How to Get a Licence to Practise Medicine in India — Step-by-Step

This guide is the practical companion to OCI Doctors and Foreign Doctors Practising in India — which covers what the rules are. Here we cover exactly what you do, in what order, with which forms and documents, to get from "foreign MBBS holder" to "registered Indian medical practitioner". If you already know the NMC framework, skip to Step 1 below.

Before You Start — Who This Walkthrough Is For

This walkthrough is for anyone with a foreign primary medical qualification (an MBBS or equivalent earned outside India) who wants to be permanently registered to practise medicine in India. This covers:

OCI cardholders who studied medicine abroad
Foreign nationals (non-OCI) looking for permanent registration — subject to the additional restrictions in the overview article

If you completed MBBS at an Indian NMC/MCI-recognised college, you do not follow this pathway — you are already in the Indian MBBS stream and register directly with a State Medical Council after your Indian internship.

The End-to-End Flow

At a high level you will move through 9 stages:

Confirm your foreign degree qualifies under NMC's 2021 Licentiate Regulations
Obtain an Eligibility Certificate from NMC (if you did not have one before going abroad)
Register for the FMGE (or NExT when applicable) with NBEMS
Sit and pass the FMGE
Secure a Compulsory Rotating Medical Internship (CRMI) slot at an approved Indian hospital
Complete 12 months of CRMI
Apply for registration with a State Medical Council (SMC)
Get endorsed on the Indian Medical Register (IMR) maintained by NMC
Renew and keep your registration current

Count on 24 to 36 months end-to-end from arrival in India, including one likely FMGE re-sit.

Stage 1 — Confirm Your Foreign Degree Qualifies

Before you spend a rupee on anything else, check that your primary medical qualification meets the NMC Foreign Medical Graduate Licentiate Regulations, 2021:

Course duration: minimum 54 months of theoretical and clinical instruction
Internship abroad: additional 12 months of clinical training at the same institution (total 66 months minimum)
Medium of instruction: English throughout
Registration in country of qualification: the degree must permit you to register and practise as a doctor in the country where it was awarded

What to gather

Final MBBS / equivalent degree certificate (original + 2 attested copies)
Year-wise marksheets / transcripts showing subjects, duration, internship
Syllabus document (detailed, if available from your university)
Internship completion certificate from the foreign institution
Medium-of-instruction certificate from the university — explicitly stating that all instruction was in English
Registration certificate from the medical council in the country of qualification, confirming your eligibility to practise there
Passport (photo page + all pages showing visa/immigration stamps)
OCI card if you have one (photo and details pages)

Common failures at this stage

Programmes from some Russian, Ukrainian, Chinese, and Central Asian universities that were historically less than 54 months or split across two institutions
Degrees where the internship was done in a different country (or a different institution in the same country) from the theoretical course
Documentation that does not explicitly state English medium

If any of these apply, address the gap before proceeding — in some cases you will need bridging coursework or a fresh internship abroad that meets the regulation.

Stage 2 — NMC Eligibility Certificate (If Applicable)

Historically, Indian citizens going abroad for MBBS needed an Eligibility Certificate from the MCI/NMC before they left. Two common scenarios today:

Scenario A — You got the Eligibility Certificate before going abroad. Keep the certificate with your documents; no separate action needed.

Scenario B — You did not get one (typical for older OCI applicants, or those who went abroad as non-Indian citizens). Apply for an Eligibility Certificate — Post-Facto / Primary Source Verification through the NMC portal before you register for FMGE.

How to apply

Portal: nmc.org.in → Foreign Medical Graduates section → Eligibility Certificate
Upload scanned copies of all degree and identity documents from Stage 1
Pay the NMC fee online (currently around Rs. 5,500 for online applications; confirm on the portal)
Processing: 2–8 weeks depending on document clarity and verification replies from the foreign institution

What NMC does

NMC will send a Primary Source Verification (PSV) request to your foreign institution to confirm the authenticity of your documents. Some institutions respond quickly; others take months. Follow up with your university directly if there is delay.

