Do we need two systems for postgraduate medical education in one country?

The articles on the National Board of Examination (NBE) were informative (1, 2). We would like to draw attention to the farcical manner in which the entry to the Diplomate of the National Board (DNB) is conducted. Admissions to MD/MS programmes are based on the candidate’s performance and rank in the entrance exam. However, admissions to DNB programmes are on the basis of a system that is open to misuse. After a common entrance test, candidates are selected by institutes usually on the basis of an interview. As we are all aware, interviews are extremely subjective and members of the interview board are likely to be influenced by external pressures. The system of entry should be similar to that practised for MD/MS entrances – an all-India entrance test followed by a rank-based counselling.

Suptendra Nath Sarbadhikari’s article comments on the low pass percentage of candidates (1). The low pass percentage is a reflection of the unsatisfactory state of affairs at the NBE and their causes need to be examined. This might be related to the type of student who enters these courses – as the entry to DNB courses is not purely merit based. Second, these courses are usually run by institutes that do not conduct undergraduate courses, and the lack of proper teaching might be a reason for poor results. The affiliation of institutes which are not running proper teaching programmes should be cancelled.

Regarding the conduct of examinations, MD/MS students are subjected to similar treatment, with no emphasis on regular assessment during the training period of three years. Our own theory examination consisted of essay questions, some of them worth 30 marks. The examination should be objective and there should be a system of continuous assessment during the training period. These changes should also be introduced for MD/MS candidates.

Murali Poduval’s article notes that the NBE is an alternate, parallel medical education system (2). It is not clear why one country should have two systems of postgraduate medical education. When the government does not distinguish between the DNB degree and the MD/MS degrees, where is the need to have a parallel system? The solution would be to abolish the DNB and strengthen MD/MS programmes so that the country has a single, transparent system of postgraduate medical education that produces good results.