AYUSH Doctors Can't Claim Parity with MBBS Doctors in Retirement Age and Pay Without Proving Equal Work”: Supreme Court Refers Controversy to Larger Bench

“Treatment of unequals as equals is impermissible — curriculum, responsibilities and critical care functions justify differential retirement ages”: SC highlights qualitative distinction between Allopathy and AYUSH

In a significant order delivered on October 17, 2025, the Supreme Court of India, in State of Rajasthan & Ors. v. Anisur Rahman & Ors., arising from SLP(C) No. 9563 of 2024 and connected petitions, addressed the contentious issue of whether AYUSH practitioners can claim parity with MBBS doctors in retirement age and service benefits. Observing sharp divergence in earlier decisions, the Court referred the matter to a larger Bench for authoritative resolution.

While reiterating that the doctrine of "equal pay for equal work" cannot be mechanically applied across different systems of medicine, the Court underscored the significant clinical, academic, and functional distinctions between allopathic doctors and practitioners of indigenous medical systems such as Ayurveda, Unani, Homeopathy, and Siddha.

“Function, Qualification, and Emergency Role Distinguish MBBS Doctors from AYUSH Practitioners” — Supreme Court Declines Blanket Equivalence

The Bench comprising CJI B. R. Gavai and Justice K. Vinod Chandran evaluated earlier rulings and concluded that AYUSH doctors do not perform critical functions such as trauma care, invasive surgeries, or emergency interventions, unlike their MBBS counterparts.

“The curriculum leading to the different qualifications, the dissimilar diagnostic methods, contrasting treatment philosophies and the disparate composition of medicines administered sets the allopathy doctors apart.”

“Casualty, critical care, trauma management and the emergency interventional procedures are dealt with by allopathy doctors and not by AYUSH doctors. These aspects… put the former in a different class altogether.”

The Court relied heavily on its 2023 judgment in State of Gujarat v. Dr. P.A. Bhatt, which upheld classification based on qualifications and rejected parity in pay between MBBS and AYUSH doctors. It was held therein that:

“Practitioners of indigenous system of medicine do not, in the present times, perform the complicated functions of a doctor having MBBS.”

Divergent Judicial Opinions Prompt Referral to Larger Bench

The case reached the Supreme Court in a batch of over 25 connected Special Leave Petitions from different states, challenging High Court orders extending parity in retirement age (typically 65 years for MBBS doctors) to AYUSH doctors.

Previously, in NDMC v. Dr. Ram Naresh Sharma, the Court had extended such benefits to AYUSH doctors, citing a Union Cabinet decision. However, in Dr. P.A. Bhatt, the Court carved out a clear distinction between retirement age and pay parity, and emphasized that educational qualification and nature of duties are valid grounds for classification.

In the present batch, the Supreme Court took cognizance of these conflicting strands:

“There is an area of ambiguity… the service conditions… should be ideally considered on the touchstone of identity of functions, similarity in work carried out and comparable duties assigned.”

Interim Directions: Conditional Continuation of AYUSH Doctors Beyond Retirement Age

Pending final adjudication by the larger Bench, the Court issued interim directions to balance administrative needs and individual rights:

“States and authorities would be entitled to continue AYUSH practitioners after the specified superannuation age, till the age applicable to MBBS doctors, but without the benefit of regular pay and allowances.”

“If AYUSH doctors are continued… they shall be paid half of the pay and allowances… which, if the reference does not yield favourable orders, will be adjusted in their pension or otherwise.”

Doctors who decline to continue on these terms will be treated as retired, and the outcome of the larger Bench will not impact them.

Core Legal Issue for the Larger Bench: Can AYUSH Doctors Be Classified Identically for Service Benefits?

The Bench formulated the underlying constitutional and service law issue:

“Can doctors administering different forms of medicine — with varying qualifications, capabilities, and duties — be treated equally for the purpose of service benefits like pay and retirement age under Articles 14 and 16?”

Given the public health importance, scarcity of qualified allopathy practitioners, and varied service conditions across states, the Court found it essential to have a consistent national interpretation.

In referring the matter to a larger Bench, the Supreme Court has paused the judicial expansion of parity claims between allopathic and indigenous medical systems. The referral preserves the possibility of eventual equality where justified, but sets a high threshold of proof for similarity in work, qualification, and function.

“It is trite… treatment of unequals as equals is impermissible.”

Until the larger Bench pronounces its ruling, the continuation of AYUSH doctors beyond their statutory retirement age shall be conditional, cautious, and fiscally regulated.

Date of Order: October 17, 2025