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How I got 238 marks for the FMGE exam. Insights in to the exam, study methods and coaching centres

WHAT IS THE FMGE EXAM/MCI SCREENING TEST?


The FMGE (Foreign Medical Graduates Exam) is a licensing exam conducted by the NBE(National Board of Exams) two times yearly. The exam has a prescribed pass mark of 150 and is compulsorily required by all foreign medical graduates (except for those who already have a medical license from the UK, USA, Canada, New Zealand or Australia) for obtaining a license to practice in India.


WHAT ARE THE ELIGIBILITY CRITERIA FOR ATTEMPTING THE FMGE?


  1. You should possess a medical degree obtained from an institution which is not located in India.

  2. You should also possess an eligibility certificate from the Medical Council of India.


WHAT IS THE ELIGIBILITY CERTIFICATE AND HOW CAN YOU OBTAIN IT?


It is a document issued by the Medical Council of India which certifies that you are eligible to complete your medical education outside India. Most people obtain this certificate before leaving India for medical education but it is of no consequence if that has not been already done and can be obtained at another convenient time provided you fulfill the eligibility criteria.

In order to obtain it, you will have to go to the Medical Council of India office in Delhi with the completed application and necessary ancillary documents.


  1. You will have to provide mark lists of 10th, 11th and 12th standards with at least 50% aggregate marks for physics, chemistry and biology if you are in the unreserved category. For categories with reservation, the marks required are an aggregate of 40% for physics, chemistry and biology.

  2. You must obtain marks equal to or more than the 50th percentile in the NEET UG exam (the required marks are rather measly in the 100s but still impossible for 49.99% of people writing the exam).


PATTERN OF MCI SCREENING TEST


FMGE is a 300 question multiple choice paper. Each question gives you 1 mark for the right answer. Wrong answers are not penalized.


The exam is conducted in two sessions of 150 questions with a lunch break in between. To pass the screening test, you need to get a combined total of 150 out of a maximum total of 300.

FMGE: AN ANALYSIS


THE RISING PASS PERCENTAGE


The December 2019 FMGE had a pass percentage of about 25%. Historically, the average pass percentage was between 10%-15% for many years. Only recently has there been an upward creep seen in that trend with pass percentages steadily approaching 20% and now reaching an all time high of 25%.


The million dollar question here is that if the exam is getting easier or are the students getting better? I would absolutely put my million dollars on the students getting better rather than the former.


FMGE COACHING INSTITUTES


The major part of the students' success can be attributed to the various FMGE coaching institutes all over India. It is only after such institutions were established that we started seeing the obvious upward trend in the pass percentage.


These institutions give a crash course of the whole MBBS topic in a short short period of 4-5 months and the knowledge obtained from these institutions is what that enables the students to perform better in the screening test.


You might ask me, How can a 6 year course be taught in 4-5 months?


And my answer is, it isn't.


The FMGE exams conducted follows a peculiar pattern. Some topics are repeated year after year while some others largely ignored. This fact has aided the rise of these coaching institutions which boasts a huge pass percentage for their students year after year (50% of their students passing is a huge accomplishment as the historic pass percentages were about 10% before these institutions started taking foot).


So, if you are under the illusion that a FMGE coaching institute is an easy substitute for your years of hard work, you are only playing yourself.


These institutes are tunnel visioned at what that is necessary to help you clear the MCI exam. They neither claim nor try to teach you the whole of your MBBS syllabus in 5 months. Their focus is narrow and is only intended to help you cross the hurdle of passing the FMGE and is not your redemption from wasting your time in med school.


If having well rounded medical knowledge built on a strong foundation is your intention, spend your time in med school wisely, learning and applying what you have learned, and don't come back hoping that these institutions can magically make you a good doctor. But the wrong kind of thinking is still widespread among foreign medical students.


