Foreign Medical Internships – and NMC Compliance

This only affects students taken admission after 2021 FMGL Regulations

As many more Indian students pursue MBBS degrees abroad, understanding the clinical internship structure abroad and its compliance with India’s National Medical Commission (NMC) guidelines under the 2021 Foreign Medical Graduate Licentiate (FMGL) Regulations has become essential. Under these FMGL Regulations of 2021, internship is a mandatory requirement to be fulfilled at the foreign institution where the student completes their degree—it is not merely an academic exercise.

My guide outlines the NMC’s requirements and analyzes the internship frameworks in Europe and the CIS region—specifically Russia, Uzbekistan, Georgia, Kazakhstan, Tajikistan, Azerbaijan, and Kyrgyzstan—based only on official regulations and foreign government sources.

There are many websites spreading false information to misguide students for business purposes. Beware, and be aware of the real facts.

Internships are mandatory from Parent College / university for licensure in India. European MD programs offer the most consistent, structured, and NMC-compliant pathways. In contrast, many CIS programs, despite being more affordable, pose significant challenges for Indian students due to non-compliant or inaccessible internship structures. Make informed decisions to safeguard your medical career.

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2021 FMGL – NMC’s Internship Requirements.

To be eligible for registration in India after earning a foreign MBBS/MD degree, students must fulfill the following internship conditions:

• The entire medical education and internship must be completed in the same country.
• Internship must be of at least 12 months’ continuous duration and completed after the academic course. (Note this carefully)
• It must be conducted under the supervision of licensed medical practitioners, and regulated by the country’s medical licensing authority.
• The graduate must be eligible to practice independently in the country where the degree was awarded.
• The course must be taught in English and have a minimum academic duration of 54 months, and More than 54 is no a credit or benefit.
• The entire program, including internship and licensure, must be completed within 10 years.
• NEET-UG qualification is mandatory before admission.
• Students must pass the FMGE/NExT exam to obtain registration in India.

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Now let’s see which all countries follow these regulations. Let me explain point wise, starting with European countries.

European MD Programs are Structured and NMC-Compliant

Countries such as Poland, Hungary, Latvia, Bulgaria, Italy, Romania, and Malta offer 6-year MD programs aligned with EU standards.

Why?? Let me tell you.

• Internship is integrated within the academic curriculum, usually during the sixth year or the last year, which is a dedicated fully structured internship.
• Supervised by national medical councils and conducted in university-affiliated hospitals.
• Governed by the European Credit Transfer and Accumulation System (ECTS).
• Fully taught in English.

NMC Compliance: These programs will meet all NMC criteria, making them a preferred option for Indian students. Students are also required to repeat the internship in India to get oriented with Indian system and this additional internship in India rule applies to all countries where ever you study.

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Now let’s talk about: CIS Region MD Programs and its Mixed Structures and Challenges

Many CIS countries offer six-year MD programs, but their internship structures often conflict with NMC’s requirements for a separate, post-MD internship aka Internatura.

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In Russia

• The standard 6-year MD program does not include a formal internship.
• To gain local licensure, graduates must complete a 1-year postgraduate internship called Internatura.
• This is Governed by Federal Law No. 125-FZ and Ministry of Health Letter No. 2374 (2005).
• Internatura involves ~2,592 clinical hours under the supervision of universities and regional healthcare authorities.
• Not consistently offered to foreign students, and typically conducted in Russian.

NMC Compliance: Despite being mandated under Federal Law No. 125 FZ and Ministry of Health Letter No. 2374 (2005), Russia’s Internatura was officially discontinued for new entrants as of September 1, 2016—replaced by ordinatura (clinical residency) and advanced retraining . What this means:

• It is not a current, government-regulated, post-MBBS internship, which disqualifies it under NMC FMGL norms.
• Though a formal postgraduate clinical training exists, it does not fulfill the NMC requirement of a structured 12-month foreign internship post-MBBS.
• Russian Internatura no longer matches NMC standards.

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In Uzbekistan

• 6 year MD in Uzbek is equal to academic duration of 54 months, the MD (MBBS equivalent) program in Uzbekistan does not include Internatura within its 6-year academic structure. Internatura in Uzbekistan is a separate, postgraduate internship program that must be completed after graduation from the MD course.
• Offers a structured post-MD internship officially titled Birlamchi maqsadli ixtisoslashtirish kurslari (Internatura), meaning 6 + 1 year duration in total.
• Regulated by the Ministry of Health under Cabinet of Ministers Resolution No. 319 (2009).
• Conducted in Uzbek or Russian, and usually at state-run hospitals like Tashkent Medical Academy (Now Tashkent State Medical University) or Bukhara State Medical Institute.
• Interns apply between August 5–20 with selection via interviews or oral exams.
• Includes rotations in internal medicine, paediatrics, anaesthesiology, and other primary care fields.
• Stipends and housing are often provided under state-funded quotas.

 NMC Compliance: While the internship meets structural requirements, language limitations and limited slots for foreign students make access difficult.

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In Georgia

* Final-year clinical training is provided as academic rotations, not as a regulated postgraduate internship.

* No official post-MD internship is mandated by the Ministry of Health.

* Graduates are typically not eligible for independent medical practice upon graduation.

NMC Compliance: The absence of a government-regulated internship makes Georgian MD programs non-compliant with FMGL norms.

