A recent notification by Tamil Nadu Medical Council (TNMC) has created panic and stress among Indian students pursuing MBBS abroad, in particular those studying in China.
The Tamil Nadu Medical Council (TNMC) is in charge of providing registrations to medical graduates which will enable them to practise medicine in the state. Recently, the TNMC made it mandatory for students who have completed their medical degree abroad to undergo a mandatory internship in any Indian hospital approved by the Medical Council of India (MCI) for one year to be eligible to practise medicine in Tamil Nadu.
This announcement has kicked up a furore among students who are pursuing medicine abroad since many feel that this rule is discriminatory, and they would lose both valuable time and money. Prior to this notification, Tamil Nadu had accepted an internship abroad. Students who studied abroad and wanted to practice in Tamil Nadu were eligible to apply for indian registration after writing a qualifying exam.
Since many universities in China have now made it mandatory from 2018 for its students to complete an internship there, medicos who are coming back to Tamil Nadu to practice say it’s become a double load for them. Students pursuing medical degrees in countries like Russia and Philippines are given an option to undergo their one year internship in their home country before they graduate as fully qualified doctors.
Around 700 foreign medical graduates apply for registration with TNMC every year, said a source in the council. However, there is no data available as to how many of these foreign medical graduates returning to Tamil Nadu studied in China. According to the Ministry of Human Resource Development 21,000 Indians are pursuing medicine in China as of 2019.
The issue began in January 2020 when the TNMC passed a resolution making the one-year internship in India mandatory to get permanent registration. The resolution passed on January 4, 2020 stated, “The medical practitioner with foreign degrees who have appeared for the screening test on or after 01.01.2020 has to complete one-year internship in any Medical Council of India (MCI) recognized institution within India for getting permanent Registration in TNMC.”
The reason for this decision, according to TNMC, was that the internship experience that young graduates get abroad as a part of their medical degree is not uniform and does not address the disease patterns of the Indian states.
“This 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,” reads the notification issued by TNMC.
After the notification was published, the TNMC revised the resolution after it received numerous representations from students who have completed around eight months of internship in other countries. Based on that, the TNMC tweaked the order on May 3 stating that whoever has given their final year exams in universities abroad before June 2019 shall be exempted from the mandatory one year internship in India. However, those who had taken their final year exams after June 2019 in institutions outside India (except Nepal) have to undergo the one-year internship in India.
This announcement has caused panic among the students who are now in their final year of undergraduate medical degree in countries like China.
“Many universities in China, which are approved by MCI, have made a one-year internship in China mandatory to be eligible to take the graduation exams. Only if we pass, we will be given our degrees. Now with this announcement, we will have to do one more year of internship in India to be eligible to work here,” a student who is pursuing his final year MBBS in China told TNM on the condition of anonymity.
Adding to their woes is that foreign medical students who want to do their internship in Tamil Nadu have to shell out anywhere between Rs 2 lakh to Rs 5 lakh as fee based on the hospital they want to pursue their internships. “The mandatory internship that we have been told to pursue does not pay us anything either. Despite doing MBBS in MCI recognized top colleges in China, we still need to do an internship in Tami Nnadu. Students studying in India get stipend for internships but we, who have done internships already abroad and are essentially repeating it here are not eligible for stipends, why?” he asked.
Speaking to TNM, an official from the TNMC justified the change in norms. “Basically internships should not be done without a license. In India, students are provided a provisional license which will be made permanent after they complete their internship of one year. An Internship is essentially practising medicine in a designated hospital under supervision of a senior doctor. Most countries except China give such provisional licenses and the students are allowed to opt for internship in India. In China, they write final exams, then do internship without license and then write the licensing (or graduation exams) exams to earn the degree. The system itself is flawed there. Hence we decided to bring in this norm for all graduates coming to India from abroad,” he explained.
When questioned if the foreign medical graduates will be paid for their internship in India, the official said that it is based on the regulations of each institution and not a blanket norm.
“Kerala’s Travancore-Cochin Medical Council has also adopted a similar arrangement with the foreign medical students and hence we also have done it. We have not done something out of the ordinary here,” he added.