A medical college offers graduate degree Bachelor of Medicine and Bachelor of Surgery (MBBS). Only institutions offering MBBS course in its curriculum are referred to as a Medical Colleges. The college may teach Post Graduate as well as Paramedical courses. The admission to government MBBS programs is highly competitive because of high subsidy and extensive hands on experience.
The MBBS course starts with the basic pre and para-clinical subjects such as biochemistry, physiology, anatomy, microbiology, pathology and pharmacology. The students simultaneously obtain hands-on training in the wards and out-patient departments, where they interact with real patients for five long years. The curriculum aims to inculcate standard protocols of history taking, examination, differential diagnosis and Complete patient Management. The student is taught to determine what investigations will be useful for a patient and what are the best treatment options. The curriculum also contains a thorough practical knowledge and practice of performing standard clinical procedures. The course also contains a 12-month-long internship, in which an intern is rotated across various specialties. Besides standard clinical care, one also gets a thorough experience of ward management, staff management and thorough counseling skills.
The degree awarded is "Bachelor of Medicine and Bachelor of Surgery". The minimum requirements for the MBBS course are 50% marks in physics, chemistry, biology and English in the '10+2' examinations. For reserved category students the requirement is 40%. MBBS admissions are not centralised. The admission requirements differ across universities. Generally, students who attain higher marks in the qualifying examinations and in the Medical Entrance examinations conducted by various agencies are accepted onto the MBBS course.
Professionals holding MBBS, BDS, BAMS BNYS, BUMS, BSMS, BHMS Degrees are referred to by the title of "Doctor" and use the prefix "Dr".
I (First) MBBS
The pre-clinical course consists of Anatomy, Physiology and Biochemistry, and these are the basic subjects of medical students and it lasts for a year. Prior to 1997 the I MBBS consisted of 11/2 years, but this was trimmed to make more time available for clinical exposure. Passing the I MBBS final examination is mandatory to proceed with the course. A candidate failing the first MBBS examination is detained until all the 1st MBBS subjects are cleared. This is considered a major drawback of the Indian medical education system.however the MCI has changed this in regulations on graduate medical education 2012. In many universities if one does not clear a subject that student will get into an intermediate batch. It is a severe drawback. Morning session usually consist of an Anatomy lecture followed by dissection, except for one day when a class in biostatistics may be taken. Afternoon sessions consist of a theory class followed by laboratory work in Physiology or Biochemistry or it may be histology branch of anatomy.
II (Second) MBBS
Pathology, Pharmacology, Microbiology, and Forensic Medicine for one and half years. After clearing all the four subjects a student advances to III MBBS. The lecture classes and lab work of these subjects are usually held in the afternoons to enable students to attend the clinical wards and out patient departments in the mornings. These are followed by Short postings (15days duration) in Pediatrics, Psychiatry, Forensic medicine, Skin & Leprosy,& Respiratory medicine & TB. This may be followed directly by major postings or a clinical posting in Community Medicine may intervene.
III (Final) MBBS-Part I
Part I consists of one year, where Social and Preventive Medicine (Community Medicine), Ear Nose and Throat and Ophthalmology form the core subjects.
IV (Final) MBBS-Part II
One year of focused training in the four basic clinical subjects, namely: Medicine, Surgery (incl. Orthopaedics), Paediatrics, Obstetrics & Gynaecology. On passing the final MBBS examination, a candidate is awarded provisional registration by the MCI or the State medical council and can start the internship. Permanent registration (license to practice) and the final Medical degree (i.e., MBBS) is given only after successful and satisfactory completion of the Compulsory Rotatory Resident Internship, also called the CRRI.
Internship and Residency
After successful completion of the MBBS course, one has to compulsorily work in the hospital attached to the medical college or in any other approved hospital allowed in some medical colleges, for a period of one year. This posting is called the Compulsory Rotatory Residential Internship or the House Surgeon in Tamil Nadu. The student gets the degree only after satisfactory completion of the CRRI. An Intern (also called an Internee or a CRRI) is posted in all the clinical departments of the hospital on a rotation basis. This gives him or her basic clinical and practical knowledge about all the disciplines of medicine and makes the medical graduate fit to work in the community as a General Physician. The schedules of an intern are usually extremely exhaustive. For example, one may have to work for the whole night and then have to start the next day duty only after about one or two hours. This may last till the afternoon. 24-hour sleepless duty at a stretch is not uncommon and sometimes the scheduled breaks are also not allowed by the superiors. He or she is also paid a monthly stipend for his work in the hospital which differs in different medical colleges on the basis of the management. The person is licensed to practice medicine only after completion of this internship. And only after finishing internship, one can receive his MBBS degree and can pursue postgraduate studies. The Interns are entrusted with clinical responsibilities under the supervision of a Medical teacher or a Resident/ PGT/ Senior medical officer. Interns are not supposed to issue medical certificates, death certificates or medico-legal documents under their own signatures.
The Internship is different from House Officership (which may follow Internship), as understood in UK and other countries. The latter is not a compulsory tenure. The House Physician or House Surgeon unlike an Intern, works in a particular department of his or her choice and is paid a monthly 'salary' for his work in the hospital (especially, in the UK). The American counterpart is simply called a "Resident" (i.e., a Resident Physician or a Resident Surgeon).
Post internship, some graduates may choose to work in different medical specialties and are often referred to as House Officers or House Physicians or House Surgeons. This is different from a post graduate training and does not lead to award of a degree. A doctor undergoing higher specialty training is referred to as a "Post Graduate Trainee" or simply a PGT. House Physicians, PGTs and interns are also called junior doctors across Indian hospitals. PGTs and House Officers are sometimes referred to as Junior Residents. After completion of post graduation, doctors may enter subspecialty training and are then known as "post doctoral trainees" or simply PDTs. They are also called as senior residents at some institutes.