Either I clear FMGE or leave India: Foreign medical graduates trapped in a cycle

Either I clear FMGE or leave India: Foreign medical graduates trapped in a cycle

After completing MBBS abroad, thousands spend years trying to pass the FMGE exam, the only way for Indian graduates from foreign medical colleges to practice in India.

Between June 2014 and December 2023, only 56,240 out of 293,025 candidates (19.9%) cleared FMGE.

Alakh Singh* finished his MBBS in China in August 2020. Since December that year, he has taken the Foreign Medical Graduate Exam (FMGE) six times. In his last attempt in December, he scored 144 out of 300, just six marks short of passing.

“In my first attempt, I scored 133. After that, I scored above 140 but couldn't clear FMGE. The first two exams were easy, but now the questions are tougher and the pattern is unclear. I focus on my strong subjects, neglecting my weak areas. My approach might be wrong,” Singh, from Varanasi, Uttar Pradesh, told Deshaurduniya.com.

Years of trying to pass the exam have caused him immense stress. “I go to the gym to relieve stress and depression. My family thinks going for physical coaching in Gautam Nagar would isolate me. So, I stay at home in Varanasi,” he said.

The FMGE Exam

The FMGE is a screening test for Indian graduates from foreign medical colleges. To practice in India, they must pass this exam. Many, like Singh, take the exam multiple times over several years.

Singh now takes online coaching from Cerebellum Academy, paying an annual fee of Rs 30,000. “I am preparing for the FMGE June 2024 session. I study for 8–9 hours daily. My online classes start at 5 pm and end between 11:30 pm and 1 am. I am more disciplined now and hope to clear the exam this time,” he said.

Why MBBS Abroad?

Most FMGs spoke to wanted to study in Indian government medical colleges but scored too low in NEET-UG. Arun Sharma* said, “I scored 350 out of 600 in NEET-UG in 2016. I couldn't get a government MBBS seat, and a foreign medical degree is cheaper than a private college in India. I did my MBBS in Georgia, costing around Rs 35 lakh, including living expenses.”

In 2023, about 11.45 lakh students passed NEET-UG, but only 1,07,948 seats were available in Indian medical colleges, meaning only about 10.6% could study in India. Top scorers usually secure government seats. Due to high fees in Indian private colleges, many go abroad, where an MBBS degree costs Rs 15–50 lakh, while Indian private colleges charge up to Rs 1.5 crore.

In February 2022, the National Medical Commission (NMC) mandated that fees for 50% of seats in private colleges and deemed universities should match those of government colleges, but this decision is under court review.

Indian students must qualify NEET-UG for MBBS admission abroad. However, in July 2022, the government said it didn't track Indian students studying medicine abroad.

NBE FMGE: Licensure Exam

FMGE is required for graduates from certain countries to practice in India. Graduates from Australia, Canada, New Zealand, the UK, and the USA are exempt. The exam consists of 300 questions from all 19 MBBS subjects. Students need 50% (150 marks) to pass. The National Board of Examinations in Medical Sciences (NBEMS) conducts the exam in June and December each year.

After passing FMGE, students register with their state medical councils for internships. Post-internship, they receive a No Objection Certificate (NOC) and then permanently register as doctors to practice in India.

FMGE Passing Percentage

From June 2014 to December 2023, the passing percentage has fluctuated, from a low of 4.93% in June 2014 to 32.25% in December 2022. December sessions usually have higher pass percentages.

Failing FMGE

Data from June 2014 to December 2023 shows only 56,240 out of 293,025 candidates (19.9%) passed the FMGE. Candidates cite various reasons and express concerns about the NBE's functioning.

Sonu Kumar earned his degree from Georgia in 2022 and has taken FMGE three times. After scoring 100 and 120 in his first two attempts, he took coaching and scored 130 in his third attempt. “Difficult questions and exam patterns are why I fail,” Kumar said.

Sharat Verma* from Jaipur, who graduated from Georgia’s New Vision University in January last year, has had two unsuccessful attempts. “The exam patterns keep changing, making it hard to prepare,” he said.

FMGE Problem

FMG student leaders and coaching managers blame students' lack of seriousness. Dr. Kaushal, from All FMGs Association (AFA), cleared FMGE on his first try without coaching. “Most FMGs don't start studying from their first year of MBBS. They try to catch up in the last year to pass the exam,” he said.

Dr. Apurva Dalvi, from All India Medical Students Association’s (AIMSA) foreign medical student's wing, said the curriculum abroad is different from India’s, leading to challenges in clinical skills and exam readiness.

Rajesh Mishra, from Next MCI Gurukul (NMG) coaching in Delhi, said FMGE results leave many students just short of passing, increasing the number of repeaters.

Lack of Transparency

NBEMS has conducted FMGE since 2002, but students and coaching owners have concerns about its functioning. They demand NBE provide question papers and answer keys and declare results quickly.

NBEMS requires FMGE aspirants to sign a non-disclosure agreement, barring them from sharing exam content. Students pay Rs 7,080 as an exam fee but don't receive question papers or answer keys.

Vidit Shah* from Ahmedabad, who graduated from a Philippine medical college in July 2022, said, “I am unemployed due to NBE policies. In the December 2023 exam, some questions had no correct answers. But we can't challenge it since there's no answer key.”

NBEMS sometimes withholds admit cards due to document deficiencies but doesn't refund the fee. “Admit cards won’t be issued to ineligible candidates, and fees will be forfeited,” NBEMS stated.

Careers Affected

Mishra of NMC coaching believes FMGs are stuck in a cycle. “Without clearing FMGE, a foreign medical graduate is just like a Class 12-pass student. FMGs can't pursue other fields, either. They prepare for the next exam session if they fail, creating a cycle,” he said.

“People mock me for not becoming a doctor after spending Rs 35 lakh for a degree from Georgia,” Kumar said.

Verma, living in Gautam Nagar, said, “Last year, two students died by suicide here. There's pressure to pass FMGE. I have no choice but to keep trying.”

Shah, who failed three times, said his future is “on hold” until he clears FMGE. “If I don't pass the June 2024 exam, I will leave the country. There’s no other option.”

FMGE June 2024 exam is on July 6.