Rajasthan's FMG Internship Crisis: Around 100 Foreign Medical Graduates Face Uncertainty

Approximately 100 Foreign Medical Graduates (FMGs) in Rajasthan are in limbo, unable to commence their mandatory Medical Internship due to a severe Stipend Issue and a critical shortage of Limited Seats. This ongoing Internship Crisis highlights a conflict between NMC Regulations and state-level implementation, impacting their future practice in India.

A growing crisis is unfolding in Rajasthan, leaving approximately 100 Foreign Medical Graduates (FMGs) in a precarious position regarding their mandatory Medical Internship. Despite clearing the Foreign Medical Graduates Examination (FMGE) and being allocated internship positions by the Rajasthan Medical Council (RMC) months ago, these aspiring doctors are still unable to commence their crucial clinical training. The core issues stem from a complex web of problems: an ongoing Stipend Issue and a severe shortage of Limited Seats in government medical colleges and affiliated hospitals, directly impacting their ability to obtain permanent registration to practice medicine in India.

The deadline for joining these internships, set for June 15, has passed, leaving these Foreign Medical Graduates in distress while their counterparts at other institutions have already begun their hospital duties. The situation, particularly highlighted at ESIC Medical College, Alwar, underscores a deep-rooted conflict between existing NMC Regulations and the ground realities of implementation by state authorities. This Internship Crisis not only jeopardizes the careers of these young doctors but also points to a significant hurdle in the broader landscape of Medical Education India.

The Dual Challenge: Stipend Issue and Limited Seats

The dilemma faced by FMGs in Rajasthan is multifaceted, primarily revolving around two critical concerns:

• The Stipend Issue: A major contention is the discrepancy in stipend payment. While the National Medical Commission (NMC Regulations) clearly state that Foreign Medical Graduates undergoing Compulsory Rotating Medical Internship (CRMI) are entitled to a stipend "on par with Indian Medical Graduates" of that institution, the actual implementation often varies. In Rajasthan, an audit-related challenge at institutions like ESIC Medical College, Alwar, arises from a Supreme Court ruling mandating stipends for all FMGs versus an NMC guideline allowing paid internships for only 7.5% of total seats. This creates confusion and reluctance among government institutions regarding how to differentiate payment among FMGs. Some institutions allegedly demand undertakings from FMGs stating they will not seek stipends, a practice that contradicts NMC Regulations.
• Limited Seats: Compounding the stipend problem is the acute shortage of Medical Internship seats. Many government medical colleges, including ESIC Medical College, Alwar, have a limited number of internship positions (e.g., 100 seats) which are already occupied by Indian Medical Graduates (IMGs) from their own institutions. This leads to a direct clash, as an equal number of Foreign Medical Graduates are also vying for these same Limited Seats. While NMC Regulations allow for an additional 7.5% quota for FMG internships in medical colleges, and a one-time relaxation allowed internships in recognized non-teaching hospitals (valid until May 2024, implying it has expired), the practical availability and allocation remain a significant challenge. Many FMGs, particularly those from Rajasthan, despite qualifying the FMGE, are unable to secure a spot.

This complex interplay of contradictory guidelines and inadequate infrastructure creates an environment of uncertainty, forcing FMGs to run from "pillar to post" between the ESIC administration, the Rajasthan Medical Council, and the Medical Education Department, with little resolution in sight.

NMC Regulations and State-Level Implementation Gaps

The core of the FMGs Rajasthan predicament lies in the gap between the comprehensive NMC Regulations and their inconsistent implementation at the state and institutional levels.

• NMC's Mandate: The NMC's Compulsory Rotating Medical Internship (CRMI) Regulations, 2021, explicitly state that all FMGs seeking permanent registration must undergo a 12-month internship at par with Indian Medical Graduates. Furthermore, the NMC has repeatedly clarified that FMGs are entitled to stipends equivalent to their Indian counterparts, emphasizing that no medical college should charge FMGs an internship fee. The Rajasthan Medical Council is mandated to prepare merit lists and allocate seats to FMGs, prioritizing domicile candidates.
• Supreme Court's Stance: The Supreme Court has also weighed in on the matter, observing that FMGs cannot be treated differently and are entitled to stipends during their internships, similar to Indian MBBS interns.
• Ground Realities in Rajasthan: Despite these clear directives, the situation in Rajasthan highlights significant administrative and infrastructural hurdles. The conflict between a Supreme Court order for stipends for all FMGs and the NMC's 7.5% paid internship quota creates an audit dilemma for government institutions. Moreover, the sheer volume of Foreign Medical Graduates needing internships far outstrips the Limited Seats available, especially after the expiry of the one-time relaxation allowing internships in non-teaching hospitals. This forces a large number of qualified FMGs into a precarious waiting game.

The disarray points to an urgent need for better coordination and a unified approach between the NMC, state medical councils, and individual medical colleges to ensure NMC Regulations are universally and uniformly applied.

The Broader Impact: Consequences for FMGs and Medical Education India

The ongoing Internship Crisis for FMGs in Rajasthan has severe implications, not just for the affected individuals but for the larger healthcare ecosystem in India.

• Delayed Registration & Career Progression: Without completing the mandatory Medical Internship, Foreign Medical Graduates cannot obtain permanent registration to practice medicine in India. This directly delays their entry into the medical workforce, impacts their eligibility for postgraduate studies (like NEET PG), and puts their entire medical qualification in limbo.
• Financial & Emotional Burden: Many FMGs have invested considerable financial resources and years in their medical education abroad. Being unable to commence their internship adds significant financial burden (living expenses without stipend) and immense emotional distress, leading to frustration and potential brain drain if they choose to pursue opportunities elsewhere.
• Healthcare Workforce Shortage: India, particularly rural areas, faces a persistent shortage of doctors. Hindering the integration of qualified Foreign Medical Graduates into the healthcare system exacerbates this shortage, impacting patient care and public health initiatives.
• Credibility of Medical Education India: Such recurrent issues in internship allocation and stipend payment can negatively affect the perception of Medical Education India on a global scale, potentially discouraging future students and creating an environment of uncertainty for those returning.

Stakeholders, including various FMG associations, are continuously appealing to the state government, the Rajasthan Medical Council, and the NMC for immediate intervention and a lasting solution. The urgent resolution of this Stipend Issue and the provision of adequate Medical Internship seats for Foreign Medical Graduates are critical to uphold justice for these aspiring doctors and strengthen India's healthcare workforce. For more detailed information on Medical Education India and updates on FMG regulations, stay tuned to Only Education or visit https://www.onlyeducation.in/exams-list/medical to know more.