Stage 3 — Register for FMGE

The FMGE (Foreign Medical Graduates Examination) is conducted by the National Board of Examinations in Medical Sciences (NBEMS), typically in June and December each year.

Where

Portal: natboard.edu.in → FMGE section

When

Registration opens roughly 8–10 weeks before the exam
Exam fee: approximately Rs. 7,080 (2025–26; reconfirm on NBEMS portal) paid online
Admit card typically issued 2 weeks before the exam

Documents you upload

Scanned passport
Scanned OCI card (if applicable)
Primary medical qualification (degree certificate)
Mark-sheets of all years of MBBS
Eligibility Certificate from NMC (from Stage 2)
Internship completion certificate from abroad
Registration certificate from the foreign medical council
Medium-of-instruction certificate
Recent passport-size photograph and signature

Exam basics

300 MCQs, two 150-question sessions in one day
Pass mark: 50% (150 correct out of 300). There is no merit ranking — only pass or fail.
No attempt limit in current regulations
Pass certificate is valid for life

Coaching centres in India offer 3- to 6-month FMGE preparation courses. Most FMGs take at least one dedicated preparation cycle — historical pass rates are 20–30%.

Stage 4 — Sit and Pass FMGE

Arrive at the centre with your admit card and original passport / photo ID
Sessions run roughly 9 am – 12:30 pm and 2 pm – 5:30 pm
Computer-based test — no paper answer sheets
Results are declared 3–4 weeks after the exam

If you pass, download the FMGE Pass Certificate from the NBEMS portal. Keep multiple printed and PDF copies — you will attach this to every subsequent application.

If you fail, note that only the total 50% matters — no subject breakdown is required. You can re-register for the next cycle immediately.

Stage 5 — Secure a CRMI Slot

The Compulsory Rotating Medical Internship (CRMI) is a 12-month internship at an Indian hospital approved for internship training. This must be completed after FMGE (not before).

How slots are allocated

Each state's Directorate of Medical Education (DME) — or the equivalent state health department — manages CRMI placements for FMGs. Typical patterns:

Tamil Nadu, Kerala, Karnataka — state-managed counselling; merit-based allotment using NEET/FMGE scores or date of FMGE pass
Maharashtra, Delhi, Punjab — application directly to medical colleges/hospitals, with state coordination
Other states — vary widely; check with that state's DME

What to apply with

FMGE Pass Certificate
Eligibility Certificate
Foreign MBBS degree, mark-sheets, internship certificate
Medical fitness certificate
Affidavit of completion of internship period (format prescribed by the state)
Identity proof (passport, OCI card), address proof
Character certificate from a previous medical institution or employer

Stipend and duration

Fixed 12 months — with prescribed minimum rotations (Medicine, Surgery, O&G, Paediatrics, Community Medicine, emergency postings)
Stipend varies: Rs. 25,000–45,000 per month at government hospitals; some private institutions pay less, some more
Missing rotations or falling below attendance minimums extends the internship — schedule leave carefully

Practical tip

Apply for CRMI slots in multiple states simultaneously. Popular states (Kerala, Tamil Nadu, Karnataka) fill up fast; less popular states (Rajasthan, Odisha, North East) often have slots available months after the exam result.

Stage 6 — Complete CRMI

Report to the allotted hospital on or before the joining date
Get your Joining Certificate
Maintain a log book of rotations, procedures, case discussions — the hospital/college keeps this
At the end of 12 months, obtain your Internship Completion Certificate signed by the Medical Superintendent / Dean

This certificate is the final piece before you can apply for State Medical Council registration.

Stage 7 — State Medical Council Registration

Each Indian state has its own State Medical Council (SMC). You register with the state where you will practise primarily.

