Why all-India quota in medical admissions must be scrapped

CHENNAI: The erosion of State autonomy has proceeded not only through successive Union actions since 1950, but also through certain judicial pronouncements, notwithstanding the Supreme Court’s own declaration that federalism forms part of the Constitution’s Basic Structure. A striking instance is the judicially created All-India Quota (AIQ), under which 15% of undergraduate seats, 50% of postgraduate seats, and all super-speciality seats in State-funded medical colleges are diverted to a central merit pool.

Introduced in 1984, the AIQ has hardened into a permanent centralised admissions regime for MBBS/BDS, MD/MS/MDS and DM/MCh courses. Justice AK Rajan’s 2020 monograph, Penalty for Progress?, offers a scathing critique of this judge-made framework and its constitutional validity.

‘Robin Hood’ origins

The AIQ originated in Dr. Pradeep Jain v. Union of India (1984). Faced with wide inter-State disparities in medical infrastructure and educational opportunity, the Supreme Court disapproved wholesale domicile-based exclusion and held that a portion of seats in government and aided medical colleges in each State should be opened to candidates from across India. It suggested that at least 30% of the ‘open’ non-reserved seats be placed in an all-India pool.

The Dr. Dinesh Kumar line of cases converted this broad judicial idea into fixed numerical quotas. In Dr. Dinesh Kumar (II) v. Motilal Nehru Medical College (1986), the AIQ was fixed at 15% of total MBBS/BDS seats in government colleges. For postgraduate courses, Pradeep Jain had contemplated that at least 50% of the open seats be filled on an all-India basis; Dinesh Kumar (II) reformulated this as 25% of total postgraduate seats.fea

Two decades later, a five-judge Constitution Bench in Saurabh Chaudri v. Union of India (2003) raised the postgraduate AIQ to 50%. At the super-speciality level, Pradeep Jain and later rulings insisted on zero domiciliary reservation and admissions based entirely on all-India merit in the ‘national interest’.

The AIQ applies only to government and government-aided institutions, not private self-financing colleges. States that invested early and substantially in medical colleges, postgraduate departments, and super-speciality units to meet their own public-health needs are compelled to surrender part of that capacity because other States failed to build theirs. Tamil Nadu, with 38 State government medical colleges, exemplifies such sustained public investment. The AIQ penalises that progress.

The point is simple. A village that digs its own well may voluntarily share its water. A higher authority may help another village dig its own. But to compel the first village to surrender a fixed share of its water indefinitely to other villages is unfair. Nothing in the Constitution requires one State to remedy another State’s administrative failure. The proper response was to require lagging States to expand medical infrastructure, with Union assistance where necessary. Instead, the Court fashioned a ‘Robin Hood’ model of redistribution, compelling progressive States to surrender seats to a central pool.

Systemic consequences

The AIQ has produced serious consequences. First, it reduces the supply of doctors familiar with local languages, cultures, and disease burdens, especially in non-Hindi-speaking States.

Effective diagnosis, counselling and treatment depend not merely on technical competence, but also on a doctor’s ability to understand a patient’s language, cultural cues, and social context. In such encounters, communication failures can be as harmful as diagnostic errors.

Second, by requiring States to surrender 15% of undergraduate seats, 50% of postgraduate seats, and all super-speciality seats created through State investment to a central pool, the AIQ becomes a powerful disincentive for States to expand medical education capacity. This is especially damaging in postgraduate and super-speciality education, where departments, hospitals, equipment and faculty require substantial public investment. Ultimately, it is the public that loses.

Third, although the AIQ was justified as a remedy for inter-State disparities, it gives no assurance that seats surrendered by well-endowed States will benefit candidates from regions with few or no medical colleges. It’s an all-India merit pool, not a deficit-region quota. Candidates from medically advanced States may also secure these seats, often with greater competitive advantage than those from backward or deficit regions. Thus, the AIQ fails to serve its own professed rationale. A fresh empirical scrutiny of its actual benefits to deficit regions is necessary.

