Why DNB exam tougher than MS/MD exam?

Monday, May 6, 2013

by Dr Kalyan R Kone

There were 6 people (accompanied by their relatives) sitting in the small waiting room outside the ward waiting for their call inside. They looked battered, tense and had such a depressed look in their eyes that even Shylock would have sympathized with them. They had cleared their DNB (Diplomate of National Board) theory exam and were making last minute preparations for their practical exam. If I were not told that they were all Doctors, I would have thought that they were all waiting for their turn to see a psychiatrist.

Dr Kalyan R Kone

Five out of six of those waiting doctors were appearing for the second or third time. In spite of that, they didn’t know what would be in store for them except one thing — only one or two would pass out of the six candidates.

I thought for a moment that it was a good ploy by the NBE (National Board of Examination) to generate funds – after all, where would these poor guys go except appearing again and again, the only other option being a generous bank/land balance in excess of 70 lakh rupees (the average present rate).

In MD/MS exam, when a candidate is appearing for the second or third time, the local examiners would try to push him/her out by offering generous help. But DNB exam has no local examiners for offering help. In the end, after three weeks of agonizing wait, those six waiting doctors found out that only one out of them cracked the practical exam.

This is not a fabricated story – this is happening every year all over India in every DNB exam centre. I don’t know whether this is a cruel joke or harassment in the name of exam. I personally know some of those who had failed the exam in spite of good practical knowledge and successful practice. For primary DNB candidates, it is a “life or death” exam. For the diploma holders, the degree is like small regalia to show to their MS/MD cousins that they are equivalent to them and most importantly for a personal reason, to stem the inferiority complex simmering in them.

It is well known that a person joins DNB course only after he/she exhausts all the avenues of getting a masters or diploma from a government medical college. These people also can’t afford the crores of rupees of capitation fee demanded by private medical colleges. But one thing is true — most of the Doctors joining this programme enlist in it out of pure interest for the subject.

When one assumes that only weaker candidates join the DNB, it is logical to surmise that the final exam would not be made relatively tougher. But the NBE wants to punish the people who join its courses by doing a completely illogical thing — the exam is made a lot tougher than the MD/MS exam. This can be deduced from the fact that three out of five students taking DNB exam after MS/MD fail in it.

The joke is — even the DNB examiners, if they would take the test, would fail in the exam. The students joining MS/MD know exactly when they would come out with the degree (most of them pass in the first attempt or else they will be kicked out with some help in second or third attempt). But the DNB students don’t have slightest clue regarding this.

Nobody is asking the NBE to make the DNB exam very easy, but to make it on par with the MS/MD exam. The NBE should not punish, instead, it should reward the students joining its courses. It should not tamper with the performance of the students and fix the pass percentage of the exam to a meagre 20-30 per cent because even a bright student can fail in the practical exam if the examiner wants to do so.

How can two external examiners decide about the capability of a student in a single day – some students can express themselves better, some can’t do it so well. The first case also decides whether the student can focus his mental energy on the next case — it is the domain into which the internal examiner steps in and rescues the student because of the association he shares with the student for the past three years, which is sorely lacking for the student taking the DNB practical exam.

It is an open secret that half of the doctors appearing for the final MS/MD exam pass only with the help of the internal examiner in a government medical college (this goes up to 70-80% in a private medical college). All those students appearing in MS/MD exam take the exam in a familiar terrain just like home ground advantage in a football match – two out of four examiners are known, the wards are familiar, the cases would be informed beforehand and no shortage of help during actual exam time.

In this context, one has to understand the level of stress imposed on DNB students — none of the examiners are known, the wards are unfamiliar, the cases are unfamiliar, no help during the exam time, sometimes there is difficulty in communicating with the patient because of the language problem — all these after a long journey to the DNB practical exam centre and overnight stay at a hotel.

The NBE should introduce a way of continuous assessment of the student along with the DNB final exam. The weightage of the final exam can be determined depending on the branch of medicine. This, in a way, would promote the continuous learning of the student during his course and decrease the stress on the student during the final exam. I hope the NBE would listen to this suggestion and make necessary amends.

In the open, MCI (Medical Council of India) and NBE fight with each other but covertly they work towards the same end — to maintain the superiority of medical colleges. The NBE makes sure that nobody escapes easily out of its system and then the MCI harasses those who come out with DNB degree by denying the same level of recognition as a MS/MD. The DNB degree applicants and holders are becoming scapegoats in this tussle. This has created a lucrative private medical college trade, which doles out degrees for money.

It is high time that the NBE increases its pass percentage so that more number of doctors would be willing to join its courses and which, along with supplying Doctors to the starved Indian health sector, will also reduce the spiralling costs of the postgraduate education offered by the private medical colleges.

The NBE should realize that the society does not require extraordinary doctors but average, reasonable doctors on par with the MS/MD postgraduates.

Author’s Clarifications:

1. DNB exam is much tougher than MS/MD. I had cleared DNB in my first attempt following MS (AIIMS) and MCh (Urology). But my colleagues who appeared along with me (premier institutes like AIIMS, SGPGI) failed the practical exam. I had also cleared my FRCS (Ed) in my first attempt. But I felt FRCS was much easier than DNB. (FRCS exam gives more tension only because of the amount of money involved.)

2. Many private hospitals are given permission to take DNB students irrespective of the amount of training they can offer. For medical branches it is partially OK, because most of the students at least will be educated by the patients. But for surgical branches, the DNB programme offered by some of the corporate and private hospitals is plain nonsense, where the DNB trainee is treated like glorified duty doctor (this makes good business sense to those hospitals because proper duty doctors demand much more salary than DNB trainees).

3. I do not agree with the statement that they are all inferior students. Even if you equate them with the private medical college students (both didn’t get the PG degree through entrance) how can you explain the near 100% pass percentage of private colleges with 30% pass percentage of DNB? If one opines that training in a medical college makes the difference, then it is a big lie because at many private colleges (not all) the training is as bad as DNB training.

4. Following some other countries’ guidelines, when your own country is deficient in doctors, is idiotic. Are we training doctors to make Americans and Europeans happy? We should have our own benchmarks and guidelines.

Update

I may be wrong in the DNB pass percentage statistics. The percentages are based on personal experiences and the stories told by the applicants. Only when the NBE comes forward and publishes its statistics yearly, we will know the true picture. And one more thing – I am yet to see a DNB convocation where 3000 students are given degrees.

I have not personally experienced DNB training. I just wrote after hearing the travails of students during their training and finally, when they appear for the exam. I have personally witnessed the discriminatory attitude of medical college authorities, MCI and even patients towards DNB postgraduates. I don’t have any personal scores to settle by writing this article.

Examiners’ leniency matters a lot in the practical exam. I want you to go back to 60′s and 70′s when MBBS pass percentages used to be very low. What happened to the present crop — have they become suddenly intelligent in spite of extraordinary increase of medical knowledge? It is the attitude of examiners that has changed.

Recently, I witnessed a postgraduate exam where a particular student argued (he was right) with the examiner regarding the treatment in a major case. He was given very low marks by that egoistic examiner. Only when the internal examiners insisted because he was their best student and drastically increased their marks the student could pass.

The DNB student sorely misses his mentor and teacher on the other side of the examination table. If a student performs well at three stations and doesn’t do well with the fourth examiner — it doesn’t matter. But, most of the students are average — a poor score at one station is enough to fail them.

In financial market there are certain terms — “spread your risk” and “don’t put all the eggs in one basket”, which is also true in the medical field. I am asking for continuous assessment of the student by holding 6 monthly semester exams (objective and short answer format) for the DNB students, which should be given at least 50 per cent share in the final exam. They should be also trained by the NBE by holding 3 or 4 monthly practical training sessions besides the education offered by the parent institution.

When I am asking for “on par” treatment, it means that the DNB students and MS/MD students should have the same level of measurement of skills — they should have the same examination pattern. My personal opinion is — there should not be different certifying bodies and MCI and NBE should merge in to one single institution. Independent governing bodies should be constituted to take care of MBBS and PG education.

Leave my personal opinions. Everybody has his own prejudices. I will come to the comments — 2 comments by Dr Abie Lawrence were excellent — Putting the examiners themselves through the process and general certification process. 1 comment by Dr Raj regarding the basic clinical training is also relevant — Centres where the results are consistently poor should be de-recognised. The comments made by Dr Dhruv and Dr Manoj Sharma are also excellent — what we are missing is the teacher-pupil relationship and patronship.

We should not forget the adage that “Fifty per cent of all doctors graduate in the bottom half of their class” — irrespective of where we keep the bar. It is the society’s choice where to keep that bar. If the bar is kept very high, there will be fewer Doctors and if the bar is very low, we would be creating more Yamas. We have to find the right bar so that sufficient number of doctors are released into the community with adequate training.

I had seen some excellent Doctors who in spite of failing the DNB exam had sufficient knowledge to take care of the patient, which means that the DNB bar is slightly higher than required. Even students passing out from the premier institutions fail in the DNB exam, which I have personally witnessed and it makes even stronger case about the futility of keeping standards so high.

Even the Doctors released from premier institutions are not Gods, they also learn by experience once they independently start their medical practice. Medicine does not stop at the exam table — it is a continuous learning process. We see again and again in the medical practice — it is not the medical knowledge but the ethics that is more problematic nowadays.

Only when Doctors come forward and discuss regarding the changes that are required and exert pressure, the health ministry would bend a little and make the necessary changes. The present institutions are happy with the status quo. We have to make them change their attitude.

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107 Comments »

Comment by PANNALAL
2013-05-07 09:37:47

This is an expression of personalized grievance of examinees,unfortunate to clear examinations in first few attempts.Suggestion for improving examination system/mode ,as to improve objectivity in assessment of level of knowledge and competence can be forwarded to NBE.In fellowships exams allover world in medical fraternity,pass percentage are immaterial.It is standard of examination which stamps the credibilty of DNB . It is considered equivalent to MD/MS ,still with significant differences in criterion of admission, exposure of training etc. Your compare with MD/MS is not absolutely valid.

 
Comment by Dr dhavalshah
2013-05-07 09:41:18

Really true picture of today’s scenario!

 
Comment by Parag goyal
2013-05-07 11:15:16

I fully agree with the views shared by Dr Kalyan. DNB exam should be at par with the MD/MS examination and should actually test the practical knowledge of candidate. There should not be any pass percentage for any exam if it actually intends to test the knowledge of the candidate.

