Kabir Paharia vs National Medical Commission

REPORTABLE IN THE SUPREME COURT OF INDIA CIVIL APPELLATE JURISDICTION

CIVIL APPEAL NO(S). OF 2025 (Arising out of SLP (Civil) No (s). 29275 of 2024)

KABIR PAHARIA ….APPELLANT(S)

VERSUS

NATIONAL MEDICAL COMMISSION AND OTHERS ….RESPONDENT(S)

ORDER

Mehta, J.

1. Heard.

2. Leave granted.

Signature Not Verified Digitally signed by SONIA BHASIN Date: 2025.05.05 14:50:37 IST Reason: 1 3. The appellant being a person with benchmark

disabilities (for short ‘PwBD’) belongs to the reserved

category of Scheduled Caste and aspires for admission

to the MBBS UG (Bachelor of Medicine and Bachelor of

Surgery) course. Having been denied admission to the

MBBS course, despite standing high in merit in his

category i.e., Scheduled Castes-PwBD quota, the

appellant approached the High Court of Delhi at New

Delhi1 by filing a Writ Petition (C) No. 12165 of 2024,

which came to be rejected vide order dated 10th

September, 2024. The Letters Patent Appeal No. 967 of

2024, preferred by the appellant, also stands rejected

by the Division Bench of the High Court vide order

dated 12th November, 2024, which is assailed in this

appeal by special leave.

1 Hereinafter referred to as ‘High Court.’

2

4. The facts in brief, essential for disposal of the

present matter, can be gathered from the detailed order

dated 2nd April, 2025 passed by this Court, which is

reproduced hereinbelow: -

“2. The petitioner passed Secondary School Examination/Class Xth in 2022 with 91.5% marks and class XIIth exams with 90% marks. He appeared for the National Eligibility-cum-Entrance Test (for short “NEET”) UG 2024 Examinations in the category of SC/PwBD candidate. The deformities suffered by the petitioner in his body are as below:-

“congenital absence of multiple fingers in both hands as well as involvement of left foot (2nd and 3rd toe), the extent whereof has been assessed at 42%.”

3. Despite the structural disadvantages referred to above, the petitioner performed exceedingly well in the examination scoring 542 marks and secured a category rank of 176. It may be stated that the cut-

off marks for these subcategories were 143-127. Having made the cut-off for the SC/PwBD category with flying colours, the petitioner staked his rightful claim for the next stage which requires the issuance of a Certificate of Disability for NEET Admissions (“NEET Disability Certificate”) by a designated ‘Disability Certification Centre’. Accordingly, the petitioner approached the Vardhman Mahavir Medical College-Safdarjung Hospital, New Delhi (for short “VMMC-SJ Hospital”) for medical assessment. Even though, the VMMC-SJ Hospital assessed the petitioner’s disability at 68%, it concluded that under

3 the NMC/MCI guidelines, the petitioner was not entitled to pursue the medical courses. The conclusions drawn by the certifying body in the certificate dated 19th August, 2024, are reproduced below for ready reference:-

“Conclusion: Based on quantification of disability The candidate is not eligible to pursue medical courses (as per NMC norms).

Remark: BILATERAL UPEER (sic) LIMB INVOLVEMENT

The Disability Certification Board certifies that the candidate is not eligible for admission in Medical/Dental courses and to avail 5% PwD reservation as per the NMC/MCI Gazette Notification.”

4. Aggrieved by his disqualification from admission in the MBBS course on the ground of benchmark disabilities, despite standing high in merit, the petitioner approached the High Court of Delhi by filing Writ Petition (Civil) No. 12165 of 2024.

5. The learned Single Bench of the High Court directed the All-India Institute of Medical Sciences, New Delhi to constitute a Board of three experts to reassess the petitioner’s disabilities and to give an opinion as to whether the petitioner would be able to pursue medical courses and perform as a Doctor. In compliance, the petitioner was subjected to reassessment by the Medical Board constituted at AIIMS, New Delhi and the report was submitted to the learned Single Judge, who upon perusal thereof, concluded that the petitioner was ineligible to pursue

4 medical courses. Accordingly, the writ petition was dismissed vide order dated 10th September, 2024.

