The FMGE reforms are overdue. They will mean little unless the exam becomes auditable.
Farooq Brazloo
The National Board of Examinations in Medical Sciences has agreed to hold an additional Foreign Medical Graduate Examination by the end of October 2026, and to move the screening test to three sittings a year. It has also accepted a package of changes on paper difficulty, examination fees, centre facilities and disclosure of candidate response sheets. For an examination that has been conducted for two decades behind a non-disclosure policy, this is the most substantial opening in its history.
It took a month of protest at Jantar Mantar to get there. The trigger was the result declared on 7 July. Of the 37,448 candidates registered for the 28 June session, 4,635 qualified. The Minister of State for Health and Family Welfare, Anupriya Patel, placed the overall pass percentage at 12.78 in a reply to Parliament. That is roughly half the 23.9 per cent of the December 2025 session, and the weakest showing in three years.
A three-member expert committee headed by Air Marshal (Retd) Dr Pawan Kapoor examined the complaints. Its recommendations are sensible and specific: a third annual sitting, a review of the fee, better infrastructure at test centres, and a question paper built to a declared difficulty distribution of 30 per cent low, 50 per cent moderate and 20 per cent high, with a ceiling on mean difficulty. Candidates are to receive their recorded responses along with question and answer IDs.
On the two demands that mattered most to the protesters, the committee said no. It found no material evidence that the video-based questions or the overall difficulty of the June paper had distorted the outcome, and declined to recommend grace or compensatory marks. The board has refused to lower the qualifying mark of 150 out of 300.
That refusal is correct, and it deserves to be defended rather than apologised for. A licensing test is not a competitive ranking exercise. It exists to establish that a graduate can be trusted with a patient in a district hospital at two in the morning. A threshold that moves in response to how many people failed it is not a threshold at all. No regulator anywhere adjusts a competence floor to a demand curve.
But the board cannot invoke patient safety to justify the standard and then decline to show its working on the standard. The two positions are joined. Until this year, NBEMS released no answer key at all, citing a non-disclosure agreement. Candidates received a score out of 300 and no means of checking how it was arrived at. In an examination where the difference between a career and a lost year is a single mark, that is an untenable position for a public body to hold. The suspicion that filled the vacuum was the predictable cost of the secrecy, not evidence of a plot.
The data the board has already released points to something more uncomfortable than an unfair paper. Around 88 per cent of those who sat the June session were repeaters. Among first-time candidates, the pass rate was above 35 per cent. The headline figure of 12.78 per cent is therefore substantially a measure of an accumulating backlog: tens of thousands of graduates cycling through attempt after attempt, paying about Rs 6,195 each time, with years of their working lives suspended between them. A third sitting will clear that queue faster. It will not explain why the queue formed.
Here the editorial line most commonly taken on this subject needs correcting. It is often argued that these students studied at universities recognised by the Government of India and should therefore not face a separate hurdle on their return. That premise no longer holds. The Foreign Medical Graduate Licentiate Regulations, notified on 18 November 2021, abolished the old approved-institution list. There is no register of NMC-recognised foreign medical colleges to point to. What exists is a set of conditions the degree itself must satisfy: at least 54 months of instruction, a 12-month internship at the same institution and in the same country, English as the medium throughout, coverage of the prescribed subjects, and a licence to practise in the country of study. A graduate who meets every one of them is still required to clear the screening test and complete an Indian internship before a State Medical Council will register them.
So the answer to the question students keep asking is that recognition and eligibility were never the same thing, and since 2021 the first category has effectively ceased to exist. The failure is not that the government imposes a screening test. It is that this change was never communicated to families with anything like the energy that recruitment agents bring to selling seats abroad. Parents are still committing savings on the strength of brochures that describe institutions as approved by a body that stopped approving institutions five years ago. The Commission’s March advisory on compensatory on-site training for students who sat through online semesters is a reminder of how much can go wrong between admission and registration, and of how little of it the student is in a position to foresee.
What is needed now is a published, dated roadmap. The board should announce the October examination window, the revised fee, the exact format in which response sheets and answer keys will be released, the grievance window for challenging a key, and the calendar for the three sittings from 2027. The Commission, for its part, should publish a plain-language compliance statement in every major Indian language, and place the burden of proving compliance on the institution and its agents rather than on an eighteen-year-old.
The graduates protesting in Delhi are not asking for a concession. They are asking to be assessed against a standard they can see. Those two things are frequently confused, usually by the institutions that benefit from the confusion. Keep the bar where it is. Make everything underneath it visible.
