Delhi HC upholds AIIMS Policy, says Institute obligated to pay stipend to Indian junior resident doctors, not foreign PG trainees

With this observation, the HC bench allowed the pleas filed by AIIMS, which challenged a single judge bench's order directing the institute to pay emoluments to foreign-national PG students at par with Indian Junior Residents, barring those who were admittedly under the "sponsored" seats.

The issues that came up for consideration before the Apex Court included whether foreign national medical trainees admitted under the "Foreign" category form a separate and intelligibly distinct class, justifying differential emoluments treatment.

Further, the bench had to consider whether acceptance of prospectus conditions barred the authorities from challenging the stipulation on constitutional grounds (estoppel), and also, whether Article 16 of the Constitution of India applied to the present case by virtue of the employer-employee relationship between the parties.

While considering the matter, the HC bench observed that there was no dispute regarding the fact that the foreign-national PG students underwent the same entrance examination, fulfilled identical eligibility requirements, and performed identical clinical, academic, and on-call responsibilities as Indian Junior Residents. However, they were not competing with general candidates

Further, the bench noted that while Indian students appointed as Junior Residents are paid monthly emoluments by AIIMS, "Sponsored/Foreign National" candidates are not.

The foreign national candidates submitted before the Single Judge bench that although they were categorised along with "sponsored candidates", they were not in fact sponsored by their home governments or any employer, and had no source of financial support corresponding to the sponsorship-based category. Their grievance was that the denial of stipend was based solely on nationality, notwithstanding performance of the same duties as their Indian counterparts.

Meanwhile, AIIMS relied upon its established policy and communications with the Central Government, arguing that seats for foreign nationals and sponsored candidates were created as "no-financial-liability" seats, and that the Prospectus gave due notice of this to all the foreign-national applications.

While considering the matter, the HC bench observed that the seats for foreign-national medical trainees admitted under the "Foreign" category, were created pursuant to governmental communications under a “no-financial-liability” condition.

Accordingly, the bench observed,

"The distinction therefore flows not merely from nationality, but from the financial architecture of such seats. It is pertinent to note that the concept of equality cannot be applied in a vacuum. Financial implications, source of engagement, and the terms of appointment constitute valid bases for classification."

"...this court is of the considered view that (i) the intelligible differentia in the present case are the source of funding and the category of seat, and (ii) the rational nexus lies in the object of ensuring that AIIMS does not incur financial liability for seats reserved for foreign nationals pursuant to sovereign arrangements. It is equally well settled that Article 14 of the COI permits differential treatment where it rests on a legitimate policy consideration and does not amount to hostile discrimination," observed the High Court.

After perusing the record, the Court noted that the Prospectus of AIIMS creates a distinct category titled "Sponsored/Foreign National", admissions to which are managed through diplomatic channels and inter-ministerial communications.

"The record further shows that these seats were deliberately created as “no financial liability” seats, pursuant to communications between AIIMS, the Ministry of Health & Family Welfare, and the Ministry of External Affairs. These seats are filled outside the open and general merit pool, and foreign nationals admitted under this category compete only among similarly placed foreign or sponsored applicants," observed the HC bench.

The Court noted that the term "foreign nationals" is not a purely nominal distinction and it denotes an objective combination of features- nationality, a different mode of selection, i.e., through diplomatic or ministerial channel rather than open domestic competition, and an express admission term that the Institute will assume no financial liability in respect of these seats.

"Therefore, these factors cumulatively constitute an intelligible differentia, and the objective of ensuring that the State exchequer does not bear financial liability for foreign trainees is both legitimate and constitutionally permissible," observed the bench.

From the record, the Court observed that the very purpose of creating the "Sponsored/Foreign National" category was to facilitate international academic cooperation, honour foreign-policy commitments, and provide a limited channel for foreign medical graduates to train in India without the financial liability to AIIMS.

"This policy emerges from long-standing inter-ministerial correspondence between the Ministry of External Affairs and the Ministry of Health & Family Welfare, which specifies that such admissions function as reciprocal or goodwill-based exchange arrangements, distinct from domestic merit seats," observed the Court.

"The Prospectus incorporated these objectives by clearly stating in advance that candidates admitted under this category “shall not be entitled to emoluments”. The advance disclosure is not incidental, but is rather, central to the design of the category. In this backdrop, the classification between Indian residents admitted through domestic competition and foreign nationals admitted through a special, diplomatically-governed, low-competition window bears a direct and logical connection to the policy that AIIMS should not incur financial liability for trainees admitted under international cooperation arrangements," it further noted.

Accordingly, the Court held that even though AIIMS is obligated to pay stipends to domestic students, extending such benefits to foreign/sponsored students who neither contribute to the domestic tax base nor form part of the national service pipeline would defeat the very fiscal rationale underlying their separate categorisation.

