KOCHI:  Bad luck seems to be doggedly pursuing the Indians studying medicine in foreign countries, including the war-torn Ukraine. Of the 24,269 students who appeared for the Foreign Medical Graduate Examination (FMGE) in July 2023, only 2,474 (a mere 10.6 per cent) passed.

The foreign medical students attribute their poor performance to a “concerted move to fail” them. The exam, which serves as a screening test for Indian students who hold medical degrees from international universities, has been conducted in violation of prescribed guidelines, they allege. The FMGE is held twice a year. The first exams in 2023 were conducted on July 30, and results were announced on Wednesday.

“These students need to clear the examination to be able to apply for internship, and later to practice medicine in India,” says Silvi Sunil of the All-Kerala Ukraine Medical Students and Parents Association (AKUMSPA). The association is holding talks with members to formulate a strategy to avoid the situation in future. “The very manner in which the examination was conducted shows that the National Medical Commission (NMC) and some vested interests in the medical community don’t want these students to clear the test,” she adds.

“Have you seen an examination in India where a student can’t seek revaluation?… Do they want to show that these students are lesser than those doing MBBS at the medical colleges in the country?” asks Silvi.

‘There is no transparency in exam’

“However, it should be noted that if MBBS students studying in India are asked to write this examination, they will fail too. The reason? The lack of adherence to guidelines that were set at the onset of the examination,” Silvi says.

Dr Sanjay Mukundan, joint secretary of the Association of Foreign Graduated Physicians (AFGP-Kerala), says FMGE was introduced to screen students from foreign medical universities.
“However, it no longer serves as a screening test as the questions are being set at a level of PG students,” he adds.

According to him, until the FMGE was introduced in 2002, there were no such examinations. Those who did internships in India used to get a licence and could practise in the country. It was after 2002 that the MCI Act came into force. However, the Act clearly mentions the norms and criteria on how to conduct the screening test. It clearly defines the mark proportion, 100 marks for preclinical subjects and 200 marks for clinical subjects, he says.

“The guidelines stipulate that the portions for the test should be from the UG syllabus, that is from the first year MBBS to the final year. Also, it is said that the questions and answers should be published besides providing a revaluation facility and so on,” Sanjay says. “Immediately after the results of the first FMGE exam were published, protests broke out as the pass percentage was too low. Students even approached the Supreme Court. Between 2003 to 2005 the pass percentage was between 25 per cent and 30 per cent,” he says.

Following SC intervention, a regulatory body, comprising representatives of MCI, NBE, and students, was formed. “The court also strictly directed that since this is an undergraduate examination it has to be conducted at that level, and should not have PG-level questions. The next year saw a pass percentage of more than 75. But it then gradually declined,” he says.

This action of the NMC raises serious doubts, says Silvi. “PG-level questions are being used to assess the knowledge of UG students. This action of the NMC raises serious doubts,” says Silvi.

The FMGE exam fee is Rs 7,080, which is very high compared to similar exams. No previous questions and answers or answer keys of any year have been published, and it does not allow for re-evaluation.
“Despite many requests to NMC and the National Board of Examination (NBE), there is no transparency in the process,” says Dr Sanjay. The only way left is to take the legal route, he adds.