6. The petitioner assailed the decision of the learned Single Judge by filing Letters Patent Appeal No. 967 of 2024. The Division Bench of the High Court of Delhi passed an order dated 27th September, 2024, and directed a fresh evaluation of the petitioner’s disabilities by a newly constituted medical Board. The three-member medical Board constituted at the AIIMS reiterated the conclusions of the earlier Medical Board and again declared the petitioner ineligible to pursue the medical courses as per the prevailing NMC norms. Upon receiving the report, the learned Division Bench of the Delhi High Court vide impugned judgment dated 12th November, 2024, endorsed the view of the board and dismissed the Letters Patent Appeal preferred by the petitioner. The said judgment is subject matter of challenge in this petition.

7. Mr. Rahul Bajaj, learned counsel representing the petitioner, contended that the impugned judgment and the decisions of both the medical Boards are inherently flawed inasmuch as neither the medical authorities nor the High Court duly adverted to the crucial concepts of assistive devices and reasonable accommodation to which the petitioner is entitled, under the Rights of Persons with Disabilities Act, 2016 (for short ‘Act of 2016’). The vital factors, i.e., the academic excellence of the petitioner, his performance in the NEET examination, the high placement in merit, were totally glossed over while denying relief to the petitioner. Shri Bajaj relied upon the judgments of this Court in Om Rathod v. Director General of Health Sciences, 2024 SCC OnLine SC 4283 and Anmol v. Union of India & Ors. 2025 SCC OnLine SC 387, to urge that the salutary principles provided under Article 41 of the

5 Constitution of India read with the Act of 2016 clearly entitle the petitioner to seek medical education as both these judgments expressly recognize the concepts of assistive devices and reasonable accommodation. By availing these moderations as provided under the decisions of this Court, the petitioner would be well equipped to perform his duties as a Doctor.

8. Learned counsel submitted that in the case of Om Rathod (supra), despite the fact that the candidate was not having both hands, he was held entitled to undergo the MBBS course pursuant to an assessment made by Dr. Satendra Singh, a specialist in the field.

9. Learned counsel submitted that Dr. Satendra Singh, while undertaking the functional assessment of the candidate Shri Om Rathod posed four questions for assessing his ability to undergo MBBS course and concluded that all the questions had to be answered in negative. The relevant excerpt from Om Rathod’s judgment is quoted below: -

“11. Dr Satendra Singh submitted his report on 20 October 2024. This Court duly furnished the report to the second respondent, National Medical Council, on 21 October 2024 to enable them to formulate their response. The report by Dr Satendra Singh outlined the functional disability of the appellant to be an inability to stand independently which may prove limiting in clinical rotations in surgical settings. The report suggested solutions to enable the appellant in such cases. The report further suggested clinical

6 accommodations for the appellant to reduce the barriers he may encounter. The report determined the accommodations necessary for the appellant to be reasonable and in compliance with existing norms. The report formulated four questions and answered them as follows:

“a) Would the proposed accommodation result in a failure to meet the NMC CBME's inherent requirements? Not in my opinion

b) Would the accommodation legitimately jeopardize patient safety? Not in my opinion

c) Would the proposed accommodation result in the improper waiver of a core requirement of the CBME? Not in my opinion

d) Would the proposed accommodation pose an undue hardship on the medical college (budgets wise)? Not in my opinion”

10. In his report, Dr. Satendra Singh quoted that the father of Neurosurgery Harvey Cushing emphasized way back in 1912 that motor skills are often the least important part of the work.

11. Learned counsel submitted that the petitioner in the case of Anmol (supra) was suffering from locomotor disability assessed at 50% with club foot right lower limb and Phocomelia (a congenital defect which causes severe limb shortening or loss of long bones), in left middle ring finger through middle phalanx with right middle index finger through middle phalanx. The candidate also suffered from speech and language disability assessed at 20%.

