Not licensed to heal: ‘Foreign doctors’ flunk qualifying test

Close to 80 per cent of these graduates fail to clear the mandatory screening exam.

October 10, 2016 01:05 am | Updated 01:58 am IST - Thiruvananthapuram:

A foreign medical degree may sound like a passport to a successful practice in India. But in reality, only a woefully small percentage of doctors with foreign degrees equivalent to the MBBS get to practice in the country — at least legally.

Somewhere between 70 and 80 per cent of these students fail to clear the mandatory screening examination conducted by the National Board of Examinations (NBE).

Since 2002, it has been mandatory for All Foreign Medical Graduates (FMGs) to clear an examination Foreign Medical Graduates Examination (FMGE) to secure a Medical Council of India (MCI) registration, without which they cannot practice in India.

Out of the 29,968 students who have appeared for the last five examinations, only 3,610 (a mere 12 per cent) have passed. Records from the MCI and the NBE reveal that while thousands of FMGs appear for the exam every year, the pass percentage has rarely gone beyond 26 per cent.

In the most recent test, only 600 out of the 5,349 candidates (11.2 per cent) passed despite relaxed examination norms and the opportunity to take the test innumerable times, a policy introduced in 2004. A number of the unsuccessful students have graduated from medical universities in China, Russia and Ukraine, which are a big draw for Indians aspiring to be doctors. These countires offer undergraduate degrees equivalent to the Indian MBBS at a far lower cost and without the tough entrance examinations and admission process.

Illegal practice

So what happens to the majority who fail to clear the FMGE?

With close to 80 per cent of graduates with foreign medical degrees from countries such as China and Ukraine among others, failing to clear the MCI’s mandatory Foreign Medical Graduate Examination (FMGE), serious public health issue has emerged as these graduates begin medical practice away from the eyes of the law.

The situation is snowballing into a serious public health issue of various dimensions, says K.V. Babu, noted public health activist. The MCI’s website shows a list of 335 institutions from various countries, including 50 from China, which are recognised institutions included in the World Directory of Medical Schools.

“The MCI has no jurisdiction over these institutions. But, it should give aspirants at least an assessment of these institutions based on the performance of their alumni. The fact that the pass percentage of FMGE has been consistently low over the years would certainly raise a pointer about the quality of medical education received. And what about those who have not been able to clear the FMGE after repeated attempts? If they are working as doctors somewhere, should not the MCI be concerned,” Dr. Babu asks.

This huge pool of medical undergraduates, who have failed the FMGE — unofficial estimates put the numbers at around 18,000 — and remain outside the profession is a mammoth waste of human resources in a nation which has serious shortage of health workers.

Bipin Batra, Executive Director, NBE, however, says that the picture is not as bleak as it is made out to be. He also rubbishes allegations that the NBE has deliberately kept the FMGE tough to keep out foreign medical graduates.

“The actual backlog is only of 3,500 students who have been repeatedly failing the FMGE. If they are left out, then of the 3,000-odd fresh students who attempt the exam every year, about 1000-1,300 manage to qualify, putting the average pass percentage at 33 per cent,”claimed Dr. Batra.

He says the FMGE is like any other licensure exam, fully based on the MCI’s curriculum, with no negative marking.

“We have tested the FMGE amongst our MBBS students, and recorded 80-90 per cent pass. Among the FMGs themselves, about 1,200 manage to pass every year in the first attempt. In the last 14 years, 22,531 students with foreign degrees have successfully registered themselves with the MCI,” he pointed out.

And those who have been consistently failing, are not unemployed, but are either practising medicine on their own or working illegally as medical officers in the private sector, he adds.

“We did try to see if their qualifications could be considered as academic degrees, rather than as clinical ones and explore their potential in non-clinical, health-related areas. But UGC has clear regulations and our proposal is stuck somewhere in the files,” Dr. Batra said.

He feels that what is required is a licensing examination for all medical undergraduates who aspire to enter clinical practice. He cites the United States Medical Licensing Examination (USMLE) as a model which the MCI can follow.

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