SC order on internship stipend reflects need for national policy for medical interns

The Supreme Court''s decree to the Army College of Medical Sciences (ACMS) to grant internship stipend arrears to its 2018 MBBS batch, who finished their internships in 2022, sends a powerful message to the medical community of the country.

The case started with a 2022 Article 32 petition filed by MBBS graduate Abhishek Yadav and others, who pointed out that MBBS interns were forced to work "18–19 hours a day" without any stipend. In September 2023, the Supreme Court permitted payment of stipends to students from later batches, but whether payment would be made to the 2022 petitioners themselves was left undecided, as they had already completed their internships. That matter was finally settled this week, when the court directed ACMS in Delhi to pay arrears for internship stipend at the rate of Rs 25,000 per month to the batch who did internships in 2022.

The court condemned the non-payment, describing it as compelling students to labor for long hours without payment.

"Why are you going to pay a stipend? They are entitled to it as a matter of right," the SC Bench headed by Justices Sudhanshu Dhulia and Aravind Kumar said.

Talking to The Tribune, Advocate Tanvi Dubey, who appeared for the petitioners said, "The complaint was that even though they have heavy working hours and grueling duties, they are not being given a basic stipend which they are entitled to as a matter of right."

She said the petitioners were not only overworked but also posted to rural areas and had to pay for their own transport and accommodation. "Let apart a basic stipend, they are actually spending a lot from their own pocket to survive and yet they are performing strenuous duties," Dubey said.

Why this order matters?

This verdict matters as, according to Dubey, ACMS had maintained that as soon as an intern's term ends, the stipend becomes a non-issue. The court did not accept that reasoning. In doing so, it established that stipend is not a discretionary allowance but an ethical and legal entitlement.

"It is a big relief for them because now they receive that ?25,000," said advocate Dubey.

The court did not rest at administrative interpretation. It gave a clear moral and constitutional censure. Justice Aravind Kumar posed the questions in point:

Justice Kumar sharply criticised the position of ACMS and stated, "You make them work for 18 hours, 19 hours and you don't want to give them a stipend?"

Broader impact on medical students

As per Dubey, the problem is rampant. Several government and private institutions of India do not have a standard stipend policy, and students become vulnerable. "They are already burdened with massive education loans," she stated. "It's an enormous crisis of their own survival because they incur these everyday expenses without any payment of stipend."

She stressed that such a scenario demotivates students and tends to discourage them from further studies or specialisation. "This is not a luxury demand. It's a basic issue of dignity," Dubey said.

Implications for Foreign Medical Graduates

The Supreme Court is also considering the petitions put forward by foreign medical graduates, who have studied MBBS abroad but are needed to intern in India prior to being permitted to practice.

Most of them are also unpaid or underpaid in their internships.

"We are saying this is sort of bonded labour because they are working conscientiously, almost performing the same tasks as Indian medical graduates. and yet they are footing heavy bills out of their own pocket," she said.

Certain institutions, including prominent ones such as RML (Ram Manohar Lohia) Hospital, have been mentioned in these petitions. "Individuals from RML not receiving a rupee, they have also put up a petition," she stated.The Supreme Court has given importance to the matter. Judges have verbally commented that FMGs also should receive a "bare minimum stipend as a matter of right." These cases are likely to be heard finally in the next few months.

Order emphasizes need for pan-India policy

Activist Dubey emphasized that the National Medical Commission (NMC) should move quickly to establish a pan-India, enforceable policy on stipend for all interns—irrespective of institution or their medical degree's origin.

"There has to be a structural, universal order to be passed by the central authority… NMC should come up with strict guidelines that payment of stipend is a matter of right for all these people," she said.

More than 70,000 MBBS students pass out annually in India, all of whom need to undergo internships. However, there is no consistent rule that guarantees they get paid well and uniformly across institutions and states.

Talking to The Tribune, Advocate Tanvi Dubey, who was representing the petitioners stated, "The complaint was that in spite of long working hours and arduous duties, they are not given a basic stipend which they are entitled as a matter of right."