No Fifth Chance for MBBS First Year Exam: Kerala HC Rejects Medico's Plea, upholds NMC rule

Kochi: The Kerala High Court recently held that a student can avail of only four attempts to clear the First Professional MBBS Degree Examination, irrespective of whether the attempts are made through regular or supplementary examinations and once these four attempts are exhausted, no further opportunity can be granted.

Single Bench Justice Bechu Kurian Thomas made the observation while dismissing a plea filed by a first-year MBBS student of Sree Narayana Institute of Medical Sciences seeking permission to appear for another First Professional MBBS examination after exhausting the four attempts permitted under the Graduate Medical Education Regulations, 2023 (GMER 2023).

The petitioner had joined the MBBS course in 2023 but could not clear her first year after failing in three subjects - Human Anatomy, Physiology and Biochemistry. She had already completed four attempts and approached the High Court seeking permission to appear in the next First Professional MBBS examination either as a "mercy chance" or as an additional opportunity within the four-year period prescribed for completing the first year.

The respondents in the case include State of Kerala, Kerala University of Health Sciences (KUHS), University Grants Commission (UGC), National Medical Commission (NMC) and the Principal of Sree Narayana Institute of Medical Sciences.

Opposing the plea, the respondents objected to the grant of any permission or even leniency being shown to the petitioner by relying on Regulation 21 of the Graduate Medical Education Regulations (GMER), 2023. The regulation states that under no circumstances can a student be allowed more than four attempts for the First Professional MBBS.

NMC guidelines

Taking note of their arguments, the court noted the National Medical Commission's guidelines, which state that no more than four attempts are permitted for a candidate to pass the Phase I MBBS examination. The total period for successfully completing the Phase I course cannot exceed four years.

Medical Dialogues had earlier reported that the National Medical Commission (NMC), under the Graduate Medical Education Regulations (GMER) 2023, had reiterated that MBBS students can get a maximum of four attempts to clear the First Professional MBBS examination.

Regulation 21 of the GMER 2023 states, "Every student admitted in accordance with these Regulations, shall undergo training as per the guidelines published by the UGMEB of NMC and displayed on the NMC website from time to time; Provided under no circumstances the student shall be allowed more than four (04) attempts for first year (First Professional MBBS) and no student shall be allowed to continue undergraduate medical course after nine (09) years from the date of admission into the course."

According to Regulation 7.7 of Regulations on Graduate Medical Education (Amendment), 2019, "No more than four attempts shall be allowed for a candidate to pass the first Professional examination. The total period for successful completion of first Professional course shall not exceed four (4) years. Partial attendance of examination in any subject shall be counted as an attempt."

The NMC guidelines further state that, "if the student fails in the supplementary examination in Phase I of MBBS, the student goes to the junior batch for teaching, learning as well as for University Examinations. There shall be no supplementary batches. If a candidate has not appeared for the University examination (both theory and practical) for a subject, then it shall not be counted as an attempt for that subject. Partial attendance in examination (only theory and only practical) in any subject shall be counted as an attempt. No more than four attempts shall be allowed for a candidate to pass the Phase I Examination. The total period for successful completion of Phase I course shall not exceed four (4) years. A learner shall not be entitled to graduate greater than ten (10) years her/his joining the First MBBS course (including continuous rotatory medical internship)."

However, as a one-time measure, the NMC had, in 2023, granted an additional attempt to MBBS students of the 2019-20 and 2020-21 batches who could not clear their First Professional examination within the prescribed four attempts. The decision was taken as a special relaxation in view of the difficulties faced by these batches during the COVID-19 pandemic.

Observation by Court

The Court held that the regulations and NMC guidelines clearly limit a First Professional MBBS student to four attempts within a period of four years.

Meanwhile, the petitioner argued that the four attempts should refer only to regular examinations and should not include supplementary examinations.

However, the court rejected this argument and observed that the regulations specifically use the term “attempts” and do not make a distinction between regular and supplementary examinations.

According to the court, the first examination taken by a candidate is the regular attempt, while subsequent examinations after failure are supplementary attempts. Therefore, both regular and supplementary examinations have to be counted within the four-attempt limit.

"When the words of the Regulation are specific and clear and does not involve any ambiguity, the court has to interpret the word in its plain and ordinary meaning. The words “four attempts for first year Professional MBBS” clearly indicates that irrespective of whether it is regular examination or supplementary examination, a student has only four attempts. The term ‘regular exam’ as far as a failed candidate is concerned, applies only to the first attempt and every subsequent attempt will in fact, be a supplementary examination. Such a confusion regarding regular examination or supplementary examination does not arise as the Regulation specifically refers to “attempts” in contradistinction to regular or supplementary examination. Hence, this Court is of the view that a candidate can avail only four attempts, irrespective of whether it is regular or supplementary and once such attempts are availed, a further opportunity cannot be granted," the bench observed.

Rejecting the plea for leniency, the court referred to an earlier Delhi High Court ruling which held that medical students do not have an unlimited right to appear for examinations and that the regulatory authorities are entitled to prescribe a limit on the number of attempts.

Subsequently, the bench noted, "Academics and academic prescriptions are not to tampered with by courts of law, unless there are exceptional reasons. Judicial interference with Regulations framed by academic bodies ought not to be done casually. Even if a specific Regulation leads a student to difficulty, the same is not a reason for this Court under Article 226 of the Constitution of India to interfere. This is all the more so when the issue under consideration relates to students of medicine, who ultimately cater to the needs of health of the society, whose competence, has a direct bearing on public health and safety."

In the present case, the court found that the petitioner had not established any exceptional circumstances or produced material to indicate that a different approach should be adopted from that what is prescribed in the Regulations. It therefore dismissed the writ petition and declined to grant her another chance to appear for the First Professional MBBS examination.

To view the court order, click on the link below:

Also read- Altogether 4 Attempts to Clear MBBS 1st prof Exams: NMC GMER 2023