Reconsider 3-year Internship Rule for FMGs: Doctors Urge Health Minister, NMC

New Delhi: Pointing out the plights of foreign medical graduates (FMGs), especially delay in achieving their academic goals, the Foreign Medical Students' Wing of the All India Medical Students' Association (AIMSA) has urged the Union Health Minister Mansukh Mandaviya and the National Medical Commission (NMC) to reconsider and revise the 3-year internship and clerkship rule.

Referring to the NMC notices dated 22.11.2023 and 07.12.2023 directing the FMGs to undergo additional years of training to compensate for practical training lost due to COVID-19 and the war in Ukraine, the association highlighted that these added years present a significant setback in the academic journey of the affected students.

In a letter addressed to the Union Health Minister on 14.03.2024, a copy of which was also sent to NMC and the President of the Undergraduate Medical Education Board (UGMEB), AIMSA-FMSW pointed out that the total duration of the MBBS course along with 2 years of clerkship and 1 year internship, leads to a prolonged academic journey, causing considerable delay in achieving academic goals.

"This extended duration poses a substantial burden on both students and parents, especially considering the challenges of unemployment in today's world. Furthermore, there is inconsistency among different state medical councils in implementing this rule, with some states requiring a 3-year internship like Haryana, Punjab, Tamil Nadu while other States mandate 2 year's of internship like Gujarat, Karnataka, Maharashtra,Delhi, Rajasthan, UP, Bihar, West Bengal, Madhya Pradesh & others. This discrepancy leads to confusion and mental distress among students," the association highlighted.

Also Read: FMGs have to Avail Academic Mobility Programme within 3 Months Deadline- NMC Issues Detailed Clarification for all FMGs

Further, AIMSA pointed out that the implementation of the 3-year internship rule contradicts the guidelines provided by the NMC in its notice dated 22.11.2023, which stipulates that the entire MBBS course must be completed within 10 years. 

"Unfortunately, this extended internship duration makes it impractical to adhere to the NMC's guidelines," the association mentioned in the letter.

"FMGs, as citizens and colleagues, may suffer adverse effects on their mental well-being and academic progression due to such stringent regulations. We believe that the existing screening test exam, along with compensatory one year of clerkship for online mode of study only and students who have not compensated in there respective college/university due to pandemic & war condition, coupled with a 1-year internship, adequately assesses their quality, knowledge, skills, and patient care management," it further added.

Arguing that an additional year would further exacerbate the mental and physical well-being of the medical graduates from abroad, the association requested NMC to reconsider the public notice released in light of students' concerns, prioritizing the academic well-being of affected students.

The FMGs who have been most affected by this rule belong to the 2016, 2017, and 2018 MBBS Batches, who had to came back to India in the middle of their medical courses due to COVID-19 pandemic or the war in Ukraine.

Medical Dialogues had earlier reported that releasing a notice dated 28th July, 2022, NMC had informed that "...the Indian students who were in the last year of their undergraduate medicine course (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. Thereafter, upon qualifying the FMG examination, such foreign medical graduates are required to undergo Compulsory Rotating Medical Internship (CRMI) for a period of two years to make up for the clinical training which could not be physically attended by them during the undergraduate medicine course in the foreign institute as also to familiarise them with practise of medicine under Indian conditions. The foreign medical graduates will be eligible to get registration only after completing the CRMI for two years."

Later NMC clarified that this relaxation was applicable only for the FMGs who were in the last year of their course. Last year on 22.11.2023, addressing several issues concerning the FMGs, NMC had mentioned that medical students abroad, who had a break in their Final year and who returned to India due to COVID pandemic or war and completed their course online such students "be allowed to continue to complete their two years before permanent registration given by the State Medical Council."

NMC had also addressed the issues of FMGs who had a break in their Penultimate year of study and mentioned that "Existing FMGs, if any, already performing internship at present, may be allowed to continue with one year of internship. They may subsequently do one year clinical clerkship and one year internship. (Thus a total of three (3) years, before obtaining Permanent Registration from concerned SMC)."

Again on December 07, 2023, NMC released another Public Notice and addressing such FMGs who returned to India in their Penultimate year, it mentioned, "Existing FMGs undergoing internship be allowed to continue to complete their three (3) years before permanent registration given by the State Medical Council."

"This is mental harassment", Claim Students: 

Speaking to Medical Dialogues, a medical student, who pursued his medical education in China and is currently undergoing internship, referred to the 3-year Internship rule and questioned, "We are already doing the same thing for two years, how can we undergo the same thing for one more year?"

"This is nothing but mental harassment. This is unacceptable," said another student, highlighting that they have been undergoing internship for around 2 years, and that too without receiving any stipend.

The students explained how this extended period of internship is causing a financial burden on their parents and also causing the students mental trauma and academic delay. They pointed out that they are not learning anything new but are going to repeat the same training thrice.

"Our demand is simple, we want NMC to take back the 3-year Internship rule. We are already undergoing one additional year of internship to compensate for our practical training. 365 days of internship without holidays is much more than the total duration of lost practical classes during the MBBS course," added the student.

The Federation of Resident Doctors' Association (FORDA) has also extended its support to the FMGs and mentioned in an X post (formerly Twitter), "FMG candidates deserve better! The current sentiment in the country regarding Foreign Medical Graduates has a hostile undertone to it. 3 years of internship (+clerkship) in particular, is not only too rigid, but also inhumane at many levels- Compunded with the adversities that these students have already had to face in the face of #COVID & #UkraineWar We urge @NMC_IND to listen to the various demands and pleas of affected students and help settle their multiple issues with rounds of talks. We will represent their interests."

Speaking to Medical Dialogues in this regard, the General Secretary of FORDA Dr Sarvesh Pandey questioned, "Which extra things will these students learn during these 2 years of clerkship? What is the fault of these students in the whole scenario of the COVID-19 pandemic and Ukraine war?"

Also Read: NMC Says FMGs Returning to India in Penultimate Year Need to undergo 3 years of Internship and Clerkship, Medicos Oppose Move