Explainer: SC order on internship stipend mirrors need for national policy for medical interns

The Supreme Court’’s order directing the Army College of Medical Sciences (ACMS) to pay internship stipend arrears to its 2018 MBBS batch, who completed their internships in 2022, leaves a strong message to the medical fraternity across the country.

The case began with a 2022 petition under Article 32 filed by medical graduate Abhishek Yadav and others, who highlighted that MBBS interns were made to work “18–19 hours a day” without receiving any stipend. In September 2023, the Supreme Court allowed the payment of stipends to students from subsequent batches, but whether the 2022 petitioners themselves would receive payment remained undecided, as they had already finished their internships. That issue was finally resolved this week, as the court ordered ACMS in Delhi to pay internship stipend arrears, calculated at Rs 25,000 per month, to the batch that completed internships in 2022.

The court criticised the non-payment, saying it amounted to forcing students to work long hours without compensation.

“Why will you pay a stipend? They deserve it as a matter of right,” the SC Bench comprising Justices Sudhanshu Dhulia and Aravind Kumar said.

Speaking to The Tribune, Advocate Tanvi Dubey, who represented the petitioners said, “The grievance was that despite heavy working hours and rigorous duties, they are not paid a basic stipend which they deserve as a matter of right.”

She added that the petitioners were not only overworked but also sent on rural postings, often having to pay for their own transport and accommodation. “Let apart a basic stipend, they are in fact spending a lot from their own pocket to survive and yet they are doing rigorous duties,” Dubey said.

n Why this order matters?

This ruling is significant because, as Dubey explained, ACMS argued that once an intern’s tenure ends, the question of stipend becomes irrelevant. The court rejected that logic. By doing so, it affirmed that stipend is not a discretionary payout but a legal and ethical right.

“It is a great respite for them because now they get that ?25,000,” said advocate Dubey.

The court didn’t stop at administrative interpretation. It issued a clear moral and constitutional rebuke. Justice Aravind Kumar asked pointedly:

Justice Kumar strongly criticised the stand of ACMS and said, “You make them work for 18 hours, 19 hours and you don’’t want to pay them a stipend?”

n Broader impact on medical students

According to Dubey, the issue is widespread. Many government and private institutions across India lack a uniform stipend policy, leaving students vulnerable. “They are already overburdened with huge education loans,” she said. “It’s a huge crisis of their own existence because they incur these day-to-day expenses without any payment of stipend.”

She emphasised that this situation demotivates students and often discourages them from pursuing further studies or specialisations. “This is not a demand for luxury. It’s a matter of basic dignity,” Dubey added.

n Implications for Foreign Medical Graduates (FMGs)

The Supreme Court is also hearing petitions filed by foreign medical graduates, who have completed MBBS degrees abroad but are required to intern in India before being allowed to practice.

Many of them, too, are unpaid or underpaid during their internships.

“We are saying this is kind of bonded labour because they are working rigorously, almost doing the same duties as Indian medical graduates... and yet they are incurring heavy expenses from their own pocket,” she said.

Some institutions, including reputed ones like RML (Ram Manohar Lohia) Hospital, have been named in these petitions. “People from RML not getting a single rupee, they have also filed a petition,” she said.The Supreme Court has taken the matter seriously. Judges have orally remarked that FMGs too deserve a “bare minimum stipend as a matter of right.” These cases are expected to be heard conclusively in the coming months.

n Order highlights need for pan-India policy

Advocate Dubey said the National Medical Commission (NMC) must act swiftly to create a pan-India, enforceable stipend policy for all interns—regardless of the institution or origin of their medical degree.

“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.

Over 70,000 MBBS students graduate every year in India, all of whom are required to complete internships. Yet, there is no standard rule ensuring that they are paid fairly and consistently across states and institutions.