The framework of medical education in India has always been straightforward: 5.5 years of study, one year of internship, and the gateway to a medical career opens.
Yet for thousands of Indian students who pursued their MBBS degrees abroad, this equation has been catastrophically rewritten by forces beyond their control and policies that seem designed to penalise rather than accommodate.
What emerges from their testimonies is not merely an educational crisis but a profound indictment of a system that has transformed victims of war and pandemic into subjects of bureaucratic persecution.
These students, evacuated from conflict zones and pandemic stricken countries, now find themselves serving what amounts to extended sentences in Indian hospitals while their professional lives remain indefinitely suspended
The crisis stems from policy changes implemented by the National Medical Commission (NMC) following the mass evacuation of Indian students from Ukraine in 2022 and earlier disruptions in China due to COVID-19.
Students who completed portions of their medical education online due to these emergencies now face three-year internship requirements in India, compared to the standard one-year internship for domestic graduates. The policy, ostensibly designed to compensate for missed clinical training, has created a system where students serve what many describe as “bonded labour” while their careers remain indefinitely on hold.
Edexlive spoke to three students from Maharashtra, Haryana and Madhya Pradesh, to understand the scope and impact of these policies, revealing a pattern of inconsistent implementation, discriminatory practices, and administrative apathy that has left foreign medical graduates (FMG) trapped in extended limbo.
Dr Shivam Sharma's story begins like many others. After failing to secure a medical seat in India, he headed to Ukraine's Dnipro State Medical University in 2017. His studies proceeded normally until March 2022, when the war forced an evacuation.
“I continued my studies there until 2022. During the COVID-19 period, I stayed back and continued learning. But when the war broke out, we had no choice but to evacuate. I returned to India in March 2022, with just two months left in my fifth year. That means around 1.2 years of my course ended up being completed online,” he says.
The aftermath has been particularly harsh in Haryana, where Dr Sharma now finds himself trapped in a three-year internship. “If you look at it as a timeline, I will spend nearly 10 years just to complete MBBS,” he says. “My friends in other states like Uttar Pradesh, Punjab, Odisha, and Tamil Nadu have received reduced internship periods, some one year, some two. But here in Haryana, despite multiple attempts to engage with the state council, we've only been told: 'If NMC changes the rule, we'll follow.'”
The inconsistency across states becomes even more apparent in Dr Rohit Tekade's experience. Currently interning at Indira Gandhi Medical College in Nagpur, Dr Tekade went to China in 2017, driven by the same constraints that affect thousands of Indian students. “My NEET score wasn't high enough for a seat in India, and studying in China was a viable alternative, both academically and financially, given the lower cost of living.”
The COVID-19 pandemic in 2020 forced him home, and like thousands of others, he completed his degree online by 2022.
“When I passed the FMG exam in January 2023, I was assigned a three-year internship. But my batchmates from other states, Jharkhand, Rajasthan, Chhattisgarh, were given only two years or even just one year,” Dr Tekade explains. When he questioned the NMC about this disparity, their response was telling: “One year was compulsory internship since I didn't complete one in China, and the remaining two years were a penalty for online education.”
This arbitrary implementation of policy has driven students to organise. Dr Tekade formed a WhatsApp group of internationally trained doctors facing similar issues, where they began compiling evidence of the varying internship durations imposed across states. “One of my batchmates in Chhattisgarh received a one-year internship. If all medical councils are under NMC, then why such irregularities?” he asks.
Internship vs clerkship
Dr Adarsh from Madhya Pradesh represents perhaps the most egregious case of policy implementation.
After completing his MBBS at Nantong University in China through online classes during the pandemic, he cleared his FMG exam in December 2022. But the real shock came later. “Only in December 2023, the NMC released a notice saying we'd have to do a three-year internship, one year officially labeled 'internship' and two years termed as 'clerkship'.”
The distinction between internship and clerkship, Dr Adarsh discovered, exists only on paper. “On the ground, there's absolutely no difference. We do the same duties, the same hours, and still, we are made to pay Rs 4,000 to the government for clerkship registration.”
The exploitation runs deeper. “Indian MBBS students do 1,900 hours of internship, but we're forced to do 3,000 hours. It's like we're being used as bonded labour,” he says.
The legal route
Frustrated by the system's intransigence, Dr Adarsh attempted to meet Dr Aruna Vanikar, the then head of the UG medical board at NMC. Her response was dismissive: “No one asked you to go to China, you must bear the consequences. If you want justice, go to court.
”So they did, filing a case in January 2025 that continues to wind through the legal system.
The legal challenge that followed has exposed the arbitrary nature of the entire system. “We gathered documentation, evidence, and testimonies, and filed a case in the Madhya Pradesh (MP) High Court. We started legal proceedings on January 7, 2025. Since then, the NMC and MP Medical Council have been repeatedly asking the court for more time. Even the court is now questioning the NMC: What is the actual difference between internship and clerkship? Because in practice, there is none. We are doing the same work under a different name, just to satisfy a bureaucratic penalty.”
The extended timeline has profound implications for career progression. “Most of us were hoping to appear for NEET PG soon after completing our internships,” Dr Tekade explains. “But now, with this extended three-year internship, those plans have been pushed back by years.”
Some relief alas
Recent court interventions offer a glimmer of hope. The Madhya Pradesh High Court has allowed foreign medical graduates to fill NEET PG 2025 forms while their cases are pending, recognising the urgency of their situation. The court noted the lack of uniformity across states and questioned the sudden policy changes that disrupted students' preparation plans.
The irony is inescapable. These students, who sought affordable medical education abroad due to limited seats in India, now find themselves penalised for circumstances entirely beyond their control. War in Ukraine, a global pandemic, and retrospective policy changes have conspired to create what amounts to causalities in systemic neglect in medical education.
Their prolonged education timeline not only delays their entry into the healthcare workforce but also represents a massive waste of human resources at a time when India faces a critical shortage of doctors.
As these young doctors continue their fight for equity and recognition, their stories serve as a stark reminder of how bureaucratic inflexibility can transform individual dreams into collective nightmares.