"In this context, the differential treatment is both objectively justified and intrinsically tied to the category‟s purpose. The nexus is therefore, clear, proximate and constitutionally sufficient: the State‟s aim of promoting international academic engagement while safeguarding public funds is directly advanced by maintaining a “nofinancial-liability” category for foreign and sponsored candidates," the Court observed at this outset.

"The Respondents‟ plea of equal pay for equal work, since they are working on same services as other class comprising nationals does not amount to inequal treatment. It is well established law that, Article 14 of the COI protects equality within similar class, and it does not apply to persons belonging to distinct classes. Mode of recruitment is an important parameter and can be deemed to be a valid ground for classification," it further noted.

Referring to Supreme Court's orders in the case of State of Bihar v. Bihar Secondary Teachers Struggle Committee, and State of U.P. v. Ministerial Karamchari Sangh, the Delhi HC bench observed, "In view of the above discussion, this court finds that the Respondents argument that identical clinical duties performed by them warrant identical stipend/emoluments is untenable in law."

Further, the bench noted that it is elementary that estoppel cannot be used to validate a provision that is otherwise unconstitutional. "However, where a policy is constitutionally sustainable, this court deems it appropriate to observe that the candidates who consciously participate in the admission process with full knowledge of the governing rules cannot be permitted to approbate and reprobate after taking advantage of the same," it held.

The Court referred to the Supreme Court order in the case of Madras Institute of Development Studies v. K. Sivasubramaniyan and noted, "Thus, the doctrine of consent and approbation/reprobation prevents the Respondents from disputing conditions that were expressly disclosed and formed an integral part of the very admission benefit they accepted. In the present case, the Respondents secured admission under the special “Foreign National” category with full knowledge of the Prospectus terms. Having exercised that choice and derived benefit therefrom, they cannot now turn around to assail the very conditions that governed their admission."

Noting that the candidates applied under the "Foreign National" category with full notice of the prospectus stipulation that no emoluments would be payable and furnished No-Objection Certificates expressly undertaking that all financial liabilities of their training would be borne by them, the HC bench observed, "Having thereafter accepted admission, completed enrolment formalities, and availed the distinct procedural and competitive advantages of a category characterised by reduced competition and a non-stipendiary framework, the Respondents cannot subsequently seek to reprobate the very conditions they had consciously approbated. The doctrine of election squarely applies: a candidate who knowingly accepts the rules of a special admission channel, acts upon them, and derives benefit therefrom, is barred from challenging those terms at a later stage."

"In simple words, the Constitution does not allow a person to accept the benefits of a special category and later challenge only the parts they dislike. The Respondents chose this special admission route knowing all its terms, including that no stipend would be paid. They cannot now keep the advantages of the category but reject the conditions that came with it. Law does not permit such “picking and choosing.” Since the policy itself is valid, and the Respondents had full notice of the rules, they are estopped from challenging them later. Issue II is therefore decided in favour of the Appellant. In simple words, the Constitution does not allow a person to accept the benefits of a special category and later challenge only the parts they dislike. The Respondents chose this special admission route knowing all its terms, including that no stipend would be paid. They cannot now keep the advantages of the category but reject the conditions that came with it. Law does not permit such “picking and choosing.” Since the policy itself is valid, and the Respondents had full notice of the rules, they are estopped from challenging them later," it further noted.

Regarding the question of whether Article 16 of the Constitution of India applies to the present case by virtue of employer-employee relationship between the parties, the bench observed,

"...this Court is of the considered view that the Appellant‟s submission with regard to Article 16 of the COI, and thereby non-application upon the Respondents‟ who are noncitizens of India, is rightly refuted in view of the fact that the relationship between the Appellant and the Respondents is of an educational institute-student, which cannot be termed as an EmployerEmployee relationship. It is contended by the Respondents that as per Clause 5 of the Post Graduate Medical Education Regulation (PGMRER), 2000, the duties performed by the students studying in post-graduate courses are integral to the successful completion of their post-graduate curriculum. The Respondents have further contended that the recruitment of senior residents to AIIMS is conducted separately by the Appellant, as detailed in its Recruitment Advertisement, which is separate from academic relationship with the Respondents...Thus, the contention of the Appellant with regards to the application of Article 16 of the COI to the present matter lacks merit."

Accordingly, the Court issued the following directions:

i. The classification “Foreign National” candidates satisfies both limbs of the Article 14 of the COI twin test when examined individually, and is therefore constitutionally sustainable.
ii. The Prospectus‟ stipulation of “no emoluments” for this special category, is neither arbitrary nor discriminatory.
iii. The Respondents, having voluntarily opted for and taken the benefit of this special admission route with full knowledge of its terms, are estopped from now seeking parity of stipend.
iv. The Impugned Judgment, in so far as, it directs payment of emoluments to non-sponsored foreign nationals at par with Indian Junior Residents, cannot be sustained.

To view the order, click on the link below:

https://medicaldialogues.in/pdf_upload/delhi-hc-aiims-stipend-310178.pdf

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