I am an NRI. I went to Medical School in India. I completed it in the required time (i.e. I didn't fail any years). I just recently gave my USMLE Step 1. Anyways here is my take on it and hopefully you can learn something. This is more geared to someone who was born and raised in America and is now considering Medical School in India. I'll try to break up the post point wise.
I. Be damned sure about YOUR decision!
a. This is a 5.5 year commitment. Longer if you fail. After considering your time to prepare for the USMLE exams(assuming you don't take them concurrently with your course work) it will be near to 6.5 years before you apply for residency.
b. You will probably have to learn a new language.
c. Life in India is nothing like life in America. It's fairly dirty and boring in most places. I got used to all this and didn't mind it much as I am fairly easy going and just accept things as they are but some people are set in their ways and you should be prepared to deal with this along with the poverty and some horrific things you may see everyday. That said there are also amazing things to see in India.
II. Location of the Medical School you choose!
a. Choosing a medical school nearer to your own place of origin would be ideal as you would have people you know who could help you should you fall ill or need money or any help at all. You may also have a house to live in with relatives. Dormitories in India are beyond ****(most of them) and you will not be able to improve anything in them. At least if you have your own place you can get an Air Conditioner(your best friend in India) etc.
III. Type of Medical School!
a. Like America, India has private medical schools and government(or state schools as we call them in the USA). There is a glaring difference between these two types of schools. A private medical school or deemed basically means the students got in there without any merit. They paid a donation because they couldn't get in elsewhere due to poor scores(since your considering India your probably in this boat also, haha). That's not to say these students are dumb, many just fall prey to the crappy system that reserves seats for 'backwards class' students who get admission with much lower scores.
However, generally speaking, demmed/private universities generally do not have the patient flow that a government medical school would have. As basically the only genuine advantage you will get from coming to India is the vast clinical experience, it is better to choose a school with good patient flow.
I have heard stories of Professors/Heads of Departments demanding money to pass students in some Deemed/private universities but this was only rumors/second hand information so I can't comment.
The trade off is that Deemed/Private Universities generally have more famous doctors working for them though I don't think you will get much time with them anyways and they are probably 'honorary' professors more than anything.
b. Government Medical Schools - Great place to learn, but you will be on your own. The entire staff is generally so overwhelmed by patients that you will find many lectures cancelled and professors just not able to give the time you would expect. Especially coming from America where the teacher:student ratio is such an important factor when choosing schools, you can throw this out the window. These professors are also paid next to nothing so don't expect them to work extra hours teaching you + their usual rounds/patient care. If you apply yourself and volunteer yourself you can find that most professors/residents will allow you to help them with nearly anything. I was assisting in operations/plastering/all types of out patient procedures. Invaluable hands on experience can be had.
IV. Cost!
a. Not much to say here. It is generally much cheaper than completing the USA undergraduate + medical school years but prices are rising! Donations are about 40-50 lakhs and places that have special NRI seats it is approaching 20,000 USD/year.
V. Schedule/Exams
a. 5.5 years.
- First Year(1 Year Long) - Anatomy, Physiology, Biochemistry. Genetics/Histology/Embryology is wrapped up as part of Anatomy and you will find yourself severely lacking in knowledge when you go to prepare for your USMLE. Especially Genetics!
- Second Year (1.5 Years Long) - Microbiology, Pathology, Forensic Medicine, Pharmacology. Probably the easiest year as it is so long.
- Third Year (1 Year Long)- E.N.T., Ophthalmology, Preventive and Social Medicine, another easy year. GIVE YOUR STEP 1 AT THE BEGINNING OF THIS YEAR IF YOU CAN!!! Probably the ideal time to give it. The subjects are tiny this year and 4-5 months to study for them is ample time.
