The Lahore High Court (LHC) has directed two private medical and dental colleges to give effect to students’ consequential claims for adjustment or refund of excess tuition fees within 30 working days from October 30, it emerged on Saturday.
It held that the institutions must implement the Pakistan Medical and Dental Council’s (PM&DC) prescribed fee limits in accordance with the regulator’s notifications and the court’s findings.
LHC Justice Khalid Ishaq, in a detailed judgment, dismissed three petitions filed by private medical institutions challenging the PM&DC’s fee regulations and allowed 12 connected petitions filed by students and their guardians seeking enforcement of the prescribed fee limits.
In the detailed judgment available with The Express Tribune, Justice Ishaq upheld the PM&DC’s statutory authority to regulate and cap tuition fees, ruling that medical and dental colleges cannot operate as purely commercial enterprises divorced from their responsibility towards society, given the connection between medical education, human life and public health.
The court held that private medical colleges have no unrestricted right to determine tuition fees and that the PM&DC is empowered to scrutinise their proposed fee structures and financial justifications to regulate charges and protect students against exorbitant fees and profiteering.
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The court held that the council’s authority to regulate tuition fees flowed from a harmonious reading of Sections 9 (powers and functions of the council), and 20 (standards of medical and dental education) of the Pakistan Medical and Dental Council Act, 2022, read with the relevant regulatory framework under Section 47 (Power to make rules and regulations), and was not a power created independently through subordinate regulations.
The judgment emphasised that 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 had no authority to examine or question an unjustified fee proposal, the statutory requirement would be rendered meaningless, Justice Ishaq noted in his order.
The court observed that the responsibility of colleges to publicly declare their tuition fees under Section 20(7) did not make their proposed fee structures immune from regulatory scrutiny. It held that the council could examine the financial justification and, where necessary, approve, modify or reject the proposed fee structure.
Rejecting the institutions’ argument that the PM&DC Act did not authorise the council to fix tuition fees, the court 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.
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The institutions had also argued that fee regulation violated their fundamental right to conduct business under Article 18 (Freedom of trade, business or profession) of the Constitution. The court rejected the contention, observing that the freedom to carry on a lawful profession, trade or business was not absolute and could be subjected to reasonable restrictions in the public interest.
However, the court clarified that the regulator must take legitimate institutional costs into account while determining permissible fee limits, adding that affordability alone could not justify a measure that disabled institutions from maintaining the educational standards required under the law.
“The relevant interest here is the integrity and continuity of regulated medical education, including protection against unjustified financial demands, while ensuring the resources necessary to maintain educational standards,” the judgment highlighted.
The court also dismissed the institutions’ argument that private medical and dental colleges were being discriminated against under Article 25 (Equality of citizens) of the Constitution compared with institutions offering other professional education.
Justice Ishaq held that medical and dental institutions operated under a distinct legislative and regulatory framework involving clinical training, institutional recognition and professional qualifications. However, he clarified that common regulation could not justify arbitrary treatment of institutions having materially different financial circumstances and that a discriminatory exercise of regulatory authority remained open to judicial review.
An important aspect of the judgment was the institutions’ participation in the fee-determination process. The court noted that the petitioner institutions had submitted their audited financial statements and sought enhancement of the prescribed tuition fees through the Pakistan Association of Medical Institutions (PAMI).
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It observed that the two petitioner institutions had participated in the process and sought enhancement of their tuition fees. They could not subsequently reverse their position and invoke the constitutional jurisdiction of the court to challenge the regulator’s authority, referring to their participation in the sixth meeting of the Fee Justification Committee held on February 18 and the withdrawal of PAMI’s petition before the Islamabad High Court on February 4.
Examining the audited accounts of University Medical and Dental College, Faisalabad, the court noted that its income for 2025 was recorded at Rs5.099 billion, with a profit of Rs378.659 million. The minutes of the Fee Justification Committee recorded that the college was liable to refund Rs841,317 per student for excessive amounts collected over and above 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 amounts collected over and above the prescribed fee.
The court also recorded the specific annual tuition fee ceilings prescribed for the two institutions under the March 11 notification: Rs2,026,341 for University Medical and Dental College, Faisalabad, and Rs2,052,099 for FMH College of Medicine and Dentistry, Lahore.
The court noted that the PM&DC had initially fixed the annual tuition fee for MBBS and BDS programmes at Rs1.8 million through its notification dated April 28, 2025, allowing a 5% increase for the 2025 session and 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.
Following scrutiny of audited financial statements and recommendations of a specially constituted Fee Justification Committee, the council issued another notification on March 11, prescribing revised fee ceilings for different categories of institutions, including conditional enhancements based on financial justification.
The judgment explained that the March 11 notification classified institutions into three categories: those that submitted proposed fee justifications and audited financial statements, those whose audited accounts had verification issues, and those that did not apply for enhancement of their tuition fee structure.
The court held that the regulatory framework was not 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.
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In another important observation, the court took notice of complaints by some students that they had faced retaliatory and victimising treatment by institutions for raising questions about enforcement of their lawful rights.
The court directed the institutions to refrain from adopting any prejudicial treatment against litigating students and stressed that students subjected to unlawful treatment could approach the court for contempt proceedings.
Concluding that the fee-control mechanism fell within the statutory authority of the PM&DC and served the legitimate purpose of protecting students, the court dismissed the three petitions filed by the private institutions challenging the notifications and allowed the 12 petitions filed by students or their guardians seeking their implementation.
It further ordered the PM&DC and the institutions concerned to implement the impugned notifications, to the extent applicable to the respective students.
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