Fourth, the AIQ’s social-justice record has been gravely deficient. While most States had been implementing OBC reservation in educational institutions from 1950, and some even earlier, the Union introduced 27% OBC reservation in educational institutions only through the Central Educational Institutions (Reservation in Admission) Act, 2006. Had AIQ seats remained with the States, a substantial share would have gone to OBC candidates under State reservation policies from 1984 itself.

What is indefensible is that OBC reservation was not extended to AIQ seats even after Central reservations were introduced in 2006; it was implemented only from 2021–22, after prolonged litigation, a Madras High Court order in July 2020, and a Union notification in July 2021. This delay deprived OBC candidates of thousands of seats.

Even more unconscionably, SC/ST reservation—15% and 7.5% respectively — in AIQ undergraduate and postgraduate seats was introduced only after the Supreme Court’s judgment in Abhay Nath v. University of Delhi (2009), nearly 25 years after the AIQ’s creation in 1984.

Super-speciality admissions carry no reservation, on the ground that ‘merit alone’ must prevail at the apex level. That justification has been shattered by the reduction of NEET-SS qualifying cut-offs to single-digit, and even zeroth, percentile levels in several years to prevent costly seats in private colleges and deemed universities from remaining vacant. When candidates at the zeroth percentile are treated as eligible, excluding reservation in the name of uncompromised merit becomes indefensible.

Constitutional fault-lines

The AIQ’s constitutional foundation is equally vulnerable.

1. Violation of stare decisis: A five-judge Constitution Bench in D.P. Joshi v. State of Madhya Bharat (1955) had upheld the constitutional validity of State domicile-based preferences in higher education. The case concerned a rule under which bona fide residents of Madhya Bharat were exempted from paying capitation fees in a State-run medical college, while non-residents were required to pay an additional fee. The petitioner challenged the rule under Articles 14 and 15, contending that it discriminated on the ground of place of birth and created an arbitrary classification between residents and non-residents.

The Court rejected both arguments. It drew a clear distinction between citizenship, domicile, and place of birth. Citizenship denotes political allegiance to the nation; domicile concerns a person’s permanent home and civil status.

It held that State domicile was legally recognisable in India, including because States could have distinct personal laws under the Concurrent List. It further held that domicile was not synonymous with place of birth and, therefore, residence-based preferences did not violate Article 15(1). Under Article 14, the classification was upheld as reasonable and rationally connected to a legitimate objective: enabling the State to support its residents and secure the availability of locally trained doctors.

Pradeep Jain (1984), decided by a three-judge Bench, departed from the binding five-judge precedent in D.P. Joshi (1955). It asserted that India has only one indivisible legal system and one domicile. Although it acknowledged that residence requirements were not barred by Article 15(1), it invoked Article 14 to restrict State preferences and justify the AIQ.

In doing so, a smaller Bench diluted a larger Bench ruling. It also effectively imported ‘residence’ into Article 15(1), where the Constitution prohibits discrimination on specified grounds, including place of birth — but not residence. This casts serious doubt on the constitutional validity of Pradeep Jain (1984).

2. Federal overreach: The compulsory surrender of State seats to a central pool also disturbs the constitutional distribution of powers under the Seventh Schedule. Entry 66 of List I confines the Union’s role to the ‘coordination and determination of standards’ in higher education. It cannot be stretched, by judicial fiat, to permit the appropriation of seats in institutions created, funded and administered by States. Nor can ‘standards’ authorise the Union, or the Court, to commandeer capacity built by State taxpayers and redistribute it nationally.

Consent-based all-India pool

The Justice Kurian Joseph Committee on Union–State Relations has therefore recommended that the AIQ, in its present form, be dispensed with. It should be replaced by a cooperative model under which States may voluntarily contribute seats of their choosing to an all-India deficit-region pool, reserved for candidates from regions with demonstrable infrastructural deficits. Such a framework would avoid the adverse consequences of the present model for States, and ensure that seats contributed by well-endowed States benefit only candidates from regions with few or no medical colleges.

— The author is retired IAS officer of Tamil Nadu cadre, former Vice-Chancellor of Indian Maritime University, Chennai, and Member, High-Level Committee on Union-State Relations constituted by the Government of Tamil Nadu