NMC: FMGs who studied online must complete onsite training; 4-year-old cutoff to decide screening test or CRMI

The National Medical Commission (NMC) has written to the registrars of State Medical Councils (SMCs) of all states and Union Territories clarifying the rules regarding mandatory onsite compensation training for foreign medical graduates (FMGs) who completed part of their MBBS education online – whether due to the COVID-19 pandemic or geopolitical crises.

The clarification, issued by the Under-Graduate Medical Education Board (UGMEB), draws on the Foreign Medical Graduate Licentiate Regulations (FMGL), 2021, to determine which regulatory framework applies to different batches of students.

According to the notice, students admitted on or before November 18, 2021, who have compensated for online instruction through physical onsite training – both clinical or theory – along with internship at the foreign medical institution, will be governed under the Screening Test Regulations. However, those who enrolled after the date, fall under the Compulsory Rotating Medical Internship (CRMI) Regulations, 2021, which require them to complete a one-year mandatory internship in India before obtaining registration.

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FMG: NMC for online vs onsite training

The NMC said that the announcement primarily responds to queries raised by stakeholders regarding how the period of online medical education must be compensated through physical training.

The commission emphasised that medical education involves extensive clinical exposure and hands-on learning, making it essential for any online component to be replaced with equivalent onsite training.

“Clinical and academic training… requires substantial hands-on learning, clinical exposure, and practical experience, which cannot be effectively substituted by virtual instructions alone,” the notice stated.

NMC on compensation training, verification rules

The clarification builds upon earlier advisories issued by the NMC in December 2023 and June 2024 , which addressed disruptions faced by foreign medical students during the pandemic and other global events. While those notices introduced the requirement for compensation training, the latest directive focuses on operational details such as documentation, verification procedures, and compliance checks before granting registration.

As per the commission, compensation for online classes must involve an actual extension of the study period and completion of academic and clinical components through physical training at the concerned foreign medical institution.

The NMC cautioned that universities cannot simply issue compensation certificates without extending the course duration, as such practices would violate the intent of the FMGL Regulations, 2021, which require foreign medical education to remain equivalent to India’s MBBS curriculum.

The commission also listed key requirements that must be verified before granting registration to foreign medical graduates:

• Completion of onsite compensation training covering both theory and clinical components.

• Qualification of the screening test or FMGL examination for foreign medical graduates.

• Completion of the one-year Compulsory Rotating Medical Internship (CRMI) in India.

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The responsibility for verifying these conditions rests with SMCs in consultation with the State Directorates of Medical Education (SDME). Only after confirming compliance with all regulatory requirements can provisional registration be granted for internship, followed by permanent registration after successful completion of CRMI.

The NMC has also warned that any registration granted without verifying these requirements will be treated as a regulatory violation, underscoring the commission’s emphasis on maintaining uniform standards in medical education and medical practice in India.