 
Comment by dr naresh krishnani
2013-05-07 11:37:48

Excellent review of DNB system and its pitfalls, congrats to u. The national board should try to improve pass percentage as India needs more and more postgraduates.

 
Comment by DR.G.BALACHANDRAN
2013-05-07 14:38:16

I do agree with dr. Kalyan.You are talking about only one side of the story.Taking prospective students into consideration ,can you say how many of them show real interest ?.The students don’ t take seriously the DNB course.As a DNB teacher I wanted to make them good doctors ,better equipped in practical aspects,best in curricular activities.In fact I went one step further and taught them how to answer a question and gave them clues regarding use of charts,colour diagrams,tables,etc.,but all in vain.I was a friend,philosopher and guide to all.But they never followed my sincere advice.The students are to be blamed squarely,why blame the NBE.for poor results.

 
Comment by dr.madhu sudan modi
2013-05-07 14:52:55

I agree fully with the veiw of dr.kalyan kone about this DNB fallacy.I personally know that many centres in india have got DNB by bribing the DNB inspector as i have seen once while i was doing myself dnb in gi surgery at kolkata ,CMRI.
IT is very strange that we passed DNB In surgical gastroenterology at CMRI.kolkata without getting to do a single laparotomy in three years.!! What a GI degree is this that you do not get a laparotomy while doing a superspeciality course in GI surgery.we were made to do only the routine ward work like post mbbs type to certain consultants who knew very less than the students.Inspite of many complaints to dnb board,nobody could do any thing to our plight.Many consultants are of expiry date type sheet.
they are just ruining the future and hopes of these enthusiastic DNB fellows and the board is sitting chupchap.very sorry to join this programme.

 
Comment by Able Lawrence
2013-05-07 17:24:37

While some of the sentiments are well justified, the solution is not to make the examination more easier but to make them objective and remove any bias either way. It is also important that the candidates and the examiners know what exactly the goal posts are and to document and communicate the objective of the certification process and the required level of knowledge or skill expected of the candidates.
It would be a good practice to put the examiners themselves through the process (and the same cases) so that they have better insight. It used to be a practice at PGIMER, Chadigarh for the examiners to be asked to see the patients themselves (without local help) and then the examiners will not be expected to perform at a level beyond what the panel examiners deem is acceptable. If the examiner cannot decipher something, then the candidate also wont be expected to do the same.
As far as private (or other college) students having it easy, we need to separate the process of training and certification. The college should do the training and issue certificate of training making the candidate eligible for certification by Board. Then all candidates irrespective of the college (except perhaps the few elite Institutions outside the purview of MCI such as PGIMER or AIIMS which have exemplary systems and are pioneers in candidate assessments) should be put through a system similar to the DNB examination.
While agreeing to the sentiments of the author, one should not try to solve the problem by dismantling the good standards set by DNB.

 
Comment by Raj
2013-05-07 18:19:13

Its a true fact that the pass percentage in DNB exams is really poor. There is no doubt that the pass percentage should improve. But that should not be at the cost of the quality of knowledge of the DNB candidates.

Most of the private hospitals for whom DNB seats have been allotted do not do justice to the training of the candidates. As very rightly pointed out by the author, the DNB candidates are used more as cheaper manpower and little is done to train them for the exams.

I work as a teaching faculty in a premier institute and have been involved in the DNB exams at many levels. As a DNB exam candidate, as a skilled assistant, and as co-ordinator. I must admit that the standard of most of the candidates who are trained in the private hospitals is very pathetic. The post MS or post diploma candidates do much better and mostly those from the Government medical colleges find the exam much easy.

Almost all of the examiners probe to find out if the candidate knows the basics of the clinical examination and have a reasonable knowledge of the principles of treatment pertaining to their specialty. Most of the candidates fail miserably in the basic clinical skills. One must remember, the pattern of DNB examination ensures that neither the candidates know the examiner, nor the examiners know about the candidate. So the question of bias or prejudice does not arise. No favoritism at all.

The consultants who admit DNB candidates under them should ensure that they are trained adequately. Centres where the results are consistently poor should be de-recognised.

Lot of healthy discussions need to take place at the higher level to ensure better training. Then only the results will go up without compromising the quality.

 
Comment by Dhruva Chaudhry
2013-05-07 19:30:24

Interesting piece. I have been both examiner & coordinator for NBE . The truth is somewhere in between. I remember in nineties it was a privilege to have a DNB degree after passing MD/ MS. Later it expanded horizontally & training provided in the institutions was deficient as rightly said they were used as a cheap manpower. Surgical branches as mentioned were the worst sufferer. Where are the beds in institute accredited for DNB students .? Same 30 beds will be shown against all the specialities At different times? Teachers are working part time in majority of them & going from one to other institutes. The biggest weak link in the chain is ‘ THE TEACHERS’. You have to see the dissertations to realise that in nearly 3/4th teachers have just appended their signatures & have even not bothered to follow the pattern . Forget the pattern even have not checked the language.
Students are malleable & needs patron. It is the patron-ship which is missing. Students pursuing DNB are definitely better as far as theory is concerned. However as you switch to analytical or indirect questioning, substantial no of them are at loss; meaning they have not been put through the rigours of basic training . In practicals one is looking at the basic skills & not the top of shelf things.
I agree sometimes the examiners are little more than strict but objective markings & presence of other examiner takes care of them.
If any thing which needs improvement , it is the teachers & teachers alone. Today infrastructure is not a problem however,corporate has to realise that everything cannot be as per there whims & fancy. You ask surgical colleagues – everyone knows about Lap cholecystectomy bot the moment you enquire about open they r blank? How can they then manage problems during the lap procedure. Secondly students needs to be exposed & allowed to do work up of the patients admitted there & not to be used as glorified secretaries.
If we take care of these fundamental issues situation can easily be reversed

 
Comment by Dr.T.H.Ramachandran
2013-05-07 20:24:14

I fully endorse the author’s analysis and conclusions. I have been training DNB candidates in surgery, and I am confident that any of my students can manage a given emergency and surgery much better than most of the MS candidates in lesser known medical colleges. Moreover, the personal tutoring and mentoring they receive in good centers is lacking in most private medical colleges. If we want to emulate the west, do it honestly as they do without any political or economic interferences. Otherwise, stop this mockery of DNB.

 
Comment by Prof. Manoj Sharma
2013-05-07 20:26:39

Easier Said than done.
NBE is a gateway to filter those that are not fit for future health care of the country.
Analysing the whole realm of NBE and DNB in a small article is making mockery of a health care system and this is not correct for an institution that is trying to introduce some norms.

There are several factors as to why the failure rate is so very high. we will discuss this later but they are only called failure rates because passing rates in MD and MS exams are very high due to many obvious reasons.The present generation of MD/MS students know the extracurricular methods of getting through exams and that we see every day…..no need to elaborate.

If one area that needs exploration and the reforms is the institution and its teachers where such a course is being conducted. Teachers have no time to teach, the standard teaching programs such as case presentation, Journal Club,Clinico pathological meeting, Seminars and permission to attend CMEs and National level conferences are not happening, so much so is the teaching of appropriate approach in scientific research and methods of evidence collection….the back bone of learning is not happening .This is amply evidenced ….again and again in the inspections of the institutions and the dissertations that come to us and stand rejection more often than not . Last evidence of this teaching training collapse can be seen in the DNB exams .

Much desired Guru Shishya Parampara is non existent so is the blunder of naming it as spoon feeding. It is something like the work of good artisan and the substandard artisan that weaves a fabrik or carves out a deity out of sandlewood.

There are certain very clear cut observations: MD/MS pass students from good institutions neither find the paper nor the examination tough and they conveniently clear them.

Same is not true for students from not so much reputed medical colleges.

Brilliant students ( MD and MS) who have been selected through their non reserved category merit do extremely well.

Students from NBE accredited institutions where standard teaching program is followed and consultants there treat DNB students as students and not as cheap labourers do better and good.

Students from NBE accredited institutions where high profile bosses themselves are busy with their career and coffeur making fail miserably as there is no role model there as a teacher.

We cannot ignore a fact that NBE entrance examination for DNB course is one of the toughest of all. so there is least likelihood that the student does not have intellect or inclination.

But one wonders as to what is that acid test that happens over next three years that instead of shining them it totally corrodes them and they perform miserably in the examination….theory or practical.

DNB examination cannot be compared with MD and MS , rather universities either should adopt NBE pattern of structured examination where friendly internal and his friendly external decide good or bad.. Instead these MD,MS students must be merged with DNB candidates: the truth will be obvious.
1-All those non deserving who get back door entries and deprive the deserving from getting a PG seat and hence become potential threat to the health care will be rendered misfits for National health Care.
2-All those who specialise in learning methods of quick results and easy sail( Sale) and direct or surrogate psychophancy during their tenure as MD and MS students will forget their ways and give them up at their best and hence start studying .
3- Teachers in medical colleges will have to work hard on students if they want to claim that they are well reputed medical colleges and PG seats are not saleable.

There is no need to feel that the deterioration in “Making of Doctor” has taken us all by surprise!!
Still one can redeem….. may be by adopting ever evolving, developing and improving by feed back mechanisms the NBE methodologies on filtering the best for national health care.

 
Comment by Dr Sarit Sharma, MD
2013-05-07 21:59:50

I totally agree with the author in his views regarding the examination system for DNB. However I don’t think these candidates are any less qualified or less trained than their MD/MS counterparts. Still the medical colleges continue to discriminate against them while allotting jobs despite clear cut guidelines fom the MoH. They are still being denied faculty positions citing that MCI will create problems while inspecting the medical college. Really sad that after passing through such a tough system, you are still being discriminated.

 
Comment by Dr. Juhi Puri
2013-05-07 23:45:44

I’ve appeared for DNB exam last November and after much wait the results are out. I want to be a plastic surgeon. And it is such articles that stop students like me to opt for a 6 year course in plastic surgery. With already a meager passing rate when I give the exam after 6 years in not sure will I be able to pass it in the first attempt. Moreover, will I get the right exposure in the college or all the cut would be taken by the professors? All these thoughts only take away the spirit of taking such a risk. Will it be an intelligent risk or a stupid failure? Please guide me regarding the good colleges where DNB plastic surgery would be fruitful. Without a proper guidance of the alumni or those who are associated with the colleges, it’s just a waste of talent. Thanks in advance. You might just save my career.

