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Thursday, 07 October 2021
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What to choose MD or DNB ?

There is a lot of confusion among the PG Aspirants regarding what to choose between MD/MS or DNB & what are the pros & cons if a candidate opts for DNB course.

Myself, Dr Noman Khan DNB Radiologist is writing this article to help clear out the confusion. I have myself chosen DNB Radiology over MD Medicine.

MD/MS & DNB Overview:

A post graduate degree Diplomate in National Board (DNB) is awarded by the National Board of Examinations under the Union Ministry of Health & Science India & the MD/MS Degree is awarded by State University’s.

As per the National Medicine Commission, Diplomate of National Board (DNB) qualification awarded by the National Board of Examination (NBE) shall be equivalent to Doctor of Medicine or Surgery MD/MS.

The DNB shall be equal in all respects to the PG qualification and the super-specialty qualification, respectively, as granted under this Act with the exception in teaching in medical colleges as they do not take DNB education in a medical college

Similarities and differences between both the courses:

Duration of both the courses is 3 years, run in both government and private set up with similar quality standard of the host institute, similar academic activities, compulsory thesis work under a qualified thesis guide with external review process (exposure to research methodology), and academic activities (library and journal facility, presentation in national and international conferences, research article publication, training program, workshop, and CME).

Clinical activity in both the courses is almost similar with respect to emergency case handling, surgical exposure, clinical case discussion, case exposure, availability of equipment and diagnostic tool, patient load to be handled, duty hour, night duty, leave entitled including maternity leave and other facilities.

Regarding the exit examination, in MD course, theory and practical examination is conducted in host institute or in host city ; in practical examination, both internal (high chance of bias in evaluation process) and external examiners are present. Furthermore, passing theory examination is not an essential criterion of eligibility to appear in the practical examination.

While DNB exit examination is an unbiased, extremely tough evaluation process both in theory and practical (conducted in different centre without the presence of internal examiner).

DNB PROS :

1. Single fees structure all across India in both government and private institutes ( currently 1.25 lakhs )

2. Baring few government institutes in few states , compulsory bond is not there in DNB

3. You can get DNB in your subject of choice even with a bit higher rank than MD. For example NEET 2020 closing rank of MD Radiology seating government college was 3287 AIR and for DNB Radiology closing rank was 9559 AIR.

4. Management and treatment of the patients are as per the standard guidelines. In many large private hospitals, the management of the case is on par with international standards.

5. There is exposure to the latest and advanced medical procedures , surgical technique s, novel investigations , high end diagnostic procedures at private hospitals.

6 . After completion of DNB , candidate is eligible for NEET Super Speciality Examination and can acquire DM or Much degree.

7. Recognition abroad : Some countries have started recognizing DNB from India more than MD/MS. So if you aim to work abroad, go for DNB degree.

Note : DNB is not recognized as a degree it's recognized as a speciality work experience. You still need to clear the medical licensing exam and do residency in that country.

DNB CONS :

1. Low passing rate.: The final exam of DNB is considered tough and the passing rate is lower generally at 60 to 65%. Even lesser for few branches like Orthopaedics , Paediatrics etc.

2. Less surgical exposure and free hands : In majority of private hospitals DNB residents are not given enough exposure and independence while working . Specially in surgical branches. The reason being in private hospitals patients are paying hefty amount for their management and treatment and also for the consultant name. Similarly even in Radiology Department , ultrasonography scans comes with the reference of consultants.

3. Improper training programme and Academics : Most of the private institutes does not have proper structured training programme for the residents. Academics is also ignored.

4 . Patient load and exposure - The patient load in any private hospital is much less than any government hospital. As a result the exposure is much less. Moreover variety of cases are much high in government hospital. This can be attributed partly to economic condition of patient presenting to government hospital. In government hospital mainly poor people come for treatment. They have long standing , neglected and chronic diseases. So , both variety and volume of case is less in DNB.

5 . Problems in private practice and socially : There is less recognition among the general public of India about DNB degree. So a doctor might face some difficulty early on if he/she starts a private practice.

6. Teaching job in Medical college: As per the new rule without work experience DNB holders can’t start teaching while MD/MS holder have no such condition.

7. Have to deal with corporate management.

8. Leaves are sanctioned according to the rule and there is less time given for preparation for final exams.

9. NBE as an authorizing and examining board is difficult to tackle and are not so student friendly.

MEDICAL VS SURGICAL BRANCH IN DNB:

Medical branches like Medicine , Paediatrics ,Radiology, Dermatology can be preferred over surgical branches like Surgery , Orthopaedics etc in DNB.

The reasons are Medical branches have less intervention and more academic part ,so resident can learn with slight support of senior or consultant but in surgical branches unless the resident do that particular surgery the will not be confident.

Conclusion :

In my opinion for a Surgical branch, DNB Institutes should be avoided & preference should be given to MD/MS.

For Medical branches one can prefer DNB depending on branch preference and personal choice provided that the institute is really good , otherwise MD/MS Institutes even in Pheripheral area should be given preference over DNB.

When it comes to MD/MS seat from a Deemed University with hefty fees & DNB one should always go for DNB even for a Surgical Branch

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