FMG internship in India: NMC releases clarification on CRMI, check out details

New Delhi: Putting an end to the confusion of the Foreign Medical Graduates (FMGs), the National Medical Commission (NMC) has now issued a clarification regarding the conduct of internships for medical graduates from abroad.

Issuing a circular in this regard on May 9, 2023, the President of UG Medical Education Board (UGMEB), Dr. Aruna V Vanikar addressed several issues including important provisions under CRMI Regulations 2021 for the FMGs, validation for Online study by Commission, applicability of NMC Public notice dated 28.07.2022 on FMGs, requirement of Domicile by FMGs for internship, completion of Internship by FMGs in parts at hospitals and medical colleges, issue concerning payment of stipend to FMGs, and one-time relaxation to Foreign Medical Graduates to complete internship.

The clarification from the Apex medical commission comes after it received representations/queries from various stakeholders including the State Medical Councils seeking clarifications on different issues regarding the mode and method of conducting Medical Internship for Foreign Medical Graduates in India.

"The issue has been carefully deliberated in the Commission and in consultation with Ministry of Health & Family Welfare through virtual meetings and it has been decided to consolidate all the guidelines/instructions issued by the Commission till date," NMC mentioned in the circular.

"Further, the clarification in respect of the applicability of NMC's Notification dated 28.07.2022 regarding two years internship by FMGs, denial of internship by State Medical Councils on the basis of Domicile and completion of internship by FMGs in parts, is also required to be given in order to raise awareness among the various stakeholders and also the public at large," the circular further mentioned.

Also Read: Limited Internship Seats, Thousands of FMGE graduates facing Uncertain Future

The clarification provided by NMC is as follows:

Important Provisions under CRMI Regulations 2021 for FMGs -

(i) Foreign medical graduates are required to undergo supervised internship in India for a minimum term of twelve months, after applying for the same to the Commission, as per the clause 4(c) of Foreign Medical Graduate Licentiate (FMGL) Regulations 2021.

(ii) Foreign Medical Graduates who are required to do Internship in India, shall do so only in medical colleges or institutions approved for providing CRMI to Indian Medical Graduates and the allocation of medical college to these FMGs will be done by the concerned State Medical Council.

(iii) The Internship shall be completed within two years of passing the final MBBS or Foreign Medical Graduate Examination (FMGE) or NExT Step-1 examination, whenever in force.

(iv) Foreign Medical Graduates may be posted to different medical colleges or institutions through a counseling or seat allocation process based on the merit.

(v) The college or institution and its affiliated hospitals and Community Health Centres shall be recognized by the Commission for conducting the CRMI programme.

Validation of Online study by Commission -

(vi) The Commission has not approved/validated the medical qualifications (both theoretical & practical) through online mode only. However, during the Covid-19 pandemic, online classes conducted by Medical colleges/institutions in India were made valid, to be supplemented by practical and clinical training as per current curriculum in all MBBS subjects in the colleges/institutions and affiliated hospitals.

(vii) Online study of medical qualification (theory along with practical) is not valid mode of study.

Applicability of NMC Public Notice dated 28.07.2022 on FMGs -

(viii) In pursuance of order dated 29.04.2022 passed by the Hon'ble Supreme Court of India in SLP No. 2536-37 of 2022, NMC issued public notice dated 28.7.2022 informing that Indian students who were in the last year of their undergraduate medicine course but due to COVID-19, Russia-Ukraine war etc. had to leave their foreign medical institute and return to India and have subsequently completed their studies as also have been granted certificate of completion of course/degree by their respective institute on or before 30th June, 2022 shall be permitted to appear in Foreign Medical Graduate Examination.

(ix) The provision of two years' internship, referred in Public Notice dated 28.07.2022, is applicable only to those Foreign Medical Graduates who were in their last year of their study of medical qualification and returned to India due to COVID-19 or Russia-Ukraine War etc. After successful completion of the medical qualification, such FMGs are required to qualify FMG Examination and subsequently undergo Compulsory Rotating Medical Internship (CRMI) for a period of two years (schedule of 12 months to be repeated) in hospital attached to medical college only.

(x) All FMGs (Except covered in point (viii) and (ix) above) are required to complete their study from respective University/Institutes in offline mode or to supplement their online theory subjects/classes by offline practical and clinical training and thereafter shall acquire a valid medical qualification which is registrable in that country where it is being acquired. After qualifying FMG Examination, FMGs shall undergo Compulsory Rotating Medical Internship (CRMI) for a period of one year in accordance with CRMI Regulations 2021.

