MBBS students fear expulsion as they fail to clear first-year exam

NEW DELHI: Hardik may have to drop out. He was unable to clear the “first professional exam” of his MBBS courses in four attempts and a change in National Medical Commission guidelines in 2020 means he will not get a fifth. Hardik, his name was changed on request, is enrolled in a government medical college in Rajasthan but fears he “will have to drop out of the MBBS programme now”.

The “first professional exam” is the exam held at the end of the first year of MBBS studies. The new NMC guideline was implemented in 2020 and for the batch taking admission in 2019. They were to write the first exam in 2020. However, as Hardik pointed out, this batch was hit hard by the Covid-19 pandemic. Even medical colleges had closed for junior students and classes resumed online with students attending through mobile phones, laptops and desktop computers. There are five students in his batch in a similar predicament.

“The first-year subjects like human anatomy require practicals and learning them online is tough. Although we had a few practical classes just before the exam, I just could not get through,” said Hardik.

“We have cleared the NEET UG and that is how we secured seats in a government medical college. But fear of expulsion is pulling down the spirits of our entire family,” said another student of a government medical college in Punjab. The National Eligibility cum Entrance Test (NEET exam) is the national-level entrance test for MBBS courses and other allied medical programmes in India.

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Teachers say that students failing to clear the first professional exam isn’t new but expulsion is.

“In each college, there are four to five students. Previously also they were repeating but now they just have four attempts and if they cannot clear in those four attempts they will have to quit MBBS,” said Dr Jeyaraj Pandian, professor and principal, Christian medical college, Ludhiana.

NMC: Competency-based UG curriculum

The first professional exam covers three MBBS subjects – human anatomy, physiology and biochemistry. As per the National Medical Commission, only four attempts are permitted for a student to clear the first professional exam.

“The NMC has mentioned that competency-based medical education will now be started in India and that is the new regulation for medical curriculum. It also clearly says that the competency-based medical education that has been rolled out is only for those students who joined in 2019.

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As per the guidelines, the first exam happened in 2020 September. An attempt in any one or two of the three subjects in the first professional exam will be counted as an attempt and the student will get a chance to appear in the supplementary exam. If a student fails even the supplementary exam, he has to repeat the first year of MBBS with the next batch of students. If the repeaters fail again, they will still get a chance to write the supplementary exam – this is the fourth attempt. If they don’t clear, they will be asked to leave MBBS.

MBBS: Why four attempts?

Till 2020, there was no restriction on the number of attempts. Students could appear for the exam any number of times. Students repeated even 25 times to clear the exams.

“This was becoming difficult and medical colleges took up the matter with the Medical Council of India (MCI), now NMC. It was decided that there will be four attempts for the students to clear the first year”, said Dr Khan Amir Maroof, professor, University College of Medical Sciences (UCMS), Delhi.

While the number of failures in the first attempt did see a rise, many of the students could clear the supplementary exam. “The regulation was very much needed but I am sad that it happened the same year when there was a loss of studies due to the pandemic and many of the students did not study or take online classes seriously,” Maroof added.

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Dr Aditya Sairam, professor, at ESIC Medical College, Chennai, agreed, saying that, it is not a single-factor problem but a multifactorial issue leading to students not being able to clear the exam. “All three subjects in the first year are basic subjects, if a student has a clear understanding of the subjects, they can move on. If there are proper teaching facilities and good faculties then they will be able to clear it. Second, the world had to deal with the pandemic and there was a lapse in teaching. The entire country was under lockdown. It took time for the system to cope with that. The third factor is the students themselves. They should not think they can study for two months and pass,” he said.

Most professors agreed that four attempts are enough, as after a particular period the student loses interest in studies. Usually, it is seen that a student clears this exam on the second attempt.

“In my college, everyone has passed and scored good marks. And in my opinion, four times is fair. Most of the students clear the exam in one attempt and a maximum of two attempts, not more than that. Students should not be given more attempts than that. Once the number of attempts is increased, the quality of doctors will come down,” said Dr Mahanavel, professor, at Stanley Medical College, Chennai.