Practical Training Is Essential: Kerala High Court Upholds Two-Year Internship Requirement for Foreign Medical Graduates

No Doctor Can Be Allowed to Practice Without Adequate Clinical Exposure - Kerala High Court dismissed a writ petition filed by two foreign medical graduates (FMGs), Dr. Thahiya Thasleem V.S. and Dr. Riya Elizabeth George, challenging the mandatory two-year Compulsory Rotating Medical Internship (CRMI) stipulated in their provisional registration certificates. The Court held that the stipulation was valid, reasonable, and in the larger public interest, ensuring adequate practical training for medical professionals.

The petitioners, graduates of Odessa National Medical University, Ukraine, contended that the imposition of a two-year CRMI under Note 3 of their provisional registration certificates was arbitrary, discriminatory, and contrary to the National Medical Commission (Compulsory Rotating Medical Internship) Regulations, 2021, which require only a one-year internship. They argued that they had completed offline training and examinations during their course, but the authorities failed to recognize their compliance.

The respondents, including the Kerala State Medical Council and the National Medical Commission (NMC), defended the requirement, asserting that it was based on Supreme Court directions and regulatory circulars issued in light of the disruptions caused by the COVID-19 pandemic and the Russia-Ukraine war, which necessitated online medical education for many students.

The Court emphasized the limited scope of judicial review in academic matters, reiterating the principle that courts should not interfere with the decisions of expert bodies unless there is a clear statutory violation.

"The courts are neither equipped nor have the academic or technical background to substitute themselves in place of statutory professional bodies to decide matters involving standards and quality of medical education," the Court observed, quoting All India Council for Technical Education v. Surinder Kumar Dhawan (2009).

Citing the Supreme Court's decision in National Medical Commission v. Pooja Thandu Naresh (2022), the Court highlighted the importance of practical training for medical professionals, stating:
"Without practical training, there cannot be any doctor who is expected to take care of the citizens of the country."

The Court noted that the medical profession deals with human life, and adequate clinical exposure is essential to ensure the competence of medical practitioners.

The petitioners claimed they had attended offline classes and examinations during their course, but the Court found no substantive evidence to support this claim. Ext.P9 certificates did not demonstrate that the petitioners had adequately supplemented online classes with offline training. The Court upheld the scrutiny conducted by the Kerala State Medical Council, which led to the inclusion of the two-year CRMI stipulation in their registration certificates.

The petitioners argued that similarly situated FMGs in other states, such as Rajasthan and Tamil Nadu, were allowed to complete only a one-year internship. However, the Court rejected this argument, stating:
"Equality in illegality cannot be a ground to challenge a lawful stipulation. The stipulation has a reasonable nexus with the object of ensuring adequate training for FMGs."

The Court upheld the stipulation of a two-year CRMI in the petitioners’ provisional registration certificates, finding it consistent with Supreme Court directions, NMC regulations, and public interest. It dismissed the writ petition as devoid of merit.

This judgment reinforces the judiciary’s reliance on expert bodies to regulate professional education and training, particularly in critical fields like medicine. By prioritizing public safety and the competence of medical practitioners, the Court highlighted the non-negotiable nature of clinical training for FMGs who faced disruptions during their education.

Date of Judgment: December 11, 2024