7 12. Mr. Bajaj contended that the petitioner herein is having much better physical/locomotor attributes and is well equipped as compared to the two candidates in the cases of Anmol (supra) and Om Rathod (supra). He also scored much higher marks than these candidates in NEET (UG) examination 2024-2025. Anmol had obtained rank 2462 in the PwD category, whereas the petitioner herein secured 176 rank and thus, he is much better placed than the candidates in the above-referred cases.

13. He submitted that the assessment made by the medical Board of the petitioner’s capability to take the medical degree course and his disqualification on the anvil of NMC norms is illegal and unsustainable in view of the law laid down by this Court in the judgments referred to supra.

14. He, therefore, urged that a direction deserves to be issued to have a reassessment done of the petitioner through Dr. Satyendra Singh on the ratio of the above referred judgments and to mandate the respondents to grant admission and accommodate the petitioner in the MBBS (UG) Course 2024-2025.

15. Relying upon the order dated 17th April, 2023, passed in the case of Vibhushita Sharma v. Union of India, Writ Petition (Civil) No.793 of 2022, learned counsel submitted that in case, this Court is not inclined to grant admission to the petitioner in the 2024-2025 MBBS Degree course, a suitable direction deserves to be issued to the respondents to admit the petitioner in the academic session 2025-2026 treating him to be NEET (UG) qualified.

16. Per contra, learned counsel representing the Union of India and National Medical Commission urged that the Commission is under the process of

8 revising its guidelines in compliance with the judgments in the cases of Om Rathod (supra) and Anmol (supra). Three meetings have already taken place, and the process is expected to be finalised before counselling for the next academic session commences. They thus, urged that the petitioner will not be prejudiced, if the consideration of this matter is deferred till the new guidelines are put in place.

17. We have given our thoughtful consideration to the submissions advanced at bar and have gone through the material placed on record.

18. Prima facie, we find substance in the submission of the learned counsel representing the respondents that the process for revising the guidelines in terms of this Court’s decisions (supra) is underway and a final outcome is expected before the counselling session for MBBS (UG) 2025-2026 commences. However, we are not inclined to defer the proceedings at this stage.

19. Denying relief to the petitioner on this premise would be totally unjustified in view of the ratio of this Court’s judgments in Om Rathod (supra) and Anmol (supra). Merely because the NMC is under the process of revising the guidelines, the petitioner’s fate cannot be allowed to hang in a limbo in spite of the fact that he has performed exceedingly well in the NEET (UG) 2024 examination and stood high in the merit in his category.

20. In view of the above, we hereby direct that a fresh Medical Board shall be constituted at the All-India Institute of Medical Sciences, New Delhi comprising of five Doctors/specialists. One of the Board members shall be a specialist in locomotor disabilities and one member shall be a Neuro-Physician.

9 21. The petitioner shall be intimated a suitable date for assessment by the Board within the next seven days. He shall appear before the Board on the appointed date whereupon the Board shall undertake a fresh assessment of the petitioner’s disabilities with due deference to the ratio of this Court’s judgments in Om Rathod (supra) and Anmol (supra). The Board’s report shall be forwarded to this Court in a sealed cover on or before 15th April, 2025.”

5. Pursuant to the aforesaid direction, the appellant

was subjected to extensive review assessment by a

Medical Board constituted at the All-India Institute of

Medical Sciences, New Delhi (for short ‘AIIMS, New

Delhi’). The report dated 24th April, 2025 has been

forwarded by the Medical Board, which is reproduced

hereinbelow for the sake of convenience: -

“Subject: Report of the medical board constituted at AIIMS for medical examination of petitioner Sh. Kabir Paharia in compliance of order dated 02.04.2025, Hon'ble Supreme Court of India, New Delhi (Section- XIV)vide Special Leave Petition (Civil) No. 29275 of 2024 titled Kabir Paharia Versus National Medical Commission & Others.

