Sanchayita Lahkar

The High Court of Kerala Single Bench of Justice N. Nagaresh has held that the imposition of Clinical Clerkship on certain Foreign Medical Graduates (FMGs) is unjustified, given that they have adequately compensated for their online classes with physical training at their parent institutions. The Court declared that the Kerala State Medical Council and the Director of Medical Education are not entitled to mandate Clinical Clerkship for such candidates and directed both authorities to process the registration applications of the petitioners within six weeks. The Court issued this directive after noting that the petitioners had complied with the guidelines laid down by the National Medical Commission (NMC) and had completed all qualifying steps including the Foreign Medical Graduate Examination (FMGE).

The petitioners, eight in number, are Foreign Medical Graduates who pursued medical education in China and returned to India due to the COVID-19 pandemic. Having enrolled during the 2017-2018 academic year, the petitioners were forced to attend classes online due to global restrictions imposed during the pandemic. Upon the normalization of international travel, they returned to their parent institutions in China to complete compensatory physical classes, in compliance with the National Medical Commission’s (NMC) directives.

Also Read: "Section 26 of AP Reorganisation Act Must Yield to Article 170(3); No Premature Delimitation Permissible": Supreme Court Upholds Constitutional Bar and Rejects Plea for Increased Assembly Seats in Andhra Pradesh and Telangana

All petitioners cleared the National Eligibility cum Entrance Test (NEET) before pursuing their studies abroad and later qualified the Foreign Medical Graduate Examination (FMGE) upon return. The core issue arose when the Kerala State Medical Council and the Director of Medical Education declined to grant provisional registration, insisting that the petitioners undergo an additional one-year Clinical Clerkship prior to commencing the one-year Compulsory Rotating Medical Internship (CRMI).

The petitioners challenged this decision, asserting that the directive for Clinical Clerkship was not mandated by the NMC and was therefore arbitrary. They contended that they had met all requirements as per the Screening Test Regulations, 2002, and the Eligibility Certificate Regulations, 2002, which governed their admission timeline. In addition, they referenced various public notices and circulars from the NMC, including Ext.P6 and Ext.P7, that supported their claim that physical classes conducted at parent institutions abroad were sufficient compensation for earlier online instruction.

Supporting documentation submitted by the petitioners included eligibility certificates, NEET and FMGE results, graduation certificates, compensatory training certificates from their parent institutions, and email confirmations from Chinese universities and the Indian Embassy in China affirming the authenticity of these documents. Among the referenced precedents were Leeba Mary Eapen v. Travancore Cochin Council of Modern Medicine (W.P.(C) No.2344/2020) and its subsequent affirmation in W.A. No.1667/2020, which held that State Medical Councils could not impose additional requirements contrary to NMC guidelines.

The Kerala State Medical Council submitted that the claims of compensatory training could not be independently verified and that a general policy resolution dated 19.09.2024 (Annexure R2[a]) required FMGs who had course disruptions during the pandemic to complete a one-year Clinical Clerkship before proceeding to CRMI. This position, according to the Council, was necessary to ensure adequate practical training in the public interest.

However, the NMC clarified in its statement dated 17.01.2025 that if students adequately compensated their online classes through physical training at the parent institution, they could be exempted from undergoing a two-year CRMI. The NMC also stated that State Medical Councils were empowered to independently assess eligibility but could not act contrary to NMC guidelines.

Based on these submissions and documentary evidence, the Court was tasked with determining whether the petitioners had fulfilled their academic requirements as per NMC norms and whether the Kerala State Medical Council was justified in insisting on Clinical Clerkship.

Justice N. Nagaresh made several observations grounded strictly in the documents and statements presented before the Court. The judgment recorded:

"The petitioners are Foreign Medical Graduates (FMG), who have completed their medical course in China. They have cleared NEET Examination and had completed all classes as per course structure in the parent institution. They have also completed compensatory physical classes in parent institution online due to Covid-19. The petitioners have also passed Foreign Medical Graduate Examination (FMGE)."

On the issue of registration, the Court noted: "The petitioners state that the action of the 2nd respondent-Kerala State Medical Council in delaying the issuance of provisional registration to the petitioners is illegal. The imposition of Clinical Clerkship before issuing provisional registration in Kerala is arbitrary."

Regarding the policy adopted by the 2nd respondent, the Court recorded: "The Council of Modern Medicine has constituted a Scrutiny Committee and every application of FMGs for registration are considered on its merits with the aid of supporting documents."

However, it also remarked: "The 2nd respondent-Council has taken a decision on 19.09.2024 holding that medical students, who had a course break during Covid-19 period and who had to undergo online classes due to it, will have to undergo one-year Clinical Clerkship before joining for the one year CRMI."

In contrast, the Court noted the NMC's position: "The NMC has also taken a stand that State Medical Councils are supposed to assess the eligibility of the applicants independently. A student may be exempted from two-year internship and instead complete a one-year CRMI if he has adequately compensated by the online classes by subsequently attending them in an offline mode."

Addressing the petitioners' specific case, the Court observed: "It is the specific case of the petitioners herein that they had travelled back to China and completed their compensatory classes. If they have completed the compensatory classes, then the 2nd respondent cannot take a stand that the petitioners have to undergo a two-year Clinical Clerkship."

And further: "The 2nd respondent in such circumstances will not be justified in imposing a two-year Clinical Clerkship upon the petitioners even though the State Medical Councils are competent to assess the eligibility of the petitioners independently."

In conclusion of the observations, the Court stated: "The petitioners are therefore entitled to relief. It is declared that 'Clinical Clerkship' is not required for the petitioners as they have compensated their online classes with physical classes in their parent institutions as directed by the 1st respondent."

Also Read: Bombay HC Refuses To Recall Demolition Order | Says Mob Fury And Footfall On Claimed Dargah Can’t Establish Legality

Justice N. Nagaresh issued directives following the legal findings:

"It is declared that 'Clinical Clerkship' is not required for the petitioners as they have compensated their online classes with physical classes in their parent institutions as directed by the 1st respondent."

The Court directed: "Respondents 2 and 3 are directed to process the registration application of the petitioners and pass appropriate orders / take appropriate decision within a period of six weeks."

The writ petition is disposed of as above.

Advocates Representing the Parties:

For the Petitioners: Shri. Shinto Mathew Abraham, Shri. Santhosh Mathew (Sr.), Sri. Arun Thomas, Smt. Veena Raveendran, Smt. Karthika Maria, Sri. Anil Sebastian Pulickel, Shri. Mathew Nevin Thomas, Smt. Leah Rachel Ninan, Shri. Karthik Rajagopal, Shri. Joe S. Adhikaram, Shri. Kurian Antony Mathew, Smt. Manasa Benny George, Smt. Aparnna S., Shri. Arun Joseph Mathew, Shri. Noel Ninan Ninan, Shri. Adeen Nazar

For the Respondents: Sri. K.S. Prenjith Kumar, Standing Counsel, National Medical Commission; Sri. Vivek Menon, Standing Counsel; Sri. Rajeev Jyothish George, Government Pleader

Case Title: Daleel Ahmmed and Others v. National Medical Commission and Others

Neutral Citation: 2025: KER:54865

Case Number: WP(C) No. 42885 of 2024

Bench: Justice N. Nagaresh