The Kerala High Court has cancelled the State Government’s controversial order that imposed a mandatory internship fee on Foreign Medical Graduates (FMGs) for completing their compulsory medical internship in government hospitals. Justice N. Nagaresh, while delivering the verdict, emphasized that the National Medical Commission (NMC) alone holds the authority to regulate medical internships, and the State Government’s action went directly against NMC regulations.
“Once FMGs pass the FMGE and obtain provisional registration, they are on par with Indian Medical Graduates (IMGs) and should not face discrimination,” the Court noted.
The petitioners, FMGs from countries like Russia, Bulgaria, and the Philippines, had passed the Foreign Medical Graduate Examination (FMGE) and received provisional registration. They applied for internships in Kerala’s government hospitals, only to be told they must pay ₹5,000 per month, totalling ₹60,000 annually. This was despite NMC’s circulars prohibiting such charges.
The FMGs contested the order dated April 3, 2025, issued by the Health and Family Welfare Department. They argued that NMC's 2022 circulars clearly stated that no fees should be levied for internships, and the State’s order violated Article 14 of the Constitution by treating FMGs unequally.
“There is no legal or educational distinction between FMGs and IMGs post-registration, and hence the fee is unjustified,”
the petitioners contended. They also highlighted that no additional infrastructure, training, or stipends were provided in exchange for the fees.
In defense, the State argued that it had the constitutional power to collect a nominal fee to cover hospital expenses. Initially ₹10,000 per month, the amount was later reduced to ₹5,000 after prior High Court direction. The Government said the charge was needed to sustain hospital operations and support training.
However, the NMC clearly stated in court that only stipends—not fees—can be fixed by states, and the central policy prohibits any charges from FMGs for internship placements. The Court supported this view, noting that the NMC Act, 2019, gives sole authority over medical education and internships to the NMC.
Referring to its earlier direction in W.P.(C) No.23663/2020, the Court observed that the new government order ignored its guidance. It also found no evidence of quid pro quo—that is, any benefit given in return for the fee.
“The imposition of fees without offering any additional training or infrastructure is arbitrary and unconstitutional,” the Court declared.
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Ultimately, the High Court held that the Government Order (GO(Rt) No.987/2025/H&FWD dated 03.04.2025) was in violation of the NMC Act and must be set aside. The Court thus quashed the order, affirming that no government medical college in Kerala can charge internship fees from FMGs.
Date of Judgment: 3rd June 2025
Bench: Justice N. Nagaresh
Case Title: Sharooq Mohammed & Ors. v. State of Kerala & Ors & Connected Cases
Case Nos.: W.P.(C) Nos. 19369, 19383, 19776, 19908, 20000, 20045, 20172, 20195, 20259 of 2025