*****************************

10 With reference to the aforementioned subject, the Medical Superintendent, AIIMS, New Delhi constituted a Medical Board consisting of the following members:-

1. Dr. S.L. Yadav - Chairperson Professor, Deptt. of P.M.R.

2. Dr. Suman Jain - Member Professor, Deptt. of Physiology

3. Dr. Divya M.R. - Member Assoc. Professor, Deptt. of Neurology

4. Dr. Arun Kumar Choudhary - Member Asstt. Professor, Deptt. of PMR

5. Dr. Sahil Batra - Member Asstt. Professor, Deptt. of Orthopaedics

6. Dr. Veeranna B. - Member Secy.

Department of Hospital Administration

The meeting of the Medical Board was held on 16.04.2024 (Wednesday) at 11:00 A.M. in the Seminar Room, Room No. 01, Ground floor, PMR OPD, Department of PMR, AIIMS, New Delhi. The available reports, earlier disability certificates and medical documents were reviewed. The petitioner Sh. Kabir Paharia was present and was examined by the members of the Medical Board. The second board meeting was held on 22nd April 2025 at 11:00 AM in the SET facility convergence block, AIIMS, New Delhi.

Mr. Kabir Paharia underwent a comprehensive neurological examination as part of the Medical Board assessment. It was observed that Mr. Kabir has a

11 significant absence of multiple digits in both hands (specifically, the index and middle fingers on the right hand, and the index, middle, and ring fingers on the left hand) as well as in the left foot (notably, the second and third toes), which is attributed to a birth complication as documented in the available medical records. His condition is deemed non-progressive, and the locomotor disability is classified as permanent. The neurological examination showed normal strength in the existing limbs and digits, with intact sensations and good coordination of the existing limbs and digits.

He was asked to demonstrate various skilled techniques in the simulation laboratory, including chest compressions, intravenous cannulation, assembly of a laryngoscope, intubation, and suturing, all of which he executed satisfactorily. He demonstrated functional adaptation using his existing digits during these tasks. However, the board observed that he faced minor challenges while attempting to put on the sterilized standard gloves. He had slight coordination problems and delays caused by the lack of fingers and empty finger slots in the gloves. An evaluation by an occupational therapist validated his independence in activities of daily living (ADLs).”

6. A careful perusal of the above report makes it

amply clear that the appellant successfully

demonstrated skilled techniques in the simulation

laboratory including chest compressions, intravenous

12 cannulation, assembly of a laryngoscope, intubation

and suturing. The Medical Board, in its report,

observed that the appellant demonstrated the

functional adaptation using his existing digits during

these tasks. The only minor challenge, which the

appellant faced during the entire procedure, was

putting on the sterilized standard gloves.

7. We feel that the mindset must change and this

trivial aberration, by no stretch of imagination, can be

a ground to deny admission to the appellant in the

MBBS UG course, when he is otherwise qualified and

scored exceeding high rank in the NEET-UG 2024.

8. As per the result of NEET-UG 2024, the appellant

secured an All-India Rank of 147946. His Scheduled

Caste category rank was 7252, and his PwBD category

rank was 176. The appellant has also submitted details

13 of the provisional NEET-UG 2024 counselling seat

allotment (Round 1), according to which a candidate

with Roll No. 14491, who ranked 159816, was allocated

a seat at AIIMS, New Delhi under the Scheduled Castes

PwBD category. Apparently thus, a candidate who stood

much below the appellant in merit has been admitted

against the reserved seat at the AIIMS, New Delhi to

which the appellant had a valid claim.

9. Manifestly, in view of the observations made by us

in the order dated 2nd April, 2025 and the consequent

successful assessment of the appellant by the Medical

Board, AIIMS, New Delhi vide report dated 24th April,

2025, the denial of admission to the appellant in the

MBBS UG course was grossly illegal, arbitrary and

violative of the appellant’s fundamental rights as

guaranteed under Articles 14 and 16 of the Constitution

14 of India. Such action not only reflects institutional bias

and systemic discrimination but also undermines the

principles of equal opportunity and non-discrimination

enshrined in our constitutional framework. The

constitutional mandate of substantive equality

demands that person with disabilities (for short ‘PwD’)

and PwBD be afforded reasonable accommodations

rather than subjected to exclusionary practices based

on unfounded presumptions about their capabilities.