Application process (typical — varies by state)

Apply online on the SMC portal or in person at the SMC office
Documents:
- Foreign MBBS degree + mark-sheets + transcripts
- NMC Eligibility Certificate
- FMGE Pass Certificate
- Internship Completion Certificate (CRMI)
- Passport / OCI card / identity proof
- Residential address proof in that state
- Passport-size photographs
- Affidavit as required by the specific SMC
Fee: typically Rs. 5,000 – Rs. 30,000 depending on the state
Processing time: 2–8 weeks

Output

The SMC issues a Registration Certificate with a unique State Medical Register number. This is your primary licence to practise medicine in that state.

Practice in other states

If you plan to practise in multiple states, you need additional registration with each additional state's SMC. Many states allow "additional registration" without re-applying from scratch — they accept your primary SMC registration as the basis.

Stage 8 — Entry on the Indian Medical Register (IMR)

The Indian Medical Register is the central register maintained by the Ethics and Medical Registration Board (EMRB) under the NMC. Entry on the IMR happens after SMC registration:

The SMC forwards your registration details to the NMC for IMR entry
You can verify your listing at nmc.org.in → Search on IMR
Historically automatic once SMC registers you; if it does not appear within 60 days, follow up with both SMC and NMC

Stage 9 — Keep Your Registration Current

Most State Medical Councils require periodic renewal — typically every 5 years
Continuing Medical Education (CME) credits are increasingly required for renewal — the NMC's Continuous Professional Development (CPD) framework is being rolled out across states
Change of address or name must be notified to the SMC
If you move states permanently, you may need to transfer or add a new SMC registration

Complete Document Checklist (From Day One)

Treat this as your minimum packet — keep originals, plus at least 3 photocopies of each (attested by a notary or gazetted officer):

Fees — Ballpark Total

Approximate out-of-pocket totals for the licensing pathway (2025–26):

NMC Eligibility Certificate: Rs. 5,500
FMGE registration: Rs. 7,000 per attempt
FMGE coaching (optional but common): Rs. 60,000 – 2,00,000
CRMI — typically stipend-positive (you earn, not pay), except minor administrative fees
State Medical Council registration: Rs. 5,000 – Rs. 30,000 depending on state
Miscellaneous (notarisation, translations, courier, travel): Rs. 20,000 – 50,000

Total: typically Rs. 1 – 3 lakh, plus whatever opportunity cost you incur during 24–36 months of process time.

Common Mistakes to Avoid

Applying for FMGE before confirming degree eligibility under the 2021 regulations. If the degree does not meet the 54+12 month / English-medium / same-institution rules, you will be rejected at the Eligibility Certificate stage and lose the FMGE fee.
Assuming "foreign postgraduate qualification" exempts you from FMGE. It does not — FMGE/NExT is at the MBBS-equivalent level.
Not planning for the CRMI slot before passing FMGE. You pass in December, then realise all Kerala/Tamil Nadu slots have been allocated and the next round is 6 months away.
Missing rotations during CRMI. Even a 2-week shortfall forces an extension.
Applying in only one state. Especially for FMGs, parallel applications give you flexibility.
Skipping primary-source verification. If NMC's request to the foreign institution bounces back, nothing moves until it is resolved — chase your university proactively.

Useful Links

NMC — nmc.org.in — regulations, Eligibility Certificate, IMR search
NBEMS — natboard.edu.in — FMGE registration and results
State Medical Councils — links from the NMC site
Directorate of Medical Education (per state) — for CRMI allocation

Bookmark these; everything else — coaching centres, consultants, forum posts — is secondary.

Final Word

Getting a medical licence in India as a foreign graduate is a document-discipline exercise as much as a clinical one. Most candidates who fail are tripped up not by the FMGE paper but by missing, incorrect, or untranslated documents at one of the nine stages above. Build the packet once, carefully, and every subsequent step becomes a matter of attaching the right papers to the right form. Follow the sequence, keep copies of everything, and budget 24–36 months end-to-end.