 
Comment by Santosh Waigankar
2013-05-08 12:40:34

There are few comments made by the author in the attached article which astonish me:

1) “Nobody is asking the NBE to make the DNB exam very easy, but to make it on par with the MS/MD exam: –
What does the author mean by ” on par ” ?!

2) “The joke is — even the DNB examiners, if they would take the test, would fail in the exam.” –
I completely disagree with this comment.

3) “How can two external examiners decide about the capability of a student in a single day – some students can express themselves better, some can’t do it so well.” –
Well I feel and still believe that giving a DNB Practical Exam is an art, aview even endorsed by Sabnis Sir in a previous write-up. I agree that it is unfortunate that the
candidate has to prove himself in the 8-9 hrs alloted to him. But I guess that is the pattern that is prevalent.

4) “It is well known that a person joins DNB course only after he/she exhausts all the avenues of getting a masters or diploma from a government medical college.” -
Completely disagree: I feel students are equally inclined towards both exams.

5) “The NBE should not punish, instead, it should reward the students joining its courses. It should not tamper with the performance of the students and fix the pass
percentage of the exam to a meagre 20-30 per cent”
Are these percentages correct ??!!!!

6) “Even a bright student can fail in the practical exam if the examiner wants to do so.”
Ridiculous !! I think there are four examiners who assess the candidate and decide his fate in the exams. They arent there to fail anyone on purpose !

Many more……

I feel that the author (who ironically is also an Urologist) has been just a little biased towards MCh program but in the end he tries to cover up by clarifying that DNB exam is much tougher than MS/MD. He himself hasn’t reached a conclusion !

 
Comment by Dr krish srikanth,MD,FCARCSI
2013-05-08 16:20:07

hai to all in the forum–

i understand the frustration of exams as it is not structured in India. I got my MD ,Anaesthesiology from University if delhi, Safdarjung and never sat fro DNB –Well in retrospect i would encourage all MD candidates to sit for DNB as well.I am keen that we structure our MD and MS in more real structured and remove either one DNB or MD or MS –Why we have two streams which each claim one is parellel to another –just adds to our medical confusions.–

we should aim to have just one straem of post graduate teachingand training –and as well i in my personnel opinion want to remove all diplomas and convert them to masters –as this is in between –we can just make all diplomas to masters with one more year in training posts
well further trained in fill from UK and as ussual we as nation can and should respect the absolute clarity of national health service in UK which has great values in training, delivering and upholding great professional principles and values in all format –

i can keep on writing but will read others views and let us carry on discussing
nice to meet you all
with regards
Dr.Krish Srikanth

 
Comment by Prof. Manoj Sharma
2013-05-08 18:59:38

A fact finding on realistic statistics revealed:

This is rubbish. Each point can be countered but only to people who are reasonable and unbiased. 3000 candidates are given degree every year by NBE which is not possible with a 25 percent result. Rather than making DNB exam like an MCI exam, students should fight that MCI exam is conducted like DNB exam. All that has been written are views of a failed person . Rather these students should improve their performance.Refrain themselves from the distractions of the sorts and focus on learning: beg borrow and steal the knowledge

 
Comment by dr. v.r. vasuki
2013-05-09 08:32:55

Dear Sir,
The comments made are true but the pitfalls in training of the candidate for the NBE exams must be revamped.
1. recognition of the institute or hospital for a particular course must be secure and strict. the inspectors must follow the bland rules laid down
2. while the candidate has a choice in counselling the institue doesn’t. this must be looked into
3, regular appraisal examinations must be conducted sincerely and this must be added bench mark in the final examination which would help the examiners to assess the candidates comprehensively. as of now the appraisal inspections are mere a formality or they are not conducted regularly.
4. in the final examinations the examiners should be from the DNB training institutes or hospitals and not merely from the medical colleges that is being practiced.
5. NBE should have a list of recognised faculty and examiners in their muster roll. This will help both the faculty/examiner and the candidate to draw a good and effective training program.
6. also recognise the faculty as NBE professors/associate/assistant prof as done in a medical college and this will also help the faculty as well as the candidate with a sense of responsilbility.

 
Comment by omkarnath
2013-05-09 13:50:08

Excellent review. surely, its plain foolishness to crucify dnb students. An exam should be tough, but it should not fail students for no rhyme or reason. The worst part is private medical college students having a 100% passing (Everyone knows how), and DNB students having a 20-30% passing (God knows Why?). this should stop. I think the best idea would be to make it compulsory for all MD/MS/DM/MCh students of PRIVATE medical colleges to appear for DNB, and they should be declared pass only if they clear both DNB and their own private college exam

 
Comment by Dr K.Gowrinath,MD,DNB.,
2013-05-09 17:12:11

I had to write DNB theory examination in 1999 after my application for promotion as associate professor was not considered by the Head of the department who quietly informed me that my MD degree from a government medical college in A.P. was not recognised by the MCI. This happened after I completed five years as assistant professor in the Dept. of Chest Diseases & TB in Sri Ramachandra Medical College,Chennai. Nobody was ready to answer my question as to why I was given the job in that medical college.I had the habit of regularly going to college library which was well equipped with journals in all specialities and read all new issues of respiratory journals.I did not find much difficulty in passing theory examination but my experience in practical examinations held at Jaipur was different.In the examination,one of the examiner who was well known to me was curious to know why I need DNB degree and I gave the reason.During presentation,my findings on pulse rate was not accepted.When I said there is no cyanosis,the examiner started talking how can I miss such an easy finding.When I said there is no pedal oedema. He wanted to demonstrate and I did it over medial malliolus. He wanted to know why I am not using the shin.To my disbelief,he did not accept the site I demonstrated as shin.Then I lost my confidence and simply could not answer to his satisfaction.If only a pulse oximeter was available,the truth would have been known.As expected,I failed but my junior collegue from A.P who performed well also had same result.Later my collegues started telling that passing DNB is very difficult and I do not stand much chance of clearing the examination.My second attempt was at Delhi and this time I did better and passed the practical examination.The theory examination is difficult to anybody who does not read journals to update his knowledge.One has to read General Medicine, as you may get a question outside your speciality. All my hard work went drain as my MD was recognised and I did not need DNB for promotion.I do not consider DNB examination format as unreasonable but can not support the behaviour of few examiners.I have been acting as PG examiner in different universities since 2003 and many times the internal examiner comes to the rescue of candidate. I do not know the basis for selecting the examiners as majority of examiners are from selected colleges mostly from central institutes, Those appearing from central Institutes probably have the advantages of facing their own professors and additionally they have access to all journals and teaching programme is regular. This advantage was not there for many of those from the rest of the country in 1990s.Another problem with DNB training is that unlike MD/MS students,they do not have opportunity to have regular clinical teaching by senior faculty in their hospitals.The result is that they fail to perform well in clinical examination and fail. My last employment was in a private medical college and passed all PG students in practical examination despite the fact that external examiners were not fully satisfied and awarded just pass marks.Once results were out in the internet,one of the the students was not happy and asked me why was given just pass marks.So I always feel that passing MD/MS is easier and the candidate may even demand high marks even with average performance if the setting is a private medical college.This situation does not arise in DNB examination.But the irony is that even with good performance one may fail if the examiners decide to pass only the best on each day.

 
Comment by Prof Ravi Kant, MS DNB FRCS FRCSI, FRCS Ed, FRCS Glasg
2013-05-10 15:14:37

The crux of the matter is uniform exam across the country like American Board. What is in a name? Government, Private, MD / MS, DNB= all should be filtered through a national uniform (across the region, across the states) SINGLE examination.

 
Comment by Dr Ranjith kumar
2013-05-10 21:53:11

ya i too accept,DNB exam pattern should change,but before changing all institutions should change their teaching programme,candidates r failing mainly due to lack of confidence,i passed out from kanchi kamakoti childs trust hospital we have excellant great teachers,infact they alawys b behind us to read,hence our pass% >90% every yr,so hence i would suggest to change both sides institutions and board.

 
Comment by Dr Swarup N
2013-05-10 21:56:47

I earnestly appreciate this initiative. Having passed through the DNB ordeal, I agree that the exam has standards which are even higher than international degrees like Royal College exams.

Although that fact can be left aside, what needs to be addressed is that the percentile method of passing candidates in practical exams is extremely unfair. This information is based on hearsay from an examiner, we were informed that NBE guidelines restricts its pass percentage to less than 50% despite the calibre of the student.Supposedly, of say a batch of 6 students appearing on 1 day, they compare each candidate to the best one of the day and decide whether he can pass the exam. In a way, that’s unfair as everyone cannot be the best, what needs to be assessed is whether the candidate can render acceptable quality care to a patient. After all,exams are just the initial step and everyone learns with experience and guidance.The NBE must have their panel discussing this point out of the closet.

MD/MS exams are definitely a cakewalk considering that the students has the support of the internal examiners, no rigid criteria or pass percentage restrictions, familiarity with the institute and
no language barrier. Although, I would admit that students procuring MD/MS in reputed colleges will be of good calibre, but not necessarily always does that reflect in their knowledge after PG. DNB candidates do have disadvantages like poor hands-on exposure in private hospitals, ‘lesser infrastructure/workload’ in some institutes etc.Also considering the average results of DNB, most candidates usually slog it out right from the beginning and so cant be labelled as undeserving as a general rule..Further, there are instances of MD/MS doctors from reputed institutes failing in DNB exams.

The NBE also must have more transparency in their examination.After so many decades, the board has started to declare marks of candidates who fail.Why should there be restrictions on passing if the candidate is of reasonable merit? There are times when candidates fare really well but still flunk with no reason offered to them.

What is ironical is that after going through the stress of repeatedly facing failure in DNB examinations, a DNB candidate still doesnt receive the respect as an MD (even if he passes from a private institute after paying capitation). And the stigma of the lay person still imagining DNB as a diploma..(afterall, it is Diplomate of National Board and not a Masters).

Why cant these topics be openly discussed in all medical bodies eg IMA, PG councils etc where the Board and its examiners should participate wholeheartedly?

To conclude, I feel DNB exam standards are acceptable but the prejudice of restricting the pass percentage irrespective of candidate’s merit is absolutely unjust. We need more transparency in the exam system and a deserving candidate should not be left to the examiner’s mercy to pass the exam..