10. On the previous date of hearing, we had sought a

response from the learned counsel representing the

respondents regarding the appellant's submission that

the candidate who secured a rank lower than the

appellant had been granted admission against the

Scheduled Castes PwBD quota in the MBBS UG course

at AIIMS, New Delhi, for the academic year 2024–2025.

15 11. Today, during the course of hearing, Ms. Archana

Pathak Dave, learned ASG, on instructions, fairly

affirms this assertion of the appellant. She further

states that as the appellant has been successfully

assessed by the Medical Board constituted at AIIMS,

New Delhi, he can be afforded admission in MBBS UG

course against the Scheduled Castes PwBD quota in the

AIIMS, New Delhi in the forthcoming counselling

session of 2025-2026.

12. Taking consideration of the fact that the 2024-

2025 academic session must have progressed

significantly and thus it would not be expedient to grant

admission to the appellant in the said session. We

accordingly direct that the appellant shall be allocated

a seat in the MBBS UG course 2025 against the

Scheduled Castes PwBD quota in the All-India Institute

16 of Medical Science, New Delhi, in the forthcoming

academic session.

13. In backdrop of the factual matrix narrated supra

and the comparative higher merit secured by the

appellant in the NEET-UG 2024 examination, we make

it clear that the appellant shall not be required to

undergo the NEET-UG 2025 examination.

14. We further direct that the National Medical

Commission shall forthwith and not later than within a

period of two months from today and at any cost before

the counselling for the 2025-2026 session commence,

complete the process of revising the guidelines in light

of judgments of this Court in Om Rathod v. Director

General of Health Sciences2 and Anmol v. Union of

India & Ors.3 so that no deserving candidate in the

2 2024 SCC OnLine SC 4283.

3 2025 SCC OnLine SC 387.

17 PwBD category is denied admission into the MBBS

course in spite of his/her/their entitlement. It must be

ensured that systemic discrimination against persons

with benchmark disabilities, whether direct or indirect,

is eliminated and that the admission process upholds

their right to equal opportunity and dignity.

15. The constitutional promise of equality is not

merely formal but substantive, requiring the State to

take affirmative measures to ensure that PwD and

PwBD can meaningfully participate in all spheres of life,

including professional education. We emphasize that

reasonable accommodation is not a matter of charity

but a fundamental right flowing from Articles 14, 16,

and 21 of our Constitution. When administrative

authorities create arbitrary barriers that exclude

qualified PwBD candidates, they not only violate

18 statutory provisions but also perpetuate the historical

injustice and stigmatisation. The fundamental rights

and the dignity of PwD and PwBD candidates must be

protected by ensuring that assessment of their

capabilities is individualised, evidence-based, and free

from stereotypical assumptions that have no scientific

foundation.

16. Before parting, we express our wholehearted

appreciation for Mr. Rahul Bajaj and Mr. Amar Jain,

learned counsel, both persons with benchmark

disability (zero vision), for the excellent assistance

provided by them during the course of hearing of the

present matter. We also express our sincere

appreciation to Mr. Gaurav Agarwal, learned senior

counsel, for his pro bono services and Ms. Archana

19 Pathak Dave, learned ASG, for her pragmatic approach

in the matter.

17. The impugned order dated 12th November, 2024,

passed by the High Court of Delhi in Letters Patent

Appeal No. 967 of 2024 is set aside.

18. Consequently, the present appeal is allowed in

these terms. No order as to costs.

19. Pending application(s), if any, shall stand disposed

of.

….……………………J. (VIKRAM NATH)

...…………………….J. (SANDEEP MEHTA) NEW DELHI;

MAY 02, 2025.

20