Indian medical students who returned from abroad due to the COVID-19 pandemic, war and other exigencies were in a tizzy following the decision of India’s Supreme Court on 29 March allowing them two attempts to complete the MBBS (Bachelor of Medicine, Bachelor of Surgery) medical degree.
They say it will extend the time it will take for them to qualify by several years even though they have continued with online courses from their medical institutions abroad.
They also criticised the time it has taken for the matter to be heard, saying the government had dragged its heels about accommodating their needs.
The Supreme Court ruling, which is an exceptional deviation from current regulations on medical students from abroad, affects students who returned from Ukraine after the Russian invasion last year and from China and the Philippines during the COVID-19 pandemic.
The ruling, directing India’s National Medical Commission to allow the one-time relaxation of its strict rules, was made after hearing petitions filed by medical students who had completed seven semesters in their respective foreign universities. These students completed their medical course through online mode while in India.
Students had campaigned for over a year – and in the case of students locked out of China since 2020 due to COVID, for several years – to be allowed into Indian medical institutions in order to complete their medical degrees. However, this was not approved by medical education authorities.
Instead, in the wake of the Supreme Court’s ruling which the court described as being “on humanitarian grounds”, they will now have to take the medical theory exam based on the syllabus of the Indian MBBS exam, according to the guidelines of the country’s National Medical Commission. Students will not be required to register in a medical college in India for this.
Practical (clinical) exams must be taken a year later, and will take place at select government medical institutes that have been tasked with conducting them. After clearing these two exams, students would be required to complete two years of mandatory hospital internship.
The official representative of China’s Ningbo University, Dr Nimshad, CEO of Eduzone Consultants, whose students had petitioned the courts, told University World News that according to this decision the students will need four extra years to qualify.
“They have to pass MBBS exams in two attempts. In the first attempt it will be theory and then they have to sit idle for a year and then appear for a practical examination. Then they have to complete two years of internship,” Nimshad said. Previously foreign students only had to complete a one-year internship.
He said many students have returned to China to complete their practicals as it will be much easier for them to do it there. “After completing the practical examination, they can take the Foreign Medical Graduates Examination (FMGE) [in India] and then go for a one-year internship,” he added.
All students graduating from medical schools abroad have to take the FMGE in order to practise as doctors in India. The FMGE tends to have a very high failure rate.
Ukraine students feel justice ‘not done’
Students who returned from Ukraine and were pursuing their medical studies online feel justice has not been done in their case and their concerns have not been heard. They said it will take several more years to complete the MBBS degree than originally envisaged. This could also incur extra costs.
According to government records, more than 20,000 Indians were in Ukraine at the time of the crisis, of which around 18,000 were students.
Shubham Jirati, a final-year student at Ternopil National Medical University, Ukraine, said: “As a final-year student I was expecting something like: we complete our degrees from our parent university, then appear for the FMGE examination in 2023, crack it, and start our medical career in a natural way.”
He told University World News: “What is the basis of this professional examination [FMGE] if we are already done with our degrees from Ukrainian universities?”, noting that the Ukrainian degree will be completed in May.
“Previously, so many students went through this way; they attended online classes during the pandemic … so why can’t we do it in such a way?” Jirati said.
Some students have even risked returning to Ukraine despite the war, in order to qualify. Others have transferred to medical schools abroad.
The father of a student who also returned from Ukraine said in Lucknow, in the northern Indian state of Uttar Pradesh, that his son had managed to get a transfer from Ukraine to Uzbekistan a year ago to get his medical degree.
“He is now completing his incomplete studies in Uzbekistan. The court took so long and still came up with a decision which is altogether against the students,” he told University World News.
Students from China prefer to return
Indian students studying in China also criticised the court decision.
“As per the Supreme Court decision, we have to do another four years in India to get permanent registration [as a doctor]. It’s almost like another MBBS duration,” said Vigneshwaran Selvaraj at Ningbo University, China, referring to the length of the undergraduate medical degree in China.
“For the 2016 batch [of incoming students], we have done one year and six months of courses in online mode, but as per our university curriculum we have done only one year of online practical (clinical) because in the last six months we have only integrated subjects and no practicals.
“In the petition we also clearly mentioned that we have to graduate from university within eight years [according to China’s rules] or else our degree will become invalid. Even after this they proposed such a scheme which would take another four years to complete the degree. So how is it possible for students like us to graduate from university within eight years?”
According to the scheme outlined by the court, “it’s clearly not possible for us to do this here. So we have to go back to China. But for that also they have not even released any guidance till now,” Selvaraj added.
“Some of our students have already passed the FMGE, but in the scheme suggested by the court no points are added for those who have passed the FMGE,” said Selvaraj.
China issuing visas
Indian medical students who returned from China after the outbreak of COVID-19 now hope they can resume their studies in China. Nearly 23,000 Indian students, mostly studying medicine, were stranded back home following the strict COVID-19 restrictions enforced by Beijing.
In June 2022, China announced plans to provide visas to Indian professionals and their families stuck in India due to the pandemic restrictions. It also began processing a limited number of visa applications from thousands of Indian students who wanted to resume their studies in their respective institutions in China.
Minister Counsellor of the Chinese Embassy in India, Chen Jianjun, told the media on 31 March in Kolkata that visas had been issued to 9,409 Indian students since August 2022. However, he noted that visa applications were yet to touch pre-pandemic levels.
Government submission
The Indian government had submitted the report of an expert committee to the apex court, suggesting that, as a one-time relaxation measure, final-year medical students should be allowed to take the MBBS final examination. Additional Solicitor General Aishwarya Bhati, appearing in the court for the government, said a committee was constituted by the government on the issue.
The government set up the committee, under the chairmanship of the director general of health services and including representatives of the ministries of health, home affairs and external affairs, on 30 December 2022 to look into possible solutions for the problems faced by medical graduates from Ukraine and China who had completed online classes of undergraduate medical courses from their penultimate year onwards.
A government affidavit also said the committee had emphasised that this relaxation should be only for one time and should not become a basis in any other such case in the future.
The students will also have to complete a compulsory two-year internship after passing the two examinations. During the first year they will not be paid during their internship, but the second year they will be paid, based on the norms laid down by the National Medical Commission.
The court largely accepted the committee’s recommendations but said the only concern was the committee recommendation that students would have one attempt to qualify for the MBBS exam. The court said the students would be given two attempts on ‘humane grounds’ and because of the difference in the medical curriculum in India and abroad.