Looks like Foreign Medical Graduate (FMG) students in India are an upset lot. On one hand, a group of FMGs are going to protest tomorrow, July 14 at Gautam Nagar, Central Park, New Delhi seeking the release of the FMGE (Foreign Medical Graduate Exam) answer key and urging the NBEMS (National Board of Education in Medical Sciences) to maintain transparency. On the other hand, FMGs in Tamil Nadu concluded a protest yesterday, July 12 and had very specific demands to make.
From the Tamil Nadu Medical Students Association (TNMSA) - FMG Wing, 150-200 students staged a demonstration along with the support of the Doctors Association for Social Equality at Valluvar Kottam, Chennai seeking an increase in the allotment of Compulsory Rotatory Residential Internship (CRRI) to 20 per cent from 7.5 per cent and allowing students to intern with District Headquater Hospitals in State.
What is the backdrop?
The National Medical Commission (NMC) released the Foreign Medical Graduate Licentiate Regulations 2021 or Compulsory Rotatory Medical Internship Regulations 2021 on November 18th 2021, issuing new rules for medical graduates including FMGs. It was observed that the intake of FMGs for internships was reduced to 7.5 per cent from 10 per cent. Additionally, it said that internships can be pursued at a medical college or institution approved by the Commission and listed by the Undergraduate Medical Education Board.
Following this move, on January 12, 2022, the Chief Minister of Tamil Nadu, MK Stalin, issued a memorandum to Union Health Minister, Mansukh L Mandaviya, seeking a few amendments in the medical field. Most notably, the seventh point in the memorandum highlighted the issue of allotment of internships to 20 per cent to 7.5 per cent and accessibility to pursue internships with District Headquarters Hospitals for FMGs.
The memorandum by CM read, "It is requested that necessary amendment may be issued to the regulations to include District Headquarters Hospitals and increase intake capacity in respect of Medical College Hospitals to 20 per cent from 7.5 per cent."
On February 23, 2022, Secretary of Tamil Nadu Medical Students Association - FMG wing, Dr Sentil Kumar, wrote to Union Health Minister, Mansukh L Mandaviya, "Requesting to make CRMI procedures and fees UNIFORM in all state and UT, to provide stipend & hostel facility," the letter read.
Based on the requests of FMGs with regards to fees for internships and stipends, the NMC issued a circular on March 4, 2022 stating, "State Medical Councils should obtain an undertaking from the medical colleges that no amount/fee is charged by the medical colleges from the FMGs for permitting them to do their internship."
Another circular was issued on May 19, 2022, subject to the illegal charge of internship fee and non-payment of stipend. The circular read, "The stipends and other facilities to FMGs should be extended equivalent to Indian Medical Graduates being trained at Government Medical Colleges as fixed by the appropriate authority applicable to the institution/University or State."
Why is this problematic?
Explaining further about the reduction in allotment of internship, General Secretary of Doctors Association for Social Equality, Tamil Nadu Dr GR Ravindranath said, "This is anti-student and anti-FMGs rights." Additionally, he urges the NMC to increase the allotment of interns to new medical colleges "as much as possible," because new colleges will be in need of medicos and FMGs can be hired to meet the requirement.
Further, the general secretary added that private colleges and other colleges are charging nearly Rs 12 lakh rupees for internships, despite the circular from NMC, which is highly condemnable. This is because, "FMGs study in other countries because they can't afford the course in India." Also, because of this high fee, the families of FMGs are affected economically, he added.
Moreover, Secretary of TNMSA - FMG Wing Dr Senthilkumar said, "The CRRI internship process is taking too long in Tamil Nadu as compared to other states."
Briefing about the time-taking process, Senthil said, "After taking six years to complete their course, FMGs come back to India and wait for the FMGE screen test for months. After the screen test starts the internship process of verifying certificates in NMC, Delhi followed by verification at State Medical Council. Meanwhile, a lot of time is gone in this process and with the less allotment of internships, the students have to wait for the next chance."
With regards to this, sharing his personal experience, Senthil who cleared the FMGE exam in December 2021, is still awaiting his internship despite finishing all the process of certificate verification. Additionally, he added that besides the high fee amount for internships, FMGs are not given stipends.
Despite having better infrastructure facilities at District Headquater Hospitals and other Government Hospitals, FMGs are unable to exercise their internship there due to the restriction in the allotment. Further, listing out the facts, Senthil said, "There are 36 Government Hospitals and seven District Headquater Hospitals which see a lot of patients. With this allotment of 7.5 per cent, the students, hospitals and patients are adversely affected."
Consequently, Senthil urges the board, "To increase the allotment of internships to 20 per cent from 7.5 per cent; allow internships with District Headquater Hospitals; unify the process across all states; all states and Union Territories to implement issue of stipend and charging no fee for internships."