 
Comment by Dr Subramanian S MD DNB MNAMS AB (Internal Med, Infectious Diseases)
2013-05-10 22:14:47

I agree with some of it, and disagree with some.
The problem is also that the MD/MS has become less “reliable” as a marker of competence. The problem is both with examiners and candidates. Let me explain. My MD exam: the question was how do you scientifically prove clubbing? Not Schamroth sign, as it will pick up only Grade 2, but about Grade 1. The answer is in Light’s Chest Mediicne, and serves NO useful clinical purpose. I had another question (I forget now), which I was stumped on. The next year, I met one of the examiners at a conference and cornered him on this. He had no clue about the answer and his explanation was that another of the examiners asked me. Part 2 of this problem is that many local (internals) are under pressure to push through under performing (incompetent) PGs as well. If these PGs did take the DNB exam, it would become obvious.
I did take my DNB exam in Medicine, and thought it was very fair. It reminded me of grand rounds back at my alma mater- it was actually no different. One question- for pleura, lung and mediastinum, we have CT and MRI. Which do you choose for which and why? Very clinically relevant question. Another with multiple sexual exposures, recc genital ulcers, multidermatomal zoster, and a consolidation of lung. Absolute paradise from the infectious diseases point of view. Another adolescent with long term anti epileptic use, seizure disorder, developmental delay and mitral regurg with a left side bronchiectasis. Good cases, unbaised examiners, and clinically relevant questions. I did see many of the candidates stutter and stammer on questions I would consider par for the course- like the patient who had a stroke and a nominal aphasia. This is a reflection of the lack of standardization of the training, not the examination. I agree that de recognition is one way, but that is again reactionary. NBE should spell out a clear curriculum, guidelines on academics etc.
I have to mention that I was the gold medalist in DNB, but the exam made more sense and was more relevant than the MD exam. I agree that this is my experience, and what I did observe of all the candidates on the day of my exam.
Cheers.
Subra.

 
Comment by neeroo
2013-05-10 22:48:13

this is the view of every sensible doctor but people not coming out wd truth n no body questioning about this to higher authority . our ministers dont underestand the gravity of the situation. one side govt hospitals and even private hospitals not gettin speciality doctors n our own mci making everything to stop becoming speciality doctor.now govt is allowing ayush doctors to practice modern medicine and mbbs doctors to do lscs. and those willing to become post graduate are sitting in library for years togather to study the things which not at all going to help in future practice. you have help our own community or else be a victim the system,,,,still licence raj in medical system the huge lobby of private medical college is behing this,,,,

 
Comment by Dr.Sampath
2013-05-10 23:32:39

Dr.Kone has raised a very relevant issue.

It is definitely difficult to pass DNB when compared to MD/MS.There definitely seems to be an unwritten rule that a fixed percentage of the doctors appearing for the exam will be passed
Even if the performance is good in the theory exam,many students fail because of this ‘rule’
Experience of the practical exams have been given by many doctors who have sent their comments

There is undoubtedly a need to have a uniform pattern of syllabus and examinations and for this reason DNB was started.However, the need to improve the standards should be uniformly followed and DNB exam should be as easy or as difficult to pass as an MD/MS Exam.

It should not be show cased by the NBE that DNB is superior to MD/MS because it is very difficult to pass.

There is a need to have more doctors with PG Specialisation in our country and the process to get a PG degree should not be very tough.

 
Comment by ukare4me
2013-05-11 00:07:12

completely agree one single nationalised system of medical education.

 
Comment by Aanand Galgali
2013-05-11 13:23:50

Dear Doctors,

The dilemma facing the medical education is such that even in this age where scientific advancements have reached astronomical heights, basic medical education is far from wanting. And I am not referring to PG education.

The standards of MBBS candidates is appalling in the market, as an administrator, we have the honour of recruiting them, my esteemed colleagues would know what I am referring to.

Surely, something and somewhere we are going wrong.

To quote a candidate who answered that as a fresh MBBS, PHC doctor, he had to create fudged records to show better nutritional status of his region, directed to do so by the public health authorities. This data was going to determine policies! An impressionable doctor was corrupted at the beginning of his career and we talk about medical education and whims and fancies of the people and systems.

Doctors, it is going to be an uphill task and we need a system overhaul. God save the country.

 
Comment by Dr Ajay Agade
2013-05-11 22:45:36

Wanted to congratulate kalyan sir for such a nice writeup. I myself went through each and every moment described by sir in first few paragraphs. just remembered all that hardship went through during my exams.
I just want to share one more thing here about the descrepency in different subjects. If you see dec 2012 pediatric specialty has result of about 17% even superspecialty like cardiology had better results..its all so frustrating and discouraging for pgs of these specialty wen they see their couligues from other dept. are passing. I hope the coming time has better student friendly outcomes

 
Comment by Pavani M
2013-05-12 10:50:52

The DNB examination is formidable to those already having MD/MS degrees because in many instances the candidate has support and protection from their professor.The main reason for DNB examination being tough is that the examiner does not know the candidate and is free to evaluate the candidate.There is no way that the candidate can protest. Considering the fact that pass marks are not 100%, no candidate shouls be failed just because he did not answer two or three questions. Those with PG degrees from the central institute have the advantage of knowing the pattern of DNB examination from their seniors and atleast one of the examiners is usually from central institute only.If one goes by the number of times central institute examiners are choosen to conduct the DNB practical examinations,the bias is obvious.Once my husband was saying that if you want to be famous even with average clinical skills you better work in certain institutes/medical colleges in our country. There is no dearth of quality examiners in state run medical colleges and in private sector medical colleges but most of them never get chance in their life time.Most of the academic programmes/publications are from very few medical institutes only. No body knows how somebody is invited to conduct DNB examination and to my knowledge,it is only based upon the reputation of institute and not the personal record.The examiner should be selected out of his personal record and the criteria of selection should be same for everybody. There is general view that those working in central institute think that they are better than those in state institutions.

 
Comment by kapil singla
2013-05-13 10:59:47

I agree with the author that DNB exam is tougher than M Ch

I have done DNB surgery & DNB Urology

I passed both the exams in first attempt

I feel that we should no blame all the DNB training centers. I was lucky to have esteemed teachers in both Surgery & urology who not only give me enough chances for learning but also enough chances for cutting.

If somebody needs any help in some particular topic then I think all the examiners are always willing to help.

Appraisals are also required as it allows a check on the progress of your thesis, log book and theory and it allows you to interact with examiners from other centers.

We should not criticise everybody. I also understand that DNB exam is tough but if you have read well and prepared well and just go in stepwise fashion inn exam, i think everbody can get through.

this year theory result in DNB urology was excellent (>90 pass out of 104). what else you want from DNB board

 
Comment by Shailesh
2013-05-19 21:16:55

Things are different for DNB and MD/MS exam. I have organized exam for both students and agree that attitude of examiners differ towards both the student. I strongly believe that pass percentage for private MD/MS students and most of the govt colleges in north India (barring few) dont should be high, when I look at the quality of knowledge I see.

 
Comment by Pavani M
2013-05-20 16:05:18

Any examination conducted by honest and learned people is welcome.If the target is difficult, the student will naturally prepare well. But unfortunately,in our country it is not so. If a student passes MD/MS from a private medical college in first attempt,the credit usually goes to the college management in many places who are afraid that if the student is failed,he may go to court alleging lack of faculty or infra structure.The examiners are usually influenced by all ways they know.The sympathy factor or recommendation factor or regional factor or caste factor will not work in DNB examination. But I am afraid,this will not apply to atleast some central institute students who usually pass with ease.Let there be a DNB examination where the examiners are not from central institutes and examiners are picked up from different parts of the country as per their teaching experience and research background.

 
Comment by SANDEEP T
2013-05-21 00:58:50

Dear kalyan,
Just, I read your blog or say, “review”. In my opinion, as you wrote ironically in this article seems to be sign of failure. Please do not discourage other fellows/student. Despite of fact mentioned in the article, I think DNB board filter only valid and practically sound students or doctor. Hundreds of MD or MS passed throughout a year, conversely situation is different in case of DNB, because examiners qualify only skilled and talented candidate not the pedagogues. I agree to Dr.Kalyan’s view, but only up to certain extent. Reasons I Specified as above. You should respect the examiners and their decisions because they have vast experience based on that they select best doctor for our country.

 
Comment by Anil
2013-05-22 19:30:09

Most hospitals appoint DNB candidates because it improves their status as a training institute while getting cheap labour at the same time. They have absolutely no interest in training. Candidate keeps failing and hospital is assured of perennial cheap labour. Since I have done MS DNB and FRCS I can say that MS is easier because of home ground advantage. FRCS though is the real test as it explores your thinking process.

 
Comment by Sumedh
2013-05-23 04:11:29

I think somebody needs to file PIL in the court of law and let the court investigate the matter.
This is not related to just one exam but the matter is related to healthcare system of India.

If the NBE can produce more specialists then it should do that rather than making exam ridiculously tough. I am not saying the standard of examination has to be reduced but another ways must be found to increase the passing percentage to a justifiable level.

 
Comment by harry
2013-05-23 09:34:34

i have given dnb theory 3 times, till now, i am unable to pass. i have passed part 1 mrcpch in first attempt without even breaking any sweat. wherever i have worked, consultants have appreciated me for my knowledge as well as clinical acumen. patients have as well appreciated me quite a number of times. i have been able to indepandantly manage a medium sized hospital. i feel dnb is ridiculous waste of time and money. what else do they need from me to prove that i am a good clinician. furthermore i have been getting the same marks, give or take one or two in all the four papers. i really doubt whether they r really correcting papers, simply giving the same marks every time

 
Comment by Jacob
2013-05-28 16:00:56

Good article! candidates prepare for the toughest part and all basic question from MBBS standard is asked. What are they trying to do. Revamp is required.

 
Comment by Jacob
2013-05-30 15:58:35

lets face the truth. MD?MS students pass because of home advantage and help. I know many doctors who cant do a simple surgery unaided

 
Comment by Dr Anil Pande
2013-05-30 20:08:18

The need of the hour is a centralized uniform and disciplined way of testing the proficiency of candidates.The dichotomy of DNB MD is to be corrected and a unified post-graduation examination like the American Board or FRCS pattern could be opted for.To those who talk about merit a gentle reminder that anyhow our noble social engineering schemes of reservations do not allow for a level playing field at all levels of education . DNB was always more difficult as an exam and actually the national board has been hard at work in trying to make it on par with other international examinations.The courses are also more rule stringent now. The difficulty in clearing these exams is a reality with many whom i personally know have cleared their FRCS and not their DNB.The board also needs to protect from discrimination their candidates.This is much less now but still persists despite multiple circulars from the health ministry.The discrepancy will perhaps if all require to be board certified after becoming board eligible.This will have to happen anyhow the question is when?

