(1) When 'upon' report by the Committee or by a visitor appointed under section 18, it appears to the Council that the courses of study and examination to be undergone in any University or medical institution in India in order to obtain a recognised medical qualification or that the standards 'of proficiency required from candidates at any examination held for the purpose of granting such qualification are not such as to secure to persons holding such qualification the knowledge and skill requisite for the efficient practice of medicine, the Council shall make a representation to that effect to the Central Government.
(2) After considering such representation, the Central Government may send it to the State Government of the State in which the University or medical institution is situated and the State Government shall forward it along with such remarks as it may choose to make to the University or medical institution, with an intimation of the period within which the University or medical institution may submit its explanation to the State Government.
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(3) On the receipt of the explanation or, where no, explanation is submitted within the period fixed, then on the expiry of that period, the State Government shall make its recommendations to the Central Government.
(4) The Central Government, after making such further inquiry, if any, as it may think fit, may, by notification in the Official Gazette direct that an entry shall be made in the appropriate Schedule against the said medical qualification declaring that it shall be a recognised medical qualification only when granted before a specified date.