The interaction of fermions with monopoles is analyzed for general spherically symmetric monopoles of arbitrary strength and massless fermions in arbitrary representations of the gauge group. The results are based on a solution to the Dirac equation in the field of the monopole, valid in the point limit and in all partial waves. The partial waves in which non-conservation of global charges may occur are identified. A two-dimensional lagrangian is derived, which includes the Coulomb interactions generated by the complete abelian subgroup of the unbroken gauge group. The fermions are represented by a set of doublets with a boundary condition that reflects the structure of the core. We derive a simple formula for the conservation laws of this model which determine all scattering processes completely. The results have a consistent interpretation in terms of anomalies and field configurations with non-trivial winding number. We give an explicit construction of the zero modes for all helicity-violating multi-fermion condensates. The formalism is applied to several higher strength monopoles in SO(10) based models.