AYUSH vs. Allopathy Doctors: Supreme Court Refers Question of Parity in Service Conditions to Larger Bench

The Supreme Court of India, in an order dated October 17, 2025, has referred a significant legal question to a larger bench for an “authoritative pronouncement.” The core issue is “whether the doctors, practicing allopathy and indigenous medicine; like Ayurveda, Homeopathy, Unani etc. can be treated equally for the purpose of determining service conditions; herein, specifically retirement age.”

The order was passed by a division bench comprising Justice B. R. Gavai and Justice K. Vinod Chandran in the case of State of Rajasthan and Ors. v. Anisur Rahman (Special Leave Petition (C) No.9563 of 2024) along with a batch of similar petitions.

While referring the matter, the court noted a “divergence of opinion” in previous judgments and established detailed interim measures for the continuance of AYUSH doctors pending the larger bench’s decision.

Background: Conflicting Judicial Precedents

The bench observed that reliance had been placed on a series of judgments that “took different stands on the question of retirement age and pay scales.”

1. New Delhi Municipal Corporation v. Dr. Ram Naresh Sharma & Ors. (2021) 17 SCC 642: The court noted that in this case, a division bench was concerned with the enhancement of retirement age from 60 to 65 years for General Duty Medical Officers (GDMO) of the Central Health Scheme (CHS), while doctors under AYUSH were denied this benefit. The Supreme Court had found that AYUSH doctors and CHS doctors “cannot be classified in different categories since though practicing different forms of medicine; indigenous system and allopathy, they render the very same service to the patients, and any classification would be unreasonable and discriminatory.” This decision was also influenced by a communication from AYUSH, issued while the matter was pending, stating that superannuation for its doctors would be 65 years, as approved by the Union Cabinet.
2. State of Gujarat & Ors. v. Dr. P.A. Bhatt & Ors. (2023) SCC OnLine SC 503: This case, which concerned different pay scales, distinguished the Dr. Ram Naresh Sharma decision on three grounds. First, that Sharma was based on the Union Cabinet’s decision. Second, “that the question of age of retirement stands on a different footing from the service conditions relating to pay and allowances.” Third, that the “fundamental distinction” of “equal work for equal pay” was not dealt with in Sharma. The Dr. P.A. Bhatt judgment held that “classification based on educational qualification was not violative of Articles 14 and 16 of the Constitution of India.” It found in the negative on the question of whether allopathy and AYUSH doctors carry out similar work, observing that “allopathy doctors are required to perform emergency treatment and provide trauma care and assist in complicated surgeries none of which can be performed by doctors having a degree in indigenous systems.” The judgment also noted that “the footfalls in Government Hospitals manned by MBBS doctors are far more than that in an institution administering treatment under the indigenous systems of medicine.”
3. Other Judgments: The bench also noted Dr. Solamon A. v. State of Kerala and Ors. (SLP (C) No.3946 of 2023), which relied on Dr. P.A. Bhatt to find that AYUSH doctors “cannot seek parity with medical doctors” due to “qualitative distinction in the academic qualifications.” Further, Central Council for Research in Ayurvedic Sciences and Another v. Bikartan Das and Others (2023 SCC Online 996) was cited, which found that “the age of superannuation is always governed by statutory rules.”

Court’s Analysis of the Divergence

The bench of Justice Gavai and Justice Chandran acknowledged the distinction drawn in Dr. P.A. Bhatt but stated, “Still, there is an area of ambiguity insofar as service conditions, especially of retirement age and the pay packages… should be ideally considered, according to us, on the touchstone of, identity of functions, similarity in work carried out and comparable duties assigned.”

The court elaborated on the functional differences: “…it is the MBBS doctors, the allopathy practitioners, who are dealing with critical care, immediate life saving measures, invasive procedures including surgeries and even postmortem; none of which can be carried out by any of the practitioners of indigenous systems of medicine.”

The order further observed that 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.”

The court stated, “These aspects according to us, puts the former in a different class altogether, who can be classified differently for service conditions. This has a reasonable nexus with the object sought to be achieved, i.e.: the sufficiency of qualified and experienced MBBS doctors with better pay scales and longer service, both.”

The bench also recorded the States’ contention “that of public good and the concern expressed is of dearth of sufficient allopathy doctors,” a dearth which the court noted “does not exist in the indigenous systems of medicine.”

The Decision: Referral to Larger Bench

Citing the “divergence of opinion” and the legal principle that “it is trite cannot result in treatment of unequals as equals,” the Supreme Court held: “We are of the opinion that there should be an authoritative pronouncement on the issue and we hence refer the matter to a larger Bench.”

The Registry was directed to place the matter before the Hon’ble the Chief Justice of India on the administrative side.

Interim Directions

Pending the larger bench’s decision, the court issued specific interim directions (Paras 10 and 11):

1. The States and authorities “would be entitled to either continue the practitioners of indigenous systems of medicine, even after the age of superannuation specified for them till the age of superannuation provided for MBBS doctors, without the benefit of regular pay and allowances.”
2. Alternatively, “it is directed that they shall be paid half of the pay and allowances.”
3. If the larger bench eventually holds in favor of the AYUSH doctors, “the practitioners would be entitled to avail pay and allowances during the period they were continued.” This applies even if they were not allowed to continue by virtue of the interim order.
4. If the reference does not yield favorable orders for the AYUSH doctors, the “half of the pay and allowances” paid “will be adjusted in their pension or otherwise against the regular pay and allowances.”
5. The court clarified: “If the State Government permits such continuance and the individual doctors do not take up such assignment without regular pay and allowances, they would be treated as retired and the fate of this reference will be inconsequential to them.”