TN FMGs launch hunger strike over internship, eligibility certificate delays

According to the associations, from Tamil Nadu, a large number of students go to countries like the Philippines, Russia, Kyrgyzstan, China,Ukraine, Armenia, Georgia, Uzbekistan, Mauritius, Singapore, and Malaysia to study medicine. Approximately 1800 of these foreign medical graduates (FMGs) successfully pass the qualifying examination conducted by the central government every year. However, these FMG graduates have recently faced many hurdles.

As per the existing rules, the FMGs must clear the Foreign Medical Graduates Examination (FMGE), the screening test, and undergo mandatory internship before being eligible to practice medicine in India. 

For CRMI, 7.5% of the total internship positions in Government Medical Colleges and Hospitals are reserved for FMG (Foreign Medical Graduate) degree holders, as per the National Medical Commission's Guidelines.

Explaining the long process before obtaining eligibility to practice in India, TNMSA FMG Wing and DASE in a release said that the FMGs must qualify the Foreign Medical Graduate Examination (FMGE) conducted by the Union Government,then travel to Delhi to obtain their passing certificate, and subsequently obtain a Provisional Eligibility Certificate (PEC) fromthe Tamil Nadu Medical Council. After this, they need to obtain No Objection Certificate (NOC) with the Tamil Nadu Dr.M.G.R. Medical University and consequently, must obtain the order for admission to undergo CRMI at a government medical college under the Directorate of Medical Education. Only after obtaining provisional registration with the Tamil Nadu Medical Council will it be possible to commence the Compulsory Rotating Medical Internship (CRMI). Until 2020, it would take up to two months from the date of application for thisprovisional eligibility certificate to obtain provisional registration.

However, the doctors explained that this process has now taken more than a year and they have alleged that the Tamil Nadu Medical Council is the main reason for the delay.

According to the doctors, in the process of verifying the PEC applications, the TNMC requests the Indian embassies in the respective countries to verify the medical degrees of the FMG degree holders. They alleged that even though Indian embassies provide the response within ten days, TNMC forces FMG graduates to wait for several months without issuing the PEC. 

Further, the doctors have also alleged carelessness on the part of TNMC when the FMGs approach the Council office with their problems and queries. They have demanded changes in aspects such as regulating visitor timings, receiving complaints, and resolving issues. For this, the doctors have opined that an adequate number of staff must be appointed.

They also criticised the TNMC for mandating an extended period of internship who pursued a part of their medical studies online during the COVID-19 pandemic, Russia-Ukraine war etc.

"The TNMC is mandating, in violation of the rules, that those who registered for the PEC from January 2025 onwards must extend their compulsory medical internship period to two or three years (One Year Regular CRMI + One/Two Year Extra CRMI). It is being verbally communicated to the doctors who registered in 2024 that the CRMI-PEC order issued by TNMC for one year will be extended to them for two or three years. As part of this, TNMC is forcibly obtaining signatures from FMG degree holders on a mandatory undertaking form without allowing them to read any of the conditions. This practice is not followed in any other state and it is not instructed by NMC. This is a completely discriminatory approach by TNMC against FMG degree holders," mentioned the release.

Another issue that the FMGs have highlighted is the CRMI seat deficiency. They explained that on November 18, 2021, the National Medical Commission introduced the CRMI regulations. In this, the FMG-CRMI seats were reduced from 10% to 7.5%. As a result, the number of FMG-CRMI seats in Tamil Nadu Government Medical Colleges decreased from 373 to 284 annually. Furthermore, 11 new medical colleges were started in 2021. In these colleges, for FMG graduates to undertake CRMI, a total of 1450 general seats and an additional 109 seats (7.5%) wereavailable until May 2026, resulting in a total of 1559 seats.

However, they pointed out that TNMC has currently suspended the approval fo FMG CRMI seats in these 11 medical colleges from August 2025 without any prior notice.

NMC on 15.05.2024 granted FMG graduates approval to undertake CRMI in district headquarter hospitals for a period of two years (from May 2024 to May 2026). However, according to the doctors, TNMC has not yet received the number of seats for this purpose from the NMC.

"Due to the COVID-19 pandemic in 2020 and 2021, and the Russia-Ukraine war in 2022, and also because the studentswho pursued their studies online did not properly follow the two (or three) year CRMI regulations of the National MedicalCommission, the number of CRMI positions is further decreasing. As a result, currently, more than 1500 graduates are in asituation where they have been waiting for more than one and a half years to undertake their CRMI," they highlighted.

Amid this, the TNMSA FMG Wing and DASE began the hunger strike protest with the following demands:

1) 7.5 to 20 percent of the total compulsory rotatory medical internship positions in medical colleges should be allottedto medical graduates who have studied medicine abroad.

2) Permission should also be granted to medical graduates who have studied medicine abroad to undergo CRMI indistrict government hospitals.

3) The Tamil Nadu government had granted permission for graduates who studied medicine abroad to undergo internship training in the 11 new medical colleges of the Tamil Nadu government. As a result, many FMG graduatesundertook internship training. This has now been completely stopped. In the colleges, permission should be granted againfor foreign medical graduates to undertake internship training in a proper manner.

4) The Tamil Nadu Medical Council should immediately stop the excessive delay in issuing Provisional EligibilityCertificates (PEC) to those who have studied medicine abroad (FMG).

5) Unlike in other states, and contrary to NMC rules, the Tamil Nadu Medical Council has issued orders stating thatmany of those who studied medicine abroad must undergo 2 or 3 years of training as intern doctors, only in Tamil Nadu.This is highly condemnable. This must be abandoned immediately.

6) Hostel facilities must also be provided to the foreign medical graduates undergoing training as intern doctors.

7) The Tamil Nadu Medical Council must cease its negligent, biased, and humiliating treatment of doctors who haveobtained medical degrees from foreign countries, which is disrespectful to them. The administrative irregularities and malpractices prevailing in the Tamil Nadu Medical Council must be rectified.

8) Steps must be taken to address the shortage of staff in the Tamil Nadu Medical Council. Sufficient staff must beappointed immediately.

9) To assist our students studying medicine abroad, 'Welfare Centre’ should be established at both the national andstate levels.

10) The visiting hours at Tamil Nadu Medical College should be changed to 11:00 AM to 1:00 PM. The visiting hoursshould be extended.

Also Read: TN FMGs announce hunger strike over provisional registration certificate, internship crisis