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Kochi, June 7, 2025:
In a watershed moment for medical education in India, the Kerala High Court has struck down the state government’s controversial internship fee order, marking a significant victory for Foreign Medical Graduates (FMGs) across the country. The ruling, delivered by Justice N Nagaresh on June 3, 2025, in the case of Sharooq Mohammed & Ors v State of Kerala, challenges long-standing systemic discrimination against FMGs and sets a vital legal precedent.
Background: The Controversial Fee Order
The case originated in April 2025, when the Kerala government mandated that FMGs pay a monthly fee of Rs 5,000—amounting to Rs 60,000 annually—for their Compulsory Rotating Medical Internship (CRMI) in state hospitals. This move came despite a 2022 circular from the National Medical Commission (NMC) explicitly stating that no fees should be charged for internships, although it allowed for certain state-specific administrative practices.
Dr. Anagha PH, an FMG interning at Ernakulam General Hospital after completing her studies in China, recalled the shock of receiving the fee notice. “We received the notice on April 19, asking us to start paying immediately. I knew this violated the NMC’s guidelines completely,” she said.
Legal Battle and Court’s Ruling
Within days, Dr. Anagha and 111 other interns filed a petition, which was later consolidated with similar challenges, representing over 200 FMGs from diverse backgrounds—including Russia, Bulgaria, the Philippines, Guyana, and China. All petitioners had cleared the challenging Foreign Medical Graduate Examination (FMGE), which has a pass rate of just 18-22%, and secured provisional registration.
Kerala’s defense argued the state’s administrative discretion and the need for infrastructure support, claiming the NMC’s authority extended only to stipends, not fees. However, the court decisively rejected this argument. The judgment declared the fee order illegal, holding that it violated the supremacy of the NMC Act and constituted discrimination against FMGs. The court reaffirmed that only the NMC has the authority to regulate internships and stipends.
National Implications and Continuing Challenges
The ruling’s impact stretches far beyond Kerala. Dr. Kaushal, Media Coordinator of the All FMGs Association, highlighted its national significance: “This is a landmark ruling not just for Kerala but for FMGs across the country. With around 500-600 FMGs completing the FMGE every six months in Kerala alone, the financial burden affected 1,200-1,500 students annually.”
Discriminatory practices against FMGs are rampant nationwide. States such as Himachal Pradesh, Tamil Nadu, Karnataka, and Maharashtra impose varying—and often hefty—internship fees, creating a patchwork of exploitative practices. Procedural delays and extended internship requirements further compound the challenges faced by FMGs.
Dr. Anagha’s story is emblematic: despite clearing the FMGE in 2022, she only received provisional registration in 2023 and was required to complete two years of internship due to part of her training being online during the COVID-19 pandemic.
The Road Ahead
While the Kerala High Court’s decision is a major step forward, the challenge now lies in ensuring its consistent implementation across all states. The NMC must strengthen its enforcement mechanisms, and state medical councils need restructuring to eliminate administrative bias against FMGs.
For FMGs like Dr. Jawhar Ali, who now advocates for stipend parity with Indian Medical Graduates (IMGs), the fight continues. “It’s very disheartening when IMGs receive stipends of around Rs 27,500 while FMGs doing the same duties receive nothing,” he said.
As similar legal challenges emerge in other states, the Kerala judgment offers hope for a more equitable, merit-based medical system in India.
Disclaimer:
This article is based on information reported by EdexLive on June 6, 2025. For the most current and detailed updates, readers are encouraged to consult the original source and official court documents. The content herein is for informational purposes only and does not constitute legal advice.
