Master of Chirurgiae

Master of Chirurgiae, also known as MCh, is the highest degree in the field of surgical science. It is a three-year course after MD or MS and a five-year course after MBBS where medical students attain mastery over surgery. The Latin term for MCh is Magister Chirugiae after completion of which one can be a surgeon. The course is known for its competitiveness and only a handful of students get the opportunity to pursue it. 

There are numerous specializations offered by the MCh degree — the top ones are plastic surgery, ENT, urology, neurosurgery, pediatric surgery, and cardiac surgery. MCh course aspirants must secure at least 55% in MBBS to be eligible to appear for the entrance examination NEET-SS. 

The course involves deep and advanced knowledge of surgery and a practical understanding of dealing with complex surgical procedures. Candidates are trained in highly specialized areas of surgery. The top medical colleges of MCh are AIIMS, PGIMER, JPIMER, Christian Medical College, and Kasturba Medical College.

The MCh course costs around INR 4,000 to 20 lakh per year in India. Upon graduation, students get to work in prominent employment settings such as ICUs, emergency, operation theatres, trauma centers, and others. The average annual salary earned by MCh specialists in the country can range from INR 8 to 20 lakh.

A brief overview of MCh is given in the table mentioned below:

The MCh degree is heavily research-oriented. Students need to work in an extremely challenging and high-pressure environment. The course combines theoretical and practical training, seminars, and thesis or projects after which one becomes proficient in the surgical field.

Surgeons are provided with in-depth knowledge of the latest advancements in surgical and biomedical techniques. Those who aspire to be an MCh must have skills such as leadership, academic excellence, and skills to thrive in the professional field.  The areas that are included in an MCh course are:

• Evidence-based practice in surgery
• Advanced understanding of service innovation process in the relevant subject area
• Quantitative and qualitative methods of research
• Writing a research proposal
• Investigative inquiry from conceptualization to completion.

Explicitly MS and MCh appear similar in the eyes of a layman. Therefore, to clear the confusion between the two degrees, a comprehensive overview is given below:

An MCh degree adds significant value to the resume of a medical professional and helps them emerge as the best in their profession. It requires huge efforts from candidates from giving the exam to securing the most coveted seats Though they have to pass several sleepless nights, the reasons that may motivate one to choose MCh courses are:

• Aspirants can choose a wide variety of specializations and gain mastery in their profession. This would give them an edge over others.

• It will train students as per the demands of the industry. The course will allow them to learn every complicated technical procedure in their field of surgery. 

• It will help in research and innovations in surgical procedures and technologies.

• MCh specialists can train juniors and students in their own domain thereby diversifying their career prospects.

• One gets to be a part of the most rewarding profession by saving the lives of thousands.

• The most promising part of the MCh degree is the salary. They tend to earn more than doctors with only MBBS degrees. 

There are more than 20 MCh specializations. Candidates have diverse specializations to choose from and must choose the best ones for themselves. The specializations decide the coursework, curriculum, and clinical structure. 

Here is a list of top MCh specializations in India:

• Cardiology: The course is targeted to train students in ailments related to the heart, chest, and lungs. It is a combination of two streams - cardiac and thoracic. Apart from surgery, students also learn to use various investigating and diagnostic procedures and understand test reports while treating patients.

• Gastroenterology: This course is dedicated to training surgeons in gastrointestinal surgery covering the upper GI tract, lower GI tract, and HPB surgery. The trainees are also exposed to endoscopy, ultrasonography, and GI vascular interventions.

• Endocrinology: A candidate opting for endocrinology develops skills and competencies in the management of surgical endocrine and breast disorders. They must be able to include genetic evaluation, functional imaging, and management of various disorders.  

• Urology: The training in urology includes in-depth knowledge of the entire urology and relevant subjects. They will also be trained in pediatric and adult urology with knowledge of sub-specialties like gynecological urology, neuro-oncology, neuro-urology, and andrology.

• Neurology: The course should help students with basic, investigative, clinical, and operative neurosciences. They will learn to perform neurosurgical operations and impart basic neurosurgical training.

• Pediatrics: MCh candidates in pediatrics will get the competence and confidence to diagnose and manage infant and childhood surgeries. They will also gain a broad understanding of the principles of basic sciences related to their domain.

Apart from the above-mentioned MCh specializations, there are some other important specializations that students can refer to for further study:

NEET-SS or National Eligibility cum Entrance Test (Super Speciality) is a single entrance examination taken for admission to various MCh courses as per section 61 (2) of the National Medical Commission Act, 2019.

