Court directs medical institutions to issue internship completion certificates without fee and process stipend disbursement within three months as per National Medical Commission guidelines
In a significant judgment addressing the rights of Foreign Medical Graduates (FMGs), the Kerala High Court has declared that the demand for internship fees from doctors undergoing Compulsory Rotatory Medical Internship (CRMI) is illegal and unsustainable in law. The court has further mandated that all such medical graduates are entitled to receive stipends during their internship period as per the guidelines laid down by the National Medical Commission.
The judgment, delivered by Justice Bechu Kurian Thomas in the case of Murukan S v. State of Kerala (W.P.(C) No. 28615 of 2024), stems from a petition filed by Murukan S, a Foreign Medical Graduate who was denied an internship completion certificate by the medical institution where he trained unless he paid an internship fee. Additionally, the petitioner claimed that he was not paid any stipend during his internship period.
Background of the Case
The petitioner approached the High Court seeking two primary reliefs: first, issuance of an internship completion certificate without payment of any internship fee, and second, directions to ensure payment of stipend in accordance with the National Medical Commission's circular dated 19.05.2022.
Court's Findings
The Court relied on its previous judgment in Sharooq Mohammed v. State of Kerala (2025 KHC Online 575), which had already established that the National Medical Commission's circular dated 19.05.2022 "unequivocally prohibits levy of internship fee" and describes such levy as illegal. The Court noted that even the Government Order dated 19.05.2022 issued by the State of Kerala was found to be legally unsustainable in light of the National Medical Commission's guidelines.
Justice Thomas observed that "the demand for internship fee is without any legal basis" and that the circular clearly stipulates that every Foreign Medical Graduate undergoing CRMI is entitled to receive a stipend during their internship period.
Key Legal Principles Established
The judgment reinforces several important legal principles:
1. Prohibition of Internship Fees: The National Medical Commission's guidelines explicitly prohibit the levy of any internship fee from FMGs undergoing CRMI. Any institution demanding such fees violates these guidelines and acts illegally.
2. Entitlement to Stipend: Every Foreign Medical Graduate undergoing CRMI is constitutionally and legally entitled to receive stipend from the government during their internship period. This is not a discretionary benefit but a mandated requirement as per the guidelines.
3. Government Responsibility: The Court has consistently held that it is the responsibility of the Government to ensure payment of stipend to all doctors undergoing CRMI, including foreign medical graduates.
Court's Directives
The Kerala High Court has issued three important directives:
1. The third respondent (the medical institution) shall immediately issue an internship completion certificate to the petitioner without demanding any internship fee.
2. Upon the petitioner's application through the medical institution (along with a copy of the completion certificate), the claim for stipend payment shall be forwarded to the competent authority immediately.
3. The competent authority of the State of Kerala shall process the petitioner's stipend claim and disburse the eligible amount at the earliest, with an outer limit of three months from the date of receipt of the claim.
Implications and Significance
This judgment has far-reaching implications for all Foreign Medical Graduates in Kerala undergoing or having undergone CRMI. The decision effectively:
- Invalidates any pending demands for internship fees from FMGs
- Establishes a clear legal precedent that such fees are ultra vires the National Medical Commission guidelines
- Creates a mechanism for FMGs to claim pending stipends from the government
- Holds medical institutions accountable for compliance with national guidelines
- Protects the rights of international medical graduates pursuing medical practice in India
The Court's reference to "various cases" wherein it has previously observed that stipend for CRMI ought to be paid by the Government indicates a consistent judicial approach to safeguarding the rights of medical interns.
Legal Framework
The judgment is grounded in the National Medical Commission Circular dated 19.05.2022, which serves as the governing framework for CRMI in India. This circular represents the regulatory authority's clear directive that FMGs cannot be charged for internship and must receive stipend, aligning with principles of equal treatment and protection of rights under the Indian Constitution.
The Kerala High Court's decision reinforces the supremacy of guidelines issued by apex regulatory bodies like the National Medical Commission over institutional practices or state government orders that contradict these guidelines.
Conclusion
The Kerala High Court's judgment in Murukan S's case represents a decisive step in protecting the rights of Foreign Medical Graduates in India. By striking down unlawful internship fee demands and ensuring stipend payment within a defined timeframe, the Court has upheld both the rule of law and the principles of fair treatment enshrined in national regulations. The judgment sends a clear message that medical institutions cannot deviate from the National Medical Commission's guidelines with impunity, and the State must ensure timely disbursement of statutorily mandated benefits to all eligible interns.
Bottom Line:
Foreign Medical Graduates undergoing Compulsory Rotatory Medical Internship (CRMI) are entitled to receive a stipend, and any demand for internship fees by the concerned authorities is illegal as per the guidelines of the National Medical Commission.
Statutory Provision(s):
National Medical Commission Circular dated 19.05.2022 (Foreign Medical Graduates - Compulsory Rotatory Medical Internship), Government Order dated 19.05.2022 issued by the State of Kerala, Indian Constitution (principles of equal treatment and protection of rights)
Murukan S v. State of Kerala, (Kerala) Law Finder Doc id # 2970369
