An interesting conversation ensued on X (formerly Twitter), between a disgruntled Foreign Medical Graduate (FMG) and Dr Yogendra Malik, a member of the NMC's Ethics and Medical Registration Board (EMRB) late in the evening of December 7, 2023. While the FMG was expressing his concerns, Dr Malik assuaged his fears and said that they are "spending half of their time on Foreign Medical Graduates (FMGs) trying to solve their genuine issues".
This comes after a notice which was released by NMC on December 7.
This public notice, in succession to another clarification notice released on November 22, addressed several issues related to FMGs or Indian students pursuing medical education from foreign countries. If we look back, the issues concerning the FMGs concerning internships, eligibility for the exam and others have been prevalent among these students. But the fresh public notice addresses points like the required internship period for the FMGs, the academic mobility programme for students, the time limit to qualify FMG exam, the validity of medical degrees obtained from the Philippines and so on, there were other concerns which arose.
For Final Year FMGs
As per the notice, those who had a break in their final year, returned to India owing to pandemic or war and completed the FMG course through online mode must follow these:
— FMGs will have to undergo one (1) year clinical clerkship (CC) in India in lieu of deficiency in their training from their parent medical college.
— The Indian Medical College may charge clerkship fee from FMGs maximum upto Rs. 5000/-PM.
— After successful completion of 1 year clerkship and supported by logbook followed by authentication from concerned college authority, they will be allowed to begin CRMI which may be done in medical college or any recognised institute.
— Such students at the stage of CRMI, shall be eligible to receive stipend equivalent to the stipend received by IMGs of that college/ Institution.
— Allotment of such students to clinical clerkship or Internship programme will be done through concerned DME and SMC, in consultation with each other.
— Existing FMGs undergoing internship be allowed to continue to complete their two years before permanent registration given by the State Medical Council.
— This relaxation is specifically for final year students who returned to India owing to covid pandemic or war.
Besides allowing FMGs to undergo a one-year clinical clerkship and a two-year clinical clerkship who have a break in their penultimate year (last second year), the major changes observed in the notice released on December 7 are:
— "Those candidates who have joined the course (equivalent to MBBS in India), physically in Ukraine/ Russia on or after 18.11.2021, and have returned/ were evacuated during the warperiod (i.e. evacuation period of Operation Ganga w.e.f. 26.02.2022 to11.03.2022) in a medical institute of either Ukraine or Russia shall be given permission to transfer/migrate to any other country (except India) to complete their study as per FMGL regulations dated 18.11.2021, and procure certificate which grants them license to practice Allopathy in that country. This permission for migration shall be specific for these students only who returned to India till 31st March, 2022. Period of permission of migration shall expire on 07.03.2024."
— "Students who were studying BS Course or had taken admission in BS course and were physically studying in Foreign Medical Institute at the time of publication of FMGL Regulation 2021 dated 18.11.2021 shall be governed by old Screening Test Regulation, 2002 however such students shall have to undergo additional one year of internship as per CRMI Regulation, 2021."
Confusion vs clarity
"Now, everything is crystal clear. There are no doubts," said Deepak Kumar, a 2021-batch student from Ternopil National Medical University, Ukraine who returned to India under Operation Ganga on March 3, 2022. He told EdexLive that in the previous notice, there was confusion on which batches were allowed to migrate to other countries to complete their study. Now, everything is crystal clear, he said, thanking the government.
To recall, the students had taken to the streets protesting several times, urging for a solution to address their issue. "We are very happy that finally, NMC has addressed the issue. We have been continuously protesting for six months. We visited NMC, met the Union Health Minister, protested at Jantar Mantar and finally, our demands have been addressed," Deepak said.
Are Philippines FMGs issues still bothering the students?
Concerning the Philippines FMGs, the notices stated that those who were physically studying BS in their institute "at the time of publication of FMGL Regulation 2021 dated 18.11.2021 shall be governed by the old Screening Test Regulation, 2002 2002 however such students shall have to undergo additional one year of internship as per CRMI Regulation, 2021."
Reacting to this development, Samunder Singh Rajpurohit, pursuing a MD Second year at UV Gullas College of Medicine, Philippines said, "As per the first notice, the BS students were not recognised. Now, even though the BS students were mentioned in the new notice, relief has been given to the physically studied FMGs. What about online mode FMGs?" he questioned. He had taken admission to a BS course in 2020 but pursued it online due to the pandemic.
To recall, the NMC de-recognised the BS Course in the Philippines on November 18, 2021. However, FMGs enrolled in the MD Course on or before this date can complete their studies, take the FMG Examination (FMGE) in India, and undergo a one-year internship to address training deficiencies.
Further, Singh points out that owing to the lockdown and travel ban, he could travel back to attend face-to-face classes only in August 2022 as the travel ban was lifted in the Philippines then,
The time limit to qualify for FMGE is 10 years: Boon or bane?
The notice read, "All FMGs shall have to complete their internship within 10 years from the date of joining their Foreign Medical Institutions to procure qualification equivalent to MBBS in India."
"As per the new rules, FMG candidates must undergo a 54-month UG (Undergraduate) programme in their respective countries, followed by a mandatory one-year internship. Following this, they are eligible to take the FMGE screening exam in India. This entire process takes approximately six to seven years. If a student fails the exam in their first or second attempts, they face the risk of being disqualified, given the ten-year time limit," opines Vivek Pandey, RTI activist/medical education activist
"The three-year internship requirement is perceived as particularly stringent, potentially extending the timeline for FMG students to over 10 years, doubling the duration compared to Indian medical graduates," he added.
On the other hand, the Ukraine FMG, Deepak Kumar said, "Clearing our FMGE within 10 years of completing our degree is good news." Additionally, he adds that 10 years will be sufficient to clear the exam.
Further highlighting the discrimination that is usually faced by FMGs, Pandey said, "Students undertaking their MBBS journey encounter a myriad of challenges, ranging from language barriers to instances of discrimination. It is crucial to adopt an inclusive approach, treating every student with the same respect accorded to Indian medical graduates (IMG), irrespective of whether they are categorised as FMGE or IMG."
"This promotes a fair and equitable environment that values the diverse experiences of all students pursuing medical education," he stressed.
