Twenty-three-year-old medical student Akash* returned from Russia in October 2020 with the hope that he would be able to work as a doctor in his home state of Tamil Nadu. The student and his family endured several hardships including financial ones while completing his studies in Russia and thought that the final hurdle would be to clear the Foreign Medical Graduate Examination. However, six months after clearing the exams, Akash is in distress, with no clarity on when he will be given a chance to intern in a hospital in Tamil Nadu, even as the state grapples with a manpower shortage.
Like Akash, nearly 500 students who cleared the Foreign Medical Graduate Examination from Tamil Nadu last year in August and December are still awaiting their chance to intern in government hospitals. The lack of a single-window system to induct graduates and the steep fee that they have to pay for joining internships are stumbling blocks. These graduates allege that they have been made to run from pillar to post for over a year to get an internship and are made to pay over Rs 5 lakh as fees.
The cumbersome process in Tamil Nadu
State president of Government All Doctors Association, Tamil Nadu, Sundaresan has through a statement listed the 12-months long cumbersome procedure to get placed as an intern in Tamil Nadu. The foreign graduate should receive a NOC from hospitals/medical colleges with an eligibility certificate and then apply to Tamil Nadu Medical Council for getting a provisional registration certificate. The students should then apply for NOC from MGR Medical University and get a government order from DME before finally approaching the hospitals for the internship.
During this process, the students are expected to pay Rs 3,50,000 to MGR Medical University and Rs 2 lakh to the medical college in which they will be posted for Compulsory Rotatory Residential Internship (CRRI).
Surendran, a foreign medical graduate awaiting internship said, â€śWe completed our Class 12 board examination just like other students and lost the MBBS seat only by a few marks. In a foreign land, we faced so many challenges and reached Tamil Nadu to practice as doctors but there is no end to our difficulties.â€ť
â€śWe are made to wait for over a year to get a posting and the fees are unaffordable for many students. We are also denied a stipend just because we completed our medical education in a foreign college,â€ť he said.
â€śThis is not the case in other states where they charge less than Rs 1 lakh for the internship. Hence, our state government should step in and immediately meet our demands,â€ť he said.
It was in January 2020 that the Tamil Nadu Medical Council, which is in charge of providing registrations to medical graduates, passed a resolution making a one-year internship in India mandatory to get permanent registration. The TNMC reasoned that the medical education these students receive abroad do not equip them to handle disease patterns in India.
â€śThis invariably results in lack of skills and knowledge in dealing with diseases specific to India, as well as interacting with the Indian patients. Indian conditions are different in terms of environment, lifestyle, and tropical diseases, from that in other countries,â€ť reads the TNMC notification. An exemption was made for students who gave their final year exams in universities abroad before June 2019.
Students seek govt intervention
States like Karnataka have decided to enroll foreign medical students with the Karnataka Medical Council and put them on COVID-19 duty. Citing this, Kumaraguru Devan, state secretary (FMG Wing) of Tamil Nadu Medical Students' Association said, â€śThe students cannot afford Rs 5 lakh for an internship and they even tried reaching district head hospitals which charge only Rs 2 lakh to join as trainee doctors. But Tamil Nadu Medical Council rejected these students saying that we have enough trained doctors.â€ť
â€śThe role of the trainee doctors during this pandemic is as important as doctors and nurses. So considering this, Tamil Nadu government should immediately employ them with stipends as trainee doctors in Tamil Nadu medical colleges and remove the Rs 5 lakh payment system,â€ť he said.
On the other hand, the Government All Doctors Association Tamil Nadu has written to Tamil Nadu Health Minister requesting to waive the fees of over Rs 5 lakh and to implement a single-window scheme to induct the graduates.
(*Names changed based on request)