SRINAGAR: Shah Sayar from Tral, Pulwama, eats only once a day. There is no lunch. To ease the burden on his family, he takes on whatever work he can find around his university in Almaty, Kazakhstan. Back home, his father puts sixty percent of his salary towards Shah's education. The family thinks twice before buying new clothes for Eid.
"My parents ask me every time they call: What is the progress of the NMC situation? Are you doing enough? Will the university reduce fees? Will the NMC give you relief?" he said. "And I just respond with silence, because for all these questions I have no answers."
Shah is not alone. Thousands of Indian students enrolled in the 2021–22 academic session at medical universities across Kazakhstan, Kyrgyzstan, Russia, Bangladesh, Ukraine, Uzbekistan, and Bosnia and Herzegovina are caught in the same bind, the consequence of a single regulatory decision made on a single day, with no warning and no transition.
The Notification That Changed Everything
On November 18, 2021, the National Medical Commission issued a new regulation for foreign medical graduates.
According to Point 4 of the notification, “no foreign medical graduate shall be granted permanent registration unless he has: (a) (i) undergone a course leading to foreign medical degree with minimum duration of fifty-four months; (ii) undergone an internship for a minimum duration of twelve months in the same foreign medical Institution.”
Students whose classes had begun before that date of issue of the notification would remain under the older 2002 regulations. Those whose classes started after it would fall under the new 2021 rules, which added a mandatory extra year of internship, effectively extending a five-year MBBS programme to six years.
The cut-off was immediate. There was no grace period, no transition clause, and no communication to students who were already mid-process, arranging documents, securing visas, and finalising education loans based on a five-year course.
For the January 2022 intake of the 2021–22 academic session, the timing was particularly harsh. Universities across these countries offer two intakes each year, an autumn intake in September and a winter intake in January, eventually merging in the fourth or fifth year of study.
Students who had chosen the January intake for practical reasons, including waiting for NEET-UG results or completing documentation, found themselves on the wrong side of a date they had never been told to worry about.
"I came in contact with an agent who thoroughly explained the procedure for a five-year MBBS programme, fees, all the details," said Shah Sayar. "Then, half of November passed and suddenly the NMC issued this regulation. I was left shell-shocked. Students and parents are yet to figure out how the NMC decided on November 18, 2021, as the date. They implemented it the same day the notification was issued."
His admission letter and university documents listed him as a 2021-batch student on a five-year course. He learned about the regulation only in his second semester, through friends.
Same Batch, Different Rules
Shahid Farooq, 23, from Baramulla, is pursuing MBBS at Asfendiyarov Kazakh National Medical University. He enrolled in January 2022 for the 2021–22 academic session.
"Before enrolling, I made sure to verify everything. My consultant and university assured me that since my academic session was 2021–22, I would fall under the old rules. At that time the course duration was five years only," he said. "This was mentioned in my admission documents and there was no indication of any additional internship or extension."
His family arranged funds through an education loan and savings, planning carefully around a fixed five-year timeline. Every financial decision including repayment schedules, return dates, future income was built on that foundation.
"Now due to the new regulation, everything has changed. We are facing the possibility of an additional internship year, which means extra expenses of around ten to twelve lakh rupees. Loan repayment is already a concern, and extending the course means more financial pressure, delayed earnings, and increased stress on my family."
Academically, Shahid was due to complete his MBBS by June 2026. He had planned to return home, prepare for licensing exams, and begin supporting his family. Now his completion may be pushed to 2027, with eligibility to practise in India delayed until 2028 — a gap of nearly two years during which he will remain financially dependent while responsibilities at home continue to grow.
"What makes this harder is the fact that we were never properly informed. At the time of admission I had no awareness of such a rule. Even later, there was confusion about whether it applied to my batch. Neither the consultant nor the university explained the risks or possible consequences. We made this decision in good faith, trusting the system and the information given to us."
'We Trusted the System'
Shweta Ekunde from Pune, Maharashtra, is in the same situation. Also studying at Asfendiyarov Kazakh National Medical University on a January 2022 intake, she had taken the extra step of calling the NMC directly before enrolling.
"They told me verbally that since my academic year is 2021–22, I would fall under the old regulations. My consultant and university said the same thing. I trusted that," she said.
