Delhi High Court Rejects FMGE Plea by Foreign Medical Graduates; Upholds Degree Authentication Rules and Finds Fragmented Studies Across Multiple Colleges Ineligible for Screening Test
Delhi High Court Upholds NMC Rule Requiring Indian Embassy Confirmation of Foreign Medical Degrees; Rejects Challenge Based on WHO Medical School Directory Listing
Facts
The petitioners were Indian citizens who had pursued allopathic medical education abroad and sought permission to take the Foreign Medical Graduate Examination (FMGE) conducted by the National Board of Examinations in Medical Sciences. Passing the screening test would enable them to seek registration as medical practitioners in India.
They challenged Regulation 4(1) of the Screening Test Regulations, 2002, as substituted in 2009. The amended provision requires a foreign primary medical qualification to be confirmed by the concerned Indian Embassy as a recognised qualification for enrolment as a medical practitioner in the country where the awarding institution is situated.
They also challenged Clause 2.14 of the FMGE Information Bulletin, which requires foreign medical degrees either to be attested by the Indian Embassy or apostilled by the competent foreign authority under the Hague Apostille Convention.
A further challenge was directed against the National Board’s communication dated 14 May 2025, holding candidates ineligible where they had submitted an alternative primary medical qualification from another institution in place of a degree from New Tokyo Medical College/Micronesia Medical College for the same period of study.
The petitioners had moved between multiple foreign medical institutions due to circumstances including COVID-19, civil unrest and the Russia-Ukraine war. They eventually completed studies at Micronesia Medical College. After being denied FMGE eligibility because the qualification was not properly authenticated, they relied upon a subsequent certificate from Central America Health Sciences University, Belize, which purportedly validated credits/studies completed at Micronesia under an inter-institutional MOU.
The National Board found that the petitioners had effectively produced qualifications from two different medical institutions for the same period of study and declined to permit them to appear in FMGE.
Issues
The principal questions were:
- Whether Regulation 4(1) of the Screening Test Regulations, 2002, requiring recognition/authentication through the concerned Indian Embassy, was ultra vires the Indian Medical Council Act, 1956 or unconstitutional.
- Whether exclusion of institutions merely listed in the WHO World Directory of Medical Schools from automatic FMGE eligibility was arbitrary.
- Whether Clause 2.14 requiring Embassy attestation or apostille of foreign medical degrees was beyond the governing statute.
- Whether authentication requirements amounted to creation of an impermissible new eligibility condition.
- Whether the petitioners could rely on a Belize qualification issued on the basis of credits obtained during studies at Micronesia Medical College.
- Whether fragmented medical education across multiple foreign institutions could constitute a valid Primary Medical Qualification for FMGE purposes.
Petitioners’ Arguments
The petitioners argued that prior to the 2009 amendment, Regulation 4(1) recognised qualifications from institutions appearing in the WHO World Directory of Medical Schools.
They contended that removing this alternative and insisting upon Indian Embassy confirmation was arbitrary and went beyond the regulation-making power under Section 33(ma) of the IMC Act, which referred only to the “modalities” of conducting the screening test.
They relied upon Rohit Naresh Agarwal v. Union of India to argue that the Medical Council could regulate how the screening test was conducted but could not create additional eligibility criteria through regulations.
They separately challenged the apostille requirement, arguing that Section 13(4A) of the IMC Act itself did not mandate Embassy attestation or apostillation of a foreign degree.
Regarding the Belize degree, they relied upon the 19 April 2021 MOU between Micronesia Medical College and Belize Medical University, contending that credits completed at Micronesia were accepted and applied toward the Belize qualification. On that basis, they argued that the subsequent Belize degree should qualify them for FMGE.
NMC’s Arguments
The National Medical Commission defended Regulation 4(1) as a statutory provision framed under Section 33(ma) read with Section 13(4A) of the IMC Act.
It argued that Embassy confirmation had a rational and important purpose because it ensured authenticity and recognition of foreign medical institutions.
The Ministry of External Affairs stated that Embassy officials who inspected Micronesia Medical College in 2023 found grossly inadequate infrastructure, including a namesake laboratory, absence of proper faculty and institutional setup, and operation from a floor of an old building.
NMC also argued that medical education fragmented across multiple institutions could not satisfy the requirement of a proper foreign Primary Medical Qualification and referred to the Foreign Medical Graduate Licentiate Regulations, 2021, which contemplate theory, practical training, clinical training and internship in the relevant foreign institution.
It submitted that allowing such fragmented education could produce inadequately trained professionals and compromise patient safety.
National Board’s Arguments
The National Board contended that it was merely applying the existing Screening Regulations.
It relied upon an advisory of the Indian Embassy in Manila stating that, despite requests, the Government of the Federated States of Micronesia had not supplied information enabling authentication of Micronesia Medical College. Therefore, the Embassy was not in a position to authenticate its degrees or educational documents.
The Board further pointed out that candidates had been producing multiple degrees from different institutions for the same study period, leading its Examination Ethics Committee to decide that an alternate PMQ could not simply be substituted for the original Micronesia qualification.
Analysis of the Law
1. Regulation 4(1) Was Within the Medical Regulator’s Expert Domain
The Court examined Section 13(4A) and Section 33(ma) of the IMC Act.
It held that the statutory scheme required Indian citizens obtaining medical qualifications abroad to clear the screening test before registration in India. Medical regulation was entrusted to an expert professional body.
The amended Regulation 4(1) removed automatic reliance on a WHO directory listing and required recognition through Indian Embassy confirmation.