 
Comment by DR. MITESH
2013-05-31 17:45:48

someone please write about dnb results after diploma paediatrics.

 
Comment by Alakendu Sekhar
2013-06-03 03:11:30

I have personally faced this DNB mockery! I have wasted my formative early three years under the mockery of training by Prof Sukumar Mukherjee at CMRI Calcutta.

This guy was absolute nonsense and didn’t pay any attention to my training rather busy in making money to combat his case against the NRI doctor Kunal Saha.

I decided to train myself to leave the country and trained inside the UK.

I now work as a consultant Neurologist in one of the prestigious Neurology Centre in the UK & would like to show these bloody professors what training means.

The first step in cleaning the postgraduate exam system in India would require to strip this bloody professors from their degree & make them appear & pass DNB exam themselves before they become the examiner.

Hell to this bloody professors in India.

 
Comment by Nandakumar Menon
2013-06-04 04:09:12

My question is ” Why do we have 2 systems (NBE & MCI) of licensing authorities in India?” Why cant the 2 be merged?
We must be the only country in the world with 2 systems
I say have one licensing authority like the American Board or the Royal College

I would also like to suggest that we include the District & Taluk Hospitals as training hospitals. This will
1. Improve these hospitals and give the patients the benefit of a teaching hospital
2. Expose the PG students to a greater variety of patients and greater chance of seeing common pathology
3 Expose PGs to smaller towns and thus give them the chance to first see the benefits and opportunities of rural life & practice

Dr Nandakumar Menon MBBS,DABS,FACS Director,Gudalur Adivasi Hospital, Gudalur,Nilgiris ,Tamilnadu

 
Comment by suman sinha
2013-06-04 07:44:06

It is well known that a person joins DNB course only after he/she exhausts all the avenues of getting a masters or diploma from a government medical college.

MD is not a masters degree. It is Doctor (not Master) of Medicine i.e. doctorate degree. It is far far superior to a masters degree. This is one of the areas where MD scores over DNB.

Regards

Dr. Suman Sinha, MBBS, MD, New Delhi

 
Comment by Dr K.Gowrinath
2013-06-04 07:56:06

The DNB examination was started in 1970s as institutions offering MD/MS degrees were very few.The original idea was to offer specialist courses for those who did not have access to MD/MS courses.The DNB became popular after it was recognised for teaching and unbiased tough examination system.

 
Comment by Dr Srinath K M
2013-06-04 22:03:50

HI.. I clearly accept the views of the author,
About myself, cleared my DNB , both theory and clinical exams in first attempt, all thanks to my teachers for their constant guidance and motivation..
After preparing myself for exam i was in dilemma whether i will clear the exams , considering so many factors involved..as everybody know and mentioned in previous various posts.

I have certain personal opinion to be shared.

1) Make Both DNB and MD/MS exams on same par, that is pan India, same question paper for same subject in theory,conduct regular internal assessment and whose marks are added to the final exam, performance of a few hours( actual exam) is not a decider ( mind this is not an T 20 match), some may be tense, excited.. various other things may be going on in candidate’s mind on one particular day and all candidates should be posted to a different center for practical exam.
2) All 4 examiners needs to be external.
3) There should be a elaborate practical assessment protocol. Like, Must know to pass the exam and have safe medical practice in future,
4) Practical exams need to be video recorded, and should be disclosed if the candidate feels unfair treatment and illogical question.
5) To remove long essay questions with objective question with clear defined answers,
6) Disclose the model answer paper and disclose the theory answer scripts of candidate if he demands unfair correction of his paper.
7) If a candidate fails, he must be made to release that , its because of his poor performance (preparation) than illogical correction of answer booklets or egoistic examiners.
8) There should be a assessment of professors, who is posted to examine the candidate, so that interpersonal bias is removed.

regards

 
Comment by Dr Bijayraj R
2013-06-06 09:36:04

Dear Sir,
I have been training/guiding a few DNB students since the last 2-3 years. I agree partially with your experience. In spite of best efforts, the results are a bit tricky/unfair.
However, it also depends on student’s attitude towards the preparations and during the exam, what the final outcome will be.
As the author has rightly put- all the eggs are in the same basket- of one day of the exams. I have seen poor candidates perform (luckily) averagely on the day and get through, and excellent candidates being plain unlucky on that one day.

Regarding the examiner’s attitudes, it is difficult to generalise.
I passed DNB in a (then) very low pass-rate specialty in the first try. My mentors, me and my friends had put in a lot of effort into the preparations. During the exams, most examiners were neutral or pleasant, but one examiner was downright abusive for no reason (He told me he wont take my case and walked away, whereas he totally missed a vague epigastric mass in my patient- the patient was supposed to have *only an inguinal hernia* !). I had to plead with him to re-examine the patient in a proper way(rather than simply push in the abdomen arrogantly), and that apart form the hernia, the person had dyspepsia, dysphagia and ?decreasing weight.
His bed-side manners towards my elderly patient were pathetic. On examining a third time he discovered the mass and my viva proceeded in the same disturbing manner. I don’t know whether the attitude was deliberate to test the candidate or whether it is just the behaviour.

The NBE can make students’ life much easier by dispatching hall tickets on time, and having helpline to answer queries. And merely having a helpline is not enough, it should be answered within a few rings (unlike 20-30-40 minutes now) and the student’s concern should be tackled appropriately.
During exam time, some students have to needlessly face serious tension because of the NBE’s delays/inefficiency.

 
Comment by Alakendu Sekhar Consultant Neurologist
2013-06-06 23:29:50

There is a need to revamp the DNB structure completely.

First of all this systems needs calibrations to test the ability to produce the safe specialist.

The Board should be free from the political influence.

The training of the officials sitting in the board need to be addressed.

I remember visiting the DNB board in Delhi, the attitude of the simple doorman to the office staff is pathetic. They all pose as if they are the guardian of all this well qualified doctors who is appearing the exams.

Secondly we need to come out of the aura of the so called professors in India. most of these professors know very little & they are self proclaimed.

Anyone who themselves has passed the exam only to be allowed to become the examiner.

Come on India, wake up & learn from Royal college of UK , how to conduct an exam.

If we are all well prepared to boot out these bloody professors & make it a sound system there is no reasons why this shouldn’t be a decent exam system.

Otherwise there would be a time when in India there wouldn’t be any specialist & all quacks would be called specialists.

My last question to Prof Manoj Sharma. What kind of professor are you. Have you passed the DNB exam yourself? If not go and take your exam first before giving your sermons.

I am sure you are one of those chauvinistic pigs who has lots of fault in themselves.

 
Comment by Alakendu Sekhar
2013-06-08 03:13:06

I have to say even your site is not free from the hypocrisy of the Indian system. In my previous post I asked a question to your so called professor Manoj Sharma & my entire post have been removed.

Good luck & long live indian hypocrite medical community.

 
Comment by dr mahantesh
2013-06-08 12:42:14

well written…but one more fact is that,getting in to MD/MS much much difficult (IN GOVT COLLEGES) than getting a seat in DNB….getting a seat in dnb is much easier.almost everyone who writes dnb entrance will get seat…

 
Comment by Dr Patel
2013-06-16 10:17:43

I totally agree with the Dr Kalyan view. Also the standard of DNB NBE board as they claim due to the passing percentage is not correct.

Today in whole world MOST OF THE SUCCESSFULL EXAMINATIONS have a predecided pattern, questions, the level of difficulty which increases gradually.

But here in practical its totally opposite. The external examiners can ask whatever they want.

Just an example, During one of my practical examinations, The examiner asked an anaesthesiology examinee to name the wedge placed to the obstetric patient. I think 99% of anaesthesiologist dont know the NAME. The examiner told examinee to go out of the hall on this question. Might be true or not. We also came to know after that, what the wedge is known. Now the knowledge is WHY THE WEDGE IS PLACED. and not what is the name of the wedge, name not mentioned in any standard textbook.

Later we came to know the examiner wrote a book on Obstetric Anaesthesia.

So this is the fate of examinees,

 
Comment by dr.madhuri
2013-06-19 01:30:17

absolutely agree with dr. Kalyan. I have a first hand experience of NBE going extra mile to harass their students. I dont understand the logic behind not sending the hall ticket on time. also the NBE takes its own sweet time to display the application status and the e hall ticket on their web site. I dont understand what satisfaction it derives by harassing the poor docs this way. The harasment doesnt stop here. There is theory n practical exam in waiting to drive someone insane.
The NBE claims that they have high standard and want to produce quality docs. I want to ask for whom u want to do that. ultimately these people are going to work in India n not in Europe or America, so why equate our standards with them. Also they have their own pattern of exam which is easier than the DNB. Having low passing rate reflects more of your own inadequacy at every level right from your screening exam to your training institute and your appointed guides. We shouldnt put all the blame on the students alone for their failure. In our field nobody is perfect n we keep learning all our life.Has NBE given a thought to psyche of the student who faces repeated failures. They tend to loose confidence in themselves. some give up the hope of passing the exam and go for foreign degrees like frcs, mrcs etc or simply shift to some diploma courses. I think this is huge loss of our already specaliest deficient health care system. There is a large pool of primary DNB pg students who have faced repeated failure, the NBE should introspect in that.

 
Comment by harshal
2013-06-30 14:01:03

Based on personal experience i have a humble request for DNB management for “breaking the trap” of keeping students enholed. An exit exam of an American- standard for an academic course taken in an indian-standard institute is not going to clap well.
Please change for ur own existance/sustainance or face an extinction. I do not advise my friends to take any DNB course as long as corruption prevails in our country. corruption gets seats allocated anywhere with fraud inspection & record. My friends do fall prey to such gruesome corrupt practice wherein some hospital gets DNB allocated for sake of cheap professional manpower.Avoid putting urself into the “corrupt dark hole”…no departments, no teachers, no protocols, no research activity, deaf & dum so called DNB-teachers, practising anything for meagre selfish gains with only one sure thing i e TOUGH ONE-DAY EXIT EXAM with people whom u have never seen or worked with….sure to break ur head unless u r lucky & not necessarily subject knowing/hardworking/skillfull.

