The National Board of Examinations (NBE) has ruled that qualification standards cannot be weakened and refused to lower the passing percentage for Foreign Medical Graduates (FMGs).
However, regarding NEET-PG, the centralized entrance exam taken by almost all Indian medical graduates, the threshold score has significantly decreased over the past five years.
The NEET PG exam uses a percentile threshold, whereas candidates must score 50% to qualify for FMGE. Initially, the threshold score for NEET PG in each of these years was the 50th percentile for the general category, equivalent to approximately 35% of marks, and the 40th percentile for the reserved category, corresponding to about 30%.
Nevertheless, to fill vacant seats, the percentage threshold was lowered annually. In 2023, it was reduced to the zero percentile for all categories, meaning everyone who took the exam was considered qualified, including those who received negative scores. In 2024, it was lowered to the 5th percentile for all, but the equivalent percentage score cannot be calculated as the assessment data for that year has not been disclosed.
If the threshold for NEET PG were set at 50% of the marks, only about 25% of participants would have passed in the last five years. The proposed unified licensing and entrance exam for postgraduate positions in India, which was intended to be common for FMGs and Indian medical graduates, named National Exit Test or NExT, has been postponed indefinitely.
The results of NEET PG raise the question: what proportion of Indian graduates can pass such an exam with a threshold of 50% instead of the 50th percentile? The NBE notes that the difference between the test for FMGs and NEET PG is that the former is intended for obtaining a license to practice, while the NEET PG exam serves to rank Indian medical graduates who have already completed their MBBS final exams for admission to postgraduate programs.
Final MBBS examinations are conducted in the medical colleges where students studied and trained, with inherent institutional bias aimed at increasing passing percentages.
FMGE was introduced in 2002 by the erstwhile Medical Council of India (MCI) allegedly to ensure that doctors trained abroad met the same standards as those trained in India. According to the 2002 rules, FMGs were required to complete a one-year internship in an MCI-approved institution after successfully passing the FMGE to obtain a license to practice.
Since November 2021, the National Medical Commission (NMC), which replaced the MCI, has mandated that all FMGs obtain a license to practice in the country where they were trained before taking the FMGE.
While the criteria for obtaining a license to practice in India for FMGs have gradually tightened, the landscape of medical education in India has seen the opposite trend. Infrastructure and faculty standards, as well as regulatory oversight for opening new medical colleges in India, have gradually been relaxed or blurred to facilitate the rapid expansion of MBBS seats.
Between 2014 and 2026, the number of medical colleges increased from 387 to 818, and the number of MBBS seats—from over 51,300 to approximately 1.3 lakh—while complaints accumulate about colleges operating without sufficient faculty, infrastructure, or patient load.
Despite the fact that every candidate taking NEET PG must have scored a minimum of 40% in each subject and 50% overall in MBBS, candidates scoring definitive, zero, or even negative marks in NEET PG call into question the quality of graduates produced by Indian medical colleges. This also raises the question: can India have different criteria or double standards when vetting FMGs versus its own medical graduates, given the extremely uneven standards of medical education here?