Supreme Court Steps In: Gujarat FMGs Fight for Unpaid Internship Stipends Amid National Backlash

New Delhi, November 28, 2025 – The Supreme Court of India issued notices to the National Medical Commission (NMC) and the Gujarat government on a petition highlighting the non-payment of stipends to Foreign Medical Graduates (FMGs) during their compulsory internships in Gujarat. Filed by the All India Parents Association of Belarus Medical Students, the plea underscores a stark disparity where Indian Medical Graduates receive stipends while FMGs bear full expenses for food, accommodation, and travel. This intervention tags the case with ongoing matters addressing widespread stipend denials to interns nationwide.​

Core Grievance and Legal Basis

The petition argues that despite repeated NMC circulars, Gujarat authorities withhold stipends from FMGs, violating Clause 3 of Schedule IV in the National Medical Commission (Compulsory Rotating Medical Internship) Regulations, 2021. This clause mandates: “All interns shall be paid stipend as fixed by the appropriate authority applicable to the institution/University or State,” limited to 52 weeks excluding certain extensions.​

FMGs, who often complete 4-6 years of study abroad before returning for a mandatory 12-month (or extended 24-month) internship in India, perform identical duties to Indian graduates—handling patient care, diagnostics, and emergency rotations. Yet, in Gujarat’s government medical colleges, they receive nothing, exacerbating financial strain after hefty investments in foreign education.​

A September 2025 letter from Gujarat’s Medical Education and Research Department explicitly stated that high-level discussions concluded stipends “cannot be provided to FMG interns,” rejecting complaints filed via the Centralised Public Grievance Redress and Monitoring System.​

Judicial History and Broader Context

The bench of Justices Aravind Kumar and PB Varale, already overseeing a batch of petitions on intern stipends, swiftly issued notices and linked this case to similar FMG and MBBS intern pleas.

This builds on prior scrutiny: In July 2025, NMC directed colleges to disclose stipend details, but by October 28, the Court rebuked non-compliance, demanding affidavits and labeling it a “slumber.” Earlier rulings affirmed FMGs deserve stipends “on par with Indian interns,” though state discretion persists, leading to inconsistencies.​

Nationally, up to 70% of medical colleges have faced allegations of zero stipends for MBBS interns, prompting Supreme Court mandates for NMC affidavits with tabulated data across states. FMGs face added hurdles post-FMGE licensing, including one-time relaxations for pandemic-disrupted studies, yet internship validation remains uneven across 670+ approved hospitals.​

Expert Perspectives on Equity and Impact

Dr. Sanjay Pai, a senior public health consultant not involved in the case, notes, “Denying stipends demotivates future doctors, especially FMGs who invest heavily abroad only to subsidize their Indian training. This parity issue erodes trust in the system.” He emphasizes that stipends—often ₹12,000-₹25,000 monthly in paying states—cover basics, preventing debt traps.​

Prof. Meena Sharma, Dean of Medical Education at a Maharashtra institution, adds, “FMGs bolster rural healthcare manpower. Withholding pay ignores their role in addressing India’s doctor shortage, projected at 600,000 by 2030 per WHO estimates. Uniform enforcement is essential.”

Conversely, some administrators cite budget constraints: Gujarat officials argue no provisions exist for “non-domicile” FMGs, though NMC clarifies no domicile requirement applies.​

Public Health Implications

This dispute signals deeper cracks in India’s medical training pipeline. FMGs comprise 20-25% of new registrants annually (over 50,000 pass FMGE yearly), vital for underserved areas. Unpaid internships risk burnout, dropout, or unethical shortcuts, compromising patient safety.​

For the public, delayed or undertrained doctors strain healthcare access. Equal stipends could retain talent in public hospitals, where 80% of internships occur, aligning with Ayushman Bharat goals.​

Readers facing similar issues should verify state NMC portals for stipend norms and escalate via FAIMA or court amicus curiae, but prioritize licensed practice post-internship.

Limitations and Path Forward

Petitioners acknowledge state fiscal autonomy, but argue it cannot override NMC mandates. No nationwide stipend floor exists, varying from ₹10,000 (Uttar Pradesh) to ₹30,000 (Delhi), fueling inequities. COVID/war extensions add costs without pay for some.​

The Court may mandate compliance affidavits soon, potentially standardizing payments. Until resolved, FMGs must budget for self-funding, underscoring calls for federal funding.​

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

1. Medical Dialogues. “Non-payment of stipend to Gujarat FMGs- Supreme Court issues notice.” November 27, 2025. https://medicaldialogues.in/news/education/non-payment-of-stipend-to-gujarat-fmgs-supreme-court-issues-notice-159645medicaldialogues​