Dr. Lijo Lukose is a foreign medical graduate. He completed his medical school at Jinan University, Guangzhou in China and after facing many obstacles like COVID, online classes, he cleared FMGE in December 2021. He is now working as an Intern doctor at Holy Family Hospital, South Delhi.

Let's see what Dr. Lijo has to say about his journey from China to India, clearing FMGE and tips for fellow FMGE aspirants through the conversation between Dr. Lijo Lukose and MedBound Times [Himani Negi and Anas Adil]

Anas: First of all, Dr. Lijo, we would like you to introduce yourself to our medical community. 

Dr. Lijo: I am Dr. Lijo Lukose. I hail from the southern part of India, Kerala. I have done my UG from Jinan University, Guangzhou, China. Currently, I am doing my Internship at Holy Family Hospital, South Delhi.

Anas: Before getting into your journey of clearing FMGE, We would like to know how it started. Why did you decide to be a doctor? And why and how did you decide to pursue your medical degree in China?

Dr. Lijo: My journey started when I was in primary school itself. My mother was a nurse in a hospital in the cardiac department. She inculcated the idea of medicine into my head. She always used to come back and say what she saw, the surgeries, and the cases. I was intrigued by all these kinds of things she used to teach me. Because of this I got oriented towards the medicine line. After my 12th, I gave my NEET exam, but unfortunately, I could not get a seat and I did not like the prospect of paying a lot of cash to get a seat. So I decided to pursue medicine abroad. 

Anas: Do you think pursuing MBBS from abroad makes any difference as compared to doing MBBS from India?

Dr. Lijo: The bottom line is the people who are pursuing education abroad will have to come to India at the end of the day. The trajectory that you are set on will be completely different if you are continuing your education in India or abroad. As of now, there are a lot of hurdles for an FMG to come back and work as a doctor in India compared to Indian medical graduates.

Anas: As there is a limited number of government seats for MBBS in India and pursuing MBBS from a private college is a hefty price, so not everyone can afford it. What do you think is a wise choice? Would it be better to take a gap year and then prepare for NEET again or to pursue MBBS abroad without taking a gap year? and How many attempts do you think a student should give before deciding to pursue MBBS abroad?

Dr. Lijo: Everybody is different, you are different from me, I am different from you, and how many attempts to clear the NEET is completely upon you. I myself had friends who gave multiple attempts and still were not able to qualify and they changed their stream to engineering and various other courses. The number of attempts you want to give is a personal opinion. Even I thought I will take a year gap and give another attempt, but then I thought what if I don’t get it? What if I will be stuck here while the world progresses and why waste one more year? So I had the option of going abroad and I went for that. But if you think you can crack it in a span of one or two years, I would say a maximum of 2 years and if you are determined that you will crack it, then you should definitely go for it.

Anas: First and foremost, congratulations again for clearing FMGE. Kindly explain this exam in brief and why one should take it. Along with that, we would really like to know how one can prepare for this exam and the sources.

Dr. Lijo: FMGE is a Foreign Medical Graduate Exam for foreign students from abroad to come and gain the practice rights to work as a doctor in India. It is a qualifying exam. Like any other country, India follows that very strictly, every other country's counterpart would be USMLE in the USA, PLAB in the UK, and in Dubai, it is the DHA exam. So all of these exams are made in such a way that a doctor who has gained his PMQ (Primary Medical Qualification) from any country can come to the set country and work as a doctor there.

The paper comprises 300 questions. Each question has 1 mark. To qualify for this exam, you must answer 150 questions correctly. So you can register yourself as a doctor in India. 

Now coming to how I prepared for the examination, I did not start preparing until I reached my final year because it did not hit me till then. In 5th year I realized that I need to clear FMGE.

The materials I suggest would be if you have your solid concept notes of MBBS, it would be 100 percent best but nobody has that determination to make notes from the first year itself. You can choose applications like Marrow and PrepLadder. They have competitively priced programs for FMGE which provide video classes, lectures, and notes, also there are sample question banks. Those sample questions are a lifesaver. They give the real-life effect of the FMGE exam. I used PrepLadder and some notes from my MBBS years.

Anas: Which application is better for FMGE preparation? And one can prepare for FMGE along with their medical school or is it something that requires separate preparation? 

Dr. Lijo: At the end of the day, each application has its own business, but different applications have different audiences. I used the PrepLadder because it has more focus on the FMGE community rather than the NEET PG community. Whereas Marrow is mostly focused on the NEET PG community. The content is very good in Marrow because they are tackling the major exam which is NEET PG. The number of video classes is less compared to the PrepLadder. DAMS have structured time classes and they don’t have any saved classes. Some of these applications had a tie-up with universities in CHINA. MIST used to conduct classes in China but not at my university. The major difference between NEET PG and FMGE is that FMGE has more conceptual questions and asks one-liners at the end, whereas NEET PG has more clinical questions. I even gave the recent NEET PG. So bottom line is that PrepLadder is a platform that may help you to crack FMGE whereas, Marrow goes into much depth which is not required for FMGE but very much required for NEET PG.

