What Happened
- The National Medical Commission (NMC) issued a notice mandating that Foreign Medical Graduates (FMGs) who completed part of their MBBS programme in online or hybrid mode must extend their study period to physically compensate for all online clinical or practical components
- The NMC clarified that no clinical or practical training can be offered online or in hybrid mode — 100% physical, on-site hospital training is required for the clinical portion of a medical degree
- The directive responds to widespread adoption of online education during the COVID-19 period, after which many Indian students pursuing MBBS abroad received partial or full clinical training virtually
- To practise medicine in India, FMGs must pass the Foreign Medical Graduate Examination (FMGE), a screening test conducted by the National Board of Examinations (NBE); those with online clinical hours must first complete the compensatory physical training
- The NExT (National Exit Test) is expected to eventually replace the FMGE as the single screening examination for all medical graduates, domestic and foreign
Static Topic Bridges
National Medical Commission: Statutory Basis and Regulatory Powers
The National Medical Commission (NMC) was established under the National Medical Commission Act, 2019, which replaced the Medical Council of India (MCI). The NMC comprises 33 members: a Chairman, 10 ex-officio members, and 22 part-time members, all appointed by the central government. Four autonomous boards operate under the NMC's supervision: the Under-Graduate Medical Education Board (UGMEB), Post-Graduate Medical Education Board (PGMEB), Medical Assessment and Rating Board (MARB), and Ethics and Medical Registration Board (EMRB). The UGMEB is responsible for setting minimum standards for medical education, curriculum, and clinical training requirements — including the requirements at issue in the FMG hands-on training directive.
- NMC Act, 2019: Replaced the MCI, which was dissolved due to allegations of corruption and regulatory capture
- MCI members were elected by the medical profession; NMC members are government-appointed — a fundamental governance shift
- NMC has power to prescribe minimum standards for clinical training; its guidelines are binding on all recognised medical institutions and on FMGs seeking Indian registration
- EMRB maintains the National Medical Register and can suspend/cancel medical registration for violations
Connection to this news: The NMC's directive on hands-on training flows directly from the UGMEB's power to set and enforce clinical training standards — any FMG who bypassed physical clinical training cannot be registered to practise in India until the deficit is made good.
Foreign Medical Graduate Examination (FMGE): Screening Mechanism
The FMGE (also known as the NMC Screening Test) is a licensing examination conducted twice a year by the National Board of Examinations in Medical Sciences (NBEMS). It is mandatory for all Indian nationals and Overseas Citizens of India (OCIs) who obtained their primary medical qualification (MBBS equivalent) from a medical institution outside India, and who wish to obtain a registration certificate from the NMC or a State Medical Council to practise in India. The FMGE comprises two papers of 150 marks each (total 300); the qualifying mark is 150 out of 300 (50%). The pass rate has historically been low — often 15-25% — indicating the standard gap between foreign medical education and Indian clinical practice requirements.
- Conducted by: National Board of Examinations in Medical Sciences (NBEMS)
- Frequency: Twice per year — January and June sessions
- Qualifying mark: 150/300 (50% aggregate in two papers combined)
- Eligibility: Indian nationals / OCIs with foreign MBBS equivalent degree
- NExT transition: NMC Act, 2019 envisages the National Exit Test (NExT) will eventually replace FMGE for FMGs and serve as the final-year examination for domestic graduates simultaneously
Connection to this news: FMGs who completed clinical training online cannot appear in the FMGE (and thus cannot register to practise in India) until NMC verifies that the physical clinical compensation has been completed — the hands-on mandate is therefore a condition precedent to FMGE eligibility.
Regulation of Indian Students Studying Medicine Abroad
A significant proportion of Indian medical students pursue MBBS in countries such as China, Russia, Ukraine, Kazakhstan, Bangladesh, Philippines, and Nepal, often because they cannot secure admission in Indian medical colleges which have limited seats. The NMC prescribes eligibility conditions for such students: they must pass NEET (National Eligibility-cum-Entrance Test) before enrolling abroad, their foreign institution must be recognised by the NMC, and they must qualify the FMGE on return. The COVID-19 pandemic and the Russia-Ukraine war (which disrupted studies of thousands of Indian students in Ukraine and Russia) created large cohorts of FMGs with interrupted or online-only clinical training — the NMC's 2026 directive directly addresses the quality gap this created.
- NEET mandatory from 2018 for Indian students wishing to study medicine abroad
- Russia and Ukraine together had ~20,000+ Indian medical students before the 2022 conflict
- NMC maintains a list of recognised foreign medical institutions; degrees from non-listed institutions do not qualify for FMGE
- MCI / NMC had periodically issued notices against specific countries' medical colleges for sub-standard training
Connection to this news: The NMC's hands-on training mandate is a direct institutional response to the COVID-era and conflict-era educational disruptions — ensuring that FMGs entering Indian clinical practice have genuinely acquired the manual skills required for safe patient care.
Key Facts & Data
- NMC statutory basis: National Medical Commission Act, 2019 (replaced MCI)
- NMC composition: 33 members (Chairman + 10 ex-officio + 22 part-time), government-appointed
- Four autonomous boards: UGMEB, PGMEB, MARB, EMRB
- FMGE: Conducted by NBEMS; qualifying mark 150/300; held twice yearly (January and June)
- FMGs with online clinical hours: Must complete physical compensatory training before appearing in FMGE
- NExT (National Exit Test): Will eventually replace FMGE as single screening test for all graduates
- NEET mandatory for Indian students enrolling in foreign medical colleges (since 2018)
- Context: COVID-19 disruptions and Russia-Ukraine war created large cohorts of FMGs with online-only clinical training