NMC FMGL Regulations 2021 Explained: The Rules Every MBBS-Abroad Student Must Meet

What are the NMC FMGL Regulations 2021?

The Foreign Medical Graduate Licentiate (FMGL) Regulations, 2021 are the rules India's National Medical Commission (NMC) uses to decide whether a foreign medical degree can lead to a licence to practise in India. They were published in the Gazette of India (Extraordinary, No. 581) on 18 November 2021 under sections 15(4) and 57 of the National Medical Commission Act, 2019.

The regulations are short, just five regulations and one schedule, but they decide where you can study, for how long, in what language and what you must do after you come home. Regulation 3 sets the baseline: no foreign medical graduate may practise medicine in India unless granted permanent registration under these rules.

This guide goes through the text clause by clause, then covers the NMC notices and country advisories issued since 2021, and ends with a checklist you can use on any university. For the exams that follow, see our guides to the FMGE exam and NExT.

Who do the FMGL rules apply to?

FMGL 2021 applies to Indian citizens and Overseas Citizens of India (OCIs) who started a foreign medical course on or after 18 November 2021. Anyone joining in 2027 is fully covered.

Regulation 5 exempts three groups: graduates who already held a foreign degree before the regulations came into force, students who were already studying abroad on that date, and anyone specifically exempted by NMC or the Central Government by notification. The first two groups stay under the earlier rules, chiefly the Screening Test Regulations, 2002.

The NBEMS bulletin for FMGE October 2026 states that the eligibility of anyone admitted on or after 18 November 2021 "shall be determined strictly" under FMGL 2021, and that an FMGE certificate obtained by falsely claiming an earlier admission date will be revoked.

FMGL 2021 requirements, clause by clause

Regulation 4 lists what you need before you can be granted permanent registration. Schedule I adds detail about content, location and timing. Here is the full set in one table.

1. Minimum course duration of 54 months

The course leading to the foreign degree must last at least fifty-four months. NMC's FAQs on FMGL confirm the figure and stress that the internship is a different phase. Clinical postings during the 54 months do not count as the internship.

In practice, a 5-year course plus a 1-year internship, or a 6-year integrated programme with a final internship or clerkship year, can both work. A 4-year course cannot, however good it is.

2. A 12-month internship at the same foreign university

Regulation 4(a)(ii) requires an internship of at least twelve months "in the same foreign medical institution". Schedule I adds that it must include hands-on training in clinical subjects. Ask the university for the internship structure in writing, including which hospital it uses and whether international students get real patient contact.

3. English as the medium of instruction

The degree must be received "with medium of instructions in English". This is where many problems arise. A programme may teach theory in English but run clinical training in the local language, because patients do not speak English. NMC's April 2026 Uzbekistan alert cited exactly this: students "not receiving hands on training" because the medium of instruction was not English.

Learning the local language is still useful, and often necessary to talk to patients. The point is that the formal teaching and examination must be in English.

4. The Schedule-I subjects

Schedule I requires theory, practical and clinical training equivalent to India's MBBS, with internship training in at least community medicine, general medicine, psychiatry, paediatrics, general surgery, anaesthesia, obstetrics and gynaecology, orthopaedics, otorhinolaryngology (ENT), ophthalmology, dermatology, emergency or casualty services, and lab services. The curriculum must match the Graduate Medical Education Regulations, 1997, and be available for review, if necessary on the university website, when you join.

5. The same institution, the same country

Schedule I 2(iii) says the entire course, training and internship must be done outside India, in the same foreign medical institution, and that no part may be done in India or in any country other than the one awarding the degree. NMC's FAQ answers "No" to the question of whether students can move to an Indian college for internship and exams.

This single clause rules out mid-course transfers, "twinning" programmes that send you to a second country, and offshore campuses in India. NMC's May 2025 advisory restated it as "clinical training must not be done in parts or across different countries".

6. A licence on par with citizens

Regulation 4(b) is the clause students most often overlook. You must be registered with the host country's medical regulator, or be competent to receive its licence, "at par with the license to practice medicine given to citizen of that country". If foreign graduates can only get a restricted licence there, the degree may fail this test.

This has been an issue for the Philippines. NMC's November 2023 notice de-recognised the Philippine BS pre-medical course from 18 November 2021 and said MD students admitted before that date need an extra year of internship in India because their course "is of 48 months only". In August 2025 Medical Dialogues reported that the Philippine higher-education regulator had told the Indian Embassy in Manila that its MD programmes align with NMC norms, but that was not an NMC notice. Our Philippines guide treats the country as "mixed" for this reason.

7. Finish within 10 years

The whole foreign course must be completed within ten years from the date of joining. Most students never come close, but long breaks, failed years or visa problems can eat into the window.

8. Supervised internship in India

Even after a full internship abroad, Regulation 4(c) requires a supervised internship in India of at least twelve months after applying to the Commission. NMC's FAQ says you apply through the State Medical Council, and the internship follows the Compulsory Rotating Medical Internship (CRMI) Regulations, 2021. Our internship guide covers seats, stipend and documents.

9. The licensing exam

Regulation 4(d) requires you to clear "the National Exit Test or such other mandated test or tests". NExT has not started, so the test today is the FMGE, conducted by NBEMS. An NMC public notice of 22 November 2023 caps the time to appear in FMGE or NExT at 10 years from completing the foreign course.

What do the FMGL rules say about online classes?

NMC's FAQ allows online classes "of theory subjects only", supplemented by offline practical and clinical training at the university and its hospital, with a certificate of completion. Students who studied online during COVID-19 or the Ukraine war must compensate with physical training.

