Welcome to part 2 of our conversation with Dr. Lijo Lukose.
This part of the interview explores the tips and tricks followed by Dr. Lijo to crack the FMGE, the current scenario of clinical exposure in India and other countries, and his opinion on how India handles the 2-year internship period in medical education.
Anas: What are some tips and tricks that you would like to give to fellow students who want to crack the FMGE? When should we start to subscribe to these FMG exam preparation platforms? Or can we just rely on our medical school studies without joining these applications?
Dr. Lijo: So, the thing is that you don’t need to rely on any of these applications at all.
If you have discipline and you have notes that you prepare from the first year. It is more than enough. But, even though I am guilty here. None of us prepared for FMGE from the first year. Because in the first year, we were relieved that we got into medical school.
If you have discipline and you have notes that you prepare from the first year it is more than enough. But, even though I am guilty here, no one of us prepared for FMGE from the first year because, in the first year, we were relieved that we got into medical school.
The first year actually goes like a new country, new places, new friends, and getting used to the new system. In the second year, you are a little more free because you have lesser subjects. You find new friends and go out. The third year is when you enter the clinical subjects and you start to feel the heat. So, in short, you don't start preparing for FMGE until you get to the final year or 4th year.
If you have the discipline to prepare from the first year, you don't need to rely on any of these applications. Just solidify your preparations, and subscribe to a question bank series for any of these apps.
There are both free and paid tests. By giving these tests, you will get an idea of how much you will score in FMGE. So, I would suggest you take any of the tests.
Realistically most of us won't be studying from the first year. Ideally, starting from the 5th year, one year is enough for cracking FMGE, and even 6 months are enough if you have a strategy.
The strategy followed by Dr. Lijo Lukaso
The strategy I followed was instead of studying for the whole syllabus of MBBS, I studied in the final year and focused on subjects that had the highest amount of marks like PSM, OBG, Medicine, and Surgery.
The thing about FMGE is that the medicine and surgery questions are completely clinically related, that's where the high conceptual-based questions come from. Whereas if you look at questions from PSM, biochemistry, and anatomy, they ask you in the form of a one-liner, they will paint a clinical picture and ask you as a one-liner. Those are easier to score compared to medicine and surgery questions. Now don’t get me wrong, you can attempt the medicine and surgery questions and get high marks if you have a really good clinical background, but usually, in that given stressful situation and in the heat of the moment you won't be thinking clearly, so there are high chances you might not get that right. So, the best bet is to get the maximum amount of marks in OBG, PSM, and Pre-meds, i.e., anatomy, biochemistry, physiology, and all. This is the strategy that I followed.
Different people have different strategies. If you start preparation from the first year, you can score points in each subject. But I was aiming toward the heavier subjects and that's where I scored the most.
Anas: What are your future plans? In which field would you like to pursue your PG degree?
Dr. Lijo: As of now, I do not have a lot of plans. I just want to work for some time in a clinical setting and get a hang of the clinical scenarios which I missed out on in my final years. In the future, I would like to pursue Internal Medicine.
Anas: Do you agree that clinical exposure is more prominent in India than abroad?
Dr. Lijo: The thing in India is that the clinical exposure you get is attributed to which college you are in. Like if you are in a government setting, in a government college, you are expected to leave the classroom and go to the hospital and continue your education there.
Now in private colleges, from the experiences that I have heard, even some of the well-known private colleges do an amazing job of teaching students. But, some private colleges are just there for the sake of being a medical college. They just admit the students and give them education but not much clinical exposure. It could be because of multiple reasons, like they are located in peripheries, where not many patients come there or they have a lack of funding, so all these kinds of issues are there when it comes to private medical colleges.
But if you are in a good medical college in India, the level of exposure you get is very good.
Now comparing this with the clinical exposure abroad, you will get this much exposure but in a different time frame. So, as I said earlier that in the Philippines they get it around 3rd year, and after their education, they have something called a clerkship which is kind of like an internship that they have to undergo. They have separate time allotted for this clerkship after every class.
Anas: Yes, even in Georgia we have something called a clerkship in our final years. Is it necessary to clear FMGE or are there other options for practicing medicine without qualifying for FMGE in India?
