While hundreds of Foreign Medical Graduates (FMG) protest outside Bihar's medical registration office, their counterparts in Tamil Nadu have witnessed administrative efficiency in action.
After a year-long struggle, Tamil Nadu's systematic intervention has resolved internship allocation delays that left qualified doctors in professional limbo.
The contrast is stark. Tamil Nadu's 300 plus FMGs who cleared the July 2024 Foreign Medical Graduate Examination (FMGE) session waited months for Compulsory Rotating Medical Internship (CRMI) allocations, mirroring Bihar's current crisis.
However, decisive action by the Tamil Nadu Medical Students' Association - Foreign Medical Graduates Wing transformed bureaucratic indifference into prompt resolution.
“Students spend months just navigating paperwork before becoming eligible to apply for CRMI internships, even after the results are out, and then face further delays waiting for the internship notification,” explains Dr S Vasanth Philip Abishak, Secretary of the association.
The process involves securing pass certificates from Delhi, provisional registration from the Tamil Nadu Medical Council, and No Objection Certificates (NOC) from Dr MGR Medical University, often taking up to four months.
“This period is fraught with intense financial and emotional stress,” Vasanth adds. “Many FMGs have taken educational loans and face mounting pressure to begin working.”
When CRMI seat allocations stalled, the association mobilised to advocate for their peers.
Their strategy began with high-level meetings at the state health secretariat. On May 26, officials, accompanied by association President Dr NM Saran, met with Principal Secretary Dr P Senthilkumar and Additional Director of Medical Education Dr E Theranirajan. The response was immediate: the CRMI application notification was released on May 28, 2025.
One beneficiary, Dr Vignesh, who studied MBBS in the Philippines, describes the relief, “imagine spending months of sleepless nights preparing for these exams only to be left helpless for nearly a year without any government updates.”
Beyond immediate relief, the association pushed for systemic reform. They reiterated demands to increase CRMI seat allocation for FMGs from the current 7.5% to 20%. Tamil Nadu Chief Minister MK Stalin had already supported this increase in a 2022 letter to the Union Health Ministry.
"The current 7.5% cap is outdated and disproportionate to the number of FMGs qualifying each year," Vasanth argues. With Tamil Nadu offering 4,430 CRMI seats against thousands of qualified candidates nationally, the mathematical inadequacy is evident.
The association also proposed expanding internship opportunities to the District Headquarters Hospital, noting that it currently operates without any interns. This expansion, they argued, would enhance healthcare services while opening up additional avenues for FMGs.
The government also committed to conducting monthly CRMI allocations based on available vacancies, establishing predictable timelines that contrast sharply with Bihar's administrative vacuum.
Bihar's graduates endure indefinite protests, Tamil Nadu's structured intervention while combining student advocacy, bureaucratic engagement, and systematic reform proposals, provides a blueprint for effectively addressing the challenges.
This collaborative model, where student organisations effectively interface with administration to resolve systemic bottlenecks, stands as a testament to what can be achieved when stakeholders work together with urgency and purpose. Tamil Nadu’s experience highlights the importance of proactive governance and inclusive dialogue in integrating Foreign Medical Graduates smoothly into the healthcare system.