 
Comment by aditya
2013-07-03 21:09:51

I am Chief of an hospital involved in recruiting doctors this is how i would rate the CV’s before i employ-
1.Meritorious Doctors from government medical colleges with adequate experience.
2.Meritorius Doctors having done MD/MS in reputed private colleges.
3.DNB graduates in medical specialities from reputed Hospitals only.
4.DNB graduates in surgical specialities – sceptical to employ them.
I do agree passing DNB exams are tough than passing MD/MS exams but one with adequate approach to exam pattern can pass with very limited practical knowledge be it MD/MS or DNB.And i strongly feel Degree alone MD/MS/DNB wont make them good doctors but the efforts during the course would thats the reason for the preference.As i have seen substandard fellows in both categories- MD/MS with capitation fee in a private college or DNB holders across various institutes.

 
Comment by Yada Venkatesham
2013-07-14 14:37:43

Dr.K.Gowrinath,

This is Venkatesh Archan from Bahrain.
Please may i know your mobile number and e-mail address.
We would like to speak to you.

Regards,

Venkatesh Archana

 
Comment by Dr.K.C.Dey
2013-07-21 13:12:47

Thanks to Dr. Kone, DNB trainig should not be provided in small centre and should be done under Rtd Professors only. There should also be assessement marks from semester perfomance and should have an Internal Examiner like MD/MS. In course of time the examiner also be a DNB holder in addition to MD/MS degree to know how sweet is the BEE-STING bite. … Dr.Dey

 
Comment by Dr. Ramesh Thakan
2013-07-21 23:14:39

Exactly,
reading each line of your review, i felt it to be my own story.
after passing DNB theory in General Surgery, i had twice failed in practical exam and now that i am appearing for my last attempt, i am leat confident this time. Bankrupt, depressed, totally frustated and above all worried for my future with no hope inspite of continuosly reading and preparing (includes presinting lots of cases in medical college itself) from last one & haif year, credit goes to NBE. Thanks a lot for this miserable life. I want to, even my family want to see myself working as surgeon, but it seems now that i want be able to make it up.

 
Comment by DR. Nitin Sanadhya
2013-07-23 11:12:40

Adding to all the stuff above. The author of article is very true. I have done my DNB training from a very small private hospital and cleared theory and practical in 1st attempt. But I tell u the passing criteria are much higher than some premiere institutes as I had oppertunity to see the final exam of MD/MS candidates .And adding to all the performance in private collages are even worse than DNB Training institutes. Lastly even if somebody clears this sort of tough exam like me, MCI has created some hurdles to appointed on teaching post of assistant professor this is really disgusting.

 
Comment by Deepak
2013-08-12 20:46:35

The problem is absolutely true.
Just feel the format of both the theory exams and practical exams dont bring out the best doctors.
The final goal of any training is to produce doctors who practice safe and wholesome medicine.
NBE has no guidelines for atleast certain specialities, including syllabus.
These problems are also not addressed by the supervisors of the DNB courses.
Why dont we follow the American Board/Royal College, UK, when we always follow their example in journals…..etc..
The Indian post graduate education system is far from being well structured and uniform throughout the country and the lead professors in each institution should start to look at this seriously, rather than bask in their own glory.

 
Comment by singham
2013-08-13 13:41:53

few facts of indian medical system…..

1) millions of quacks are practising medicine without training and control over them….who is responsible for the lives of those patients…??

2) thousands of bogus so-called ayurvedic products r sold in market ,to increase height, to increase sex-power, to cure health-problems ..even cancer…..is there no department in india to check them..?

3) most of the medical students till today dont know about this non-sense NBE..supreme court says that MCI has bo right to conduct a common exam for india…..then who the hell is responsible for taking exams and by which law…??

4)why dnb entrance is made so much easy and exit so much tough….??? what is the status of dnb trained candidate….is he or she a specialist or not….?? if trained then why cant practice that speciality…??

5) why supreme court of india endorsed private medical colleges…?? just to boost indian economy..??
6) in fact india has no system for medical education and health care…..sab uperwale ki marji hai or apna caliber hai……!!!

 
Comment by dr ashutosh
2013-08-16 08:56:38

I truly agree with author. There must be something fishy in NBE to fail students and then take money and pass.More than 1000 students are stucked in DNB exams.Only Rajnukant knows when they will pass and start serving to patients.
Need a combined attempt to raise voices.

 
Comment by Dr. Dnb(dvd)
2013-08-22 22:58:17

Respected SIR, I have one question regarding DNB. I am primary DNB Dermatology candidate. I have completed 3 year training. But i have not passed DNB final exam. My question is whether i can start my clinical practice before passing DNB FINAL?

 
Comment by Die N Burn
2013-09-30 04:30:06

i really dont think writing about DNB exam pattern is gonna change anything, but it is a good forum to vent out one’s anger and frustration against the system.

people dont realise the harsh reality till they actually go through it. before taking DNB , every1 i knew had passed the exams in first attempt and i had these rosy concepts about DNB that if you are good you will pass the exam all this changed when the reality hit me.

For starters, the statistics of DNB exam, pass percentage in theory is somewhere between 18 -20 % and in pracs is 40 -50 % (in most of the subjects ), which makes the actual pass percentage a meagre of 8 – 10 %. It reflects that the system is completely flawed and you cannot blame it on students (that they are incompetent). my question is why such a flawed system is even permitted to continue.

why medical colleges are being made the exam centres and medical college professors coming to take our exam. if DNB centres are capable enough to impart training , they should be made centres and DNB teachers be made examiners.

Is the DNB training institute to be blamed for providing substandard training (i ve paid them a fee of 40k/year for training me). Or NBE which still allows such institutes to continue training. And if neither are wrong , then something is definitely wrong with the examiner and exam pattern . But it will be easy to put the blame on the student (Reality check – i have met MD candidates who did post graduation from premier institutes of india – yes i am talking about AIIMS PGI giving 3rd attempts at practical)

if you take DNB – you will Die and burn.

 
Comment by sathish
2013-10-02 23:17:33

can i do dnb…?

 
Comment by siddu
2013-10-05 13:49:03

dnb surgical branches in corporate hospitals is a crap, waste of time , all high profile patients we have to do their discharge summaries and all clerical duty doctor work dnb is waste of time and money

 
Comment by DR.VINOD
2013-10-30 13:04:48

I have a couple of things to add
1. I totally agree with semester exam, that can be done online. there should be an online teaching schedule for DNB, followed by a topic examination by board;may be of short questions that should be hand written evaluated by DNB centre or can be mailed to national centre that may be also evaluated there.
2. Regarding private places: during all the discussions you are praising the government medical colleges and private medical colleges. I know certain medical colleges that lacks the facilities and faculty to run evenMBBScourses are conducting MD/MS course accepting huge money margins (money matter may or may not be correct). the de-recognsion of DNB which was started for betterment of medical post graduation aiming a value more than md/ms ; but unfortunately the derailed mind thoughts of our own seniors made the the degree of board little inferior. by god’s grace the officials recognized it and again gave the recognision.
As you know very well , many private institutes have excellent facility even better than a medical college. They are inspected by Board & they are conducting courses only after recognizing their centre.
Personally I have witnessed many DNB exams, I feel it is very particular in assessing a students knowledge and I don’t feel it is very tough. I agree it is not as liberal as md/ms exam .
thank you for getting an opportunity to open my mind.

 
Comment by DR.VINOD
2013-10-30 13:16:24

you have to rate according to the work experience rather than the degree they possesses and the training they had undergone after the basic degree DNB/MD/MS. Any way you have to recognize a national examination more than a university level examination may be little tough to pass. but I still feel if you study well you can easily pass of course DNB is not as liberal as MD/MS.

 
Comment by DR.VINOD
2013-10-30 13:27:45

training in surgical specialties are different from medical specialty now a days because many constraints taking part during the present days than past. you know very well the litigations are more. you may not be that much depressed by writing the discharge summary that is also part of your job. I have studied most my operation procedure because of prof.jacob and prof. gopalakrishnan by writing the operation notes thoroughly. unlike in olden days in this era you can approach – many simulation exercises that can be done through computer and dummies, before doing it in real person. even entrusting post graduate students in doing surgeries is not correct in government hospitals also, but they get a chance because of the rush and one duty surgeon can not do all the procedures by his own in the stipulated time.
so my advise don’t be panic be generous and study. if you know the theory and the basics well you can become a good surgeon, no doubt about it.

 
Comment by jayadatt
2013-11-28 13:08:48

i wud also like to add something.. as in mci had made dnb equivalent..but trust me.. wn ur applyin for a super speciality..seat thers no single.. webste of a colgge wthr its govt..pvt deemed.. evn aiims pgi..donot show that.. “dnb candidates can apply’ no wayyyy elilblity shows nly md/ms canditates.. y cant dnb guys do dm and mch??? heights f discrimintaion..wen thy said equivalent al thy mean is.. ul get promotion in a pvt medical..colge..hahah..evn pvt med colges want that thy can pay less to dnb profs and..mci..inspection wud..take a les toll on ther bank balance! God sve India

 
Comment by santosh
2013-11-28 14:16:30

Thank u for your analysis..I personally know institution getting derecognised for poor pass %,but they get recognition in next session..NBE should not only be strict with the poor students..it should also be strict with rich institutions..I personally disagree with the people arguing for a standard in medical care.medical standards just does not involve a brilliant doctor,it also needs good infrastructure,good government

 
Comment by dr sangare santosh
2013-11-29 00:31:14

Absilutely right dr kone..we should aggressive ly come forward to change this attitude of mci and nbe…to save the harassment of coming generation…u just take iinitiative we can change the existing system…what happens that after passing we stop this all social work and concentrate on practice..but as aseniors we should push this matter to mci representative and health ministry….come on freind lets help our struggling friends from this grave situation. ..

 
Comment by Dr SANTOSH
2013-11-29 02:15:02

Excellent suggestion sir. But is hard to happen. The final product should be of national value and not like those of paid seat or quota seat.

 
Comment by santosh
2013-12-04 21:50:37

are you anyway aware of dnb training hospitals?are you aware of any medical colleges and teaching?
are you a doctor?whatever is written in this article is the naked truth.
keep your negative opinions about this article to yourself and go to a medical college exam day to see for yourself how md/ms fellows pass the exam….