These institutions are enabled by the huge amounts of students who may never pass without their help and also by the students who have already written the FMGE. Exams conducted by the National Board of Exams are under a blanket NDA (Non Disclosure Agreement). The exam and its contents is the property of the NBE and revealing its contents to a third party can result in any kind of penalty that the NBE may deem fit to be imposed upon you. Still, the questions that came in the exams are reconstructed in fine detail along with the given choices by the students in collaboration with many of these already mentioned institutes. The coaching centers take this info, analyze it and then teach the students those topics along with a few related topics from which probable questions may come the next time and also some MCQ tests from these selected topics. These institutes promise up to an 80% strike rate in the exam from the topics that they have taught.


So coaching institutions = not a substitute for a good medical education.


While it may seem like I got a grudge against coaching institutions, that is far the truth. I, myself attended a well reputed coaching center to prepare for the FMGE and the training provided there was instrumental, without which, getting 238 would have been impossible. I estimate getting about 180-200 marks if it were not for the coaching I went through.


The cherry picking and teaching is extremely useful if your only objective is to clear the MCI screening test.


STUDYING FOR THE FMGE


Unlike what you might think, self study for the FMGE is a very viable strategy. But this requires early preparation starting from med school unless you are some sort of a super human who can complete the examination syllabus in the 5-6 months of free time that you may get before attempting the exam. Depending on your personal circumstance, you may never even get any time for preparation before the exam.


For all those who are in or starting med school, the best way to go forth is to take your studies sincerely and supplement it some target oriented practice for the FMGE. I recommend getting the scanned copies of notes from the existing FMGE coaching centers and using it as a rough guide to pick out the currently relevant topics for the FMGE. For doing this, please choose the notes form the lasts 2-3 years only and never go beyond that as you run the risk of getting stuck with topics which are currently past their point of relevancy and missing out on other topics which are more important at the moment. After you have done this, study these topics in detail from whatever source that you are using in med school.


After you have done this, go through the scanned notes and highlight anything that stands out or something new that you have not yet come across in your personal studies.


FMGE exam do contain many questions which can be easily answered without giving it any thought by seeing a "key phrase". These "key phrases" are taught as is in coaching institutes and picking them up is surely a step in the right direction.


Also, whatever you highlight can be used for multiple fast revisions before the exam without wasting your time on stuff that you already know or the "fluff" that surrounds the important core points.


As you are preparing for a multiple choice exam, it is quintessential that you are already familiar with the art of solving MCQs. I recommend getting a paid subscription to any of the test series provided by online coaching platforms. After you complete studying a topic, make it a habit to solve MCQs related to what you have just studied.


Being familiar with solving MCQs will help you in a multitude of ways, viz-a-viz:

  1. Help you reduce the mistakes caused due to inattention. Not fully reading either the question or the subsequent options or skipping over important wordings such as 'except' are mistakes which are repeated all too often unless you make a conscious effort to avoid them.

  2. Gives you insight in to how to manage time. You have a total of 300 minutes in two sessions of 150 minutes each to complete the exam. You can take as much or as little time as you wish for an individual question. Learning to solve MCQs well in advance will let you answer straight to the point questions or questions with specific "key phrases" in a matter of seconds and will free up the remaining time for answering lengthy questions or those questions whose answers are not immediately apparent.

  3. Reinforces already learned concepts in your memory.

  4. Teaches you to rule out wrong answers and to make an educated guess from among the remaining options for questions that you do not know the answer for. Not attending a question in an exam with no negative marking for wrong answers is a cardinal sin.


For all those who think that they did a less than stellar job in med school or those who did not pass the FMGE in their first try, joining a coaching institute is very highly recommended. As I have already mentioned above, the only thing coaching institutes are focused at is providing you with very lean notes which are designed for a high strike rate in the exam. Getting 200-210 marks is not at all impossible if you study the materials made available by the coaching centers impeccably.


A NOTE ON SUBJECT WEIGHTAGES


The four main subjects with the most marks backing them are Surgery, Medicine, Obstetrics and Gynecology, and Preventive and Social Medicine with each giving you between 30-35 marks. Not studying any of these subjects, except medicine, is only to your peril. Medicine is only left out because of the vastness of the subject, as no one can finish medicine in a manner which will give them maximum returns for the time spend.


