Supreme Court directs Centre, NMC to find Solution for FMGs unable to complete Clinical Training

New Delhi: While considering the pleas by MBBS graduates from abroad who were unable to complete their clinical training due to COVID-19 or war-torn situation, the Supreme Court on Friday asked the Union Ministry of Health, the Ministry of External Affairs and the Ministry of Home in consultation with the National Medical Commission (NMC) to find a solution for these students.

Although the top court bench of justices BR Gavai and Vikram Nath expressed sympathy with the students who could not complete their clinical training in foreign countries such as China and Ukraine due to Covid and other unforeseen events, NMC opposes any relaxations for such students.

In this regard, the counsel for NMC, Advocate Gaurav Sharma opined that a medical student who has not undergone clinical training was like someone who has learned the theory of swimming but never entered the water. Expressing such opinion, the NMC counsel further submitted that such students should not be allowed to treat Indian patients under any circumstances, adds Live Law.

However, urging the Union Government to consider the matter on humanitarian ground and observing that career of several students were at stake, the bench asked the Union government to constitute a committee of experts to find out solutions for the students' situations. The court remarked that these students can be national assets when the country is facing a dearth of doctors.

Therefore, the top court bench dictated in the order,

"…Though we find that this is a fit case wherein some solution which must be evolved by the experts in the field, we refrain ourselves from issuing any directions. However, we request the Union of India, i.e the Ministry of Health, the Ministry of External Affairs and the Ministry of Home in consultation with the National Medical Commissions to find a solution to address this human problem. We are sure that the Union of India will give due importance to our suggestion and find out a solution so that the career of students, who are undisputedly an asset to the nation and particularly when there is a dearth of doctors in the country, will be positively addressed."

The bench also clarified, "We are restricting this to only those students who have completed seven or eight semesters by June 2022. We do not want to issue a mandamus because we know our limitations."

These observations came from the bench while considering the pleas by the MBBS graduates from abroad who could not complete their clinical training due to unforeseen events such as COVID-19 pandemic and the Russia-Ukraine war.

Also Read: Accommodation of Ukraine Returned Medicos Discussed in Supreme Court, Next Hearing on December 8

Medical Dialogues had earlier reported that previously the Central Government had filed an affidavit before the Supreme Court stating that Indian medical students who returned from Ukraine cannot be accommodated in Indian universities as there is no provision in the National Medical Commission Act allowing it.

In its affidavit filed in the Supreme Court, the Union Ministry of Health had pointed out it had already introduced some "proactive measures to assist the returnee students". On September 16, the top court suggested that the Central government could develop a web portal providing details of foreign universities for the Ukraine-returned students to complete their studies, as per the government's academic mobility programme.

Consequently, on November 11, the Supreme Court had asked the Centre to file an affidavit to inform it about the number of medical students who were pursuing their studies in Ukraine who have been accommodated in other countries. Accordingly, the Central Government had informed the top court bench that out of a total 15,783 Indian students who had enrolled in Ukrainian medical universities, 14,973 are undergoing online classes, which have been conducted by the universities.

However, the counsels appearing for the petitioners had requested the Supreme Court bench to provide clinical accommodations to the students of fourth, fifth and sixth-year batches as a "one-time measure". It was also stated that considering the fact that the students continued their classes online, they should be allowed practical and clinical training.

On the other hand, Additional Solicitor General Aishwarya Bhati had contended that it was not possible to provide accommodation to the Ukraine returned medical students because the Apex medical education regulatory body, National Medical Commission had strict mandates against this.

However, Senior Advocate S. Nagamuthu, who appeared on behalf of the students submitted, "This court has held that the order passed in the other batch would also be applicable to our case. Therefore, the students who joined the medical course in China in 2016 should be given the same benefits. Several state medical councils have complied. Only Kerala and Tamil Nadu have refused. This is when we are covered by two judgements of this court."

The senior counsel explained that the reason why the petitioner students were unable to avail the benefits of the scheme prepared by the Central Government as per the Supreme Court order was because they had completed only seven semesters physically and were in their penultimate years. However, the central government scheme only covered the final year students.