Her admission letter and university contract specified a five-year course. Her family planned for total expenses of twenty-five to thirty lakh rupees. The additional internship now means an expense of ten to twelve lakh rupees.
"The main issue is that our contract is only for five years. For the internship, we will have to take re-admission and pay extra fees, which was never part of the plan. Many of my friends have taken education loans based on a five-year course. This sudden increase in cost has created a big financial burden for families," she said.
This is a wider problem than individual family finances. Most Indian students pursuing MBBS abroad secure education loans based on admission documents specifying a five-year programme. Banks processed those loans accordingly. Adding an extra year now places students in a position where banks will not release additional funds, leaving them to cover the costs themselves.
Shweta was due to complete her degree by June 2026. The delay now pushes her graduation to September 2027 and her eligibility for the Foreign Medical Graduate Examination to around June 2028, a career delay of nearly two years. Her family had expected her home by August 2026.
"We have tried contacting the NMC, but there has been no clear response or support so far. We don't know what decision the NMC will take. I had no information about this rule when I took admission. I came to know about it in my second year, but even then, it was not clear whether my batch came under the old or new rules."
The Human Cost
For Shah Sayar, the uncertainty has affected far more than finances.
"I cannot concentrate on studies knowing I will have to pay an extra ten lakhs and stay for one and a half years extra to complete the same degree. I get nightmares about the situation my family is going through," he said.
He and his September-intake batch-mates attend the same classes, have the same teachers, follow the same schedule, and will graduate in the same ceremony. The only difference is a date on a document, which falls four months apart, and which places them under different regulations entirely.
"Same batch, same classroom, same teachers, same graduation ceremony, but I will have to do at least one and a half years extra," he said.
Combined with licensing exams, internship, and registration formalities, Shah estimates his path to practising medicine in India will now take close to nine and a half years, compared to around eight under the old rules.
The financial toll has changed how he lives. Annual costs at his university - tuition, hostel, travel, visa, and personal expenses - already ran to approximately seven lakh rupees. Inflation and increased hostel rents have added to the pressure. He has cut meals and taken on additional work to avoid burdening his family further.
"My family is already going out of their way to support me. The mere financial burden will force half of my batchmates to either sell property or drop out. Ageing students who came here after three or four attempts and are yet to support their families feel distraught, dejected, and an utter failure."
The Numbers Behind the Crisis
The impact on enrolment at Asfendiyarov Kazakh National Medical University reflects the broader consequences of the regulation.
In 2021, before the rule was widely understood, 702 students enrolled. By 2022 that number had fallen to 300, and it has remained at around 250 in 2023 and 2024, dropping further to 191 in 2025. Comparable data for other affected universities is not yet available.
Students Plea
The students are not asking for the regulation to be reversed. Their request is: a grandfather clause, or transitional relief, that would treat the entire 2021–22 academic batch, regardless of whether they joined in September or January, under the same set of rules.
Specifically, they are calling for the NMC to either extend the cut-off date to March 31, 2022, or grant a one-time exemption for students of this batch, on the grounds that the regulation came into effect mid-session, without notice, at a point when many had already committed financially and legally to a five-year course.
"I strongly believe that students of the 2021–22 batch deserve fair treatment. We joined a five-year course with a clear understanding, and changing the rules midway has put us in a very difficult position," said Shahid Farooq.
"I believe there should be a uniform rule for the entire 2021–22 batch so that no student suffers because of time differences," said Shweta Ekunde.
"I am not demanding anything. I am requesting the administration to treat us as their own. We want to serve the community. Please don't create hurdles for us and solve our case on a humanitarian basis," said Shah Sayar.
The issue has reached the political level. A student delegation has approached several elected representatives, including Er. Rashid, Waheed-ur-Rehman Parra, Sajad Gani Lone, and Rafiq Ahmad Malik, all of whom have since approached the Ministry of Health and Family Welfare pressing for a resolution.
The NMC is understood to be preparing a fresh regulation on foreign medical graduates. What it will say and whether it will address the situation of the 2021–22 January intake remains to be seen.
For students like Shahid, Shweta, and Shah, the wait continues. Their goal has not changed. The path to reaching it has simply become longer, more expensive, and far less certain than the one they signed up for.
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