Introduction:
The Madhya Pradesh High Court has sought the response of the Union Government on a challenge to the applicability of the National Medical Commission’s Foreign Medical Graduate Licentiate (FMGL) Regulations, 2021, in a case involving an MBBS student who commenced his medical education in Ukraine shortly before the new regulatory framework came into force.
A Division Bench comprising Chief Justice Alpesh Yeshwant Kogje and Justice Vivek Rusia was hearing a writ petition filed by Anoop Panchoria, a resident of Bhopal, against the Union of India and the National Medical Commission. The petitioner has questioned whether the stringent requirements introduced under the 2021 Regulations can be applied to him when he had already paid his fees and travelled to Ukraine before the Regulations came into force, but his formal classes commenced thereafter.
The matter also raises a significant practical issue arising from the Russia-Ukraine war. The petitioner claims that the requirement imposed by the 2021 Regulations to complete a 12-month internship in the same foreign medical institution from which the primary medical qualification was obtained has become practically impossible for him to satisfy because of the continuing circumstances in Ukraine.
The petitioner had appeared for NEET-2021 and secured admission to Horbachevsky Ternopil National Medical University in Ternopil, Ukraine. According to his petition, the Ministry of Education and Science of Ukraine issued him an invitation for study on June 14, 2021, following which he obtained the necessary visa.
He deposited US$1,900 towards his course fees on November 3, 2021 and reached Ukraine on November 7, 2021. However, the National Medical Commission’s FMGL Regulations, 2021 came into force on November 18, 2021. His classes formally commenced on December 10, 2021.
The distinction between these dates forms the heart of the dispute.
The petitioner relies upon Regulation 5(1)(b) of the 2021 Regulations, which excludes candidates who were already pursuing education in foreign institutions before the Regulations came into force. Regulation 5(2) provides that such candidates would instead be governed by the regulations that were applicable to them previously.
The petitioner’s case is that his education in Ukraine should be treated as having commenced before November 18, 2021 because he had already secured admission, paid the prescribed fees and physically reached the university by November 7, 2021. According to him, the fact that formal classes began on December 10 should not deprive him of the benefit of the exemption.
The NMC, however, took a different view. In response to an RTI query, the Commission reportedly informed the petitioner on March 2, 2023 that he would be governed by the 2021 Regulations because his classes commenced only on December 10, 2021, after the new regulatory framework had come into force.
The petitioner has therefore challenged the applicability of the 2021 Regulations to his case, particularly the requirements concerning internship and registration.
Under Regulation 4(a)(ii), a foreign medical graduate is required to undergo an internship for a minimum period of 12 months in the same foreign medical institution. Schedule I, Clause 2(b), also requires completion of a 12-month internship in the same foreign institution where the primary medical qualification was obtained, along with hands-on clinical training in various medical subjects.
According to the petitioner, these requirements create a particularly difficult situation for students whose medical education in Ukraine was disrupted by the war. He claims that he may not be able to return to his university in Ukraine to undertake the prescribed internship and obtain the necessary certification.
The petitioner has therefore challenged the relevant provisions of the 2021 Regulations as being inapplicable to him and has sought to be governed instead by the earlier Medical Council of India Screening Test Regulations, 2002. He has also questioned the constitutional validity of the challenged provisions, alleging that their application to students in circumstances such as his violates Articles 14 and 19(1)(g) of the Constitution.
The High Court, at this stage, has not finally adjudicated upon the validity or applicability of the Regulations. It has merely sought the Union Government’s response and granted time to file the same. The matter has been listed for October 29.
Arguments of the Parties:
The petitioner, represented by Senior Advocate Aditya Sanghi along with Advocate Anjali Patel, has primarily challenged the applicability of the 2021 Regulations on the basis of the transitional provisions contained within the Regulations themselves.
The central submission is that the petitioner had already taken substantial and irreversible steps towards pursuing his medical education in Ukraine before November 18, 2021, which is the date on which the FMGL Regulations, 2021 came into force.
The petitioner had secured admission to Horbachevsky Ternopil National Medical University pursuant to an invitation issued by the Ukrainian Ministry of Education and Science on June 14, 2021. He had obtained a visa, paid US$1,900 towards his fees on November 3, 2021 and physically travelled to Ukraine on November 7, 2021.
According to the petitioner, these circumstances demonstrate that he had already entered into the process of pursuing medical education in the foreign institution before the new regulations became operative.
The petitioner’s argument is therefore based upon the expression used in Regulation 5(1)(b), which excludes candidates who were “pursuing their education” in foreign institutions before the commencement of the 2021 Regulations.
The petitioner contends that the phrase should not be interpreted narrowly so as to mean only the date on which classroom teaching formally commenced. Such an interpretation, according to him, would disregard the actual circumstances in which a foreign medical student secures admission, pays fees, obtains a visa, travels to the foreign country and begins the process of joining the institution.
His classes commenced on December 10, 2021, approximately three weeks after the Regulations came into force. The petitioner argues that this short gap should not determine the regulatory framework applicable to his entire medical education when the process of admission and migration to Ukraine had already been completed before November 18.
