Mumbai, Jul 19 (TOI): Dashing a medical graduate's hopes of continuing as a postdoctoral scholar in the US, the Central health ministry denied him the permission necessary for his visa, citing an acute shortage of doctors in India. The refusal, the second such for Dr Sunil Noothi, comes despite the Bombay high court pulling up the ministry for its unreasonable and improper decision. The move is likely to have repercussions on thousands of other research scholars who wish to study in the US, said doctors.

The first refusal came in 2015. In its June 28 denial this year, the Centre said that India has 6.9 lakh doctors and needs 4 lakh more by 2022. Allowing Dr Noothi (39) to go abroad would be against public interest, it said. It would violate its policy to stop issuing a No Obligation to Return to India (NORI) certificate since 2011 to doctors aged under 65, said the ministry.

A NORI certificate is a US government requirement to waive its obligatory two-year home residency to J1 visa holders. In 2014, the Indian government set out a policy to ensure that doctors return to India after completing their training or higher studies in the USA. It banned issuance of NORI except to doctors aged over 65 years.

The HC had clearly said that the Central policy against issuing a NORI cannot be made applicable to Dr Noothi, who is a research scholar, not a medical practitioner.

Last December, the HC bench at Aurangabad directed the health ministry to reconsider its decision after Dr Noothi challenged the denial of a NORI certificate to him. Noothi's counsel Rahul Totala said it was a test case, the first such individual challenge in the country filed against the ban on NORI. The Central Maharashtra Association of Resident Doctors (CMARD), had also moved the Aurangabad bench the HC in 2015 to challenge the anti-NORI policy introduced in 2014 as "retrograde''. The petition was admitted for hearing by the HC and is pending.

Totala said that Dr Noothi had never practised medicine since his MBBS degree in 2002 and intends to only do research. Totala had assailed the ministry's move as "discriminatory, highhanded and arbitrary''. But S B Deshpande, additional solicitor general, had argued that there was a rise in Indian doctors migrating to the US. He said 30% of doctors in the UK and 25% in Canada are of Indian origin. " There is acute shortage of doctors, nurses, paramedical staff and health workers in India,'' he said.

Dr Noothi was even willing to surrender his medical licence as he only wished to pursue research. The HC had found his intention commendable and had rapped the Centre for "making it difficult for him to prosecute his research work''—to find a cure for blood cancer—which the HC added "is likely to help the entire mankind''.

The HC bench of Justices R M Borde and S S Patil had said refusing him NORI "does not appear to be fair, reasonable and proper'' and had said that "it is expected of the respondents to encourage the petitioner for doing the research work by issuing NORI certificate instead of creating technical hurdles in his commendable research project''. It had also directed that the Centre could make the NORI conditional—to ensure that he does not practise medicine abroad.

Dr Noothi, a medical graduate from Bangalore, received a doctoral degree in 2010 from the Tata Institute of Fundamental Research, Mumbai. He pursued research training as a post-doctoral Fellow since 2011 in the US, first in Ohio on cancer and cell biology and later at the University of Kentucky in molecular genetics from 2013. He was on a J1 visa for research scholars, for five years. The research he was pursuing is not available in India and he is bound by a confidentiality agreement and can't undertake similar research elsewhere. When his visa was due to expire, the US Homeland Department required a NORI certificate from India to process his visa extension, but the Indian government refused.

Totala said that till 2013, the Indian government was issuing NORI subject to certain bond conditions to ensure the students returned later.

But in a three-page order, declining Dr Noothi's plea afresh after the HC order, N Kumara Swamy, under secretary to government of India, ministry of health, said that the "policy not to issue NORI to applicants except those over 65 years of age does not make a distinction between a medical practitioner and a research scholar''.

The ministry said it "cannot disregard the policy to improve public health in the country''. "If issued, it would defeat the government of India's endeavour to bridge the gap of medical professionals and fully utilize the clinical experience of medical graduates in speciality and super speciality areas and increase their number.''

Advocate Totala, said, "It is unfortunate that the health ministry has again refused him the certificate. He had to return on December 28, 2015. He has had to give up research as similar facilities are not available in India and is working as a tutor in a government medical college in Karnataka based only on his MBBS degree, not PhD.''

"The government ought to have applied its mind as even the HC observed,'' he said. "Now that two years are almost over, Noothi is considering his options and rules to apply for his research job and visa again.''

Scientist in US, now tutor here

Dr Sunil Noothi (39) now works as a tutor at a college in Karnataka—the lowest position in a medical college—earning Rs 29,000 a month.

In the US, he was getting $41,000 a year, and a grant of $300,000 per year for five years for research since 2013.

"Since the government is not issuing a NORI necessary for waiving the 2 year home residency requirement in India, once that period expires this December, it would be open for me to seek a research job and visa without the NORI requirement. However, since I have lost two years and also the research project I was working, I am not going to get the same work. I will thus have to start a new research project from scratch and have lost precious years. All the effort ending in an incomplete project could cost me up to five or 10 years of my career. I feel sad that the government is failing to distinguish between scientists and practising doctors and impeding research while NORI is not even a requirement for a waiver for practising Indian physicians in the US. The US government considers me a scientist, while the Indian treats me as a doctor even though I have not practised since graduation"—Dr Sunil Noothi.