Requirement of Domicile by FMGs for internship -

(xi) State Medical Councils shall not deny allotment of medical colleges for internship to FMGs on the basis of their domicile. An FMG can complete his/her internship from a medical college in any State/UT, if found eligible otherwise.

Completion of Internship by FMGs in parts at hospitals/medical colleges -

(xii) In case, an FMG has already completed first one year of his/her internship in any medical college in India, he/she shall be free to complete remaining part of his/her internship(2nd year of internship) from another medical college/State/UT, as per the availability of seats for conducting internship for FMGs.

Payment of stipend to FMGs -

(xiii) National Medical Commission vide Circular dated 19.05.2022, requested to all Directorates of Medical Education & State Medical Councils to ensure that no internship fee is charged by the medical colleges/institutes from these interns Indian and Foreign Medical Graduates and stipend including other facilities is being provided to FMGs as equivalent to Indian Medical Graduates in the States/UTs.

(xiv) However, considering the requests/representations from various State Governments/UTs/medical colleges wherein it was intimated that there has been no budgetary provision in their allocation of annual budget to provide stipend to Foreign Medical Graduates, the Commission vide circular dated 19.10.2022 has already clarified that the amount of stipend to be paid to the interns is to be decided/fixed by the appropriate authority applicable to the Institution/University or State. The implementation of these guidelines/instructions/advisory is solely at the discretion of the concerned State authorities under which the medical college/institute is located.

(xv) However, stipend is payable to FMG interns only during 2nd year of internship, as one year is in lieu of the missed clinical training during MBBS course in Foreign Medical College/Institute.

One-time Relaxation to Foreign Medical Graduates to complete Internship -

(xvi) A number of requests/queries received from different State Medical Councils regarding non-availability of seats for FMGs to start their internships at their State/UT especially due to the implementation of the two years' internship for FMGs. Their request has been considered in National Medical Commission favourably in the Coordination Meeting of Chairman, NMC with Presidents and Members of the four Boards of NMC held on 2nd May 2023

(xvii) After careful consideration of the situation and issue faced by the FMGs in order to explore seats to complete their internship, it is decided by UGMEB to validate the list of Recognized Non-teaching Hospitals for Compulsory Rotating Medical Internship issued by the erstwhile Medical Council of India, for a period of one year from the issue of this circular i.e. upto May 2024, for conduct of internship for Foreign Medical Graduates only. List of Recognized Non-teaching Hospitals for Compulsory Rotating Medical Internship issued by the erstwhile Medical Council of India is at Annexure. This relaxation is granted only as a one-time measure.

(xviii) The allotment of FMGs in these Non-teaching Hospitals shall also be done only through concerned State Medical Councils.

"All State Medical Councils and Directorates of Medical Education are requested to kindly ensure the implementation of the above guidelines/instructions while allocating medical colleges to Foreign Medical Graduates," NMc mentioned in the circular.

The clarification from NMC has been issued at a time when thousands of medical graduates from abroad are facing difficulty to get enrolled for the Internship programme due to inadequate internship seats. 

Medical Dialogues had earlier reported that around 2,000 FMG doctors are facing the issue. In case of Rajasthan alone, only around 30 percent of the total students, who cleared the mandatory FMGE test in January have secured a seat for Internship. Earlier, Rajasthan Medical Council only held counselling for filling only 399 seats while the state almost has approximately 2,000 FMG internship seats. 966 of the 1,365 exam-qualified candidates are still waiting for an internship seat. In Haryana, around 40 students are yet to get an internship seat, sources informed Medical Dialogues.

Students are not certain about the number of available seats in several States and even after three months of the FMGE results, many states across the country have not yet commenced the counselling process.

Recently, the Federation of All India Medical Association (FAIMA) also raised the problems faced by the FMGs across the country and especially in Delhi. FAIMA wrote to the chairman of the National Medical Commission (NMC). FAIMA urged NMC to take action to address the concerns of foreign medical graduates in India.

In a recent meeting with the NMC officials, the Federation of Resident Doctors Association (FORDA) also communicated the problem with the authorities. After the meeting on May 4, FORDA assured that a solution would soon be provided by the Apex medical commission, most likely within one week.

To view the notice, click on the link below -

https://medicaldialogues.in/pdf_upload/fmg-209268.pdf

Also Read: Limited Seats for FMG Internship: FORDA raises matter to NMC, assures solution in one week