The Court held that such a policy decision, taken by an expert regulatory body on the basis of experience in regulating medical education, deserved judicial deference and could be interfered with only if shown to be absolutely arbitrary. No such arbitrariness was established.
2. WHO Directory Listing Does Not Independently Establish FMGE Eligibility
The Court therefore rejected the proposition that inclusion of a medical school in an international directory was sufficient by itself.
The Indian regulator could legitimately insist upon independent confirmation that the qualification was recognised for medical practice in the country where the institution operated.
3. Apostille and Embassy Attestation Requirements Are Valid
The High Court also upheld Clause 2.14.
It held that requiring a foreign degree to be attested or apostilled is simply a mechanism for authentication of the educational document.
Such verification enables the examination authority to prevent candidates relying upon fake or false qualifications from entering the screening process.
The Court therefore found no prejudice or illegality in demanding authentication.
4. Authentication Is Not the Same as Creating a New Eligibility Criterion
This distinction was central to the rejection of the petitioners’ reliance on Rohit Naresh Agarwal.
The Court held that Regulation 4(1) and Clause 2.14 did not create a new substantive academic eligibility criterion. They merely required authentication of the foreign medical qualification relied upon by the candidate.
Thus, the earlier decision concerning impermissible retrospective eligibility conditions did not govern the present case.
5. Micronesia Qualification Could Not Be Authenticated
The Court accepted the significance of the Indian Embassy advisory.
The Embassy had sought information from the Government of the Federated States of Micronesia concerning the medical college but received no response. Consequently, it stated that it could not authenticate degrees or educational documents issued by the institution.
That provided a legitimate basis for refusing FMGE eligibility on the Micronesia qualification.
6. Alternate Belize Degree Did Not Cure the Defect
The Court also rejected the attempt to rely on the Belize qualification.
The petitioners had first relied on a Micronesia qualification for FMGE June 2023 and later produced a Belize qualification for FMGE December 2023 covering the same period of study.
The High Court agreed with the National Board that qualifications from two institutions for the same period could not simply be substituted in this manner.
7. Fragmented Medical Education Was Held Ineligible
The Court went further and held that the petitioners had undergone fragmented studies in two or three different foreign medical colleges.
According to the Court, treating such fragmented training as a valid PMQ would not be in the public interest because it could compromise the quality of medical professionals permitted to practise in India.
The quality and continuity of medical education were therefore treated as legitimate regulatory concerns.
Precedent Analysis
Rohit Naresh Agarwal v. Union of India, 2013 SCC OnLine Del 3904
The petitioners relied heavily upon this judgment.
There, Regulation 4(3) had imposed an additional eligibility requirement and was being applied retrospectively. The earlier Division Bench held that Section 33(ma) authorised regulations concerning modalities of the screening test rather than creation of fresh eligibility criteria.
The present Court distinguished that decision because the impugned provisions concerned authentication of an existing foreign medical qualification, not creation of a new eligibility standard.
Yash Ahuja & Ors. v. Medical Council of India & Ors., (2009) 10 SCC 313
This was relied upon for the underlying object of screening foreign medical graduates.
The Supreme Court had explained that the screening mechanism was introduced to ensure that foreign medical graduates possess adequate knowledge and skills comparable to Indian medical standards and to prevent inadequately trained doctors from treating patients in India.
The Delhi High Court applied that public-health rationale to reject recognition of fragmented foreign medical studies.
Court’s Reasoning
The Court treated the case primarily as one concerning medical standards, authenticity of foreign qualifications and patient safety.
Its reasoning proceeded in three stages:
First, it held that an expert medical regulator may legitimately insist upon Indian Embassy recognition of a foreign medical qualification rather than automatically accepting a school merely because it appears in an international directory.
Second, requiring Embassy attestation or apostille is a reasonable authenticity safeguard and not an impermissible substantive eligibility condition.
Third, the petitioners could not overcome the absence of authentication of their Micronesia qualification by subsequently producing another qualification from Belize based substantially on the same period of study.
The Court considered such fragmented and overlapping educational credentials incompatible with the standards expected of doctors who would ultimately treat patients in India.
Conclusion
The Delhi High Court rejected all three principal challenges.
It upheld:
- Regulation 4(1) of the Screening Test Regulations, 2002;
- Clause 2.14 of the FMGE Information Bulletin requiring Embassy attestation/apostille; and
- the 14 May 2025 decision declaring the petitioners ineligible for FMGE.
The Court held that fragmented foreign medical studies across multiple institutions could not be treated as a valid PMQ in the circumstances and that allowing inadequately verified qualifications would compromise the quality of medical professionals in India.
The writ petition and all pending applications were accordingly dismissed with no order as to costs.
Case Details
Case: Brij Sharadbhai Bhatt & Ors. v. National Medical Commission & Ors.
Court: High Court of Delhi at New Delhi
Case Number: W.P.(C) 11266/2025 with CM APPL. 46312/2025, CM APPL. 27936/2026 and CM APPL. 46444/2026
Bench: Chief Justice Devendra Kumar Upadhyaya and Justice Tejas Karia
Judgment by: Chief Justice Devendra Kumar Upadhyaya
Reserved on: 23 July 2026
Date: 3 September 2026
Subject: FMGE eligibility; foreign medical degree authentication; Screening Test Regulations, 2002; fragmented foreign medical education
Result: Writ petition dismissed; Regulation 4(1), FMGE authentication requirement and National Board’s refusal of eligibility upheld; no costs.
