How FMGE is said to be ‘tougher’ than domestic MBBS exams

Social Justice & Health Governance · 6 October 2026 · Based on The Hindu (original report)

2-minute summary

The Foreign Medical Graduate Examination (FMGE) June 2026 results witnessed a sharp decline in the pass rate to just 12.4%, sparking widespread student protests and intense debate over medical licensing standards in India. Foreign Medical Graduates (FMGs) argue that the examination lacks a level playing field compared to domestic MBBS assessments. The FMGE, conducted by the National Board of Examinations in Medical Sciences (NBEMS), has transitioned toward highly clinical, image-based, and video-based questions. Additionally, the exam heavily tests India-specific public health administration—such as local Primary Health Centre (PHC) staffing norms and historical domestic health committees (e.g., the Bhore and Kartar Singh committees)—which are entirely absent from foreign medical curricula. While domestic students are assessed through subjective university exams, FMGs must clear this rigorous centralized screening to practice, highlighting structural gaps that the proposed National Exit Test (NExT) aims to resolve.

Why it's in the news

The pass percentage for the FMGE June 2026 session plummeted to 12.4%, triggering nationwide student protests and intensifying the policy debate surrounding regulatory barriers, clinical parity, and licensing reforms for foreign-trained Indian doctors.

Facts to remember

The pass rate for the Foreign Medical Graduate Examination (FMGE) June 2026 session plummeted to 12.4%.
The FMGE is a screening test conducted by the National Board of Examinations in Medical Sciences (NBEMS).
The National Medical Commission (NMC) is the statutory body regulating medical education and professionals in India under the NMC Act, 2019.
The FMGE syllabus tests India-specific public health administrative frameworks, including the recommendations of the Bhore Committee and Kartar Singh Committee.

Background and context

Every year, thousands of Indian students pursue MBBS degrees abroad in countries like Russia, China, Ukraine, Belarus, and Central Asian republics due to the high competition and cost of medical education in India. To practice medicine in India, these Foreign Medical Graduates (FMGs) must clear the FMGE, a screening test established to ensure their clinical competence aligns with Indian standards. Historically, the FMGE has seen low pass rates, often hovering between 10% and 20%, leading to a growing backlog of unlicensed medical graduates. FMGs have long argued that the exam is disproportionately difficult compared to the university-level examinations taken by domestic MBBS students. To address this disparity and standardize medical licensing, the National Medical Commission (NMC) Act, 2019, proposed the National Exit Test (NExT), which is intended to serve as a common qualifying final-year MBBS exam and a licensing test for both domestic and foreign medical graduates.

Constitutional provisions

Article 21 — The Right to Health is recognized as an integral part of the Right to Life, which is impacted by the availability and quality of licensed medical professionals.
Article 47 — Directs the State to regard the raising of the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties.

Committees and reports

Bhore Committee — Laid the foundation of public health planning in India, recommending the integration of preventive and curative services, which remains a core topic in the FMGE's Community Medicine section.
Kartar Singh Committee — Recommended the introduction of multipurpose health workers to streamline primary healthcare delivery, a structural detail frequently tested in the FMGE.

Government schemes

National Health Mission (NHM) — Governs the rural healthcare delivery infrastructure, including the staffing norms of Primary Health Centres (PHCs) tested in the FMGE.

International organisations

World Health Organization (WHO) — Prescribes the standard doctor-to-population ratio of 1:1000, which India aims to achieve by optimizing the licensing and integration of qualified medical graduates.

Mains practice: Analyze the regulatory and structural challenges faced by Foreign Medical Graduates (FMGs) in India. How can the proposed National Exit Test (NExT) address the issue of a 'level playing field' in medical licensing?

The plummeting pass rate of the Foreign Medical Graduate Examination (FMGE) to 12.4% in June 2026 has highlighted deep structural and regulatory challenges in India's medical licensing system. While India faces a shortage of doctors, thousands of foreign-trained Indian graduates remain locked out of practice.

• **Regulatory and Curriculum Mismatch**: Foreign medical curricula naturally omit India-specific public health administration. The FMGE heavily tests domestic health systems, including historical policy frameworks like the Bhore Committee (1946) and Kartar Singh Committee (1973), alongside Primary Health Centre (PHC) staffing norms under the National Health Mission (NHM). FMGs are thus tested on administrative details they were never taught.

• **Clinical Exposure Deficit**: FMGs often lack hands-on clinical exposure to high-volume, resource-constrained Indian hospital settings. The recent shift by the National Board of Examinations in Medical Sciences (NBEMS) toward complex, video-based clinical scenarios exacerbates this gap.

