Rajasthan FMGs Face Mounting Internship Uncertainty: Stipend Anomalies and Seat Shortages

The plight of around 100 Foreign Medical Graduates (FMGs) in Rajasthan deepens as they remain uncertain about commencing their mandatory Medical Internship. Issues surrounding Stipend Payments and a critical lack of Available Seats challenge NMC Regulations, raising concerns for Medical Education in India and the future of these Foreign Medical Graduates.

A pressing challenge continues to cast a shadow over the careers of approximately 100 Foreign Medical Graduates (FMGs) in Rajasthan. These medical professionals, having successfully cleared the Foreign Medical Graduates Examination (FMGE) and awaiting their mandatory Medical Internship, find themselves trapped in a state of prolonged uncertainty. The core of this predicament lies in a combination of persistent Stipend Issues and a significant shortage of Available Seats for internships within the state's medical colleges. This ongoing dilemma for FMGs in Rajasthan not only jeopardizes their immediate career prospects but also highlights systemic challenges within the broader framework of Medical Education in India.

Despite receiving their provisional internship allocations from the Rajasthan Medical Council (RMC), many of these Foreign Medical Graduates have been unable to join their assigned institutions. The passing of the June 15 deadline for joining has amplified their distress, while their peers in other states or through different admission channels have already commenced their vital practical training. The situation points to a critical gap between the clear directives issued by the National Medical Commission (NMC Regulations) and the practical implementation at the state and institutional levels.

The Dual Hurdle: Stipend Disparities and Seat Scarcity

The challenges confronting FMGs in Rajasthan are rooted in a two-pronged problem:

• The Chronic Stipend Issue: A central point of contention is the inconsistent application of stipend policies. While NMC Regulations explicitly mandate that Foreign Medical Graduates undertaking the Compulsory Rotating Medical Internship (CRMI) should receive a stipend "on par with Indian Medical Graduates" at the same institution, this directive often faces implementation hurdles. In Rajasthan, particularly at institutions like ESIC Medical College, Alwar, an audit-related challenge has reportedly arisen. This challenge is rooted in reconciling a Supreme Court ruling (emphasizing stipends for all FMGs) with certain NMC guidelines that previously mentioned a quota (e.g., 7.5% of total seats) for paid internships. Such ambiguities reportedly lead some institutions to seek undertakings from FMGs that they will not demand stipends, a practice directly contradictory to the spirit of NMC Regulations.
• Acute Shortage of Available Seats: Beyond the stipend concerns, the fundamental problem of Limited Seats for Medical Internship remains critical. Many government medical colleges possess a fixed number of internship slots primarily allocated to their own Indian Medical Graduates. Despite the NMC's provision for an additional 7.5% quota for FMG internships in medical colleges, and a one-time relaxation (valid until May 2024, now expired) allowing internships in recognized non-teaching hospitals, the practical availability of seats is insufficient for the volume of qualified Foreign Medical Graduates seeking placement. This disparity leaves a substantial number of FMGs in Rajasthan, particularly those who are state domiciles, without a confirmed internship, despite having successfully cleared the FMGE.

This combination of financial uncertainty and logistical bottlenecks forces Foreign Medical Graduates to endure prolonged periods of waiting, navigating a complex bureaucratic maze involving the ESIC administration, the Rajasthan Medical Council, and the Medical Education Department, often with limited success.

NMC Directives Versus State-Level Realities

The predicament of FMGs in Rajasthan significantly underscores the disconnect between national-level NMC Regulations and their on-ground execution by state bodies and individual medical institutions.

• The NMC's Stance: The NMC has consistently reiterated through its CRMI Regulations, 2021, and subsequent clarifications that FMGs must undergo a 12-month internship equivalent to IMGs and are entitled to equal stipends. The Rajasthan Medical Council is tasked with managing the merit-based allocation of these internship seats.
• Judicial Intervention: The Supreme Court has also intervened, emphasizing that Foreign Medical Graduates cannot be discriminated against in terms of stipend payment during their mandatory internships.
• The Rajasthan Gap: Despite these clear mandates, Rajasthan faces operational challenges. The interplay between central directives and state-specific budget or audit concerns has created a grey area regarding stipend payments. Furthermore, the capacity constraints within existing government medical colleges mean that the number of Available Seats simply cannot accommodate all eligible FMGs, especially after the expiry of temporary relaxations. This structural inadequacy perpetuates the Internship Crisis.

This situation calls for immediate and collaborative efforts from the NMC, state medical authorities, and educational institutions to develop a robust, uniform, and sustainable mechanism for FMG internships that fully complies with national regulations.

Far-Reaching Consequences for FMGs and Medical Education in India

The protracted Internship Crisis for FMGs in Rajasthan carries significant long-term implications, impacting both the individuals involved and the broader landscape of Medical Education in India.

• Career Stagnation and Financial Strain: The inability to commence the mandatory Medical Internship directly prevents Foreign Medical Graduates from obtaining permanent licenses to practice medicine in India. This not only halts their career progression and eligibility for postgraduate exams but also imposes immense financial and emotional strain, as they face living expenses without a regular income.
• Exacerbated Doctor Shortage: India, particularly its underserved rural areas, continues to face a substantial shortage of healthcare professionals. Hindering the seamless integration of qualified FMGs into the healthcare workforce deprives the nation of valuable medical talent, potentially worsening healthcare access.
• Deterioration of Trust and Potential Brain Drain: The recurring administrative hurdles and the lack of clarity can erode trust among Foreign Medical Graduates in the Indian medical system. This might compel some to seek alternative career opportunities abroad, leading to a 'brain drain' of medical professionals trained at significant personal cost.
• Reputation of Medical Education in India: Such persistent issues can negatively impact India's reputation as a welcoming destination for its citizens to return and practice after obtaining medical qualifications abroad.

Various associations representing FMGs are actively pursuing the matter with the state government, the Rajasthan Medical Council, and the NMC, urging for an expeditious and equitable resolution. Addressing this Internship Crisis, particularly concerning the Stipend Issues and provision of adequate Available Seats, is paramount for justice for these young doctors and the enhancement of India's healthcare delivery system. For more insights into Medical Education in India and ongoing developments, stay tuned to Only Education or visit Only Education's Medical Exams List to know more.