Subjects such as Anatomy, Physiology, Biochemistry, Pathology, Pharmacology, ENT, Ophthalmology, Pediatrics and Microbiology gives you between 13-17 marks per subject. Forensic medicine and Radiology gives you 10 marks each. Studying these subjects, especially with recent notes from a coaching institute is very important as these subjects give you the best return for the time spend.


Other even shorter subjects such as Anesthesiology, Orthopedics, Dermatology and Psychiatry gives you 5 marks each. These are also very time efficient like the other short subjects mentioned above.

You are free to skip studying 4-5 of the short subjects without hurting your chances of passing the exam provided you study the rest of the subjects well. If you are really sure that a subject is way over your head or if you are not going to be able to properly revise the material that you are going to learn thrice before the exam, it is better to just consider that subject non-existent and go on with what you can learn and revise properly. If you skip more than 4-5 subjects, your chances of passing the exam exponentially falls. Even if you have heard from your seniors that learning only 12 subjects are enough to pass the exam, please err on the side of caution as the safety margin you then have is only razor thin and a slight upset can put you on the wrong side which is always a disaster as you will later have to go through another six months of preparation and a lot of mental distress.



Learning only once without any revision before the exam is a recipe for disaster. Not remembering what you already studied is a substantial risk you run if you don’t revise as much as you can before the exam. Only bite off what you can swallow.


THE IMPORTANCE OF REVISIONS


The last month to six weeks of your preparation must be reserved exclusively for revising the already learned topics. The notes that you have made or the ones provided from the coaching centers are the only material that you should be using. Using the same notes you have made by hand will help you improve your visual memory. I recommend at least three revisions before the exam. The first revision will obviously be a slow affair and can take you about 3-4 weeks to complete. The second revision will be way quicker taking only about half the time that you took for the first. During the second revision, I also suggest marking up any absolutely important points that you may wish to read again. Whatever you have highlighted during the second revision makes up your third revision which should be done is a span of 3-4 days just before the exam.


These three revisions will make sure that you will never forget the topics that you might have read 5-6 months before the exam and will also save you much regret from not being able to answer questions from topics that you know you have learned some time back but cannot recall in the exam hall.



Trying to study new topics during your revision time is a fallacy as, when the exam approaches, you will be left with neither the things you already studied nor the new things you tried to study at the thirteenth hour. Learn to be content with what you already know and keep telling yourself that trying to read up some other topics that your friends are reading or wanting to study from a new source to obtain a bit more knowledge will surely be your pitfall.


WHAT WAS MY FMGE PREPARATION LIKE?


I wasn't ever the kind of guy who tried to ace whatever I did in med school. Being the best in anything is a very time consuming ordeal and requires immense amounts of perseverance. I had neither or those as having a lot of "me" time each day for playing computer games, watching TV shows are drinking by myself (whiskey only please!!) was my foremost priority. So I was content to settle at being good and not the best.


To your health!!

Unofficially, my preparation started about 10 months before the December 2019 FMGE exam when me and a couple of my friends started meeting 2-3 days per week in the evening to discuss and partially study some assorted notes that we obtained from various coaching centers. We kept doing this for about 2-3 months before putting a stop to it as the final university exams were approaching. I did not take these sessions very seriously as I never made any notes or tried committing whatever I did not know to my memory. What was mostly being done was just revising what we already knew or trying to figure out what we did not know.



Officially, it all started after I joined a coaching center the first week of August 2019. Classes typically lasted 10 hours from morning till late in to the evening. Most days, I used to get back home between 7pm and 8pm after the classes at the coaching institute were done.


Sitting in the class for 10 hours daily is no small feat as most of us would have never had to sit in a class for more than 4-5 hours every day. I had my attention wander a lot while I was in the class. But, I took a rather innovative approach to make the best of the short attention span that I could spare. Whenever I was being taught something that I already had an idea about, I spend very little effort concentrating on it. I spend this time very fruitfully on my phone, tapping away at some games or talking to my friends while spending just enough time to write down what was being written by the teacher on the screen or maybe even skip writing down a few things. And, whatever that was new for me, I gave it my full and unwavering attention.