The petitioner further relies upon Regulation 5(2), which provides that candidates covered by the transitional exclusion would continue to be governed by the erstwhile applicable regulations.
He accordingly contends that he should fall under the Medical Council of India Screening Test Regulations, 2002 rather than the more stringent requirements introduced under the FMGL Regulations, 2021.
The dispute assumes greater significance because the petitioner subsequently left Ukraine after the outbreak of the Russia-Ukraine war and continued his MBBS course online from Bhopal.
The petitioner argues that the war has fundamentally altered the circumstances under which the 2021 Regulations would have to be complied with. A requirement which may ordinarily be capable of being fulfilled by an overseas medical student may become practically impossible when the foreign institution is situated in a country affected by armed conflict.
The principal difficulty concerns the mandatory 12-month internship.
Under Regulation 4(a)(ii), the foreign medical graduate is required to complete an internship of at least 12 months in the same foreign medical institution. Schedule I, Clause 2(b), similarly requires the foreign graduate to complete a 12-month internship in the same institution from which the primary medical qualification was obtained and to receive hands-on clinical training in the prescribed subjects.
The petitioner submits that compliance with this requirement would effectively require him to return to Ukraine, complete the internship in the same institution and obtain the necessary certification. He has contended that, in view of the continuing Russia-Ukraine conflict, such a requirement has become “in the realm of impossibility.”
The petition also raises the practical consequences of not being permitted to fulfil the requirement in Ukraine. According to the petitioner, circumstances may compel him to shift to another medical college or another country, or potentially to pursue his remaining education in India. Yet the NMC’s interpretation of the 2021 Regulations would continue to require him to fulfil the same-institution internship requirement.
The petitioner therefore contends that students affected by circumstances beyond their control should not be placed in a regulatory situation where they are simultaneously prevented from transferring their education elsewhere and required to complete an internship in an institution to which they may no longer be able to safely or practically return.
He has also compared the 2021 framework with the earlier Medical Council of India Screening Test Regulations, 2002. According to the petition, the earlier regulatory framework principally required an Indian citizen obtaining a primary medical qualification from outside India to qualify the prescribed screening test for provisional or permanent registration.
The petitioner contends that the 2021 Regulations introduced additional requirements concerning the course structure, clinical training and internship. These additional conditions, according to him, have created particular hardship for students whose education was disrupted by the Ukraine war.
On this basis, the petitioner has sought a declaration that the 2021 Regulations, particularly Regulations 4 and 5(b) and Schedule I, Clause 2(b), should not be applied to him. He has sought a direction that his case be governed by the 2002 Regulations.
The petitioner has additionally challenged the relevant provisions on constitutional grounds. He has alleged that their application to his circumstances violates Article 14, which guarantees equality before law and equal protection of laws, and Article 19(1)(g), which protects the right to practise any profession or carry on any occupation, trade or business.
The constitutional challenge is therefore connected with the petitioner’s broader argument that the regulatory conditions cannot be applied in a manner that makes it practically impossible for a student, whose education was disrupted by an armed conflict, to obtain the registration necessary to practise medicine in India.
The Union Government, represented by Advocate Piyush Bhatnagar, was granted time by the High Court to place its response on record. Advocate Aparna Sthapak appeared for the National Medical Commission.
At the present stage, the respondents have not been finally adjudicated upon on the merits of the petitioner’s claims. The Court has merely directed the Union Government to respond before the matter is taken up further.
Consequently, the precise justification for applying the 2021 Regulations to the petitioner, the interpretation of the transitional clause, and the constitutional challenge remain matters for consideration by the High Court after the respondents’ stand is placed before it.
Court’s Judgment:
The Division Bench of Chief Justice Alpesh Yeshwant Kogje and Justice Vivek Rusia did not finally determine the petitioner’s entitlement under either the 2002 Regulations or the FMGL Regulations, 2021. Instead, after considering the nature of the challenge, the Court granted time to the Union Government to file its response and listed the matter for October 29.
The order is therefore significant at this stage primarily because the Court has called upon the Union Government to address a challenge involving the interaction between the transitional provisions of the 2021 Regulations and the exceptional circumstances faced by Indian medical students whose education in Ukraine was disrupted by the war.
The first important issue arising from the petition is the meaning and application of Regulation 5 of the 2021 Regulations.
The Regulations came into force on November 18, 2021. Regulation 5(1)(b), as relied upon by the petitioner, excludes candidates who were already pursuing education in foreign institutions before the Regulations came into force. Regulation 5(2) consequently preserves the applicability of the earlier regulatory framework to such candidates.
The petitioner seeks to establish that he falls within this protected category.
The factual chronology assumes considerable importance in determining this issue. The petitioner received the Ukrainian Ministry of Education and Science’s invitation for study on June 14, 2021. He subsequently obtained his visa, deposited US$1,900 in fees on November 3 and reached Ukraine on November 7.
The FMGL Regulations came into force on November 18, while his formal classes commenced on December 10.
