MD, MS and PG diploma training rules under PGMER-23

Course lengths

PGMER-23 sets the duration, including the examination period (Chapter II):

Annexure 1 lists 32 MD and 6 MS qualifications; Annexure 3 lists 28 diplomas. Colleges may apply to convert diploma seats to degree seats, and no new applications to start or increase diploma seats are being entertained.

No migration. “No student finally designated to a medical institution … shall be permitted migration to any other medical institution” (Section 4.7).

How training is organised

All PG students “will work as full-time resident doctors”, with graded responsibility for patients where the specialty involves patient care (Section 5.2(i)–(ii)). Students of broad-specialty courses are called junior residents (Section 7.1).

Requirements that apply to every PG student:

• Thesis. All broad- and super-specialty students do thesis research and write a thesis (Section 5.2(iii)).

• E-logbook. Updated weekly, and assessed and authenticated monthly by the guide. MS and MCh students must record the surgical procedures they assisted in or performed (Section 5.2(vi)–(vii)). The FAQs state that students from the 2023-24 batch maintain the logbook digitally.

• Teaching. PG students take part in teaching undergraduates and interns (Section 5.2(viii)).

• Research output. To sit the final examination, a degree student must have done at least one of: a poster presentation or a podium presentation at a national, zonal or state conference of the specialty, or a research paper published or accepted as first author in a journal of the specialty (Section 5.2(x)).

• Three courses, expected in the first year, each a condition for sitting the examination (Section 5.2(xi)–(xiii)):

  • an online course in research methodology, through a designated institution’s portal;
  • a course in ethics, including Good Clinical Practice and Good Laboratory Practice where relevant, run by the institution or university;
  • Basic and Advanced Cardiac Life Support (BCLS and ACLS), run by the institution.

  The FAQs add that the ethics and cardiac life support requirements apply to all students admitted from 2021, and that the academic cell of each college designs and runs these courses until further directions.

The District Residency Programme

Every MD/MS student in a college under the NMC does a compulsory residential rotation of three months in a district hospital or the district health system, as part of the course (Section 5.2(xv)).

• When: the 3rd, 4th or 5th semester. Students who joined MD/MS after a diploma in the same specialty, and PG diploma students, do it in the 3rd semester.
• Where: a functional public-sector or government-funded hospital of at least 50 beds, or other facilities in the district health system — community, primary, sub- and urban health centres and outreach. A PG medical institution or super-specialty hospital does not count.
• ESIC hospitals may be used if they do not run PG courses or super-specialty services (FAQ 4).
• Other states: if a state cannot place all its residents, they may be posted to other states by mutual agreement of the governments, with the approval of the PGMEB. Students from the North East Zone studying elsewhere may do the programme in their own states (FAQ 5; Section 5.2(xv)X(f)–(g)).
• Work: outpatient, inpatient, casualty and other duties of the specialty, including night duties, under a District Residency Programme Coordinator. Students of non-clinical specialties work in laboratory, pharmacy, forensic, public health or managerial roles, or in ICMR and other national research facilities.
• Weekly holiday by rotation, subject to exigencies; leave under the parent college or university’s rules, sanctioned by the District Residency Programme Coordinator.
• The state provides accommodation, mess, transport where needed, and security, especially for women residents.
• Satisfactory completion is essential before the final examination. The coordinator issues the completion certificate.
• The programme applies from the batch that joined in the 2021 academic session.

Leave and attendance

Section 5.5 sets the leave rules:

• 20 days of paid (casual) leave a year
• 5 days of academic leave a year, in addition
• One weekly holiday, subject to exigencies of work
• Maternity and paternity leave as per existing government rules

Leave beyond the permitted days extends the course by the same number of days. A student may sit the examination with 80% attendance.

The FAQs of 10 April 2024 work this through (FAQ 1–2):

The FAQs state that academic leave, if taken, is counted as duty, and that training is extended by the days of maternity or paternity leave and of excess casual leave.

Colleges must provide residential accommodation, but students are not obliged to stay in the hostel (Section 5.6).

The final examination

The college conducts formative assessment; the university conducts the summative (final) examination. A university may hold no more than two examinations a year in a subject, 4–8 months apart (Section 8.1). There must be at least four examiners, at least two external, and at least one from a university outside the state (Section 8.2).

MD / MS (Section 8.3):

• Theory: four papers of 100 marks each. Paper 1 is on basic medical sciences and Paper 4 on recent advances.
• Clinical/practical and viva: one long case and two short cases in clinical subjects, with an OSCE; 300 marks for clinical/practical and 100 for viva.
• Thesis: 20 marks within the clinical/practical total, evaluated — with a viva on the thesis — by an external examiner from outside the state (FAQ 6).

Failing either head means re-appearing in both theory and clinical/practical. No grace marks.

PG diploma: three theory papers (300 marks) and 300 marks for clinical/practical and viva, with the same 50% per head and 40% per paper rule.

Valuation (Section 8.4): every answer script is valued twice and the average taken; if the two differ by 15% or more, a third valuation is done and the best two averaged. No revaluation after results. Universities are to move to digital valuation.