Unpaid and Unequal: The Ongoing Struggle of Foreign Medical Graduates in India for Fair Internship Practices

Foreign Medical Graduate (FMG) interns in India continue their fight for fair treatment, as numerous medical colleges defy National Medical Commission (NMC) regulations. Many institutions deny stipends to FMG interns and, in some cases, even charge them fees. FMGs demand equal opportunities and the right to pursue their medical careers without financial exploitation.

Medical Colleges Ignoring Stipend Rules

Despite directives from the Supreme Court mandating equal stipend payments for FMG and domestic MBBS interns, medical colleges have largely neglected this issue. Some institutions circumvent the ruling by compelling FMG interns to sign affidavits waiving their right to a stipend, while others have ceased offering FMG internship seats altogether.

A Difficult Choice for FMG Interns

Facing institutional pressure, FMGs feel forced to comply with these demands in order to complete their two-year Compulsory Rotating Medical Internship (CRMI), which is necessary for securing permanent registration from the state medical council.

No FMG Seats at Leading Delhi Medical Colleges

In April, the Delhi Medical Council (DMC) released an internship seat distribution list, highlighting the absence of FMG seats at top institutions such as AIIMS, Maulana Azad Medical College, Army College of Medical Sciences, Atal Bihari Vajpayee Institute of Medical Sciences, and RML Hospital. These colleges cited ‘administrative reasons’ for not accommodating FMGs.

Scarcity of FMG Internship Seats in Delhi

Delhi FMGs struggle to secure internships due to limited approved seats and financial constraints cited by medical colleges. According to Dr. Girish Tyagi, secretary of DMC, only 60 internship seats were available for FMGs this year. Institutions like Maulana Azad Medical College, which offered 18 seats last year, declined to accommodate FMGs in 2024 due to financial and infrastructure challenges.

Internship Cancellations and Stipend Refusals

Initially, North Delhi Municipal Medical College (NDMMC), also known as Hindu Rao Hospital, allocated five internship seats for FMGs per the DMC counseling list. However, on April 29, the hospital rescinded these seats, citing inadequate funds and infrastructure. Following discussions with DMC, the hospital agreed to reinstate the seats but only on the condition that FMG interns sign affidavits relinquishing their right to a stipend.

AFA Appeals to NMC for More Internship Seats

On May 1, 2024, the All FMGs Association (AFA) met with NMC officials to discuss the limited availability of internship seats. AFA urged NMC to allow non-teaching health institutions to provide internships for FMGs. In 2023, NMC had increased FMG internship seats in Delhi to 587 by allowing standalone postgraduate medical institutes and non-teaching hospitals to participate.

Nationwide Stipend Exploitation of FMGs

The issue of stipend denial extends beyond Delhi. FMG interns across states like Gujarat, Jammu and Kashmir, Himachal Pradesh, and Punjab report being forced to sign agreements stating they will not demand stipends.

Internship Fees Despite NMC Regulations

Despite NMC rules requiring equal stipend payments and prohibiting internship fees for FMGs, some institutions continue to exploit them financially. Atal Medical and Research University in Mandi, Himachal Pradesh, has imposed hefty internship fees instead of paying stipends. Several government medical colleges in the state, including those in Kangra, Nahan, Hamirpur, and Chamba, charge fees ranging from Rs 96,000 to Rs 1,92,000. Indira Gandhi Medical College in Shimla and Shri Lal Bahadur Shastri Medical College in Mandi have eliminated FMG internship seats altogether for the 2024-25 session.

Himachal Pradesh’s Silence on Stipend Issue

Himachal Pradesh medical colleges have stated that there is currently no provision for stipends for FMGs, and the state government has yet to take a decision on this matter.

FMG Interns Forced to Pay for Internships

A first-year FMG intern at Shri Lal Bahadur Shastri Medical College in Mandi revealed that they were required to pay Rs 32,000 upon starting their internship in May 2023 under the Rogi Kalyan Samiti (RKS) scheme. Interns were made to sign undertakings agreeing not to request a stipend, or they risked losing their internship placements.

Gujarat: No Stipend, No Fee

An FMG intern from Junagadh, Gujarat, who completed her medical degree in Georgia, stated that while she was not required to pay an internship fee, she would receive no stipend despite working long hours.

Jammu & Kashmir FMGs Protest Stipend Denial

Dr. Khan, an FMG from Kashmir, led a protest with 50 interns at Government Medical College, Udhampur, demanding stipends. However, the administration cited a lack of funds as the reason for non-payment. In 2021-22, stipends were temporarily granted after a similar protest, but this provision was later discontinued. Despite all FMG interns being assigned hospitals as per the counseling list released on May 1, 2023, their requests for stipends remain unaddressed.

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