New Delhi: Only a fraction of those who go abroad to pursue a medical degree qualify to practice in India, data with the National Board of Examination (NBE) shows.
According to the NBE data, in the past seven academic sessions, an average of only 15 per cent of students have passed the qualifying exam mandated by the Medical Council of India (MCI).
The NBE conducts the Foreign Medical Graduate Exam (FMGE) for students with MBBS degrees from countries such as Russia, China, Bangladesh, Philippines, Nepal, Kazakhstan and Ukraine. The exam does not apply to MBBS graduates from the US, UK, Australia, Canada and New Zealand, who can practice in India without having to take it.
The data shows that an average of 13,000 students appear for the FMGE annually. The highest pass percentage for the exam was in 2012-13 when 28.29 per cent of those who appeared qualified to become doctors in the country. That figure dipped to 16.65 per cent in 2013-14; 13.09 per cent in 2014-15; 11.32 per cent in 2015-16, and 9.44 per cent in 2016-17.
In 2017-18, it was 11.17 per cent while in 2018-19, 15.10 per cent of those who appeared qualified.
The dismal numbers have prompted the Indian Medical Association to flag the issue of such MBBS graduates practising in India illegally.
Experts say that a large number of those who don’t clear the exam enter parallel professions such as working for a pharmaceutical company or one that manufactures equipment, as consultants to private hospitals or in the health ministry.
Many others continue to appear for the test for up to three years. There is no age or attempt restriction on candidates appearing for the FMGE exam.
Most qualifiers from Bangladesh
The data also shows that while Russia and China have emerged as the hub for those seeking cheap medical degrees abroad, the maximum number of such students who qualify the FMGE are those with an MBBS degree from Bangladesh.
Between 2012-13 and 2016-17, those with MBBS degrees from Bangladesh topped the list of FMGE qualifiers. In 2016-17, students with degrees from Bangladesh were followed by those with an MBBS from the Philippines, Nepal, Kazakhstan and Ukraine.
Students with degrees from China and Russia feature at the bottom of the list.
“Bangladesh has the highest pass percentage for FMGE because the curriculum, practices, medical convention and the people are very similar to India and hence students are able to easily adjust to the Indian pattern,” said Mukesh Kumar of the Eklavya Overseas Consultants.
“Students who go Russia and China are usually not able to qualify for the exam. In Russia, for the first three years, the curriculum is taught in English but the fourth year is in Russian. Also, the practices there are different from India,” Kumar added. “It’s a similar case for students going to China, because they study Chinese traditional practices and medicine, which is very different from India.”
‘Illegal doctors a problem’
The IMA has suggested various regulatory mechanisms to the Indian government to clamp down on doctors practising illegally.
“There is a mushrooming of doctors who go abroad to pursue MBBS but are not able to qualify the MCI exam once they are back. Such people are practising as quacks,” said K.K. Aggarwal, a former IMA president.
“Some among them are also choosing to go for alternate professions like health business. We have been telling the government to be more strict with people who are not qualified to practice in India but some still go unnoticed and work as quacks in hospitals in villages where there aren’t any. Some of these people are also employed by hospitals as back-up doctors.”
Dr. R.N. Tandon, honorary secretary general, IMA, agrees that the government should be more stringent to improve the situation.
“We (IMA) had given a number of suggestions to the government in the past, we were fighting against the bridge course and quackery but nothing has been done on our suggestions,” Tandon said. “Ultimately it is the public that suffers when the quality of doctors is not good.”
NEET to make it tougher
With the Modi government having introduced the National Eligibility Entrance Test (NEET) for medical education, it is now going to get tougher to get a medical degree from abroad.
Under the earlier system, anyone with the right amount of money could study medicine abroad. In 2018, however, the Modi government wrote to embassies across the world to make sure that only students with the minimum NEET pass marks of 119 are given admission.
Coaching consultants say that due to the mandatory NEET option, the number of people going abroad will automatically come down.
“Now that the government is making NEET compulsory for studying abroad as well, only those who are actually intelligent and have interest in medicine will be able to go and hence the number of quality doctors that we get back in India will also rise,” said Neeraj Chaurasiya, senior consultant and Director of MCI Gurukul, a Delhi-based coaching centre for FMGE.
“Let’s face it, we need more qualified good doctors in India and studying medicine in India is very difficult. The number of people who appear for NEET every year is more than 10 lakh, and there are only about 30,000 government college seats. The rest are private which are way more expensive. Hence students are left with no option but to go abroad.”
Akash Asmi, who completed his MBBS from Kyrgyzstan in 2018, will give his second attempt to qualify FMGE and says that there are many others struggling for two-three years to qualify the test.
“I wrote the FMGE test last year but could not qualify it. I am writing it again this year and I hope to crack it this time,” Asmi told ThePrint. “However, there are many others with me in the coaching who have been struggling for two-three years to clear the test.”