- Fourth Year (1 Year Long) - Surgery, Pediatrics, Medicine, Ob/Gyn. Orthopedics is part of surgery generally. Tough year. So much reading.
b. Exams - So this was probably the biggest and hardest part for me to get past. Exams here are not MCQ. They are long essay style questions. Generally the exam is 40 points(for half of a subject, I.E. Anatomy 1 = 40 Points, Anatomy 2 = 40 ponts,) You will have 1 main question asking you like "What is the anatomy and clinical relevance of the Breast" This might be worth 8 points or 10 points. Then you may have like 3-4 questions worth 4-5 points and then 5 or so questions worth 2 points.
The problem with this type of set-up is if you don't know a question and its worth a good amount of points, your screwed. 50% is passing(20/40). It's easy enough but you have to remember NO-ONE gets full marks for a question. At-least no one in my school or state did. If you wrote that Breast question perfectly straight from a Graduate Surgery Book you would probably get a max of 6.5/8 on it. I'm not sure why they do this but it's India so you will find yourself asking that question a lot. Most people in my school scored around 55%-60% overall.
There are usually only 2 exams you have to care about. Your Pre-liminary exams and your University exams. Pre-lim exams are basically internal exams your college takes to "qualify" you for taking the University. I believe you need to score a 35% to qualify. However, the 15% you lack(if you scored a 35%) will have to be made up in your University exam so that you average a 50%. Its all weighted and scaled weird so usually you only have to make up 3-4 points at max. I.E. If your University Exam is out of 100 for Anatomy, and you scored a 45/100 in your prelims, you would require a 55/100 in your University exam to pass. A good thing is if you score higher than 50% on your prelims than those points can then be added to your university so if you had scored 55/100 in your Prelim, and 45/100 in your University, you would pass.
Passing is tough. At least in the Government school I went to was. 35% of my first year class failed. 10% failed in second year. 5% failed in Third year. 25% failed in fourth year.
c. Failing. To go on to the next year, you must pass all the subjects of the previous year. If you pass Anatomy and Physiology but fail Biochemistry. They let you join the lectures of second year but you have to pass Biochemistry before being allowed to sit for second year exams. After the first round of exams, if you failed one, then 40 days later they give the exam again to everyone who failed. If you fail again you can then only take it 6 months later. This is for first year only. During second year and beyond, if you fail a subject you can continue on but the repeat exam is only offered every 6months from now on. Basically if you fail more than once you will join a "minor" batch which is a group of people from varying batches who have failed. Your classmates generally move on ahead of you and its pretty tough to catch up again.
VI. Internship
a. After you complete your 4.5 years of exams you're required to do a rotating internship. 2 months medicine, 2 months surgery 2 months ob/gyn etc. Make sure you choose Psychiatry as your elective as you need 1 month of Psychiatry as per USA requirements. Learn as much as you can and start studying for your Steps. LoR from India have no value but get some just in case you decide to do an observership/random job/research/anything else.
VII. Things to note.
b. If you have the option of going to Medical School in America but wasting a year or 2 and going to India and saving a year or 2, I would most strongly suggest you stay in America if you are sure you will get admission! Something most people don't think about is that once you take that step and graduate from a medical school outside of the States you are now placed in the category of an FMG. This severely limits your residency chances. It doesn't make matching impossible but going into the more competitive fields is certainly more difficult. Even matching into IM will require you to score higher than your average US graduate. If your only goal is to just be a doctor and get into IM sure India is great. There IS a difference however in doing IM in a lesser known IM place in America and doing IM in a Harvard Associated Hospital, something pretty out of reach for an FMG.
Whatever you decide just be sure and firm and follow through with your decision. I thoroughly enjoyed my time in India, made some great friends, learned 2 new languages, learned how to drive there, learned so much about my culture, got into cricket, and many other great things that while it may not make me a great candidate for residency but it is something that I have done that most medical students - or anyone for that matter will never get the chance to do. The different perspective you get on life after living here will give you a new found appreciation of America and I personally think having this perspective makes you a better clinician.
Best of luck!