A public notice of 7 December 2023 set the compensation framework. A further notice on 18 March 2026 clarified how State Medical Councils should verify it, and NMC's FAQs of 8 June 2026 say that notice "does not create any new category of eligibility". If you ever study online, keep official transcripts, attendance records and passport stamps.

NMC clarifications and advisories since 2021

FMGL 2021 has not been rewritten, but NMC has issued a series of notices that shape how it is applied. Here are the ones that matter most for new students.

The May 2025 advisory is worth quoting directly: students graduating from non-compliant institutions "will be held ineligible for licensing exams i.e. FMGE in India", and "the onus of this disqualification lies solely with the student".

The April 2026 Uzbekistan advisory

On 1 April 2026 NMC's Under-Graduate Medical Education Board issued an alert note on admissions in Uzbekistan, based on a communication from the Embassy of India in Tashkent. It named:

1. Bukhara State Medical Institute (BSMI)
2. Samarkand State Medical University (SSMU)
3. Tashkent State Medical University (TSMU)
4. TIT Institute of Medical Sciences, Bangalore, described as an offshore campus of the TSMU Termez branch

The embassy's concerns were admissions beyond sanctioned intake, students not getting hands-on training because clinical teaching was not in English, and complaints about the Termez–Bangalore offshore model. NMC advised Indian citizens and OCIs considering Uzbekistan "or similar destinations" to exercise extreme caution.

In clarifications reported in August 2026, the Indian Embassy in Tashkent said the advisory was precautionary and not a ban, and the Haryana Medical Council said the same for the three universities. Uzbekistan is not closed, but every Uzbekistan university needs a careful FMGL check. The April 2026 note cites the separate July 2025 alert on the Chirchik branch of TSMU and three Belize institutions, and we found no NMC notice withdrawing it.

Offshore campuses and twinning programmes

An offshore campus is a foreign university's programme taught partly or fully in another country, sometimes in India. Under Schedule I 2(iii), no part of your medical training may be done in India or in a third country. NMC's May 2025 advisory was issued as an alert on "unauthorised medical colleges and off-shore medical programs", and its April 2026 Uzbekistan note cautioned against "offshore programs operating in violation of regulatory norms", naming a Bangalore campus linked to a Tashkent university branch.

If an agent offers "first two years in India, then abroad", or a degree from one country with clinical years in another, assume it fails FMGL 2021 unless NMC has said otherwise in writing.

The myth of "NMC-approved universities"

NMC does not approve, recognise or list foreign medical universities. There is no official "NMC-approved" list for any country. The FMGL Regulations set conditions on your course; compliance is tested when you apply for FMGE, internship and registration.

The only college list NMC publishes is of medical colleges in India. Its advisory of 5 November 2026, issued after a Supreme Court direction, tells students to check a college against that list and not to pay agents, personal bank accounts or unverified intermediaries; it names no foreign university. Our guide to what NMC actually publishes about foreign universities sets out every NMC advisory that names a foreign institution.

The Health Ministry told Parliament in July 2022 that because a qualifying NEET result is deemed to be the Eligibility Certificate, "no separate permission required from NMC" is needed to go abroad, and data on students studying abroad is not maintained centrally. No one, including NMC, signs off on your university before you leave.

When an agent says "NMC-approved", it usually means one of three things: the university is listed in the World Directory of Medical Schools, Indian graduates of it have passed FMGE before, or the agent simply wants a sale. None of these is approval. Read our red flags guide before paying anyone.

Check your university: a 12-point FMGL checklist

Use this list on every university you shortlist. Ask for documents, not verbal promises.

1. Course length: get the official curriculum showing at least 54 months of study, separate from the internship.
2. Internship: confirm a 12-month internship at the same university, with the hospital named.
3. Language: confirm in writing that teaching and exams for all years, including clinical years, are in English.
4. Subjects: compare the curriculum with the Schedule-I subject list (medicine, surgery, paediatrics, obstetrics and gynaecology, community medicine, psychiatry, orthopaedics, ENT, ophthalmology, dermatology, anaesthesia, emergency).
5. Single institution: no transfers, twinning, Indian campus or third-country clinical rotations.
6. Local licence: ask whether foreign graduates get the same licence as citizens, and look for the regulator's or embassy's confirmation.
7. Government recognition: check that the university and its medical programme are recognised by the host government and listed in WDOMS.
8. NMC advisories: search NMC's public notices for the university and country, and read the Indian embassy's advice.
9. Intake size: ask how many international students join each year. Over-admission was a key concern in the Uzbekistan alert.
10. FMGE record: look up the university in the NBEMS institute-wise FMGE performance report. Low pass rates are a warning sign.
11. NEET: make sure you hold a qualifying NEET-UG result that will still be valid on the day you join.
12. Payments: pay fees to the university's own account and keep receipts, as NMC's April 2026 alert advises.

What if your course does not comply?

If your course fails any FMGL clause, the NBEMS bulletin says you will be declared ineligible for FMGE, and you cannot get provisional or permanent registration in India. NMC's own wording is that deviations in duration, medium of instruction, syllabus, clinical training or internship "may result in disqualification".

You might still practise in the country where you studied, or try other countries' licensing routes (see our guide to USMLE, PLAB and other exams), but the Indian route would be closed. That is why the checks above matter more than any brochure. If you are still comparing destinations, start with our overview of countries for MBBS abroad and the eligibility guide.