Medical students secure LHC relief

Court orders colleges to refund excess fees

LAHORE:

The Lahore High Court (LHC) has directed private medical and dental colleges to implement the Pakistan Medical and Dental Council's (PMDC) prescribed tuition fee limits and settle students' consequential claims for adjustment or refund of excess fees within 30 working days.

Justice Khalid Ishaq, in a detailed judgment, dismissed three petitions filed by private medical institutions challenging the PMDC's fee regulations and allowed 12 connected petitions filed by students and their parents seeking enforcement of the prescribed fee limits.

The court upheld the PMDC's statutory authority to regulate and cap tuition fees, observing that private medical and dental colleges could not operate as purely commercial enterprises detached from their responsibilities towards society, particularly because medical education was directly linked to human life and public health.

It held that private institutions had no unrestricted right to determine tuition fees and that the PMDC was empowered to scrutinise their proposed fee structures and financial justifications to regulate charges and protect students against exorbitant fees and profiteering.

The judgment observed that the council's authority flowed from a harmonious reading of Sections 9, 20 and 47 of the Pakistan Medical and Dental Council Act, 2022, rather than being a power created independently through subordinate regulations.

It said the requirement under Section 20(8) of the Act for private medical and dental colleges to submit their financial statements, proposed fee structures and justifications to the council could not be treated as a mere formality or passive record-keeping exercise.

If the regulator lacked the authority to examine or question an unjustified fee proposal, the statutory requirement would be rendered meaningless.

The court observed that the obligation of colleges to publicly declare their tuition fees did not make their proposed fee structures immune from regulatory scrutiny. The council could examine their financial justifications and, where necessary, approve, modify or reject the proposed fee structures.

Rejecting the institutions' argument that the PMDC Act did not expressly authorise the council to fix tuition fees, Justice Ishaq held that Sections 9 and 20 had to be read together in the context of the legislative framework governing medical education and the Council's regulatory responsibilities.

The institutions had also argued that fee regulation violated their fundamental right to conduct business under Article 18 of the Constitution.

The court rejected the contention, observing that the freedom to pursue a lawful profession, trade or business was not absolute and could be subjected to reasonable restrictions in the public interest.

However, it clarified that the regulator must take legitimate institutional costs into account when determining permissible fee limits. Affordability alone, it said, could not justify a measure that prevented institutions from maintaining the educational standards required under the law.

The court also dismissed the argument that private medical and dental colleges were being discriminated against under Article 25 of the Constitution compared with institutions offering other professional education.

It held that medical and dental institutions operated under a distinct legislative and regulatory framework involving clinical training, institutional recognition and professional qualifications.

An important consideration in the judgment was the institutions' own participation in the fee-determination process. The court noted that the petitioner colleges had submitted audited financial statements and sought an enhancement of the prescribed tuition fees through the Pakistan Association of Medical Institutions (Pami).

Having participated in the process and sought higher fee limits, the institutions could not subsequently reverse their position and invoke the constitutional jurisdiction of the court to challenge the regulator's authority, it observed.

Examining the audited accounts of University Medical and Dental College, Faisalabad, the court noted that its income for 2025 stood at Rs5.099 billion, with a profit of Rs378.659 million.

Minutes of the Fee Justification Committee recorded that the college was liable to refund Rs841,317 per student for amounts collected in excess of the prescribed fee.

Similarly, FMH College of Medicine and Dentistry, Lahore, had reported an annual income of Rs1.867 billion and a profit of Rs111.941 million. The committee's minutes recorded that the institution was liable to refund Rs741,802 per student for excess amounts collected.

The court noted that the PMDC had initially fixed the annual tuition fee for MBBS and BDS programmes at Rs1.8 million through a notification issued on April 28, 2025.

The notification allowed a five per cent increase for the 2025 session, with subsequent increases linked to the Consumer Price Index (CPI) inflation rate from the 2026 session onwards.

A subsequent notification dated October 6, 2025, capped the tuition fee at Rs1.89 million for the 2025-26 session.

After examining audited financial statements and considering recommendations of a specially constituted Fee Justification Committee, the council issued another notification on March 11, 2026, prescribing revised fee ceilings for different categories of institutions, including conditional enhancements based on financial justifications.

The court held that the regulatory framework did not impose an arbitrary restriction on private institutions, as it provided them an opportunity to seek higher fee limits by submitting audited accounts and establishing genuine financial requirements.

It also took notice of complaints by some students that they had faced retaliatory and victimising treatment by institutions for raising questions about the enforcement of their lawful rights.

It directed the colleges to refrain from subjecting enrolled students to any prejudicial treatment. Students facing unlawful treatment, the court observed, could approach it for initiation of contempt proceedings under Article 204 of the Constitution read with the Contempt of Court Ordinance, 2003.