 
Comment by Dr. Ramesh shah
2013-12-12 11:17:00

I have read all comments with wisdom and patience. Its seems as there is no system in medical education. I am surprised, why not, should DNB be banned by GOI and should MD/MS seats be increased. Everybody related to the field must be aware that candidates completed MD/MS from various medical colleges govt/private in India easily pass out through internal examination system while a candidate pursuing DNB works a lot during 3 years training course and then face all external examination system.

NBE is just harassing and increasing the crowd of shattered and confused doctors in the society. They are just working here and there without having any inclination immaterial of how intelligent a doctor is, undermines herself/ himself, which hampers the quality of treatment.

You may fix that for how many times you test candidates in theory exam. Once theory is cleared, the candidates must pass viva exam. Its absolutely a wrong thought process to stop a candidate in VIVA.

I request, please increase the percentage of DNB results in order to strengthen the quality doctors.

 
Comment by srinath
2013-12-23 20:44:14

dear sir,

i fully agree with ur views ,

my suggestions ,

cancel all DNB ,DIPLOMA, POSTS and let us have only MD/MS all over india

 
Comment by dr.sanchayan mandal
2014-03-07 12:23:02

hello sir
i am interested in dnb 6year direct course for ctvs/neuro/plastic/pedia. can anybody help me by providing the information in details.my dr.sanchayan2012 at gmail dot com

 
Comment by Manish De
2014-03-24 12:02:31

Hello Doctors, I am interested in doing DNB 6yrs CTVS course in RG KAR Medical College, Kolkata. This is one of the reputed GOVT colleges in Kolkata to have opened a DNB seat for the first time. I hv passed my MBBS in 2012 from Medical College, Kolkata & have done my internship & housemanship in CARDIOLOGY(6 months) & CCU(6 months) in the same scheduled to end in this March,2014. I hv secured a 7k rank in AIPGMEE in nov 2013 & 3k rank in DNB nov 2013 in my 2nd attempt in giving the exams. Now, I had already a mindset to study this year properly for the entrance exams in nov 2014. But, just recently I had seen that the DNB CTVS course has opened seats in RG KAR medical College. I ask all of you if you can help me with this that, if I do a DNB CTVS 6yrs from a reputed GOVT college from WEST BENGAL(If I get the seat at all in my DNB counselling happening now), will it be worth it now as I am getting the same exposures that a MS-Mch CTVS surgeons get?? & if at all by God’s grace I pass out after 6 yrs from this course will my degree MBBS,DNB(CTVS, RG KAR MC) hold good compared to a MBBS,MS,Mch(CTVS)?? Or I will be discriminated in the GOVT/Private hospitals & I hv to get a foreign fellowship degree after completing my DNB course to have to prove to them that I am at par?? It will be really helpful if u guys can help me out here in different questions that I asked, I am in a great dilemma right now. Thanks in advance.

 
Comment by anomoyous
2014-05-13 14:51:11

Mr.kalyan’s view is correct. I totally agree with it. And congrats . Obviously this is unfair.

 
Comment by Madhusudhan
2014-05-15 19:39:49

The basic problem in India is the lack of standardisation of training in medicine across all specialties. This is so crucial in surgical specialties that some of the so called teaching units and university/government hospitals lack the infrastructure and well trained teachers. Add to this the caste system/corruption/politics——. A highly meritorius student after years of hard work and dedication is left in the community with inadequate skills (and tons of useless outdated theoretical knowledge) to practice, survive and impart this (if in a teaching job) to his students. Now imaginre the fate of this student!!!???.
DNB is no doubt difficult to pass( for reasons already discussed above) but is not equated with MS/MD . I was turned down good posts in reputed hospitals over a MS candidate from a rubbish institution (in karnataka) because my DNB degree was not equated!!!. This happens in so called private hospitals which are not even fit for breeding cats and dogs!!!.
After my PG I had to really struggle to survive (with my young family) and put up with all the nuisances of dirty politics in private practice. Finally i bid adieu to UK for my higher training. Fortunately i have been able to progress to the level of a consultant. Looking back, i realise the quality of training required to be able to practice as a good doctor and into independent practice as a consultant and the disparity that exists in comparison with the western world. The system here is robust and well regulated at all levels.
There is no point in talking about the DNB degree in isolation the whole system needs a revamp and the training structure will need to be standardised at a national level. The local and so called ‘deemed’ universities are next to useless. The years spent in training should be increased coupled with good quality trainers. Only then we will justify our talent.

 
Comment by rahul
2014-05-17 12:17:22

its very true sir..

thanks for opening forum…..
delhi rohtak centre ,in obst.& gnecology is constantly giving poor results…..
shame on rohtak hod obst & gynecology.
rohtak…down…down…

one more thing… why dnb final attempt students r put on the same centre …same day..???
some of them will fail again…..ille….?

worst system of india…!!!!!

 
Comment by dr madhuri
2014-05-19 01:34:47

It seems there is a quite huge lot of NBE sufferers. My suggestion is that we should get united and fight against them legal battle, make them answerable in court of law…. Dats d only way to put an end to horrible NBE practices.

 
Comment by Dr Debarshi Lahiri
2014-05-30 12:25:45

I feel the best solution would be to video record the practical examination particularly the case viva. This will help us know that whether the examiners actually followed the marks distribution pattern prescribed by the nbe and will ensure that they don’t act on their whims and fancies. Recording will also help the board and the candidates later if anyone files an RTI application. I feel all of us should immediately appeal to nbe to implement this.
Thanks

 
Comment by Thomas P J
2014-08-06 19:23:18

Dear sir,

I would appreciate to receive your advise for my son passed in 1542 rank for year 2014 in DNB exam.
Is it advisable to sent him for DNB rather than MD? Anybody can advise me?

Your valuable advise is appreciated.

 
Comment by Dr.Surya Sudhakaran
2014-09-22 19:13:49

I completely agree with you sir. I have completed diploma in ophthalmology and have cleated dnb theory in first attempt waiting for practical dates. I completed d.o in a private medical college. Honestly the knowledge of MS students in these private colleges are extremely poor because there is no need for them to work extremely hard to clear their exams. While dnb students cannot afford to levee anything to luck or internal help . 90 lakhs is the capitation fee in a private college for MS degree and the luxury of passing without having any knowledge. DNB intake is after common entrance exam these days. I hope national board really understands that the standards set is too high and lack of 90 lakhs should not be a criteria for a student to suffer such a mental trauma.

 
Comment by Shilpa
2014-09-30 22:53:28

Dear sir, I am a victim of dnb theory pass . My husband a post diploma candidate of Ortho writing for the twelfth time we r blindly hoping against hope that one day he will be declared pass. I myself a guide n examiner for pg student never subjected any candidate to such humiliation. As years pass the performance interest to write theory will definitely deteriorate. And strangely they don’t have second valuation at all. We value the theory MD paper by three examiners if discrepancy of marks is more than thirteen it will go to fourth examiner RGUHS bangalore.those dnb fellows in the board don’t answer the phone for any queries. They r at advantage coz they r in Delhi n it is difficult to reach them.legally they must be made answerable. Just hope victims like us raise in one voice bring it to the media and put an end to this board

 
Comment by Dr karan
2014-11-05 20:51:42

Hiiii

I am.agree with Shilpa
Additiionally I know a student Atul who bribed the.examner n Rohtak PGI becauae he was failed three times in DNB final practicle exam during 2009-2010
.

 
Comment by swapan
2014-11-25 16:57:09

Enough comments are available in relevant websites and Indian Journal of Medical Ethics. But will these be of any use if relevant authorities do not take notice of these? Sometimes,even if their attention is drawn, they do not wish to take it seriously.The sufferers of DNB system being students who are ill equipped to do anything in this regard, organisations such as yours or others who care for higher medical education and healthcare for all are requested to tap powerful individuals who may be of help in this regard. You may refer to following link and see the desparate efforts by some students 6 years ago with almost no change in status since then:
http://iradix.in/forum/1-dnb-radiology/1219-the-trick-of-passing-d-n-b-theory.html?start=6
(One may read it fully and make his own conclusions.)
My personal opinion is that Competent authorities do not take these accusations seriously. As a nation, we are apathetic to healthcare and especially to the problems of these guys who have rightly or wrongly chosen to do DNB-PG after MBBS, but did not leave the country. We would rather continue to spread frustration in these brighter young men than look for solutions to get them through a nightmarish system of exam conducted by a Govt appointed agency created for a purpose that it is unable to serve. Senior teaching doctors with moral values may be approached for their opinion.)

 
Comment by rani
2014-12-01 11:23:27

thats true dnb baoard is ruunning by the clerks not by the doctors .sir, we know how the candidates r passing now some proffessers given statement now degeree is awarded to candidates really doesn”t no the clinical skills they r getting the prestigeous degree by influence ,someother way.it was very sad examiners should think realize about their pg period this is not western countries without recomandation r someother way how they got their degrees. no one is truthful today .still corruption is going in dnb baoard .every one knows that externaly some people r covering all these things.we have seen prestigeous institutes in india consultants how they r very good in surgical skills at age of 50s also.they r fit for asking viva . wen we talk about this is shamful for us .only one reason for faling practicals by awarding theory by these examiners {baoard}is ego of the some examiners.mci and dnb r equivalent in money making this was encouraging by the government only.wen questiong of the standards why dnb given accredation to the hospitals were consultants rnot eligible for thesis guides,not even have facilities in doing thesis.so many pitfalls r there.we r highly educateds by hiding the truths some professors r covering all these things .this is india we cannont speak any thing even though big democratic country but there no human rights at all .

 
Comment by Sonali
2014-12-25 13:04:45

Hi Dr. Madhusudhan,

Can you please guide as to the process of moving to UK for further career prospects. I have just finished my DNB (Anaesthesia).

Your help will be appreciated.

Regards,
Sonali

 
Comment by MS
2015-01-28 13:12:00

I had written DNB Theory thrice and failed, 9 years back. Would like to try another attempt. Does anybody know, whether not attempting the exam for 9 years will make me not eligible to take the exam?