The National Board of Examination (NBE) conducts the NEET-SS exam. There is no other national, state, or institute-level exam valid for entry to MCh courses under most of the institutions and universities in India. The test is valid for almost all government and private medical colleges, universities and deemed universities, and armed forces medical service institutions.

INI CET is another MCh entrance exam conducted by AIIMS or All India Institute of Medical Sciences. The INI CET full form is the Institute of National Importance Combined Entrance Test. From 2021, the scores of this exam are accepted for entry to MCh courses in 12 AIIMS institutes, PGIMER Chandigarh, JPIMER Puducherry, NIMHANS Bengaluru, and Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum. 

Similar to every medical course, the MCh course also has certain eligibility criteria that students must fulfill to become a specialist in the field. The common eligibility criteria are given below for easy reference before enrolling in the course:

• Students have to complete MBBS or MD degree.

• They are required to submit NEET-SS or INI-CET scores to be eligible for applying for MCh.

• They must have completed their SMC/NMC registration.

• Foreign medical candidates do not need registration under NMC.

• Those who have MS qualifications need to provide proof of their license to the university. One also has to have an active part in an MS degree or receive an interim pass certificate.

• Must have a valid identity card that includes Pan Card, Adhaar Card, Driving License, or Voter ID.

The universities require candidates to submit certain documents to get admission to MCh courses. The document list is provided below:

• MBBS/MS degree certificate

• Admit card of entrance exam

• NEET SS or INI-CET result card

• NMC registration certificate

• Valid ID proof

As MCh is a highly specialized course, students can only apply through the entrance examination. There is no provision for direct admission based on merit. The common steps to apply for MCh courses in India are:

Step 1: Select medical colleges offering the specialization that the candidate is seeking.
Step 2: Fill up the application form by visiting the university portal.
Step 3: Submit all the documents required by the university.
Step 4: Take the entrance test to get selected for the program.
Step 5: Clear the cut-off of the particular specialization.
Step 6: A merit list of qualified candidates will be prepared.
Step 7: Complete the counseling process which includes registering on the official website of MCC, choice filling and locking, fee payment and application processing, and lastly provisional seat allotment. Complete rounds of counseling, as required. 
Step 8: Finish the admission process by submitting other documents as mentioned.

Aspirants get to choose the colleges based on their ranks in the entrance exam, the cut-off, and the availability of specialization in that particular college. The list of popular colleges is given below:

Let us observe some of the top MCh colleges across popular cities in India:

New Delhi

New Delhi has some of the most renowned MCh colleges. They are:

• Vardhman Mahavir Medical College and Safdarjung Hospital
• Lady Hardinge Medical College for Women
• Dr. Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research
• Institute of Liver and Biliary Sciences

Bengaluru 

The top colleges for MCh in Bengaluru are:

• St Johns Medical College
• MS Ramaiah Medical College
• Bangalore Medical College and Research Institute
• National Institute of Mental Health and Neuro Sciences
• Raja Rajeshwari Medical College and Hospital
• Indira Gandhi Institute of Child Health
• Sri Jayadeva Institute of Cardiovascular Sciences and Research

Mumbai

The medical colleges that provide MCh courses in Mumbai are given below:

• Grant Medical College
• Seth GS Medical College
• Lokmanya Tilak Municipal Medical College
• Topiwala National Medical College and BYL Nair Charitable Hospital
• Tata Memorial Hospital
• MGM Medical College and Hospital
• Bombay Hospital Institute of Medical Sciences

Kolkata

Kolkata boasts the presence of some top medical colleges for MCh. Some of them are:

• Institute of Post-Graduate Medical Education and Research
• Medical College
• Calcutta National Medical College
• RG Kar Medical College and Hospital
• Nilratan Sircar Medical College

Chennai

The medical colleges in Chennai provide MCh courses to students. The most popular ones are:

• SRM Medical College Hospital and Research Centre
• Sri Ramachandra Medical College and Research Institute
• Stanley Medical College
• Government Kilpauk Medical College
• Chengalpattu Medical College

Studying MCh abroad can enhance the academic and professional development of students interested in surgery and improving the safety of patients. Professional surgical training coupled with research outputs motivates them to continue their studies outside India. Some of the top MCh universities abroad are:

The average tuition fees charged by government colleges for MCh courses are comparatively low whereas private colleges charge high fees for providing the same course. However, as the return on investment (ROI) is high, the course is worth the expenditure. The course fees of some of the top colleges are given below:

The MCh course is goal oriented and aims to train students to perform the following functions:

• Recognize the needs of health of the community as relevant to the specialty and super specialty.

• Carry out professional obligations effectively and efficiently supported by scientific knowledge and skill.

• Master competencies related to specialty so as to deliver secondary and tertiary healthcare.

• