Condemnable that final year MBBS students don't want to render services in critical times, laments Gujarat HC

Besides the rejection, the bench of honorable Chief Justice, Vikram Nath and Justice Pardiwala, has, however, has laid down certain conditions for the benefits of the medicos who serve during the pandemic observing that the hard work of the corona warriors shall not go unnoticed.

Medical Dialogues had earlier reported that Over 146 final year MBBS students of NHL Municipal Medical College and AMC MET Medical College had challenged the Government Resolution (GR) of mandatory COVID duty for final year students. The medicos while voicing against the government's diktat for them to join Covid-19 duty as 'Corona Sahayaks', had contended that such "voluntarism" cannot be thrust upon them.

Also Read:COVID Duty for MBBS Students: Over 140 MBBS students move HC to quash GMC circular

Then, the medical students moved the high court submitting that neither the students have any qualifications nor they have the experience to perform such duties.

Now, during the recent hearing of the case before the HC, the petitioner MBBS student submitted that the impugned resolution dated 17.07.2020 issued by Department of Health and Family Welfare, Government of Gujarat and following circular dated 22.07.2020 and show cause notice 23.07.2020 is "arbitrary, discriminatory, irrational, de hors the power, disproportionate, unreasonable exercise of power suffers from the unreasonable restriction on fundamental rights and excessive delegation of legislative power without a guideline and in addition violative of Section 65 of the Disaster Management Act 2005 read with sub-clause 9 of clause 11 of Gujarat COVID Regulations 2020 notified on 13.03.2020 and be pleased to therefore declare the same to be violative of Articles 14, 19 & 21 of the Constitution of India and hence being unconstitutional".

The medicos urged the bench to restrain the government and the medical college from compelling them to compulsorily perform duties and render services as 'Corona Sahayak' while holding those compelling petitioner students to become 'Corona Sahayak' is illegal, unlawful and unconstitutional.

The counsel appearing for the MBBS students said that although the final year MBBS students may be taught about the Covid-19 in theory and practice, yet they should not be assigned any clinical duties. The counsel added that the Government Resolution is violative of Article 14 of the Constitution of India because it is mandatory only for the medical students of the colleges run by the Corporation to render their services; wheres, the students of other Government medical colleges have been requested to render their services. In other States also it is not compulsory or mandatory for the medical students to render their services to combat the Covid pandemic.

In response to these contentions, the government stated that resolution has been issued by the State keeping in mind the larger public interest.

The state submitted that it has become very difficult to procure necessary help in the form of medical services, leaving the government with no other option but to ask final year MBBS students to render their services. It was also submitted that If other states have not made it compulsory for their medical students to render services, it does not mean that Gujarat cannot issue a resolution seeking compulsory service from medical students.

Showing serious displeasure over the plea, the bench said that this litigation has thoroughly disappointed the Court. "It is very unfortunate to adjudicate the writ application of the present nature and that too at the instance of medical students"

Relying on its earlier orders, the bench implied that it had made several observations with a view to motivate the students pursuing Medicine and the members of the Medical fraternity with a hope that they would come forward in these critical times and render their invaluable services to the society at large.

"Unfortunately, here are the writ-applicants who do not want to render their services in these critical times on one pretext or the other substantially on a lame excuse that past five months they have not been able to attend their college and within next three to four months they will have to appear in the final exam and they need time to prepare themselves for the exam. Such attitude is quite condemnable."

On the fact that the student are not yet competent to tend to patients in these times, the bench observed:

The primary role of medical students is to learn medicine. However, students are also clinicians who care for patients. As clinicians in training and close to graduating, the final year MBBS students are well equipped with the knowledge and skills to undertake ancillary roles in the hospitals during the pandemic. They can interview patients, communicate with families, write notes, assist with procedures (such as taking nasal swabs for Covid samples), and help with care coordination and discharge planning. By taking up such secondary duties, students would drastically reduce the overall burdens on clinical teams of doctors and nurses who can focus on providing the best treatments to their patients. We believe that the contribution of students would significantly improve the patient care.

It is disheartening to see that the medical students in the final year of their programme who have a vast wealth of potential to help out during the pandemic are choosing to shy away from their responsibilities. The pandemic is proof how noble and selfless the profession of medicine is. Thousands of doctors across the country are working tirelessly for hours together to save lives. They are risking their everything to fulfill their duty. Our final year MBBS students whose help we desperately seek are simply months away from becoming full fledged doctors. Although they do not have the tag and identity of a doctor, yet their training and knowledge make them competent enough to take up supporting roles to fight the pandemic. As the future health-care workforce, final year medical students are potentially a part of the health-care system's response to public health emergencies. They are the future of this nation's health infrastructure. It would be shameful if they choose to hide away from their duty that they have so rigorously and diligently trained for since the past 4 years.

The court emphasized that this unprecedented time era is the perfect time to showcase the ability as a doctor to perfectly balance medical education and professional values. Medical students across the world who have volunteered and lent a helping hand during the pandemic, report a deep sense of satisfaction that comes from saving lives and helping the helpless.

The bench then relied on the observation made by the Supreme Court in Shayara Bano v. Union of India and others, wherein the SC held that manifest arbitrariness must be something done by the Legislature capriciously, irrationally and/or without adequate determining principle. When something is done, which is excessive and disproportionate, such legislation would be manifestly arbitrary.

"By any stretch of imagination the impugned Government Resolution calling upon the writ-applicants being final year MBBS students to render their services in this hour of crisis cannot be termed as arbitrary, much less, manifestly arbitrary. The impugned resolution has been issued with a definite purpose and object. It is the need of the hour that compelled the State Government to come out with such resolution so that the State Government gets a helping hand in combating with the Covid-19 pandemic."

The bench then wondered as to why the writ applicants being final year MBBS students are resisting to even undergo the necessary training so that in future if their services are required, they can be deployed in a particular designated COVID hospital to render their services according to their training.

The bench agreed to the submission of the state that there is no other option but to ask the final year MBBS students who are now quite trained, to render their services. There is no discrimination worth the name between the students of Government Medical Colleges and the students of the medical colleges run and controlled by the Corporation.

" In fact, it is a matter of policy. If the other States have not made it compulsory for the medical students to render their services, that does not mean that the State of Gujarat cannot issue a resolution making it compulsory for the medical students to render their services. In such a situation, there is no discrimination and, therefore, no question of any violation of Article 14 of the Constitution of India."

On the GR issued by the state, the court observed:

"the State, in exercise of its executive power, is charged with the duty and the responsibility of carrying on the general administration of the State. So long as the State Government does not go against the provisions of the Constitution or any law, the width and amplitude of its executive power cannot be circumscribed. The intention in issuing the impugned resolution has a direct nexus with public interest."

When the State is badly in need of the services of the final year M.B.B.S. students to meet with the emergent situation of the Covid-19 pandemic, then in such circumstances, an order can be validly and legally made by the Government even without furnishing reasons and the court may not even compel the Government to give reasons

Referring to several other observations made by the SC and other High courts, the bench rejected the plea and observed:

Being students they owe lot of responsibilities and obligations. In the near future they are going to be the members of the medical fraternity. Therefore, it hardly makes any difference whether as on date they are fullfledged doctors or final year M.B.B.S. students. We understand this much that being the final year M.B.B.S. students, they are now well trained in all faculties of Medicine. They cannot say that they would not do a particular type of work.

However, while concluding the case, the HC directed the State Government to look into the following crucial aspects:

(1) The students must be thoroughly trained in the tasks and jobs assigned to them. The adequate training program should be held that teaches them the basics. The faculty should make sure that the students feel skilled and confident before they start practical work.

(2) The students would be putting in their time and efforts and this must not go unnoticed. The college and the Government shall appreciate their efforts and offer a stipend payment for their hard work.

(3) The students must not feel that their lives or the lives of their loved ones are at risk. The Government should make adequate arrangements for the students on Covid duty to self isolate themselves.

(4) Severely immunocompromised students, who have chronic underlying conditions like diabetes, heart conditions, cardiovascular diseases or others, shall be spared from compulsory duty under the pretext of their service being a severe health hazard.

(5) In appreciation, the academic transcripts of the students should mention that they boldly performed duties at the Covid hospitals and centers during the time of pandemic. This is honourable and will be appreciated across the globe when they apply for further studies and specializations.

As a note to MBBS students, the bench said:

Any one with reasonable intelligence matched with hard work can become a doctor and attain the coveted degree of MBBS. However, privileged are the few who are blessed with an opportunity to use their degree and learning to heal this ailing world while it is going through a global crises. You have an opportunity now to not just become the qualified doctors but front-line soldiers in this war against the Covid-19 pandemic. It is neither a demand nor a request. In our opinion, this is a privilege that all of you are blessed with to achieve the self satisfaction of becoming Doctors for a cause. On one hand it is a call of duty. But more than duty, here is an opportunity of a life time to experience the beautify of healing on a scale and challenges which, in our opinion, happen to be historic. Your reward will be the satisfaction of saving lives to scale. Your reward will be self-fulfillment. You will earn the respect of your family, friends and peers as front-line Covid Warriors but, above all, else you will find new respect for life and for living with a sense of purpose and responsibility. Rise to this opportunity to make MBBS = Medics Bound By Service (to all humanity).