Inside India’s Medical Paradox: Thousands of Qualified Foreign Medical Graduates Face Two-Year Internship Wait, Some Turn to Delivery Jobs to Survive

NEW DELHI — Thousands of Indian citizens who earned medical degrees abroad and successfully cleared the nation’s stringent licensing exam are trapped in an administrative bottleneck, leaving them unable to practice medicine. Many of these qualified doctors have been waiting up to two years for mandatory internship placements, forcing some into gig work and delivery jobs to survive.

Advocacy groups are now urging immediate intervention from the National Medical Commission (NMC) and state health ministries to resolve a crisis that critics say threatens both the futures of young physicians and the country’s public health infrastructure.

A Growing Crisis: Left in Limbo After Passing the Exam

To practice medicine in India, Foreign Medical Graduates (FMGs) must clear the highly competitive Foreign Medical Graduates Examination (FMGE) and complete a Compulsory Rotating Medical Internship (CRMI). However, data compiled by the All FMGs Association (AFA) reveals a severe system backlog. Many graduates who cleared the exam in early 2025 remain unallocated as of mid-2026. In states like Tamil Nadu, Kerala, and West Bengal, waiting periods have stretched between 18 to 24 months.

The scope of the issue is highlighted by the results of the June 2025 FMGE cycle. Out of 37,207 candidates who sat for the test, only 7,452 passed—a meager 18.61% pass rate, making it one of the toughest on record. Yet, despite clearing this high hurdle, thousands of these successful candidates cannot find a hospital to complete their training.

Regional Variances in FMG Placement Shortages

Fragmented Systems and Financial Disputes Drive the Bottleneck

The root of the crisis lies in a fragmented regulatory structure. While the central NMC sets overarching policies, individual State Medical Councils manage the actual allocation of internship slots. The NMC recommended that state bodies utilize 100% of internship seats in new medical colleges and up to 7.5% in older institutions for FMGs. However, implementation on the ground has been highly inconsistent.

According to Dr. Kaushal, media coordinator for the All FMGs Association, financial considerations are stalling the process. The NMC’s decision to extend internship validity rules gave local councils more leeway, which some have used to delay counseling cycles.

“State medical councils are delaying counseling because they are reluctant to provide stipends to FMGs,” Dr. Kaushal stated. “This delay heavily impacts FMGs who plan to take the postgraduate entrance exams next year.”

Several compounding issues have worsened the bottleneck:

• Budgetary Cuts: Multiple medical colleges have quietly removed designated FMG internship seats, citing a lack of institutional funds.

• Bureaucratic Hurdles: The verification process—which requires securing an embassy No Objection Certificate (NOC) and local verification certificates—takes up to four months in states like Tamil Nadu.

• Domicile Restrictions: Certain states prioritize local graduates, leaving non-domicile FMGs at the bottom of the waiting list regardless of their exam scores.

The Human Cost: From Stethoscopes to Food Delivery

For the affected doctors, the delay is more than a professional inconvenience—it is a financial catastrophe. The vast majority of these students rely on substantial educational loans to fund their degrees abroad. Without an internship, they cannot obtain permanent registration to practice, leaving them unemployed during a critical phase of their careers.

The desperate situation has spilled over onto social media platforms, where verified accounts have highlighted young physicians taking up food delivery and gig work to keep up with loan interest payments.

“A profession once respected is now struggling for survival,” noted one widely shared medical community post. “Many young MBBS graduates are taking delivery jobs just to repay loans—not because they want to, but because there are no stable opportunities.”

The frustration reached a boiling point in West Bengal, where over 150 qualified FMGs remain stranded due to a lack of slots. When a delegation of 20 graduates visited the state health headquarters at Swasthya Bhavan to appeal for assistance, an official reportedly told them to approach the High Court if they wanted to challenge the system—a response that drew sharp public criticism from medical unions.

Career Trajectories and Postgraduate Eligibility at Risk

The long delays also threaten future career advancement. To qualify for the National Eligibility cum Entrance Test for Postgraduates (NEET-PG), candidates must complete their mandatory internship by a rigid deadline.

For instance, in Haryana, where 658 FMG passouts competed for just 493 available seats, representations sent to authorities warned that if internships did not commence by July 31st, hundreds would lose their eligibility for the NEET-PG 2026 cycle.

“These delays waste valuable years,” Dr. Kaushal emphasized. “Students cannot appear for the postgraduate exam during this waiting period. Once the internship finally concludes, it takes another one to two years to clear the entrance test. The administrative registration process alone consumes months.”

Quality Control vs. Healthcare Workforce Demand

The National Medical Commission maintains that strict oversight is necessary to preserve the quality of patient care. Dr. Aruna V. Vanikar, President of the Undergraduate Medical Education Board (UGMEB) under the NMC, defended recent rigorous structural changes.

“Several State Medical Councils have been assigning FMGs to start their internship without ensuring proper training,” Dr. Vanikar noted. “To maintain the quality of medical training, the NMC has decided to extend the existing internship tenure requirements where necessary.”

Regulators point out that erratic FMGE pass rates—which historically hover between 10% and 25%—suggest variable clinical standards across foreign institutions, particularly for students whose education was disrupted by online classes during the pandemic.

However, independent healthcare policy experts highlight a glaring paradox. Ministry of Health data indicates India has roughly 1.38 million registered allopathic doctors, yielding a doctor-to-population ratio of 1:811—which technically surpasses the World Health Organization’s standard of 1:1,000. Yet, this workforce is severely maldistributed, leaving rural areas acutely underserved. Workforce projections indicate India requires an additional 1.8 million healthcare workers to meet minimum density targets nationwide, making the forced sidelining of qualified doctors a missed public health opportunity.

Recent Interventions and the Path Forward

In response to growing pressure, the NMC announced a centralized seat matrix in March 2026, opening up 43,250 CRMI slots nationwide for the 2026–27 cycle. The commission also extended the recognition of non-teaching hospitals for internship rotations, providing alternative pathways to clear the backlog. Additionally, Tamil Nadu introduced a dedicated online portal to bring transparency to the allocation process.

Despite these steps, advocacy groups argue that administrative inertia at the state level continues to stall progress. The depth of the crisis was underscored when the Supreme Court of India issued formal notices to the NMC regarding severe internship delays in southern states, following a petition titled Association of Doctors and Medical Students v. National Medical Commission.

To resolve the impasse, the All FMGs Association has called on the Union Health Minister to enforce a uniform national timeline mandating internship registration within two months of FMGE results, penalize state councils that withhold stipends, and clear the administrative backlog before the upcoming NEET-PG deadlines.

What This Means for Readers

• For Aspiring Medical Students: Families considering foreign medical education must thoroughly research the post-graduation pathway, local state council rules, and potential hidden transition timelines before enrolling abroad.

• For the General Public: The current bottleneck slows the deployment of trained medical staff into a system already struggling with rural healthcare deficits. Faster integration could mean better access to care in underserved regions.

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

• https://medicaldialogues.in/news/education/fmgs-awaiting-up-to-2-years-for-internship-some-take-delivery-jobs-to-survive-medicos-urge-nmc-health-ministers-intervention-172040