The Kerala High Court recently set aside a State government order levying internship fees from foreign medical graduates (FMGs) for compulsory rotating medical internship (CRMI) [Sharooq Mohammed & ors v State of Kerala & ors and connected cases]..Justice N Nagaresh held that the levy of fees illegal and contrary to the guidelines issued by the National Medical Commission (NMC). The Court ruled that when the NMC circulars clearly prohibit collection of internship fees, the State government cannot override the same by citing administrative concerns or discretion."As the NMC Circular dated 19.05.2022 unequivocally prohibits levy of internship fee and describes the levy of any internship fee as illegal, the GO dated 03.04.2025 is legally unsustainable," the Court ordered on June 3..The Court also highlighted the active role FMGs play in patient care in government hospitals.The Court reasoned that interns are often deployed to examine the patients and thus, the medical colleges also benefit from their service. "The medical interns are getting experience as Doctors while working in a resident medical capacity. Such interns are often deployed to examine the patients, prescribe medicines and may even be directed to conduct minor surgical procedures. The Medical Colleges / General Hospitals are therefore getting benefits of their service, which is in the nature of employment," the Court stated..The judgment was passed on a batch of petitions filed by Indian students/ FMGs (petitioners) who pursued their medical degrees outside India.Indian citizens and Overseas Citizens of India who have obtained their primary medical qualifications from institutions outside India are required to pass the Foreign Medical Graduate Examination (FMGE) in order to get registration under the National Medical Commission (NMC) or any State Medical Council. They are required to obtain provisional registration under the State Medical Councils in order to apply for Compulsory Rotating Medical Internship (CRMI). The FMGs are required to complete a 12 month CRMI on par with Indian Medical Graduates (IMGs) in order to become eligible to apply for permanent registration under the State Medical Councils.The petitioners in these petitions had completed their medical degree courses abroad, in countries like Russia, Bulgaria, Philippines and Guyana. On their return after education, they applied for CRMI and were allotted to various General Hospitals. The petitioners were required to pay an annual fee to complete their one year internship. The fee demanded was higher than the fees levied from Indian Medical Graduates.The petitioners then moved the Court challenging the Government Order (GO) dated April 3, which mandated FMGs to pay ₹5,000 per month to do internship at District and General Hospitals.The State justified the fee by arguing that such hospitals lack full teaching infrastructure and require additional resources to accommodate FMGs. The FMGs relied upon an NMC circular as per which no internship fees can be levied on FMGs.The government counsel, however, submitted that a subsequent NMC circular issued on May 9, 2023, gives the State discretion to decide not only the amount of stipend but also to fix an internship fee for FMGs..The Court rejected this argument and clarified that the discretion applied only to determine stipend for the interns.Accordingly, the Court set aside the GO and held that the levy of ₹5,000 per month as internship fee on FMGs was illegal..Advocates Abhilash KN, TK Ananda Krishnan, Sidharth OK, VK Sidhique, and Farah Jyothi Pradeep represented the petitioners.Standing Counsel Prenjith Kumar appeared for the National Medical Commission (NMC).Special Government Pleader PG Pramod represented the State government..[Read Judgment]