P.S. I apologize if I offended any one by my posting about India, it was not my intention. If there is any mis-information I posted feel free to post your thoughts, I just wrote what I experienced/heard/saw. Every country has it's pro's and con's, including the USA.
I. Be damned sure about YOUR decision!
a. This is a 5.5 year commitment. Longer if you fail. After considering your time to prepare for the USMLE exams(assuming you don't take them concurrently with your course work) it will be near to 6.5 years before you apply for residency.
b. You will probably have to learn a new language.
c. Life in India is nothing like life in America. It's fairly dirty and boring in most places. I got used to all this and didn't mind it much as I am fairly easy going and just accept things as they are but some people are set in their ways and you should be prepared to deal with this along with the poverty and some horrific things you may see everyday. That said there are also amazing things to see in India.
II. Location of the Medical School you choose!
a. Choosing a medical school nearer to your own place of origin would be ideal as you would have people you know who could help you should you fall ill or need money or any help at all. You may also have a house to live in with relatives. Dormitories in India are beyond ****(most of them) and you will not be able to improve anything in them. At least if you have your own place you can get an Air Conditioner(your best friend in India) etc.
III. Type of Medical School!
a. Like America, India has private medical schools and government(or state schools as we call them in the USA). There is a glaring difference between these two types of schools. A private medical school or deemed basically means the students got in there without any merit. They paid a donation because they couldn't get in elsewhere due to poor scores(since your considering India your probably in this boat also, haha). That's not to say these students are dumb, many just fall prey to the crappy system that reserves seats for 'backwards class' students who get admission with much lower scores.
However, generally speaking, demmed/private universities generally do not have the patient flow that a government medical school would have. As basically the only genuine advantage you will get from coming to India is the vast clinical experience, it is better to choose a school with good patient flow.
I have heard stories of Professors/Heads of Departments demanding money to pass students in some Deemed/private universities but this was only rumors/second hand information so I can't comment.
The trade off is that Deemed/Private Universities generally have more famous doctors working for them though I don't think you will get much time with them anyways and they are probably 'honorary' professors more than anything.
b. Government Medical Schools - Great place to learn, but you will be on your own. The entire staff is generally so overwhelmed by patients that you will find many lectures cancelled and professors just not able to give the time you would expect. Especially coming from America where the teacher:student ratio is such an important factor when choosing schools, you can throw this out the window. These professors are also paid next to nothing so don't expect them to work extra hours teaching you + their usual rounds/patient care. If you apply yourself and volunteer yourself you can find that most professors/residents will allow you to help them with nearly anything. I was assisting in operations/plastering/all types of out patient procedures. Invaluable hands on experience can be had.
IV. Cost!
a. Not much to say here. It is generally much cheaper than completing the USA undergraduate + medical school years but prices are rising! Donations are about 40-50 lakhs and places that have special NRI seats it is approaching 20,000 USD/year.
V. Schedule/Exams
a. 5.5 years.
- First Year(1 Year Long) - Anatomy, Physiology, Biochemistry. Genetics/Histology/Embryology is wrapped up as part of Anatomy and you will find yourself severely lacking in knowledge when you go to prepare for your USMLE. Especially Genetics!
- Second Year (1.5 Years Long) - Microbiology, Pathology, Forensic Medicine, Pharmacology. Probably the easiest year as it is so long.
- Third Year (1 Year Long)- E.N.T., Ophthalmology, Preventive and Social Medicine, another easy year. GIVE YOUR STEP 1 AT THE BEGINNING OF THIS YEAR IF YOU CAN!!! Probably the ideal time to give it. The subjects are tiny this year and 4-5 months to study for them is ample time.
- Fourth Year (1 Year Long) - Surgery, Pediatrics, Medicine, Ob/Gyn. Orthopedics is part of surgery generally. Tough year. So much reading.
b. Exams - So this was probably the biggest and hardest part for me to get past. Exams here are not MCQ. They are long essay style questions. Generally the exam is 40 points(for half of a subject, I.E. Anatomy 1 = 40 Points, Anatomy 2 = 40 ponts,) You will have 1 main question asking you like "What is the anatomy and clinical relevance of the Breast" This might be worth 8 points or 10 points. Then you may have like 3-4 questions worth 4-5 points and then 5 or so questions worth 2 points.
