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In the aftermath of the COVID-19 pandemic, as India’s healthcare system slowly regains its balance, a silent crisis continues to unfold. Thousands of Foreign Medical Graduates (FMGs) who returned home to India after studying medicine abroad are now facing what they call an “unjust and discriminatory” requirement: up to three years of internship, often unpaid.
FMGs are Indian nationals who studied medicine in foreign countries like Russia, Ukraine, China, the Philippines, and Bangladesh. To practice in India, they must pass the Foreign Medical Graduate Examination (FMGE), a rigorous national licensure test, and complete a one-year Compulsory Rotating Medical Internship (CRMI), as mandated by the National Medical Commission (NMC). [2,3]
During the pandemic, visa suspensions and travel bans forced many FMGs to complete portions of their coursework online, a move mirrored by Indian medical students in domestic colleges. However, only FMGs are now being asked to “compensate” for that online learning with additional internship years. [5]
Some FMGs have been granted a one-year internship, but only if they can show that they remained abroad during the pandemic. The deciding factor? A passport stamp. Those who returned to India due to emergency or visa expiry, often involuntarily, are the ones now facing longer internships. [2]
Each additional year isn’t just a number — it’s a delay in our careers, our ability to serve patients, support our families, and build our future. These are the prime years of our lives, and we’ve already passed the rigorous FMGE. If that doesn’t prove our competence, then what does? We are not asking for favors — we are asking for fairness, clarity, and recognition of our hard work under unprecedented global circumstances. Before imposing such decisions, shouldn’t there be a transparent, evidence-based rationale? Shouldn’t the focus be on competency, not just counting years?
Dr. R, MBBS, FMG, Philippines
Perhaps most controversially, many FMGs report that these additional internship years are largely unpaid. While officially called “training,” the work hours, responsibilities, and shifts are indistinguishable from that of a regular medical officer. [6]
Legal experts are also questioning the inconsistency. If the FMGE certifies competency, what additional evaluation justifies extending internships, and only for FMGs? [7]
Alongside professional delays and financial burdens, FMGs are reporting rising cases of mental distress. Extended uncertainty, perceived discrimination, and social stigma are taking a toll. [8]
It’s very depressing even thinking about 3 years of internship. We have been suffering a lot both mentally and financially. We have completed six years of education, followed by a three-year internship and a one-year delay to receive our allotment. It’s a total of 10 years!!! We are literally hopeless in this situation. Ukraine - Russia war or COVID-19 neither of these was our mistake, despite passing the licensing exam, why do we have to suffer this much? Even Indian medical graduates did online classes for COVID-19. Only we FMGs face such torment from the Indian government. We studied with students from all parts of the world such as Arab, Africa, and Morocco, and none of these countries had such partiality with their students. ONLY IN INDIA, this takes place.
Dr. A, MBBS, FMG, Ukraine
The NMC initially defended its decision, citing clinical competency concerns due to online education. However, in June 2024, the commission issued a partial rollback, allowing one-year internships for some FMGs who can provide additional proof of clinical training.
But ambiguity remains, and no clear, uniform policy has yet been implemented.
Not only FMGs, but also student organizations, legal advocates, and public health experts are now calling on the NMC to
Standardize internship rules across all FMGs
Recognize FMGE as a valid measure of competency
Ensure fair stipend policies for all interns
References:
National Medical Commission. “Public Notice Regarding FMG Internship.” June 7, 2024. https://www.nmc.org.in/MCIRest/open/getDocument?path=/Documents/Public/Portal/LatestNews/Public+notice+fmg.pdf.
National Medical Commission. “Guidelines for Registration of Foreign Medical Graduates.” https://www.nmc.org.in/MCIRest/open/getDocument?path=/Documents/Public/Portal/LatestNews/Document%20(1).pdf.
National Medical Commission. “Compulsory Rotating Medical Internship Regulations, 2021.” The Gazette of India, November 18, 2021.
National Medical Commission. “Public Notice Regarding FMG Internship.” June 7, 2024. https://www.nmc.org.in/MCIRest/open/getDocument?path=/Documents/Public/Portal/LatestNews/Public+notice+fmg.pdf.
DT Next. “Withdraw Recent Guidelines on Extended Internships: Foreign Medical Graduates in Tamil Nadu.” June 11, 2024. https://www.dtnext.in/news/city/withdraw-recent-guidelines-on-extended-internships-foreign-medical-graduates-in-tamil-nadu-789570.
Only Education. “SC Questions NMC Over FMG Internship Stipends.” April 2025. https://www.onlyeducation.in/news/post/fm-gs-raise-voice-over-unpaid-internships-sc-seeks-nmc-reply.
Shiksha. “FMG Association Meets NMC to Discuss 3-Year Internship Rule, Non-Payment of Stipend.” April 2025. https://www.shiksha.com/news/medicine-health-sciences-fmg-association-meets-nmc-to-discuss-3-year-internship-rule-non-payment-of-stipend-details-blogId-163361.
DT Next. “Withdraw Recent Guidelines on Extended Internships: Foreign Medical Graduates in Tamil Nadu.” June 11, 2024. https://www.dtnext.in/news/city/withdraw-recent-guidelines-on-extended-internships-foreign-medical-graduates-in-tamil-nadu-789570