 
Comment by MP
2015-02-11 16:42:12

I agree with Dr. Kalyan despite of being a non-medico. Here, I want the Natboard people to treat DNB candidates with respect and not just harrass them mentally. I have experienced the harrassment despite of being a non-meidco. My husband is a medico and appeared DNB theory in June 2014. Anyone who doubt the caliber of candidates passing in this paper, I request to see the question paper and you will come to know that the question paper was a nightmare. My husband still cleared it. However, despite 3 of 4 pract cases and viva being excellent , so best that even the examiners said excellent and one viva was avergae, Natboard should not have right to fail such a brilliant candidate. By doing this they are going th go in loss. Will loose faith and will get curses from wives like me coz we go through all the depressions that our husbands suffer from. Plus even the hospitals do not pay much. Natboard please look into this seriously and stop deciding passing quota as prepaid money. Pass students who deserve and stop taking bribes for passing underserved candidates. I hate Natboard for failing such a brilliant student like my husband . More than the blessing of his patients to him , I curse natboard for loosing a doctor , a brillant doctor who has lost faith in DNB, Natboard and the entire NBE system. Kuddos to your success of keeping such standards.

 
Comment by murthy
2015-03-13 14:46:48

hai all doctors
the artical is excellent given by dr.kalyan.
some points i need to add.
1.if any medical board giving less results,what is the point to keep maintaining it by paying thousand of rupees by the students,with no out come[pass percentage]??????
ex. like if a medicine hving lot of side effects or adverse reactions, we ban that medicine from pharmacopia

2.if any M.S or M.D candidate can write DNB directly, why cant a trained DNB student can write a local M.D or M.S university exams directly by paying the examination fee.
here the MCI will interfere…but the role of MCI is making standarisation of medical eduction. but not for DNB,
every oneshould think DNB is not medical education.???????????????

3.if a candidate pass M.D or M.S ,but failed in DNB means….
is the M.D or M.S is low standard or DNB is high standard ?????????????????????

 
Comment by chinmay
2015-05-24 21:36:48

sir, the same scenario exists at some centres which have MD/MS seats….why blame DNB board alone ??even MCI is to be blamed too

 
Comment by Rupika
2015-07-02 19:33:12

What is the point of having diploma courses.I don’t think anyone takes up a diploma course willingly only to suffer the upcoming storm that the secondary DNB is.

 
Comment by Dr A Suresh Chandra
2015-07-04 00:17:30

Why we can’t have one uniform exam pattern or system at national level so that it creates standards in medical training teaching and practice. This will remove uncertainty frustration and saves many patients lives(including doctors lives!). ONE NATION ONE SYSTEM please

 
Comment by harsha gupta.
2015-07-06 23:23:44

I just read now.recently 3rd attempt candidate faild in148.5 marks.discrmancy in center also one center faild 4 student out of 25 and one center pass only 6 out of 25.how could it possible? Becas of some externl was vry dangerous and they r nt satisfd wth any ans.so he didnt gv marks to student.even in 3rd attempt also.4center relzd list of result 17 faild out of 104.but 17 faild in out of 24.ye kaisa exm hai yaar.ye log humare bare me kyo ni sochte hai.jab tak koi sucide ni karega tab tak yahi chalta rahega kya..

 
Comment by Selvaraj
2015-07-22 19:01:03

I agree with the views of the author that the pass percentage is poor in the National Board Practical Exams.

Having been a candidate who cleared the practical Examination of the National Board in the first attempt, and having been a skilled assistant in the exam halls of the national board a few times, and having been a non examiner co ordinator on two occasions for the practical exams and having been the examiner for the past few years, I can assure one thing. National Board never interferes with the results of the practical examinations. The Board never instructs the examiners to give a fixed percentage. There have been instances where 70% of the candidates have passed and there have been instances where only 15 or 18% got through. The results depend basically on the performance of the candidates.

The candidates appearing for the National Board of Examination Practicals are in no way inferior to the MD/MS candidates but their training definitely is much below the standards. Mainly because DNB is allotted to the Private Hospitals. Especially in surgical fields, the surgeon may be interested in one particular are of surgery and hardly there are any clinical classes.

This is evident from the fact that in all the Crash Clinical courses conducted by Medical Colleges, the maximum participants are DNB candidates who get trained in the Private hospitals. Unless the training imparted to the DNB candidates in the private hospitals improves, the pass percentage is unlikely to improve.

None of the examiners I have seen so far have a fixed mind set about giving a poor result. If the candidate knows the basics, then he is automatically through. I dont think it is fair to give pass to a candidate who does not know the basics, just for the sake of a higher pass percentage

 
Comment by Dr.Sharief
2015-07-23 11:35:36

I do agree. Why NBE is giving accreditation indiscriminately to the hospitals in really not understood.

Who ever he may who justify on poor result is totally immaturity. How can one justify in the name of quality of examination? How can one say examination must be in low standards? Everybody accept
to improve the quality of education. Other wise why should run the institution or courses? What does poor results speaks? Doesn’t it mean poor quality of education?

 
Comment by akash
2015-07-27 03:39:52

i dont understand why nobody is telling the truth.

big private hospitals bribe MCI state council, for getting seats recognized (DNB) because they cant shout on normal srs who leave if harrased and dey hv to pay less to a DNB, by DNB dey get doggies for > 3 yrs and that too loyal bec dey cannot leave. so senior and junior consultants can sleep happily at home MCI people can hv a holiday with bribed money and more parents can say that their children are doctors.

i dont understand why everybody is complaining.
india is a shit country and it will remain like this.

KUDOZ

 
Comment by Kiran
2015-07-27 19:42:16

Is the DNB’s system of training specialists in hospitals and not in medical colleges like MD/MS, closer to the American system for training specialists?
And is NBE completely independent and can not be over ruled by MCI?
PS I am an engineer and did not know about DNB degree till yesterday.

 
Comment by dr shalini singh
2015-09-14 20:56:08

Truely said Dr Kalyan.

 
Comment by SS
2015-12-31 23:21:45

“It is well known that a person joins DNB course only after he/she exhausts all the avenues of getting a masters or diploma from a government medical college”.- this is very often true.
It is also true that “DNB surgical branches in corporate hospitals is a crap, waste of time , all high profile patients we have to do their discharge summaries”
Though a lot has changed, still NBE is giving accreditation indiscriminately to the hospitals especially to single discipline & super specialty hospitals.
If DNB exam results are poor, find out why candidates could not do well in exams & ensure to correct the deficiencies.
But please note NBE maintains very high standards of assessments coupled with uniform structured pattern of exams across INDIA.
There are flaws in MCI run Medical colleges, and their standards must be elevated, but do not lower DNB standards.

 
Comment by Gomathy Gopinath
2016-01-02 02:30:11

I agree with Dr. Kalyan on many of the issues raised. Candidates joining DNB course at majority of the recognised hospitals do not get adequate training in the subject or in research for thesis. Teachers do not have adequate time to devote to the candidates as they have to attend to routine and emergency hospital work, their primary concern.

 
Comment by D, Saroja
2016-01-13 06:50:41

Dr. Gomathy perhaps does not know that the MCI recognised institutions imparting MD degrees too are lacking in BASIC INFRASTRUCTURE, MINIMALLY REQUIRED FACULTY TO CONDUCT PG COURSE AND EVEN ADEQUATE SPACE TO RUN THE DEPARTMENT. this is amply visible on several of the MCI inspections. Several renowned institutions in the capital are examples of the same .Teachers in medical colleges too are busy with their private practice clandestine or obvious. There are several medical colleges where evening clinics for post graduates and under graduates do not happen. Patients are wait listed and hence lot of academics are missed.
As such examination system is also defective because passing of candidate depends not on his knowledge but his pleasing and sycophantic capacity for his Head of the department and other faculty.
Even the external examiners are influenced as per the likes and dislikes of the HOD.

 
Comment by bkdatta
2016-05-19 21:37:43

If the situation is still the same then whom to address?

 
Comment by Drhm
2016-05-22 19:55:54

Im a recently passed out md anaesthesia from a reputed college in india. I cleared the dnb theory on the first attempt and gave my practicals in delhi. We were warned that the centre has a repute of failing students. The practicals were conducted on par with md exams. Out of the six stations , i performed well in 4 such that the examiners said very good at the end of each viva . 2 stations i put in an average performance but i answered most questions they put forward. I thought overall i had done really well as it was better than my md viva exams in which i scored the second highest in my institute. But the results were shocking i was failed by a big margin. In fact all the 6 who had appeared that day failed and many more the previous day as well. All these candidates were from reputable institites (afmc kem ltmc etc..) where training is good theoritically and practically . These candidates have been managing emergencies on their own and some are already pursuing superspeciality courses. Its a shame that such discriminatory failing is not checked by the nbe.
It is of my personal opinion that its not the training which is at fault or the prepratory level but it is the vindictiveness of the examiner ,who would have gone through the same process earlier in their careers , who should be checked and regulated . Examiners known to fail without proper reason should be warned or removed from the examination process . A familiar internal is a great advantage because he or she can check these abhorrent practices of egoistical examiners who consider themselves the vigilantes of the medical education system that desperately need more specialist doctors .
Results are centre and examiner specific and not in most cases the inadequacy of the candidates

 
Comment by ANUP DOKANIA
2017-03-28 19:58:45

Sir,
with all due respect….the board i.e NBE holds the passing rate minimal because ,otherwise who would pay to get into private colleges. A MS ortho is over 2 Cr , imagine ,if 50 per cent passed out ..the loss incurred by the pvt colleges.
The same set of examiners keep moving around in the country and decide the fate….their attitude is different for pvt MS candidates where pts are hired .
Would appreciate if you can provide us with the number of students appeared and number who have passed since 1990 till date …in Orthopaedics .
20-30 per cent is very high as stated by dr.kalyan……i feel its in single digits.
these days it has improved after many changes like 6 monthly appraisals n exams …giving marks etc.
it was a horrible affair in the early 2000 to 2010 period .
All i say is , this NBE is neck deep in corruption ..be it DNB ,,or FMG …it takes money from pvt colleges to pass out their MBBS grads in crops.
Suddenly one college from ukraine has a high pass out…then one from china and so on.

 
Comment by Abhishek Roy, M.B.B.S., M.D., DNB
2017-06-05 00:52:38

This blog post speaks volumes. I won’t disagree with the fact that DNB is a very tough nut to crack. And I’ll be lying if I didn’t accept that DNB is the toughest exam of my life till now. But what I understand is that hard work is required but one cannot ignore the fact that even a bit of luck too is required. The examiners, your composure while answering, topics on which the questions are asked and all. There should be more transparency in the examination systems of the DNB. One should understand that a student puts in a lot of effort for the exam and it’s devastating for a “Good” student who has really put in a lot of labour. I am more satisfied in passing the DNB exam in the first attempt than I was in passing my MD exam even though I was the 2nd Rank holder in MD university exams in my state!!

 
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