Raghuram Nayak, who spent six years earning a medical degree in Ukraine, has spent the past three years trying to clear the examination that will allow him to practise medicine in India. In June this year, he failed the examination held twice a year a sixth consecutive time. Nayak studied medicine at the Zaporazhye State Medical University in Ukraine because his rank in the medical college entrance tests was not good enough to get an admission into government-run medical colleges in India and his parents could not afford the capitation fees sought by some private colleges.
He is among several thousand Indian medical graduates from foreign universities struggling to get a licence to practise in their homeland. They are claiming that they are victims of a screening examination that is unfair and whose grading practices appear tainted.
Members of the All India Foreign Medical Graduates Association today staged a demonstration at the National Board of Examinations (NBE), the agency that conducts the Foreign Medical Graduate Examination (FMGE), a multiple choice test that carries a maximum score of 300. Only candidates who score 150 or higher can practise medicine in India.
The association has cited the declining proportion of candidates who clear the examination each year to claim that its questions are intentionally designed to fail candidates rather than serve as a screening test to test their medical knowledge and skills. In June 2014, less than five per cent cleared the examination. In June this year, the pass percentage is less than 10 per cent, the association has said.
"Even post-graduate medical students in India cannot answer many of the questions we are asked in this examination," said Nayak, whose scores have remained below 147 the six times he has taken the test. The examination system is opaque. Some students receive the same marks year after year," he said.
Senior officials in the NBE were not available for comment. Two officials contacted by this newspaper on telephone said they were not authorised to speak to the media.
The association has drawn up a list of 31 candidates who have received the same marks in consecutive tests. One medical graduate obtained 140 out of 300 four consecutive times in the examinations held in September 2012, March 2013, September 2013, and June 2014. A medical graduate from Belarus got 144 out of 300 twice, in December 2014 and June 2015, according to documents released by the association.
"How can I get the same score twice? What is the probability of that?" the medical graduate from Belarus asked.
The association estimates that about 3,000 Indian students every year choose to study medicine in China, the Central Asian republics and Russia because medical education in those countries is less expensive compared with private medical colleges in India.
"For six years of studies, the cost there is less than or just about Rs 20 lakh," said Najeerul Ameen, a medical graduate from Russia and president of the association. "Here in India, the capitation fees in some of the private medical colleges run into a minimum of Rs 40 lakh," he said.
Nayak said he opted to study in Ukraine because his parents could not afford to pay Rs 60 lakh a private medical college had sought for a seat in the course leading to the MBBS degree.
A senior cardiovascular surgeon, who was once a member of the board of the NBE, said that an intentionally tough examination would suit the interests of many private medical colleges in India that charge capitation fees from students who don't make it into medical colleges on merit.
"This exam is a screening test and should be at the same level as MBBS test papers here in India, but it appears designed to address the brightest of candidates. This could explain the low pass percentage," said K Michael Shyamprasad, former vice-president of the NBE.
Shyamprasad and others, however, pointed out that some of the candidates with degrees from medical colleges in China or the Central Asian republics have limited clinical experience because they are unable to adequately communicate with local patients.
The association has demanded that the NBE should make available question papers to candidates so that they can, if they believe there is a need to, challenge the scores assigned to them.