needed to integrate merit with equity. If India aims for a robust healthcare system, it must allow States greater flexibility in medical education policies, ensuring that local needs are met rather than centralising control over admissions.