FMGE fever

Dr Rosh Khun
Just a month ago on 31st July 2019, the result of the Foreign Medical Graduates Examination (FMGE-June 2019) was declared for the medical aspirants who wanted to become a bona fide Doctor in India. This test is mandatory for an Indian citizen who has a medical degree from a foreign medical college to practice medicine in the country. It is held twice in a year in June and December. In the last exam, FMGE June 2019 the number of candidates appeared was 13,364 in which 2,767 were qualified at the success rate of 20.7 percent. As one of the successful candidates in the qualified group of this year, I would like to share my experiences about the strategy on how I cracked this exam after I had graduated from the Kunming Medical University of China. It could be helpful to those juniors of mine who often asked my suggestion on this painstaking exam.
Coaching Struggle
Normally it’s always in the middle of every year that a bunch of Foreign Medical Graduates (FMGs) come to New Delhi and stay to join the coaching classes for the exam. It’s a tsunami for all the FMGs that the rental place is the only food left as in that of a disaster, so every FMG tried hard to adjust in Gautam Nagar (New Delhi), which is the famous place where it is flooded with new tenants (entrants) who came for this preparation. Searching for accommodation and trying to get admission in a popular coaching institute for the screening test (FMGE) is indeed a hard phase for every aspirant. FMGs gets high fever at this time as tensions from all sides including the expectations from friends and family along with the burden to prove themselves as a Doctor (although the degree has been achieved from the respective foreign medical universities). Sometimes, it seems obnoxious that a medical graduate still had to study all the subjects again newly and fight the myth which says ‘FMGs are not good enough’. The myth has been existing because of the minimum pass percentage of FMGE and remained unqualified to work in India as the license is not issued by the National Board of Education (NBE). The hardships of FMGE fever can only be experienced by FMGs and remained untold to the people of other academic backgrounds (non FMGs).
In the initial phase, almost every aspirant thought it was not possible to carry such hefty responsibilities as the level of expectations was humongous. Though already graduated and even awarded the degree, half of the prestige still seems to be missing for every FMG. Hence, the journey of career has to start again by studying the whole 19 subjects newly, similar to the full course of Bachelor of Medicine and Bachelor of Surgery (MBBS). Subsequently, these vast 19 subjects have to be finished in a mere four months of crowded classes conducted in the coaching institute. It’s always a hectic phase indeed, to have 10-12hrs of intensive class every day without holidays in the weekend. Students normally get a break only when the high profiled Doctors who were teaching in the class took off from the institute for other purposes. Whenever such breaks were given, it would be usefully converted into a preparatory leave in which a test shall be taken on a successive day. It is otherwise a stage of collecting pains and frustrations, but by gaining huge knowledge and wisdom. One will also find the surrounding of the coaching institute to be inefficient where students have to eat unhealthy street and junk foods in a given 10-minute recess period.  On a lighter note, almost a month later everyone gets resistant to infections. It was indeed a big cut-off season for preparations where it is always good for the aspirant to avoid social media (Facebook, Instagram, etc.), except for the academic groups/platforms in WhatsApp or any app for sharing study materials and learning new ideas.
Preparatory Strategies
For the benefits of the future aspirants, I would like to highlight a few tips which helped me in clearing this exam as below,
1. Joining the coaching institute of one’s favourite choice and keeping faith on it
2. Revision of the class notes every day after the class (at home) and even during the break period (in the institute)
3. Additional study of question banks (e.g. FMGE solutions by Deepak Marwah) of the latest edition along with scheduled preparation, dedication and punctuality
4. Regularly checking our personal study enhancement by giving the test and discussions (T&D) conducted by the coaching institute or any online medical applications (Prep Ladder, FMGE solutions App, etc.)
5. Changing the biological clock and avoidance of being a night owl. One should remember that the exam starts in the morning and ends in the evening that our brain needs to be kept active (not drowsy) during the period. Automatic functioning of the biological clock needs at least 21 days, so it is better to start maintaining a proper habit of good sleeping and safe eating from the beginning of preparations itself.
