Why Over 10K Indian Medical Students In Philippines Deserve Immediate Relief From NMC

A recent advisory issued by the Indian medical education regulator, the National Medical Commission, has put the career of over 10,000 medical students studying in the Philippines, at stake.

These students have been pursuing their undergraduate medical courses for the past one to two years across Philippines’ colleges. Now, the advisory says that their course is not valid and hence they cannot appear for the Exit Exam (earlier screening test) in India to become a doctor.

Thousands of Indian students pursued the same course in the past and became doctors in India. The sudden change of norms has left the students clueless about their career prospects.

India and the Philippines follow different medical education systems. While in India, a candidate appears for NEET (National Eligibility Cum Entrance Test) after class 12 and based on individual scores gets admission to a five-and-a-half-year MBBS course. In the Philippines, a candidate first completes a BS Biology course of 1.5 to 2 years, and then gets admission into a four-year-long MD programme.

After completing the MD course, Indians who have a medical degree from the Philippines come back to India and appear for a screening test. On successfully passing the test, they get a license to practice in India.

But, a couple of communications from the NMC has put the careers of thousands of students on hold. First, the Gazette notification of November 18, 2021, among other things, said that candidates who were pursuing undergraduate medical courses would not be allowed to sit for the screening test if the duration of their course was less than 54 months.
 
After the students sought clarification from the NMC on whether BS Biology would be considered a part of the four-year MD course, the NMC’s answer was negative.

Further, in its advisory dated March 25, 2022, the NMC clarified that the BS Biology and MD courses were two separate degrees in the Philippines and that BS courses could not be equated/included with the MBBS course. 

It also said that after the publication of the Gazette notification of November 18, 2021, students who had already taken admission for any foreign medical qualification/course which was not equivalent to the MBBS course in India could not be treated as eligible qualifications for registration to practice medicine in India.

While the students have challenged both -- the Gazette notification, as well as the NMC’s advisory in the Delhi High Court -- legal and health experts, have come out in support of these students.

Retrospective application of the law is bad 

According to legal experts, the NMC’s notification should come into force from the day it has been enacted, i.e. November 18, 2021, and whatever admissions had happened before that should be held valid.

“There have been cases in the Supreme Court where the retrospective application of the laws was challenged and the Hon’ble court had passed its verdict in favour of students. Retrospective application of any law is against the principle of natural justice,” Shikhar Ranjan, former law officer of the erstwhile regulator, Medical Council of India, said.

NMC can’t make law with extraterritorial jurisdiction

Legal experts say that NMC cannot decide the duration of undergraduate medical courses offered in other countries. 

This is against a Supreme Court dated May 9, 2011, in Medical Council of India vs. J. Saai Prasanna & Ors case. The court had categorically held that “for examining the validity of the medical qualification granted by a medical institution in any country outside India, the norms and tests of the country where the medical institution is situated, will have to be fulfilled for recognition of the degree in that country and the norms that are prescribed by the Indian Medical Council Act, 1956 regarding Indian medical institutions will have no relevance.”

No valid reason for invalidating the BS Biology course

The NMC in its advisory reasons that because candidates in the BS course are not taught pre-clinical subjects such as Anatomy, Biochemistry, Biophysics, Microbiology, etc. and are taught basic subjects such as Biology, Psychology, etc. -- which is equivalent to class 12 in India – it deems the course invalid in India.

“Hence, BS Biology is a basic degree course prior to the starting of Graduate/Primary Medical Course in reference with Indian education. The same doesn’t even qualify a candidate to be eligible for admission in the MBBS course in India,” the NMC’s advisory says.   

However, Dr Abellia, Vice President of Academic Affairs at Lyceum Northwestern University, in the Philippines contradicts NMC’s argument and says that subjects like Human Anatomy, Physiology, immunology, forensic medicine, etc. are taught under BS Biology in the Philippines.

“BS Biology is a part of the medical education system of the Philippines, which is recognised all over the world. The course content is very much pre-medical and pre-clinical but I think NMC has wrong notions about it. This is the only system through which doctors are produced in the Philippines and go to other countries to practice.”  

She added, “I don’t deny that there may be a handful of black sheep in the system who might be taking things for a ride but such cases are everywhere in the world. The whole medical education system of a country cannot be disregarded just because of that.” Several doctors practising in India have passed the same course

Before the Gazette notification of November 18, 2021, students used to return to India after doing the BS Biology and the MD course and appear for screening tests. Those who passed the test have become doctors and are practising across the country. 

“What has gone wrong today that NMC is not in favour of giving relief to students who took admission in BS Biology before Nov 18, 2021? It is surprising that NMC has recognised the MD course before November 18, 2021,” an education counsellor said.

He added, “But these candidates also first did BS Biology and then took admission in MD. So, it is completely inexplicable why the NMC discriminated with the two batches of 2020 and 2021 of BS Biology.”

The Philippines’ pass percentage in screening tests is the highest among all countries

Out of all the candidates who appear in screening tests after completing their undergraduate medical course from foreign countries, candidates from the Philippines have maintained the best pass percentage.

“In 2019, out of the total students of Philippines who appeared for the screening test, 50.21 per cent passed. This is the highest pass percentage in any country. If you compare the result of the past ten years, you will find the Philippines topping the pass percentage chart,” Anuj Goyal from Get My University, said.

He added, "If a medical student from India aspires for the USMLE (the United States Medical Licensing Examination) to pursue his post-graduation in the US, will ECFMGE (Educational Commission for Foreign Medical Graduates) disqualify him on the ground that India hasn’t followed the US pattern of Education? The role of regulatory bodies should be to create opportunities and keep checks and balances to audit the quality of students through screening exams rather than changing the framework of existing accepted education systems across the countries.”

Srinivasa Babu, a parent, whose son had completed his MD degree from the Philippines and now pursuing his post-graduation in Australia said, “The Philippines follows an advanced education system based on problem-based learning and systemic learning widely acclaimed by world bodies like ECFMGE, WHO (World Health Organisation), FAIMER (Foundation for Advancement of International Medical Education and Research), etc. How can NMC decide for other countries to follow a 54-month education system?”