NMC FMGL Regulations of 2021: Complete Guide for Indian MBBS Students Abroad

Based on: 2021 NMC FMGL Regulations, 2023 NMC Clarification, 2025 NMC Advisory

📅 When and Who is Affected?

The Foreign Medical Graduate Licentiate (FMGL) Regulations 2021 came into effect on 18 November 2021.

• 🧑‍⚕️ This law applies to:
  All Indian students who enrolled in MBBS programs abroad on or after 18 Nov 2021.
• Students who joined before this date continue to be governed by the Screening Test Regulations, 2002.

📚 Key Requirements Under FMGL 2021

1️⃣ Course Duration: 54 Months + 12-Month Internship

• 54 months (4½ years) of academic study: theory, practicals, and clinical training must be done at the same foreign institution.
• A separate 12-month internship must follow the academic phase.No part-time, online, or blended formats are accepted.
• ⚠️ The entire degree (course + internship) must be completed within 10 years of enrolment.
• Students must obtain a license to practice in the same foreign country post-graduation.

2️⃣ Medium of Instruction: English Only

• The full MBBS program must be taught entirely in English.
• Institutions must certify this formally during application to NMC.

3️⃣ Curriculum & Licensing Recognition

• The course must closely match the Indian MBBS syllabus in structure and content.
• The university must be:
  o Approved by that country’s medical regulatory authority.
  o Listed in the World Directory of Medical Schools (WDOMS).
• Students must be eligible to obtain a license to practice in the same country, just like local students.
• ❌ If Indian students are taught using a different or inferior curriculum than local students, NMC may reject recognition.

4️⃣ No Institution Switching or Transfers Allowed

• Students must complete the entire course and internship at the same university.
• Transfers due to war, pandemic, or any other reason are not allowed under FMGL 2021.

5️⃣ Supervised Compensatory Internship (India) for Disruptions

• In case of war or pandemic (e.g., Ukraine crisis), affected students may complete up to a 1-year clerkship in India at NMC-approved institutions.
• This internship is only a backup and must be NMC-approved in advance.

6️⃣ Double Internship Requirement

• After completing MBBS abroad and clearing the FMGE or NExT, all candidates must:
  o Complete a second, 12-month internship in India at a recognized teaching hospital.

7️⃣ Licensing in the Foreign Country is Mandatory

• The student must:
  o Acquire a foreign medical license after internship.
  o Be eligible to practice independently in that country.
• 🔍 Having a license valid only for foreign students or with special restrictions may lead to NMC disqualification.

8️⃣ NExT to Replace FMGE

• The Foreign Medical Graduate Examination (FMGE) is being replaced by the National Exit Test (NExT).
• NExT is mandatory for:
  o Final-year Indian MBBS students.
  o Foreign Medical Graduates (FMGs) from 2024 onwards.

9️⃣ 10-Year Completion Limit

• Students must complete:
  o MBBS course + internship abroad
  o NExT (or FMGE)
  o 12-month Indian internship
  ✅ All within 10 years from their initial enrolment date abroad.

🧑‍⚖️ Government & Court Backing

• The Supreme Court of India upheld the FMGL 2021 regulations in January 2024, ruling them legal, binding, and necessary for maintaining healthcare quality.
• No exceptions will be entertained under court intervention.

✅ Summary Table

🆕 Additional Key Points under FMGL Regulations 2021 & Updates

1. ✅ Clarification Notice: November 2023

• NMC issued a clarification on 22–23 November 2023 for FMGs (such as those from Ukraine or the Philippines):
  o FMGs with fully offline education + internship abroad can obtain provisional registration from their State Medical Council in India, followed by a Compulsory Rotating Medical Internship (CRMI) in India under the CRMI Regulations, 2021.
  o FMGs whose final-year training was online only may benefit from a one-time mobility scheme (except India) to resume their course in a third country within 3 months of that notice (in continuation of the earlier September 2022 mobility scheme).

2. 🧠 Curriculum Transparency Requirement

• Foreign institutions must provide full syllabus information publicly before students join—accessible preferably on their websites—for verification by Indian authorities under Section 61(2) of the NMC Act.

3. 📋 Core Clinical Subject Training Mandate

• The 12-month internship must include hands-on rotatory training across all core disciplines, including:
       – Community Medicine
       – Psychiatry
       – Pediatrics
       – Anesthesia
       – Obstetrics & Gynecology
       – Orthopedics, ENT, Ophthalmology, Dermatology
       – Emergency Services, Lab Subspecialties

4. ⏱️ Strict Time Window on Licentiate Exam & Internship

• As of December 2023, NMC clarified that:
       – FMGs must clear FMGE or NExT within 10 years from the date of joining the foreign institution, not just course.
       – Similarly, the Indian internship must also be completed within this 10-year limit, inclusive of FMGE/NExT timelines.

5. 📌 Eligibility Relaxations for Pre-Regulation Enrollments

• Students already admitted into MD or BS programs abroad on or before 18 Nov 2021 may:
       – Follow Screening Test Regulations 2002 instead of FMGL 2021.
       – But in certain cases (e.g., BS course), an additional 1-year internship per CRMI Regulation 2021 is mandated.

6. FMGL Criteria

• Foreign countries which do not issue equivalent practice licenses to foreign students make medical degrees post-2021 ineligible for NMC recognition—even if program duration is sufficient.

7. 🗂️ Student Accountability Emphasized

• NMC advisory reminds that non-compliance with duration, syllabus, medium, training, or internship rules can void recognition, and this responsibility lies solely with the student—not host institutions or agents.

8. ⚖️ State-Specific Disparities in Indian Internships

• May be applicable as per State Council.

9. 📅 Clarification on 54-Month Rule Interpretation

• The “54 months” refers to structured academic curriculum—not necessarily physical stay duration in the host country.
• Taking short breaks (e.g., for vacations) does not necessarily count against the rule unless educational hours/certification were compromised.

🧩 Updated Summary Table (Expanded)

2025 Advisory

The 2025 advisory highlights all the above-mentioned points and emphasizes:

Risk of disqualification: This solely lies with the student. No agent is responsible, nor can they help with registration in India.

💡 Why This Regulation Matters

• ✅ Ensures global standardization of medical education.
• 🔒 Prevents fraudulent or substandard MBBS programs.
• 💼 Makes sure graduates are competent and licensable.
• 🩺 Guarantees equal training for Indian and local students abroad.

Tips for Future Students

• Verify official NMC notices, not educational agents, for updates on eligibility, exam timelines, or internship guidelines.
• Only enroll in WHOlisted universities with full syllabus publication and recognition by the host country’s medical council.
• Avoid institutions or countries that deny equal licensing rights to foreign students.
• Check state-level internship policies in India to assess time commitments and bond obligations.
• Track your overall timeline from day 1 of admission—you have at most 10 years to complete foreign training, exam, and Indian internship.

✍️ Final Note

If you’re planning to study MBBS abroad, it’s crucial to:

• Choose your university wisely.
• Avoid any program that violates FMGL norms.
• Ensure curriculum, internship, and licensing comply with NMC and local country rules.

🛑 Ignorance of these rules can result in your degree being invalid in India—even after spending years and lakhs abroad.