Dr. Lijo: So, I would like to talk about this internship a bit more. Every country has its own procedure for how they practice medicine and how medicine is taught. As you mentioned about the clinical experience in Georgia, the Philippines has its own and in the Caribbean islands it's different and likewise in China, it is completely different.
I feel that different countries have their own perspective to teach medicine. In the USA it's completely different. You do a BSc degree and then you get into a medical school, which is similar to what they follow in the Philippines.
When you come to India, India doesn't address the fact that how medical education is being taught in different countries. They see it like a cookie-cutter sort of problem like you are given 4 and half years of medical training and one year of internship. Have you done this? This is the only question they ask in India. They do not look through the perspective of education in different countries and how medical education is important in different countries. That is a huge issue that India needs to leave behind because at the end of the day if a country is awarding you a medical degree, that means you have undergone all sorts of medical training that are certified by that country. We are no longer citizens of one country, we are global citizens. So, India should accept the fact that different countries teach medicine in different ways.
Because India is very hardbound to this rule, FMGE is the only legal way to practice as a doctor in India. You can undergo an observer ship which doesn’t require provisional registration but if it comes to any point where you have to interact with a patient you have to deal with a patient, you will need a degree, and a registration number.
Anas: Would you like to share anything else with us? Something more about your journey?
Dr. Lijo: I started my journey in 2016 when I moved to China and it has been a hell of a ride. I had to leave the country which really hurt me. And then I came back to India. India had its own problems with the online education that I did. I thought my problems would end there but then the 2 years of internship issues came which are still being held in court. But, I was fortunate to complete one year of internship in Delhi and I don’t know what the future holds. But, till now I have not regretted any of the steps that I have taken, i.e., going abroad and then coming back to India. Working here as an intern is so rewarding.
Right now I'm in community medicine postings and I get to interact with a lot of patients from the villages and the peripheries. They see you as Gods and you're holding that much amount of responsibility when you are dealing with them. It is such a rewarding field. The responsibility and the joy that comes with it at the end of the day cannot be explained in words.
Anas: What are your views on the 2-year internship in India?
Dr. Lijo: This issue of 2 years is different when you look at it from different perspectives. So, if you look from an Indian perspective we have not undergone clinical training because of online classes but if you look at it from a student's perspective, most of my colleagues and other people who have undergone these 2 years of internship come from a less privileged sort of family.
Most of the internships in India are not paid, the one I'm doing in Delhi is also not paid. We don't get stipends as compared to Indian medical graduates who get stipends every month. So, a lot of these people, some from economically and socially disadvantaged families, come with loans. Because of COVID, these loans were put on pause and you do not need to pay them till your completion of the internship. But, now because of the 2-year internship rule, they have to pay the loans while they are doing their internship.
How an internship is done varies in different medical colleges in India. In the periphery no checks are done, some internships are done to just show clinical activity in the hospital and there are no clinical guidelines on how these internships are happening.
My friend is doing an internship in a peripheral hospital, no one is checking his work, and no patients are coming in. He has to go there and sit there and basically show that there are doctors coming to this hospital. So, a 2-year internship is a half-make thing, it's not going to help students.
When I spoke to my fellow interns, and other senior doctors, they said that 1 year of internship is enough and you learn enough.
According to my opinion, 2 years of the internship is just slavery. You are not being paid, no guarantee of stipends. It is not at all useful. A 2-year internship is not required.
Medicine is not just about 5 years. You keep learning till the day you die, that's why we say I am a practicing doctor rather than a working doctor. You will continue to learn after you have completed a year of internship at a clinic, no matter where you are.
Anas: Any final message for students who are planning to give their FMGE and to those who did not qualify for it this year?
Dr. Lijo: Revising is a key aspect of the FMGE exam. From whatever sources you use, marrow, prep ladder, or any sort of notes, revise as much as you can.
At the end of the day when you are sitting in front of the computer, you will not remember everything because it's really stressful and there's a lot of pressure. But, if you have revised well, there is active and passive learning. If you actively revise something, it will remain in your passive memory and even one mark can be the difference between passing and failing.
People who couldn’t qualify this time, don’t worry it's completely all right. You just need to revise a bit more. That would be my take-home message for you all!
(HN)
