Fewer state doctors: Long wait for permanent registration in Andhra Pradesh

Becoming a doctor has been a dream for a long time. For some like Sai Alekya, a foreign medical graduate (FMG) from Visakhapatnam, it has been a dream since she was four years old. But not all dreams come true, and some dreams take a long time to come true.

On December 9, she was waiting for the registrar’s response regarding issuance of Permanent Registration (PR) outside the Andhra Pradesh Medical Council (APMC) office located on the premises of Dr NTR University of Health Sciences in Vijayawada. Alekya had brains. Full of anxiety, despair and helplessness.

Dr. Alekya, along with 50 other FMGs, gathered outside the APMC office and staged a protest exposing their plight and seeking an explanation from the APMC about their PRs.

“Weeks passed without proper response from APMC due to delay in providing PRs,” she says.

After completing medical courses equivalent to MBBS (Bachelor of Medicine and Bachelor of Surgery) from other countries, graduates who wish to work or study in India are required to pass the Foreign Medical Graduate Examination (FMGE), a screening test. A one-year compulsory rotating medical internship (CRMI), which Indian medical graduates also undergo. After completing CRMI, both foreign and Indian graduates get PR from the State Medical Council.

The FMGE, conducted by the National Board of Examinations in Medical Sciences, is held twice a year, in June and December. Considered one of the toughest, the pass percentage in 2023, when 10,261 out of 61,616 graduates took the exam, was 16.65%. In 2022, the pass percentage for the exam was 23.35%.

In Andhra Pradesh, 73 FMGs wrote FMGE in December 2022. They completed their internship in May 2024 and are waiting for their PR since six months. They all completed their medical education at universities in Russia, Georgia, Kyrgyzstan and Kazakhstan.

However, Dr., who will complete his internship in November 2024, after the APMC stopped issuing PRs citing various factors. The wait had just begun for Alekya and her batchmates.

Meanwhile, Dimple Mehta, who graduated from a university in Russia in 2022, said she was in India for almost a year and returned to write her exams. She passed FMGE in January 2023. In June 2023, the Rajasthan Medical Council allotted him a one-year internship. She received her PR on July 11, 2024, and is currently working as a medical officer.

States like Andhra Pradesh, Delhi, Haryana, Jammu and Kashmir, Punjab, Tamil Nadu, and Kerala have denied or stopped permanent registration for FMGs with one year of internship experience. In contrast, states like Gujarat, West Bengal, Rajasthan, Assam, Orissa, Telangana and Karnataka have issued permanent registration and given postgraduate seats to students.

The problem arose due to gaps in their studies during the COVID-19 pandemic. All these graduates returned to India during the pandemic and continued their online studies in the last and final years of their courses. Some returned to their parent universities and wrote the exam offline, while others did not.

NMC Notice

The NMC issued a public notice on June 7, 2024, stating that FMGs who will attend online classes for any duration while completing their course must undergo a two-year internship, which led to protests.

After the outcry, the NMC withdrew the June 7 notification and issued a new notification on June 19, stating that all students who had adequately compensated physical classes instead of online classes and passed an exam equivalent to MBBS should be eligible for a one-year internship.

Dr. Alekya (26) graduated from a Russian university in 2021 and belongs to the batch affected by the epidemic. She was in her last year when the epidemic started.

In 2020, after writing her fourth year final exams, she came to India in June for vacation, as usual. It was also the peak of the epidemic. Her final year classes were scheduled to begin in October 2020. His stay at home, for three months, was extended until February 2021 due to travel restrictions and non-availability of flights.

However, she returned to her parent university, wrote her final exam offline, and practiced there for two more months to compensate for the missed practical sessions.

After returning to India, she wrote the FMGE in June 2023 and was allotted a one-year internship, which she completed in November 2024.

While it has been a little over a month for PR, it has been painful for him, his mind filled with thoughts of uncertainty.

“Students who completed internship in May 2024 have not got PR yet. What do I do if the process takes too long for us? Application for NEET PG-2025 exam starts in April. Will I get my PR by then?” asks Alekya, her voice cracking.

Mostly raised by her mother, a nurse, Alekya always wanted to become a medical professional like her mother. His father, who has been ill for a long time, does not go to work.

In EAMCET of Telangana and Andhra Pradesh, he secured a rank under 7,000 and 12,000 respectively in 2015. According to news reports, 69,840 students passed for the medical stream in AP in 2015. However, he could not get a seat. Medical colleges in two Telugu states.