• **Absence of a Level Playing Field**: Domestic MBBS students are assessed through subjective, university-specific professional exams, whereas FMGs must clear a highly competitive, centralized, objective screening test (FMGE) to secure registration, creating an unequal entry barrier.

**Role of the National Exit Test (NExT):**

Under the National Medical Commission (NMC) Act, 2019, the proposed NExT aims to replace both the final-year MBBS university exams and the FMGE with a single, uniform licensing exam. This will establish a standardized benchmark of clinical competence, eliminating the dual-standard system and ensuring that both domestic and foreign-trained graduates are evaluated on identical parameters.

**Way Forward:**

To ease the transition, the Ministry of Health and Family Welfare should introduce structured, clinical bridge courses focusing on Indian public health systems and local disease demographics. Furthermore, NBEMS must ensure transparency by releasing official mock papers and syllabus weightages to prevent panic and reliance on informal 'recall' papers. Standardizing licensing through NExT, while handholding FMGs through clinical orientations, is vital to achieving Sustainable Development Goal 3 (Good Health and Well-being) and strengthening India's rural healthcare delivery.

Prelims practice questions

Q1. Consider the following statements regarding the medical licensing and regulatory framework in India: 1. The Foreign Medical Graduate Examination (FMGE) is a statutory screening test conducted by the National Board of Examinations in Medical Sciences (NBEMS). 2. The National Medical Commission (NMC) was established as a statutory body under the National Medical Commission Act, 2019. 3. The proposed National Exit Test (NExT) is intended to replace both the FMGE and the final-year MBBS university professional examinations. How many of the above statements are correct?

Only one
Only two
All three
None

Answer: C. Statement 1 is correct: The FMGE is conducted by the NBEMS, which is an autonomous body under the Ministry of Health and Family Welfare. Statement 2 is correct: The NMC is the statutory regulator established under the NMC Act, 2019, replacing the Medical Council of India. Statement 3 is correct: The NExT is designed to act as a common qualifying final-year MBBS exam, a licensing exam to practice medicine, and a gateway for postgraduate admissions for both domestic and foreign graduates.

Q2. With reference to the history of public health planning and committees in India, consider the following statements: 1. The Bhore Committee (1946) recommended the integration of preventive and curative services at all administrative levels. 2. The Kartar Singh Committee (1973) recommended the introduction of multipurpose health workers to streamline rural healthcare delivery. Which of the statements given above is/are correct?

1 only
2 only
Both 1 and 2
Neither 1 nor 2

Answer: C. Both statements are correct. The Bhore Committee (Health Survey and Development Committee, 1946) laid the foundation of modern public health in India by advocating for integrated health services. The Kartar Singh Committee (1973) focused on family planning and recommended multipurpose health workers to replace specialized single-purpose workers in rural areas.

Q3. Which of the following statements is correct regarding the National Medical Commission (NMC) of India?

It is a non-statutory advisory body established by an executive resolution of the Union Cabinet to oversee medical ethics.
It is headed by the Union Minister of Health and Family Welfare as its ex-officio chairperson to ensure political accountability.
It has the sole authority to conduct the Joint Entrance Examination (JEE) for admission to premier engineering institutions.
It is a statutory body that regulates medical education, professionals, and institutions under the National Medical Commission Act, 2019.

Answer: D. Option D is correct because the NMC is indeed a statutory body established under the National Medical Commission Act, 2019. Option A is incorrect because it is statutory, not advisory/executive. Option B is incorrect because it is headed by a medical professional/academic chairperson, not the Union Minister. Option C is incorrect because JEE is conducted by the National Testing Agency (NTA).

Revision flashcards

Which statutory body regulates medical education and professionals in India, and under which Act was it established? The National Medical Commission (NMC), established under the National Medical Commission (NMC) Act, 2019, which replaced the Medical Council of India (MCI).
Which autonomous body is responsible for conducting the Foreign Medical Graduate Examination (FMGE) in India? The National Board of Examinations in Medical Sciences (NBEMS), which functions under the Ministry of Health and Family Welfare.
What was the pass percentage of candidates in the Foreign Medical Graduate Examination (FMGE) June 2026 session? 12.4%. This sharp decline triggered widespread student protests and demands for regulatory reforms in medical licensing.
What structural changes in the FMGE exam pattern in June 2026 caused concern among foreign medical graduates? The introduction of unfamiliar video-based modules, highly clinical-based questions, and complex diagnostic images that caught aspirants off guard.
Why do Foreign Medical Graduates (FMGs) often struggle with the Community Medicine section of the FMGE? Because it heavily tests India-specific public health administration, local primary health centre (PHC) staffing norms, and historical domestic health committees (like Bhore or Kartar Singh), which are not taught in foreign medical curricula.