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Internship Status in Georgia (2025 Update)

What the MD Program Offers:

• Georgian medical universities offer a 6-year MD program (considered equivalent to academic duration of 54 months in MBBS).
• The final year usually includes clinical rotations, but: These rotations are academic modules, not formal internships.
• They are not supervised or regulated by the Georgian Ministry of Health.
• There is no official licensing after completing the MD alone; graduates must pursue postgraduate training to be eligible for independent practice.

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Internatura in Georgia: Not Available

* Georgia does not offer a post-MD internship system like Internatura found in Russia or Uzbekistan.

* There is no government-recognized postgraduate internship regulated by the national health authority.

* There is no official documentation from the Ministry of Education and Science or the Ministry of Health of Georgia confirming the existence of Internatura.

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NMC Compliance Status

According to the Foreign Medical Graduate Licentiate (FMGL) Regulations, 2021 issued by the National Medical Commission (NMC) of India, to be eligible for licensure in India:

1. The internship must be 12 months, well structured, supervised, and conducted after the MD program, not 6th year clinical rotation which is wrongly told 5 + 1.
2. It must be regulated by the national medical licensing authority in Georgia.
3. The graduate must be eligible for independent practice in the country of education, which is to get licence from National Post-Diploma Qualification Exam (NPDQE).

Georgia fails to meet these conditions because:

* No structured post-MD internship exists.

* Graduates cannot practice independently in Georgia with just an MD degree.

* Clinical exposure is limited to in-course academic rotations, not government-recognized internships.

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In Kazakhstan: Structured Internship with Government Oversight

Kazakhstan is one of the few CIS countries that offers a government-regulated internship (known as “internatura”) after the MD degree (equalent to 54 months academic duration) , aligning it well with the NMC’s Foreign Medical Graduate Licentiate (FMGL) Regulations, 2021.

Key Features:

• Regulatory Framework: Defined by the Ministry of Health under Order No. ҚР ДСМ 300/2020, internship is mandatory clinical training conducted post-MD.
• Duration: 1 year of structured, full-time clinical work under mentorship.
• Location: Conducted at university-affiliated hospitals and clinical bases.
• Certification: Interns undergo state assessment and receive a certificate of completion, qualifying them for licensure in Kazakhstan.
• Medium: Programs are increasingly being taught in English, and interns are supervised by licensed medical professionals.

Residency (Ordinatura):

In addition to internatura, graduates can apply for 2–4 year residency training for specialization. This pathway is regulated under Ministerial Order No. 28 (Jan 30, 2008).

NMC Compliance:

Kazakhstan’s internship structure fulfills all key NMC conditions, which is 6+1 years.

• 12-month duration addition to 6 year.
• Regulated by national licensing authority
• Leads to independent practice eligibility in Kazakhstan

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Kyrgyzstan: Gaps in Internship Structure

Unlike Kazakhstan, Kyrgyzstan does not offer a formally structured, government-regulated internship program post-MD.

Key Observations:

• Clinical Rotations: Offered during the final year of the MD program, often in university hospitals, that is not internship.
• Lack of Regulation: No official internatura framework regulated by the Ministry of Health.
• No Postgraduate Internship: Kyrgyzstan does not mandate a structured post-MD internship for licensure.

 NMC Compliance:

Due to the absence of a government-recognized internship:

• Kyrgyzstan fails to meet the NMC’s 12-month, post-MD, supervised internship requirement. The final yaer clinical rotation is not internship.

🇰🇬 Kyrgyzstan – Limited Postgraduate Internship Clarity

• Kyrgyzstan offers short-term clinical attachments (2–4 weeks) via institutions like International Higher School of Medicine—but these are non-governmental electives, not regulated postgraduate internships
• There is no evidence from the Ministry of Health or Education of a formal internship program equivalent to Kazakhstan’s model, or a structured post-MD mandatory internship.

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• Kazakhstan offers a legally defined 1-year internship and structured residency, aligning with NMC’s FMGL requirements for a post-MBBS internship done in the same country. The total duration makes 7 year including NMC complaint internship.
• Kyrgyzstan lacks a government-recognized postgraduate internship. The short-term electives available to foreign students do not fulfill NMC criteria.

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Quick Comparison: Internship Structures

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Why “Internatura” Matters for Indian Students

• Russia and Uzbekistan offer formal, post-MD internships regulated by the government.
• Uzbekistan’s Internatura, though compliant in structure, is limited by language and competitive selection.
• Russia’s Internatura may not be accessible or recognized for foreign students and is not always aligned with NMC requirements.
• Georgia lacks a post-MD internship altogether, and Kazakhstan/Kyrgyzstan lack uniform regulation.

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Consequences of a Non-Compliant Internship

• Risk of disqualification as per 19th May 2025 NMC advisory, this risk sole lays on candidate.
• Delayed NMC registration, leading to a loss of time and career progression.
• Increased financial burden due to additional living expenses and training costs.
• Reduced eligibility for postgraduate studies and international licensing (USMLE, PLAB, etc.).

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 Final Advice for Indian Medical Aspirants

Before selecting a foreign medical university, always:

 Verify: use the designated countries government sources only.

• Whether the internship is post-MD, 12 months long, and government regulated.
• If foreign students are eligible for the internship and local licensure.
• That the course is taught entirely in English.
• Consult the NMC Gazette or seek guidance from reliable medical education advisors.