The Committee, recommends that the final year MBBS examination be considered as the Licentiate Examination.
New Delhi : Settling the debate of the proposal of a common exit exam after MBBS, the Rajya Sabha Committee has given its recommendations. The committee has recommended certain modifications with which the clause proposing the National Licentiate exam would now be adopted in the modified bill
Simply put these recommendations include
- Merging the Exit exam (National Licentiate Exam, NLE) with Final year MBBS Exam and its conduction at the State Level
- The examination should be a common short-question based examination for all final professional students at a level commensurate with the current final professional theory examination.
- De-linking PG NEET exam from the NLE as the use of same instruments for merit ranking for post-graduate entrance may not serve the purpose because a qualifying examination and a rating examination should not preferably be equated
- Doctors passing out of institutions such as AIIMS, JIPMER, and other on which NMC Bill is not applicable, will have to clear the National Licentiate Exam
It is reported that Clause 15 of the proposed National Medical Commission Bill provides that National Licentiate Examination for students graduating from the medical institutions for granting licence to medical practice, enrolment and admission to postgraduate medical courses.
The clause had become a bone of contention between the medical fraternity and the government, with thousands of young doctors taking to streets opposing an additional exam as a license to practice. The government on the other hand had justified the clause as bringing uniformity in the quality of medical education in the country.
After going through all the view-points given by various stakeholders, the Rajya Sabha Committee,which had been asked by the Lok Sabha to take stakeholders opinion and recommend appropriate changes to the NMC bill has given the following recommendations
4.15.6 The Committee in its 92nd Report had recommended to introduce a common exit test for MBBS doctors as an instrument of quality assurance, and to ensure that the quality and competencies of a doctor, before one starts practicing, are guaranteed and standardized. The Committee held a detailed discussion on the issue of the National Licentiate Examination in view of the suggestions of the stakeholders. The clause 15 mandates a uniform National Licentiate Examination for students graduating from the medical institutions governed by the proposed NMC Act. A three year grace period has been provided for the NLE to be operational. The Committee has taken note of the concerns expressed by various experts and stakeholders regarding the advisability of introducing the NLE at this stage.
4.15.7 The Licentiate exam is proposed to be compulsory for any MBBS doctor to make him eligible to practice medicine. The Committee, however, observes that unless the NLE is carefully designed, there is apprehension that a sizeable number of MBBS doctors who have passed their university level examinations, may be debarred from practice on disqualifying NLE. This will not only undermines the sanctity of the examinations conducted by various universities but also put an extra pressure on the system when the country is already facing a shortage of doctors. This will create a dichotomy where the university certifies a doctor as fit to practice and the failure to qualify NLE exam renders him unfit to practice. It is obvious that the implementation problem will be huge and the country will, over a period of time, have a population of mismatched unhappy doctors, who have nowhere to go.
4.15.8 The above analysis leads the Committee to the conclusion that the NLE will put undue stress on students, especially those who come from backward sections of the society and States, who cannot afford private guidance/tuitions for NLE and may not be able to crack the Multiple Choice Questions (MCQs).
4.15.9 Taking all the above factors into account, the Committee recommends that the Licentiate examination be integrated with the final year MBBS examination and be conducted at the State Level. The final MBBS examination should be of a common pattern within a particular State, initially due to the logistical constraints, and could be extended across the country as the system streamlines. The Committee also recommends that the final year MBBS exam should be designed in such a way that it takes into consideration not only the cognitive domain but also the assessment of skills by having practical problems/case study types of questions as a major component, with a strong tilt towards primary healthcare requirements.
4.15.10 The Committee further observes that the theoretical examination should be a common short-question based examination for all final professional students at a level commensurate with the current final professional theory examination. The examiners for conducting the practical examinations should be external and to be decided through a lottery from an empanelled list of examiners. The Committee is of the considered view that making provision for the final year MBBS examination as the Licentiate Examination would test both the theoretical and clinical aptitude of the students. The Committee, therefore, recommends that the final year MBBS examination be considered as the Licentiate Examination.
4.15.11 Further, the Committee is of the strong view that if PG entrance and licentiate examination are combined, the students will concentrate only on performing in entrance examination, during their undergraduate days and internship. The Committee, therefore, recommends that the PG NEET for admission to PG courses may continue as of now as an interim management till a mechanism is evolved within three to five years for the conduct of a common final year MBBS examination which has an adequate structure, so that subjectivity in the theoretical examination is replaced by common problem/case study based MCQ type examination. The common final year MBBS examination may be conducted within a particular State by any State University/State Health University or any other suitable agency.
4.15.12 The Committee also observes that the NLE has also been proposed to serve as an instrument for post-graduate entrance. The Committee is of the view that a licentiate exam is a good instrument to maintain a minimum standard across all graduates. The Committee, however, is of the firm view that to use the same instruments for merit ranking for post-graduate entrance may not serve the purpose because a qualifying examination and a rating examination should not preferably be equated. The Committee, accordingly, recommends that necessary modifications may be made in the above clause to address its above mentioned concerns.
4.15.13 Further, the Committee fails to understand as to how the MBBS students passing out from AIIMS, JIPMER and such other institutions on which NMC Act will not be applicable, will be allowed to get registered in the State/National Register or get admission into postgraduate courses in other medical institutions, without qualifying the NLE. In this regard, the Committee notes the views of the Government and recommends for inclusion of other medical institutions established by separate Act of Parliament in clause 15(1). The Committee also recommends suitable changes in the clause 15(5) to incorporate such medical institutions for conducting common counseling for admission to the postgraduate courses.
The committee in its report final stated that Subject to the above recommendations, the clause is adopted.