At this outset, Justice Gavai asked NMC counsel, "Have you granted the benefit to these students?"

Responding to this, Advocate Sharma for NMC explained, "After the second year, every day, a medical student, under the guidance of a professor or an associate professor, is supposed to gain practical knowledge in hospitals. For one and a half years, that is, three semesters, these students have not studied. Nothing has happened in this duration."

He also pointed out that the case for these students was clearly contradictory to the students of the previous batch who could avail the central government scheme for completing clinical training. The NMC counsel submitted, "The previous batch missed only three months. Even then, they were directed to undergo one year of additional training." He also asserted that giving further relaxation under the policy would be dangerous and the situation could be remedied only if the students went back to China.

However, describing the problem faced by these students as a "Catch 22" situation, Additional Advocate-General for Tamil Nadu, Amit Anand Tiwari pithily explained, "They cannot go back now because they have completed their course. Here also, they are not allowed. This is a Catch-22 situation."

"This is a human situation which needs to be addressed soon," he further pointed out.

The counsel for the students Nagamuthu also submitted in this context, "These students are neither here, nor there. Even in the earlier case, the court accepted that the time and money of these students should not go to waste."

Live Law adds that the bench observed that most of these students completed their courses but could not complete their clinical training from their parent institutes abroad due to unforeseen events. Further, these students cannot go back to the colleges since they have completed their courses.

"A very precarious situation has arisen as the students have already completed their courses and now it will not be even possible for them to return to the respective institutions to complete the clinical training in so far as the relation between them and the respective institution stands severed," observed the bench.

While both the NMC and the Central Government were adamant in their stand that relaxations cannot be given to the petitioner students who were not in their final year, the Court considered the fact that they have completed their courses online and also took note of the unforeseen events such as war and the pandemic.

Further considering the fact that all the petitioners have passed the FMGE exam, the bench urged the authorities to have a relook at the situation and observed, "We find that the career of almost 500 students are at stake. They have completed 7 semesters physically and 3 online."

Therefore, addressing the Additional Solicitor General Aishwarya Bhati, Justice Gavai remarked, "Madam, we only request you to consider this on humanitarian grounds and find a way out. We request the highest authority in the central government to address this human problem keeping in mind the career of the students. We are restricting this to only those students who have completed seven or eight semesters by June 2022. We do not want to issue a mandamus because we know our limitations."

The bench further added, "Leaving it to the National Medical Council would be no good, since we know how adamant they are."

Responding to this, ASG Bhati mentioned, "You are aware that physicians in India are well respected because of the strict guidelines that we follow."

Justice Gavai countered, "I hope you remember Ahmedabad."

Admitting that the court does not possess the expertise to second guess the decision taken by the authorities, the bench expressed the need for a solution considering the hardships faced by the students.

"If no solution is found at this stage, their entire careers will be left at lurch and their families will be put at sufferance. Though we find that this is a fit case wherein some solution which must be evolved by the experts in the field, we refrain ourselves from issuing any directions. However, we request the Union of India, i.e the Ministry of Health, the Ministry of External Affairs and the Ministry of Home in consultation with the National Medical Commissions to find a solution to address this human problem. We are sure that the Union of India will give due importance to our suggestion and find out a solution so that the career of students, who are undisputedly an asset to the nation and particularly when there is a dearth of doctors in the country, will be positively addressed", observed the bench.

Posting the matter for further hearing on January 25, 2023. the bench further noted, "Taking into consideration that the career of the students is at stake, we request the Union of India and the NMC to address the issue at the earliest and inform the court of a possible way out."

After dictating the order, Justice Gavai orally told the Additional Solicitor General Aishwarya Bhati "Give them a republic day gift."

"This is a human problem, which needs to be addressed", further noted the bench. 

Clarifying that the order was restricted only for the petitioners who were in their penultimate years, Justice Gavai orally said, "Now don't come with cases of 2nd year and 3rd year students. This is only for such students who had completed 3.5 years and who have passed their exams before June 30, 2022."