Thus, the dispute is not about a student who had no connection with the foreign institution before the new Regulations came into force. Rather, the petitioner had already completed admission-related formalities, paid fees and travelled to the foreign country before the cut-off date. His contention is that these circumstances should be sufficient to bring him within the transitional protection.
The NMC’s response to his RTI query, however, indicates that the Commission has treated the date on which formal classes commenced as decisive. Since classes began on December 10, 2021, the NMC informed the petitioner that he would be governed by the 2021 Regulations.
The High Court will therefore be required to consider, after receiving the respondents’ response, whether “pursuing education” under the transitional provision refers exclusively to the formal commencement of classes or whether the expression can encompass the process of admission, payment of fees, obtaining permission to study and physical joining of the foreign institution.
The answer could have significant consequences for determining the regulatory framework applicable to students whose admission process straddled the November 18, 2021 cut-off date.
The second major issue concerns the 12-month internship requirement.
The FMGL Regulations prescribe additional requirements for foreign medical graduates seeking registration in India. Regulation 4(a)(ii), as relied upon by the petitioner, requires completion of a minimum 12-month internship in the same foreign medical institution. Schedule I, Clause 2(b), similarly requires the graduate to complete a 12-month internship in the same institution from which the primary medical qualification was obtained, along with hands-on clinical training in the relevant medical subjects.
The petitioner argues that the requirement cannot be examined in isolation from the extraordinary circumstances that have affected medical students in Ukraine.
His case is that he left Ukraine after the outbreak of the Russia-Ukraine war and has since continued his MBBS studies online from Bhopal. The difficulty, therefore, is not simply that he does not wish to undertake the required internship in Ukraine. His argument is that circumstances arising from the war may make it impossible for him to return to the same institution and fulfil the regulatory requirement.
This raises the legal question whether a regulatory requirement that is ordinarily applicable to foreign medical graduates can be insisted upon without modification where compliance has allegedly become impossible because of circumstances arising from an armed conflict.
The petitioner has described the situation as being “in the realm of impossibility.” The Court has not, at this stage, recorded a final finding accepting or rejecting that contention.
The issue will therefore require consideration alongside the statutory purpose of the FMGL Regulations, the regulatory objectives of ensuring adequate clinical training for foreign medical graduates, and the transitional protection specifically incorporated into the 2021 framework.
The petition also raises the issue of whether students affected by the Ukraine war can transfer their education to another institution or country.
According to the petitioner, if he is required to return to his original university to complete the internship but is unable to do so because of the prevailing circumstances, he may be left without a practical route to fulfil the registration requirements. At the same time, if he moves to another institution or country, the same-institution requirement may prevent him from satisfying the 2021 Regulations.
This creates the situation described by the petitioner as a regulatory impasse.
The Court will ultimately have to examine whether the regulatory framework contains any mechanism capable of addressing such extraordinary circumstances or whether the petitioner’s case requires relief from the strict application of the impugned provisions.
Another important aspect of the petition is the comparison between the 2021 Regulations and the Medical Council of India Screening Test Regulations, 2002.
The petitioner relies upon the earlier framework to contend that the regulatory requirements applicable to foreign medical graduates were different before the FMGL Regulations came into force. According to his case, the earlier regime focused upon the prescribed screening examination for foreign medical graduates seeking provisional or permanent registration.
The petitioner therefore argues that applying the 2021 Regulations to him would subject him to additional requirements that were not applicable when he had initiated his medical education process.
This argument is closely linked to his interpretation of the transitional provision. If the Court ultimately accepts that he was already pursuing his education before November 18, 2021, Regulation 5(2) would become relevant because it provides for the application of the erstwhile regulations to candidates falling within the protected category.
The constitutional challenge is another aspect that remains pending.
The petitioner has questioned the challenged provisions under Articles 14 and 19(1)(g) of the Constitution. The Article 14 challenge would require consideration of whether the regulatory distinction or its application to students in the petitioner’s circumstances has a rational and legally sustainable basis.
The Article 19(1)(g) challenge concerns the effect of the regulatory requirements upon the ability of qualified foreign medical graduates to enter or practise the medical profession in India.
However, the right under Article 19(1)(g) is subject to reasonable restrictions imposed by law. Consequently, the constitutional question cannot be answered merely by showing that a regulation creates difficulties for a particular candidate. The Court would have to examine the nature, purpose and proportionality of the regulatory requirements, as well as whether the impugned provisions operate within the statutory and constitutional framework governing medical education and registration.
At the present stage, the High Court has not expressed any final view on these constitutional questions.
The Court’s decision to seek a response from the Union Government is particularly relevant because the issues raised involve national medical regulation and the implementation of the FMGL framework. The Union Government and the NMC will have the opportunity to explain the rationale behind applying the 2021 Regulations to students whose classes formally commenced after November 18, 2021, notwithstanding that their admission-related processes may have begun earlier.
The respondents may also have to address the practical and regulatory implicaions of the Ukraine conflict for students who cannot complete the prescrib