At Patna’s ESIC, foreign medical interns’ months long wait for stipend

But that was not to be. Ankesh is one of 128 FMG interns – 102 men and 26 women – who have not been paid their stipend for months. Established in 2021 under the ESI Corporation, an autonomous body of the Union Ministry of Labour and Employment, the ESIC Medical College and Hospital in Bihta college is affiliated with Bihar University of Health Sciences and had an initial intake of 100 students.

While its first batch has yet to complete graduation, the college has yet another programme: an internship programme for Foreign Medical Graduate (FMG) who have completed their education abroad. So far, the college has had three batches of FMG interns – 45 in July 2024, 55 in December 2024, and 28 in February 2025. However, according to the interns The Indian Express spoke to, they have yet to be paid stipends.

In an effort to get paid, the interns have written letters to Union Health Minister Mansukh Mandaviya as well as Leader of Opposition Rahul Gandhi on March 25 seeking their intervention.  “Despite being assigned to this institution by competent authorities in accordance with the norms, regulations, and guidelines set by the Hon’ble Supreme Court of India, the National Medical Commission (NMC), and the Employees’ State Insurance Corporation (ESIC), we have not received our stipends for the past eight months,” the letter to Gandhi, written on March 25, says.

But so far, there has been no action. “We’ve received nothing despite NMC guidelines stating that foreign medical graduates who have passed the FMG exam should receive the same stipend as their Indian Medical Graduate counterparts during internship,” Prince Jaiswal, another 28-year-old intern, says.

For Ankesh — who completed his medical education in Russia where his family spent Rs 24 lakh on his medical education – non-payment of stipend has meant that he had put on hold his dreams of building a clay-tiled roof at home and supporting his aging parents. Coming from a family of small farmers and the oldest of three siblings, he spends Rs. 4,000/month to rent a room he shares with another colleague some 2 km from the hospital and often skips meals to make ends meet. “I still rely on friends for even daily personal expenses,” he says.

Unpaid loads, borrowing from family — how the interns live

According to rules by the National Medical Commission – the regulatory body for medical education in India – foreign medical graduates (FMGs) must clear the Foreign Medical Graduate Examination (FMGE) conducted by the National Board of Examinations (NBE) and eventually complete a year-long internship in approved medical colleges. Rules also state that their stipend should be the same as to those provided to Indian medical graduates being trained at government medical colleges.

“The internship is mandatory and a prerequisite to practice medicine in India, pursue postgraduate studies, or become junior resident doctors. One can’t apply for anything before its completion,” Ayush Kumar Chaturvedi, 26 — who joined ESIC in February after studying in Kyrgyzstan — tells The Indian Express.

While typical duty hours last eight hours, it could stretch up to 17 during night shifts. NMC rules also mandate 12 weeks of community medicine, which interns at the ESIC Medical College rotationally undertake at Departmental Community Medicine Centre, Rural Primary Health Centre in Koilwar, and Urban Health Centre at ESIC Phulwari.

For several of the foreign medical interns, the lack of a stipend means they have to borrow heavily from home, adding to their family’s debt burden.

“My father had to sell 3.5 bighas of land to fund my education. When this amount too ran out, my parents borrowed from relatives and family to fund my education,” Ankesh says, while his colleague Balram Kumar, 31, adds: “I still have to take Rs. 15,000 monthly from home. I don’t want to but the interns aren’t allowed to work anywhere else either until the completion of the internship.”

For Shiwangi Ojha, a 27-year-old intern at ESIC Bihta since July last year, the institute was “the only choice” she had, having been assigned here after the Foreign Medical Graduate Examination. “The confirmation letter by the hospital was delayed. On July 22, 2024 when we finally received it, no other hospitals had seats,” she says.

“Sometimes relatives pass taunts — what’s the point of such an expensive education if I can’t earn?” one medical intern, who spent Rs 35 lakh to study at Kyrgyzstan’s International Higher School of Medicine, says, adding: “But my supportive parents keep me going”.

On his part, ESIC Dean Dr Binay Kumar Biswas claimed the interns were never promised a stipend.

“The allegation placed is false. There was no promise of providing stipend at the time of joining. Rather, each student had submitted an undertaking on Rs 100 notarised stamp paper that stipend would only be provided in case such decision/order are available from institute’s higher authority in future,” he told The Indian Express in an emailed response.

It went on to say: “There is no delay in payment; payment has not taken place yet… The matter is under process; once finalised, final decision would be accordingly… There is no fixed time-line; however, the matter is under process at appropriate level. Once directives are available, it would be followed accordingly”.

However, a source at the Union Ministry of Labour and Employment said that approval to pay the stipend to FMG interns was given Friday.

Meanwhile, the Congress accused ESIC and the Union labour ministry of violating labour laws. “…as such, non-payment of stipends in Bihar will discourage doctors from working in rural areas. After such experiences, would they ever consider returning to their home state, Bihar, to work? This will only fuel the brain drain from the state, leading to increased migration,” Congress spokesperson Gyan Ranjan Gupta says.