Becoming a doctor is a long-cherished dream. For some like Sai Alekya, a foreign medical graduate (FMG) from Visakhapatnam, it has been a dream since she was only four years old. But not all dreams come true, and some take a very long time to come true.
On December 9, while she was waiting outside the Andhra Pradesh Medical Council (APMC) office located on the campus of Dr NTR University of Health Sciences in Vijayawada for the registrar’s response on issuing permanent registration (PR), Dr Alekya This thought came to mind. Full of anxiety, despair and helplessness.
Dr. Alekya, along with 50 other FMGs, had gathered outside the APMC office to protest to highlight their plight and seek clarification from APMC regarding their PR.
“Weeks have passed without a proper response from the APMC on what is the reason for the delay in giving the PRs,” she says.
After completing a medical course equivalent to MBBS (Bachelor of Medicine and Bachelor of Surgery) from other countries, graduates who wish to work or study in India must appear for the Foreign Medical Graduates Examination (FMGE), a Must pass screening test. One-year compulsory rotating medical internship (CRMI), which Indian medical graduates also undergo. After completing CRMI, both foreign and Indian graduates obtain PR from the State Medical Council.
FMGE conducted by the National Board of Examination in Medical Sciences is conducted twice a year in June and December. Considered one of the toughest, the pass percentage in 2023 was 16.65%, when 10,261 out of 61,616 graduates appeared for the exam. The pass percentage of the exam in 2022 was 23.35%.
In Andhra Pradesh, 73 FMGs wrote FMGE in December 2022. He completed his internship in May 2024 and has been waiting for his PR for six months. All of them completed their medical education in universities in Russia, Georgia, Kyrgyzstan and Kazakhstan.
However, the wait had just begun for Dr. Alekya and his batchmates, who completed their internship in November 2024 as the APMC had put on hold the release of PR citing various factors.
Meanwhile, Dimple Mehta, who will graduate from a university in Russia in 2022, said she was in India for about a year and went back to take her exams. He passed FMGE in January 2023. In June 2023, Rajasthan Medical Council allotted him a one-year internship. She got her PR on July 11, 2024 and is now working as a medical officer.
States like Andhra Pradesh, Delhi, Haryana, Jammu and Kashmir, Punjab, Tamil Nadu and Kerala have refused or stopped permanent registration for FMGs with one year internship experience. In contrast, states like Gujarat, West Bengal, Rajasthan, Assam, Orissa, Telangana and Karnataka have released permanent registration and offered postgraduate seats to students.
This problem arose due to the gap in his studies during the COVID-19 pandemic. All these graduates returned to India during the pandemic and continued their studies online during the final and final years of their courses. Some returned to their native universities and took the offline exams, while others did not.
NMC notice
NMC issued a public notice on June 7, 2024, stating that FMGs who attend online classes for any period during the completion of their courses will be required to undergo a mandatory two-year internship, which will be Because there was opposition.
Following the outcry, the NMC withdrew the June 7 notice and issued a fresh notice on June 19, stating that all students who have paid adequate compensation and have passed an examination equivalent to MBBS will opt for physical classes instead of online classes. , they should be eligible for one year internship.
Dr Alekya (26) graduated from a Russian university in 2021, and belongs to the batch that was affected by the pandemic. She was in her final year when the pandemic started.
In 2020, after giving her fourth year final exams, she came to India for holidays in June as usual. This was also the peak of the epidemic. Her final year classes were to begin in October 2020. Her three-month stay at home was extended till February 2021 due to travel restrictions and unavailability of flights.
However, she returned to her original university, took her final exams offline, and practiced there for two more months to make up for the lost practical sessions.
After returning to India, he wrote FMGE in June 2023 and was allotted a one-year internship, which he completed in November 2024.
While the wait for PR has been a little over a month now, it has been excruciating, burdensome for her as her mind is filled with thoughts of uncertainty.
“Students who completed their internship in May 2024 have not received PR yet. What will I do if this process takes us the same amount of time? Application for NEET PG-2025 exam will start in April. Will I get my PR by then?” Alekya asks, her voice breaking.
Alekya was raised mostly by her mother, a nurse, Alekya always wanted to become a medical professional like her mother. Her father, who has been ill for a long time, does not go to work.
In EAMCET in Telangana and Andhra Pradesh in 2015, he secured less than 7,000 and 12,000 ranks respectively. According to news reports, 69,840 students appeared for the medical stream in AP in 2015. However, she could not secure a seat. Medical colleges in two Telugu states.
Nevertheless, Alekya’s family, determined to make him a doctor, decided that he should pursue his studies in Russia. “My parents were supportive because seeing me as a doctor was not only my dream but also that of my family,” says Dr. Alekya, who flew to Russia in 2016 at the age of 17.
Like Dr. Alekya, many FMGs from the two batches affected by the pandemic are worried.
