Kerala’s Medical Crisis: Foreign Graduates Linked to Rising Negligence
• FMGs Undermining Kerala’s Healthcare: A Growing Concern
• Unqualified Doctors in Kerala: The Hidden Risk in Healthcare
Nirmal Jose Pynadath
Sprouts News Network
Over 25,000 foreign medical graduates (FMGs) employed by private hospitals in Kerala are inherently lowering the quality of medical treatment. Their detrimental presence has led to growing concern over medical negligence, with cases including pregnant women losing fetuses, delayed surgeries resulting in complications requiring amputation, misdiagnoses, and diagnostic delays.
These unskilled doctors, who graduated from countries with different healthcare systems, disease profiles, and teaching standards, are not fully aligned with Kerala’s medical needs. Many have not cleared the mandatory Foreign Medical Graduate Examination (FMGE) conducted by the National Medical Commission. Private hospitals exploit them as cheap labor.
The FMGE is a significant hurdle for FMGs, with pass rates often below 20%. The All Kerala Ukraine Medical Graduates and Parents Association has highlighted over 5,000 aspirants affected by the Ukraine war, underlining the state’s large FMG population.
When 1,000 Kerala-based foreign medical graduates appear for the FMGE, only about 200 pass each session. Over time, this creates a surplus of unlicensed doctors, leaving them vulnerable to exploitation by private hospitals.
Moreover, cost-cutting private hospitals in Kerala also recruit FMGs from neighboring states like Karnataka and Tamil Nadu. Since their training does not match Kerala’s medical context, they often lack confidence and feel underprepared for patient care. In Kerala’s overcrowded hospitals, FMGs with the lowest pay scales and unpaid internships are forced to work grueling shifts of 72 to 100 hours. The lowest reported salary for FMGs hovers around Rs 20,000 per month, while government internships for FMGs in Kerala offer no pay—an outright violation of National Medical Commission (NMC) guidelines.
FMGs are even seen handling duties in emergency and ICU settings, which clearly reflects a dip in treatment quality. Alarmingly, unqualified FMGs are employed in settings that should require top-notch care.
The sluggish judicial process in Kerala worsens the issue: only 11% of civil medical negligence cases are resolved, one of the lowest rates in India. Criminal cases fare even worse, as proving medical negligence requires strong evidence, which is often hard to obtain due to bias within medical boards favoring doctors.
One such case is the 2024 death of Vinod Kumar at TMH Hospital in Kozhikode, where a fake doctor without an MBBS degree was employed—highlighting the risks of unqualified doctors slipping through regulatory cracks.
Also Read: Maharashtra Forms Panel to Boost Beer Consumption.
There are numerous cases in which patients treated by FMGs have shown significantly higher mortality rates compared to those treated by Kerala-trained graduates, according to data from affected families. Readmission rates also differ, suggesting FMGs may deliver lower-quality care. This challenges the assumption that FMGs are equally competent—medical negligence appears to support the opposite.
The root of FMG-related negligence in Kerala lies in their inadequate skills and less reliance on technology in their home countries, contrasting sharply with Kerala’s high-tech medical environment. A rigorous licensing process—including mandatory FMGE certification and Kerala State Medical Council (KSMC) crackdowns on unregistered doctors—is urgently needed.
With thousands of FMGs now ubiquitous in the state, Kerala’s reputation for quality healthcare demands serious scrutiny.