Anas: What was your timeline of preparation?  

Dr. Lijo: My preparation began in 5th year, and I started to study pre-medical subjects that I had forgotten, but I started full-fledged preparation before 6 months.

Anas: Overall what do you think is FMGE a very hard exam or is it just a myth? What are your views on this that the students who study abroad have to work really hard to match with the doctors who graduated from India?

Dr. Lijo: I personally feel the myth is kind of true. I would stress on kind of. When it comes to IMG (Indian Medical Graduate), they have a lot of clinical exposure from the 2nd year itself, they get to do clinical attachments, observe, and do ward rounds. Whereas for us FMGs, we have less clinical exposure. I have heard that in the Philippines there is early clinical exposure but for us, in China, we went to hospitals only during 4th year. So definitely, IMGs have an upper edge over FMGs for clinical exposure. Because all of us FMGs have to undergo the FMGE exam, that's where we have an academic edge. I think that's what differentiated us from them. I recently gave the NEET PG and I did not have much time to prepare. I only had one month. But I felt that compared to my fellow IMGs, I found the exam easier since I had given FMGE exam. I would say that this is the biggest sort of difference.

Anas: We would like you to tell us a little bit about your journey in China as a medical student and how is it different from India. Would you recommend future aspirants to pursue their medical degrees in China? 

Dr. Lijo: My journey in China started in 2016 after I completed my 12th examination. By the end of the year, I left for China and started my medical education there. It was pretty fun. I got to meet a lot of people there. I got to see a new culture. I never thought that I would be going to China if you would have asked me when I was in primary school. It was a completely different experience being there, with different cultures, and a lot of new food. If you go abroad you have to learn their culture and their language. That is a very important thing. So in China, we used to have classes on the Chinese language and traditional Chinese medicine which opened my eyes to a lot of things that are only practiced in China. China has its own system of medicine called 'Traditional Herbal Medicine'. I was fortunate enough to get a glimpse of that. We could study more about it and all together it was a pretty good experience and I liked it very much. Unfortunately, I could not stick around for a long time because of the COVID issue. So I had to come back to India during my final year. Because of that, I couldn't enjoy my final year there in China and I still regret that. A lot of my friends who were there were scattered across the country in different parts, some of them doing their internship, and some of them still trying to attempt their FMGE exam. And if you ask me if a medicine aspirant has to go abroad, I would suggest they go for it, it’s a pretty good thing. As the fairytale line goes, A frog who stays in the well, never saw the river outside. Once you go abroad you'll understand the different things out there. The technology they use there in China, I don't see that they use them in India. So the difference in practice and the amount of focus and care that you give to patients is completely different from what you see in India. I am not saying that it is bad here in India but there are a lot of differences involved. I would completely encourage anyone who wants to go abroad to go for it once this issue of COVID and online classes gets sorted out. It’s a pretty good world out there and the amount of exposure and contacts you get there is mind-boggling.

Anas: What are your thoughts on online classes? Subjects that are clinical-based were taught online. How will online education help us in any way? 

Dr. Lijo: Okay! So, our batch was the most badly hit batch, because we were just going to start clinical rotations, but I had to leave the country by the end of my 4th year. We were going to start clinical practice but that was the time that we got hit by COVID. And I heard that different countries managed the system very differently. Some of them allowed their students to stay back and undergo quarantine and all but because China was the epicenter of all of this issue and because of the global tension, they had to evacuate the entire campus. All of us foreigners had to leave the country and we were not granted entry I think until now. I think recently those who got the visa are eligible to go back but our batches cannot go back because our courses are all completed. So if you ask me I would say that online classes are not that good. For medicine, hands-on classes are the best and especially if you are in the final year where you have clinical scenarios, you have to go to the clinic, see the patients, interpret the diagnosis, and see the lab values. All of this can be done only in a clinic and not from the online classes. It all depends on a case-by-case basis. So if I had to undergo online classes for biochemistry and all, I would happily confer but if it was online classes for ophthalmology and orthopedics, it is difficult because that is when you study a case and go to the hospital to see those cases. So I would say that's where the online classes lack. 

Anas: How is your journey going on in India after clearing FMGE till now?

Dr. Lijo: After clearing FMGE, I applied to Delhi for Provisional Registration. So every doctor after clearing FMGE has to apply for provisional registration to the medical councils of their respective states. Although I am from Kerala, I did not apply in Kerala because of the latency that is being experienced here at the Kerala Medical Council. Also, there was an issue with online education. They were not granting me provisional registration as of now. So I directly went and applied in Delhi. They provided me with provisional registration and I started my internship here in Delhi.

Stay tuned for 'Part 2' of the interview to know which tips and tricks helped Dr. Lijo to crack this exam and when is the right time to apply.