The problem with this type of set-up is if you don't know a question and its worth a good amount of points, your screwed. 50% is passing(20/40). It's easy enough but you have to remember NO-ONE gets full marks for a question. At-least no one in my school or state did. If you wrote that Breast question perfectly straight from a Graduate Surgery Book you would probably get a max of 6.5/8 on it. I'm not sure why they do this but it's India so you will find yourself asking that question a lot. Most people in my school scored around 55%-60% overall.
There are usually only 2 exams you have to care about. Your Pre-liminary exams and your University exams. Pre-lim exams are basically internal exams your college takes to "qualify" you for taking the University. I believe you need to score a 35% to qualify. However, the 15% you lack(if you scored a 35%) will have to be made up in your University exam so that you average a 50%. Its all weighted and scaled weird so usually you only have to make up 3-4 points at max. I.E. If your University Exam is out of 100 for Anatomy, and you scored a 45/100 in your prelims, you would require a 55/100 in your University exam to pass. A good thing is if you score higher than 50% on your prelims than those points can then be added to your university so if you had scored 55/100 in your Prelim, and 45/100 in your University, you would pass.
Passing is tough. At least in the Government school I went to was. 35% of my first year class failed. 10% failed in second year. 5% failed in Third year. 25% failed in fourth year.
c. Failing. To go on to the next year, you must pass all the subjects of the previous year. If you pass Anatomy and Physiology but fail Biochemistry. They let you join the lectures of second year but you have to pass Biochemistry before being allowed to sit for second year exams. After the first round of exams, if you failed one, then 40 days later they give the exam again to everyone who failed. If you fail again you can then only take it 6 months later. This is for first year only. During second year and beyond, if you fail a subject you can continue on but the repeat exam is only offered every 6months from now on. Basically if you fail more than once you will join a "minor" batch which is a group of people from varying batches who have failed. Your classmates generally move on ahead of you and its pretty tough to catch up again.
VI. Internship
a. After you complete your 4.5 years of exams you're required to do a rotating internship. 2 months medicine, 2 months surgery 2 months ob/gyn etc. Make sure you choose Psychiatry as your elective as you need 1 month of Psychiatry as per USA requirements. Learn as much as you can and start studying for your Steps. LoR from India have no value but get some just in case you decide to do an observership/random job/research/anything else.
VII. Things to note.
b. If you have the option of going to Medical School in America but wasting a year or 2 and going to India and saving a year or 2, I would most strongly suggest you stay in America if you are sure you will get admission! Something most people don't think about is that once you take that step and graduate from a medical school outside of the States you are now placed in the category of an FMG. This severely limits your residency chances. It doesn't make matching impossible but going into the more competitive fields is certainly more difficult. Even matching into IM will require you to score higher than your average US graduate. If your only goal is to just be a doctor and get into IM sure India is great. There IS a difference however in doing IM in a lesser known IM place in America and doing IM in a Harvard Associated Hospital, something pretty out of reach for an FMG.
Whatever you decide just be sure and firm and follow through with your decision. I thoroughly enjoyed my time in India, made some great friends, learned 2 new languages, learned how to drive there, learned so much about my culture, got into cricket, and many other great things that while it may not make me a great candidate for residency but it is something that I have done that most medical students - or anyone for that matter will never get the chance to do. The different perspective you get on life after living here will give you a new found appreciation of America and I personally think having this perspective makes you a better clinician.
Best of luck!
P.S. I apologize if I offended any one by my posting about India, it was not my intention. If there is any mis-information I posted feel free to post your thoughts, I just wrote what I experienced/heard/saw. Every country has it's pro's and con's, including the USA.