In a major verdict on June 3, the Kerala High Court struck down the state government’s decision to levy internship fees on Foreign Medical Graduates (FMGs). The court held the order, issued in April, as “not justified,” calling it illegal and beyond the powers of the state.

Justice N Nagaresh, who presided over the matter in Sharooq Mohammed & Ors v State of Kerala, stated: “When the NMC Act, 2019 mandates payment of stipend to medical interns for their service, the State will not be justified in levying internship fee from the Medical Graduates.”

Over 200 FMGs challenged fee

The petition was filed by more than 200 Indian citizens who had earned their medical degrees in countries such as Russia, China, the Philippines, Bulgaria, and Guyana. Upon returning to India, they passed the stringent Foreign Medical Graduate Examination (FMGE) and began their Compulsory Rotating Medical Internship (CRMI), seeking equal treatment with Indian Medical Graduates (IMGs).

According to the petitioners, they were served a notice on April 19 demanding immediate payment of the internship fee. They contended this directly contradicted the guidelines of the National Medical Commission (NMC). The petitioners also highlighted that the assumption that all FMGs are financially privileged is false, adding that many of them come from modest backgrounds and pursue their studies on education loans.

Government stance rejected

The state defended the fee, claiming it was essential to support infrastructure costs. However, the court dismissed this rationale, noting there is “no legislation, Central or State, governing internships in India.” It ruled the fee as “illegal and ultravires.”

The bench observed that FMGs, during their internships, serve in a “resident medical capacity,” carrying out key duties such as patient examination and medical procedures—duties typically associated with paid employment.

Verdict sets national precedent

Legal experts and FMG associations welcomed the ruling, calling it a watershed moment not just for Kerala but for FMGs across India. The judgment is expected to influence similar disputes in other states, including Himachal Pradesh, Tamil Nadu, Karnataka, and Maharashtra, where FMGs have voiced concerns over administrative delays and alleged exploitation.

Urgent need for national guidelines

Though the judgment did not settle the issue of stipends for FMGs, it has reignited calls for the NMC to implement uniform policies. The court’s observations are being seen as a directive to the regulatory body to resolve inconsistencies and ensure fairness in internship conditions across the country.