Kerala High Court Upholds 2-Year Internship for Foreign Medical Graduates with Online Classes, Cites Public Interest - 2025-04-21

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Kerala High Court Affirms Two-Year Internship for Foreign Medical Graduates with Online Study

Ernakulam, Kerala - The Kerala High Court has dismissed a writ petition filed by two foreign medical graduates challenging the requirement to undergo a two-year Compulsory Rotating Medical Internship (CRMI). Justice C.S.Dias , presiding over the case on December 11, 2024, upheld the stipulation imposed by the Kerala State Medical Council, emphasizing the necessity of adequate practical training for doctors, particularly those who undertook part of their medical education online due to the COVID-19 pandemic and the Russia-Ukraine war.

Case Background: Petitioners Challenge Two-Year Internship Mandate

The petitioners, Dr. Thahiya Thasleem and Dr. Riya Elizabeth George , graduates of Odessa National Medical University, Ukraine, completed their six-year medical program and passed the Foreign Medical Graduate Examination (FMGE) in India. They were granted provisional registration by the Kerala State Medical Council, but their certificates included a note stipulating a two-year CRMI. The doctors argued that as per National Medical Commission (NMC) regulations, only a one-year CRMI is mandatory, and the two-year requirement was arbitrary and discriminatory. They sought to quash this note and enforce a one-year internship.

Arguments Presented: One Year vs. Two Years CRMI

The petitioners contended that they completed their medical course with physical attendance at Odessa National Medical University, except for final examinations conducted online after being airlifted from Ukraine due to the war. They argued that a public notice by the NMC, allowing one-year CRMI for graduates with sufficient offline classes, should apply to them. They also pointed to other states allowing permanent registration after a one-year CRMI.

The respondents, including the Kerala State Medical Council and the NMC, countered that due to the pandemic and war, many foreign medical graduates had online classes, impacting their clinical training. Citing Supreme Court directives in National Medical Commission v. Pooja Thandu Naresh and Ors , they emphasized the necessity of practical training for doctors to ensure public health and safety. They presented circulars mandating a two-year CRMI for graduates who had online classes, unless adequately compensated by offline training. The respondents argued that university communications indicated the petitioners had some online study periods.

Court's Reasoning: Emphasis on Practical Training and Expert Opinion

Justice Dias , in his judgment, underscored the Supreme Court's observations in Pooja Thandu Naresh , which highlighted that "without practical training, there cannot be any Doctor who is expected to take care of the citizens of the country." The court acknowledged the NMC's regulations and circulars issued in response to the Supreme Court's directives, aimed at ensuring sufficient clinical exposure for foreign medical graduates affected by online learning during disruptive global events.

The High Court noted the petitioners' claim of primarily offline classes, but observed a lack of conclusive evidence to substantiate consistent offline attendance throughout the pandemic period, especially during their final year. The court emphasized that whether the online classes were adequately compensated with offline sessions were "disputed questions" not suitable for adjudication in a writ petition.

Relying on established legal principles, the court reiterated that courts should be hesitant to interfere in academic matters and should respect the wisdom of expert bodies like the NMC. Citing precedents like Chancellor and Another v. Dr. Bijayananda Kar and Others and All India Council for Technical Education v. Surinder Kumar Dhawan and Others , the court stressed judicial restraint in substituting expert opinions on academic standards.

Decision and Implications: Petition Dismissed in Public Interest

Ultimately, the Kerala High Court dismissed the writ petition, upholding the two-year CRMI stipulation. Justice Dias concluded that the condition in the provisional registration certificates was not arbitrary but was incorporated in "larger public interest to ensure that foreign medical graduates are granted permanent registration only after getting adequate practical training." The court found a "reasonable nexus" between the two-year CRMI condition and the objective of ensuring competent medical professionals for public healthcare.

This judgment reinforces the regulatory measures implemented by the NMC and State Medical Councils to address concerns regarding the practical training of foreign medical graduates who experienced disruptions to their clinical education due to global crises. It underscores the judiciary's deference to expert bodies in academic and professional standards within the medical field, especially when public safety is paramount.