The Kerala High Court on Monday upheld the State Medical Council’s decision to mandate clinical clerkship for Foreign Medical Graduates (FMGs) who studied in China and completed a portion of their education online during the COVID-19 pandemic [Kerala State Medical Council v Daleel Ahmed & ors]
The Division Bench of Justice Sushrut Arvind Dharmadhikari and Justice PV Balakrishnan allowed an appeal filed by the Kerala State Medical Council against a single-judge's order directing the council to process the registration application of these candidates.
The Court found that the candidates had not adequately compensated their online classes with equivalent physical training as required by the National Medical Commission (NMC)'s public notices and clarifications issued in 2023 and 2024.
It said that the only objective in directing the candidates to undergo a one-year clinical clerkship was to ensure the quality of health care delivery in the country and nothing more.
"In the light of the afore facts, we are of the considered view that the stand taken by the appellant insisting respondent Nos. 1 to 8 to undergo a one-year clinical clerkship cannot be stated as arbitrary, unjustifiable or without any basis," the Court ruled.
The eight candidates had completed their MBBS-equivalent degree in different medical universities in China. Due to the COVID-19 pandemic, they had to return to India. During their stay in India, they continued their education online from home.
When the COVID restrictions eased, they returned to China where they completed a short round of compensatory physical classes and their one-year internship there. After graduation, they also cleared the Foreign Medical Graduate Examination (FMGE) in India.
However, when they applied for provisional registration in Kerala, the State Medical Council denied registration stating that each student must first complete a one-year clinical clerkship in India to compensate the period of their online classes.
The students then approached the High Court. A single-judge directed the Kerala State Medical Council and the Director of Medical Education to process their registration applications without insisting on clerkship, observing that they had completed compensatory classes in China and were entitled to provisional registration
State Medical Council then challenged the decision.
In its verdict dated December 1, the Division Bench, while referring to two public notices issued by the NMC, stated that the decisions regarding FMGs were taken in view of the fact that medical profession deals with precious human life.
In the first notice, it was stated that NMC decided not to accept certificates regarding compensation for online theory subjects with offline practical and clinical training, after it found that the FMGs were maliciously obtaining compensatory certificates from their parent Universities. For these students, Compulsory Rotating Medical Internship (CRMI) for a period of two/three years was mandated.
The second notice, however, clarified that FMGs who had 'sufficiently compensated' their online classes with physical onsite sessions of equal duration and had cleared the MBBS equivalent examination, were to only undergo one-year of CRMI.
Noting that the compensatory classes taken by the FMGs in the present case were significantly shorter and were conducted alongside the next academic year, the Court held that the council was justified in insisting a one-year clinical clerkship.
"The purpose of issuing these public notices is to ensure that candidates who were unable to attend physical classes during the COVID pandemic and attended classes online, meet the standards required for the courses, to ensure that there is no compromise in the standards of medical education, and that the integrity and safety of the health care delivery system are maintained," the Court said.
Thus, the Court held that the eight students must undergo one full year of clinical clerkship before the council considers their applications for registration.
Senior counsel N Raghuraj appeared for the Kerala State Medical Council.
Senior counsel Santhosh Mathew represented the FMG students.
Advocate KS Prenjith Kumar appeared for the NMC.
Government Pleader Tela Chand V represented the Director of Medical Education.
[Read Judgment]