To remember all the 19 subjects is a bit confusing and forgettable norm. Also, it is common to forget almost half of the terminologies (named syndromes, etc.) or whichever tough part we studied. However, there is no need to worry as studying thoroughly and revising the notes for at least three rounds for each subject will help in memorization. The human brain can only recall a few of what has been studied so it’s quite normal if we do not remember the whole notes. To pick up or find one’s own strong subjects is very important in such a crucial phase of extreme preparation. One must focus more on his/her strong subjects, however, it’s still mandatory to study those few subjects which have high yielding topics and marks. Those small subjects shouldn’t be taken easily as they are the source to score more. Almost one-liner questions are being asked from the minor subjects and one can hit the bull’s eye with that.
Qualifying Marks
As per the FMGE guidelines, only 150 marks is the passing score that a candidate requires, and it is not a “competitive” exam but a simple “screening” test. Most of the questions are memory-based queries (not a knowledge or application type) in which repeated revisions could help at the end. The FMGE mostly ask to choose the best answers and not the right answers among the four options. So, two options may be always overlapping, and one must choose the best one. A person who attains 149 marks is almost equal to the one who scores 100 or less mark. Similarly, the one who achieved more than 200 marks is simply equal to the one who obtained 150 marks. Scoring the high mark depends on how many subjects a person could cover, in which it’s easy to acquire more than 200 marks if a person studied all the 19 subjects properly.
Although the questions are nearly similar to the Post Graduates Examinations (PG exam) one must not try to grab more knowledge while preparing, it is better to exist in the circle of the knowledge given by the coaching institute and keep revising it thoroughly. The fact that the FMGE questions are quite parallel to PG exam becomes one of the factors in launching The National Medical Council (NMC) Bill which proposes a common final year MBBS exam to be known as National Exit Test (NEXT), for admission to post-graduate medical courses for the qualified licensed Doctor and obtaining a license to practice medicine in India for the FMGs. Recently, the parliament has already passed the long-awaited NMC Bill in the Lok Sabha session of 2019. However, the NMC Bill will be taking a few years to become an Act. Even NEXT starts to run, FMGE fever will not be resolved as still, FMGs needs a screening test whatever the name and pattern of the examination changes. Hence, the core way of preparation will still be the same.
Final Preparation
The final stage is the most crucial phase of the preparation where one gets less time to set his/her future career. Following are a few strategies that a candidate can adopt at this critical juncture.
1. When there is only a week left for the exam, revising one-liner sentences is indeed beneficial and reading the latest mock test questions which were conducted by the coaching institute or any online App for FMGE is tremendously helpful. It will be almost impossible to revise or study all the 19 subjects when there is a week left for the exam.
2. Revisiting those high yielding subjects like Preventive Social Medicine (PSM), Surgery, Obstetrics, and Gynaecology (OBG) would be useful. The last two days should be kept only for the subjects like Pharmacology or those named syndromes and other difficult terminologies etc. which we tend to forget the most.
3. On the day before the exam, one can even avoid studying and focus on memorizing or contemplating the preparation made. It would help in removing the stress and anxiety of the exam. Relaxation and a night of deep sleep are important before going to appear this exam that promotes the lifetime career of every FMG.
‘FMGE fever’ can be treated by a full dose of dedication in proper time.
The drug of choice of curing the FMGE fever is self-esteem and believing to crack it for what one deserves. All the FMGs have overcome the language barriers, different environment (or weather) and bias of living standards in different countries while studying MBBS for lengthy years. Therefore, for one more time why not face this fever of challenge and apply the pieces of knowledge to cure it? FMGE is not a degree but just an explanation. Stay motivated, work hard and expect the best outcome. Hence, I wish all the Doctors who have passed out from abroad a very good future ahead in serving the people with love and care by clearing this screening test of everyone’s dream.
Dr. Rosh Khun is MBBS from Kunming Medical University, China.