Nevertheless, determined to make him a doctor, Alekya’s family decided that he should pursue his studies in Russia. Dr. who flew to Russia in 2016 at the age of 17. Alekya says, “My parents supported me because it was not only my dream but also my family’s dream to see me as a doctor.

Dr. Like Alekya, many FMGs from the two batches affected by the epidemic are concerned.

The protesting foreign doctors said they have given their exams offline and have compensation certificates, but they have been denied PR. They add that APMC registrar I. Ramesh informed them that some have not “compensated adequately for their practical sessions” as per NMC guidelines.

Asked about the reason for the delay in issuing the PR in July 2024, the registrar said the APMC council members were yet to be selected and nominated and he did not have the authority to decide on the matter. He also said that as per NMC guidelines, FMGs are required to undergo two years of internship.

V. Aruna Wanikar, former chairman of the Board of Graduate Medical Education, NMC, New Delhi, who signed the two June 7 and 19 circulars, said the decision of who is eligible for PR rests with the State Medical Council (SMC). Despite the June 19 notification, if the SMC feels the two-year internship is necessary, they can allot the same, said Ms. Aruna Vaniker, who was relieved of her duties on September 24.

In Telangana, Vice President of the Medical Council, Srinivasa Gundagani said Hindu They followed only one rule while determining the duration of internship. “All those who took the final year exam offline got one year and those who did not return got two years of internship,” he said.

“But we were all given a year, and now they are asking us to wait. Moreover, all of us have passed the FMGE, which is supposed to test our medical knowledge. Our batchmates in other states have also written the exam and got PR,” points out Karthik, another FMG belonging to the batch who wrote FMGE in December 2022, cleared it in the first attempt and completed a one-year internship in May. 2024.

Cabinet formation awaited

Even after 6 months, the state government has not been able to nominate members to the council. The 23-member council comprising 13 elected doctors, 6 nominated members and four ex-officio members was dissolved after the change of government in June. Director of Medical Education DSVL Narasimham said that this matter is under the government.

To add to the delay, the NMC on November 19 issued an advisory to SMCs to “always request confirmation of medical degree from the concerned foreign medical college/university through the concerned Indian Embassy/High Commission before or before granting permanent registration”. Recommending them for registration in NMR (National Medical Registrar).

“What did they do from June to November?” Dr. returned to his parent university in Kyrgyzstan. Asks Karthik to complete the syllabus. He has an indemnity certificate but is yet to receive PR. He says that when the technical registration is released, the test process should be completed before alloting the internship to them.

“I have visited the APMC office four times so far along with my daughter. Every time we come, we hear a new reason. We don’t think they sent our degrees to the embassy,” says a distraught father from Kakinada. Her daughter cleared NEET PG but could not attend counseling without PR.

However, the process of checking the certificate will take time. Ramesh clarified. “We are sending the list of all degrees and marks to the respective Indian embassies. The PR will be given to genuine degree holders as soon as the examination process is completed,” he assured the doctors. He says that the process of rejecting fake degrees is for the benefit of the society.

FMGs also feel that prejudice against them is the main reason behind the delay in issuing PR. “Discrimination against FMGs is not new to us. It is ingrained in the Indian medical system,” said Dr. Karthik says, it’s hard to explain why he is lazy at home. “Being unemployed at this age and spending a fortune on education is difficult to say the least,” said Dr. Karthik adds, his voice reflecting the pain he is going through.

“We are 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,” said Dr. Alekya adds. ₹ 40 lakh, and the delay leads to thoughts of depression.

Indian Medical Association state member S Dinesh Reddy, who graduated from a Ukrainian university in 2011, says there is a general feeling that the standard of education in foreign universities is low, and therefore FMGs are made to jump through many hoops.

“Standards are the same everywhere. But how much we earn from any university education depends on an individual,” says Dr. Dinesh Reddy, adding that the main objective of FMGE is to screen graduates.

Assurance of Pawan Kalyan

They health minister Y. Met Satyakumar Yadav and Human Resource Development Minister N Lokesh thrice but could not meet. Fed up, the FMGs now knocked on the door of Deputy Chief Minister Pawan Kalyan, who assured them to look into the matter.

Last week, Andhra Pradesh Health Department released a notification for the recruitment of Civil Assistant Surgeon Posts (280 Posts). Even if eligible, no FMG can apply without PR.

“We are not getting internship stipend, which is against NMC rules. However, we completed it. Now, we should be given PR atleast without much delay. We have spent eight years getting degrees. How many more years do we have to wait,’ said Chandra, another graduate, over the phone.

(Student name changed to protect identity)