What I did each day after class varied according to my mood on that particular day. Some days I spend 2-3 hours learning before I went to sleep, some days I was too lazy to lift a finger after taking a bath and wasted my time playing games or even browsing through a multitude of non-essential item listings on Amazon.


This notwithstanding, I did make it a habit to take out thirty minutes at the night to read through whatever was taught during the morning even if I couldn't learn it by heart. It helped me consolidate the things that I listened to throughout the day in class and also made it a bit easier to orient myself when I took the notes later for a much more detailed study.


The time I did the most studying were on the free days between my classes. Even though the whole course lasted for four and a half months, classes were only held on 70-80 days and this gave me ample time to sit down and do whatever I had to do to learn the already completed material perfectly. My learning had everything from reading and recalling to listening to music, looking up info on the internet, taking breaks and even short naps. Whatever I did, I made sure to finish all the portions that were allocated to be completed before the day was up.


If you want a detailed look at various memorization techniques (some that I have used myself and some not), please see my post here.


Before I got to the five weeks at the end that I kept aside for revisions, I had enough time to learn all subjects thoroughly and even do a second study session on a couple of the important subjects such as social and preventive medicine, surgery and, a few smaller but high yielding subjects.


I did skip the classes of certain subjects and used that time for learning others which I thought were more important. I never bothered attending more than one class in medicine and microbiology as these did not keep up with the high standards that were maintained while teaching the rest of the subjects. I also skipped the test and discussion sessions conducted during the last month before the exam as i felt that these were a waste of many good hours which I could use to polish up on what I have already learned.

The first 22-23 days of the Time that I kept aside was used to do my first revision. I did already have days planned out for each subjects in my mind considering the time that I had to spend to study them once before. Each day, I would spend about 8-10 hours of my daily waking time on studies as the situation demanded. Out of this, about 2 hours each day were spend exclusively on doing MCQ tests from an online platform , for going through the answers and to read up of the explanations of questions which I did not know. The free time I got was spend on leisure as I still continued my habit of watching TV shows and playing computer games at this time too.

The second revision was substantially quicker taking only about half the time that I took for the first revision. This time too, I kept doing MCQs but those were done only two or three times during this period. Some of the time every day went in to collecting last minute revision notes from a few WhatsApp and Telegram groups and going through them. As I said before, I did not try to learn something which was new to me at this time and whenever such things came in whatever revision notes that I came across, I outright skipped them without giving it another thought. During this time, I also made sure to highlight few important points from my notes for the final revision.


The third and the final revision was done in a span of four days with me going through the already highlighted portions from the second revision. At this time, I did not do any MCQs or try reading anything which was not from my notes. All the free time I got was spend relaxing as I was mostly trying to keep my head clear. And, I would advise you to do the same and stop looking at what your friends are doing and go so far as to avoid socializing to prevent unnecessary panic and worrying at the last moment.


The day of the exam was uneventful. I have had already practiced doing a lot of MCQs so solving more MCQs in the exam was not a big deal. Even then, I spend about 30-50 seconds per question and carefully read the whole question before marking the answers. After finishing the questions, I had about 25 minutes left in each session which I used to go through the questions one last and final time before the exam ended. One advice I want to give is to use the break between the two exam sessions just for eating and relaxing and maybe for some personal revision. Please don’t use this time to discuss questions that you have already answered in the first session as this can only lead to mental distress and interfere with your performance in the second session.

And, that guys is how I got 238 for the December 2019 MCI screening test.

CLOSING THOUGHTS

Even after all the bad rep that the FMGE exam has received (and some rightly so), passing the Indian licensing exam for foreign medical graduates is not as dreaded a task as it may seem if you do a good advanced preparation with many revisions. To every FMGE aspirant reading this, I extend you my best wishes. Good luck, have fun.



If you have any questions, comments or suggestions, please put them down in the comments section and I will try to answer as much as possible.

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Thiruvananthapuram

Kerala, India

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