The protesting foreign doctors say that they have given their examinations offline and also have indemnity certificates, yet they are being denied PR. They say APMC registrar I. Ramesh informed them that some “have not paid adequate compensation for their practical sessions” as per NMC guidelines.
When asked about the reasons for the delay in issuing the PR in July 2024, the Registrar informed him that the APMC Council members have not yet been elected and nominated and they do not have the power to take decisions in the matter. He also said that the FMGs will have to undergo two years of internship as per NMC guidelines.
V. Aruna Vanikar, former chairperson of the Undergraduate Medical Education Board, NMC, New Delhi, who signed the two circulars dated June 7 and 19, said the decision on who is eligible for PR rests with the State Medical Council (SMC). Despite the June 19 notification, if the SMC feels there is a need for a two-year internship, they can allot it, said Ms Aruna Vanikar, who was relieved of her duties on September 24.
Srinivas Gundagaani, Vice President of Medical Council in Telangana said The Hindu He followed only one rule while deciding the duration of internship. “Those who appeared for the final year exams offline got a one-year opportunity, and those who did not go back got a two-year internship,” he said.
“But we all were given one year’s time, and now they are asking us to wait. Additionally, we have all passed the FMGE, which tests our medical knowledge. Our batchmates in other states have also taken the exam and got PR,” says Karthik, another FMG from the batch who will write the FMGE in December 2022. He cleared it in the first attempt and completed his one-year internship in May. of. 2024.
Awaiting council formation
Even after six months have passed, the state government has still not nominated members to the council. The 23-member council, comprising 13 members elected by doctors, six nominated members and four ex-officio members, was dissolved upon the change of government in June. Director of Medical Education DSVL Narasimham said the matter is under the government’s jurisdiction.
To compound the delay, the NMC issued an advisory to SMCs on November 19, “On or before granting permanent registration, they must obtain confirmation of medical degree from the concerned foreign medical college/university through the concerned Indian Embassy/High Commission. To recommend for registration in NMR (National Medical Registrar).
“What did they do from June to November?” asks Dr Karthik, who has returned to Kyrgyzstan to complete a course at his native university. He has indemnity certificate but has not received PR yet. He says that when the provisional registration was issued, the verification process should have been done before allotting him the internship.
“I have made four visits to the APMC office so far with my daughter. Every time we come, we hear a new reason. We don’t think they have sent our degrees to the embassy,” says a distraught father from Kakinada. His daughter has passed NEET PG, but cannot attend counseling without PR.
“We are sending all the degrees and mark lists to the respective Indian embassies. PR will be given to genuine degree holders as soon as the verification process is completed.I. RameshRegistrar, Andhra Pradesh Medical Council
However, Dr. Ramesh clarified that the process of verification of certificates takes time. “We are sending all the degrees and mark lists to the respective Indian embassies. PR will be given to genuine degree holders as soon as the verification process is completed,” he assured the doctors. He says the process of rejecting fake degrees is for the benefit of society.
FMG feels that the main reason for delay in issuing PR to them is prejudice against them. “Discrimination against FMG is not new to us. It is pervasive in the Indian medical system,” says Dr. Karthik, who finds it difficult to explain why he is idle at home. “It is difficult to remain unemployed at this age and after spending a lot of money on studies,” says Dr. Karthik, his voice reflecting the anger he is going through.
“We were made to feel inferior to our Indian counterparts as we did not get a rank in EAMCET and had to go to other countries to study”sai alekyaforeign medical graduate
“We were made to feel inferior to our Indian counterparts because we did not get a rank in EAMCET and had to go to other countries to study,” says Dr Alekya, who wants to help her mother repay the loan. ₹40 lakh, and the delay is causing thoughts of depression.
Indian Medical Association state member S. Dinesh Reddy, who graduated from a Ukrainian university in 2011, says there is a common perception that education standards in foreign universities are low, and that is why FMGs have to go through many hurdles.
“The standards are the same everywhere. But how much we earn from education in any university depends on the individual,” says Dr Dinesh Reddy, adding that the objective of the FMGE is to screen graduates.
Pawan Kalyan assurance
He is Health Minister Y. Satya Kumar Yadav and Human Resource Development Minister N. Met Lokesh thrice, but to no avail. Fed up, the FMG now approached Deputy Chief Minister Pawan Kalyan, who assured him that he would look into the issue.
Last week, Andhra Pradesh Health Department had released a notification for recruitment to the post of Civil Assistant Surgeon (280 posts). Even if eligible, no FMG can apply without PR.
“We have not received internship stipend, which is against NMC rules. Still, we got it done. Now, we should at least be given PR without any delay. We’ve already spent eight years getting our degrees. How many more years should we wait,” Chandra, another graduate, says on the call.
(Students’ names changed to protect their identities)
published – December 20, 2024 06:47 am IST
