Equal Pay for Equal Care: Supreme Court Mandates Stipend Parity for Foreign Medical Graduates

NEW DELHI — In a landmark decision that addresses a long-standing grievance within India’s healthcare workforce, the Supreme Court of India has directed that Foreign Medical Graduates (FMGs) must receive monthly stipends equal to those paid to their Indian-trained counterparts.

The ruling, delivered on February 12, 2026, by a division bench comprising Justices Aravind Kumar and Prasanna B. Varale, orders the Jharkhand government and the Rajendra Institute of Medical Sciences (RIMS), Ranchi, to clear all overdue stipends for FMGs within three weeks. This judgment reinforces the principle of “equal pay for equal work,” effectively ending years of financial discrimination against Indian citizens who earn their medical degrees abroad before returning home to serve.

A Victory for Fairness in Medical Training

The case reached the apex court after a group of FMGs at RIMS, Ranchi—who served their compulsory rotating internship between June 2023 and June 2024—found themselves receiving significantly lower pay than Indian Medical Graduates (IMGs). In some instances, senior interns were being paid less than their juniors for whom stipends had already been mandated.

The Court’s directive was unequivocal: medical students who have cleared the necessary screening exams and are performing the same clinical duties “stand on the same footing” and cannot be discriminated against based on where they obtained their degree.

Key Highlights of the Ruling:

• Parity is Mandatory: Institutions cannot pay FMGs less than the standard rate for MBBS interns (typically ranging from ₹18,000 to ₹30,000 per month depending on the state).

• Immediate Reimbursement: RIMS Ranchi must disburse the pending difference in stipends to the petitioners within a 21-day window.

• Administrative Immunity: The Court clarified that institutions will not face adverse action from the University Grants Commission (UGC) for complying with these financial disbursements.

Understanding the FMG Journey

For thousands of Indian students, pursuing an MBBS in countries like Kazakhstan, the Philippines, Russia, or China is a practical response to the high competition and limited seats in domestic government colleges. However, the path back to practicing in India is rigorous.

To become licensed, these graduates must pass the National Medical Commission (NMC) screening exam (currently the FMGE, transitioning toward NEXT) and complete one year of Compulsory Rotating Medical Internship (CRMI) in an Indian hospital.

“If we are working the same hours, handling the same responsibilities, and being evaluated by the same teachers, then any difference in stipend becomes artificial discrimination,” stated a legal representative for the FMG petitioners during the hearings.

Expert Perspectives: More Than Just Money

While the financial relief is significant, experts suggest the implications for public health and morale are even greater.

Dr. Ramesh Raju, an education policy researcher at the Centre for Chronic Disease Control, New Delhi, views this as a vital step for workforce integration. “Treating FMGs as inferior trainees, even symbolically through lower stipends, corrodes morale and signals a low-value perception of their contribution,” Dr. Raju noted. “This order forces institutions to internalize that foreign-trained Indian graduates are a permanent, essential part of our health-human-resources system.”

Dr. Vivek Nangia of the Public Health Foundation of India adds that the fiscal impact on state budgets is minimal compared to the long-term gains. “On a per-doctor basis, the cost is small; the human-capital and equity gains are far larger. We are integrating hundreds of additional doctors into a system that is already stretched thin.”

Statistical Context

Potential Challenges and Limitations

Despite the legal victory, some administrators at state-run hospitals have expressed private concerns regarding budget constraints. There is a lingering worry among student advocates that institutions might respond by reducing the number of internship “seats” available to FMGs to avoid the added payroll cost.

Furthermore, Dr. Aparna Sengupta, a Bengaluru-based health-systems specialist, cautions that “pay parity is just one part of a larger picture.” FMGs still face hurdles including:

1. Placement Access: Competition for internships in prestigious or well-equipped hospitals.

2. Quality Bias: Addressing the “stigma” sometimes associated with foreign degrees.

3. Residency Hurdles: Navigating the highly competitive postgraduate entrance systems.

What This Means for Future Interns

For Indian students currently studying abroad, this ruling provides a legal “shield.” The National Medical Commission had previously issued circulars in March and May 2022 stating that FMGs should be paid equally, but the Supreme Court’s intervention adds a level of enforcement that was previously lacking.

Steps for FMGs to Protect Their Rights:

• Verify Credentials: Ensure your degree is from an NMC-recognized institution.

• Document Everything: Keep copies of your internship offer letters and any communications regarding pay.

• Research Local Rates: Before starting, check the stipend currently paid to MBBS interns at that specific government college.

• Formal Recourse: If pay is denied, students are encouraged to make a written representation to the college and the State Health Department, citing the February 2026 Supreme Court order.

The Road Ahead

The Supreme Court’s decision marks a definitive shift toward a more unified medical workforce. By removing the financial “penalty” for studying abroad, the judiciary is helping to ensure that the focus of an internship remains where it belongs: on clinical training and patient care, rather than financial survival.

As the National Exit Test (NExT) looms on the horizon to further standardize medical licensing, the elimination of stipend disparities serves as a foundational step in treating all Indian doctors with the professional dignity their service requires.

Medical Disclaimer

Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.

References

• Supreme Court of India. Writ Petition (C) No. 232/2025 (Stipend-parity judgment for FMGs at Rajendra Institute of Medical Sciences, Ranchi), February 12, 2026.

• Medical Dialogues. “Supreme Court orders stipend to FMGs on par with Indian MBBS graduates,” February 10, 2026.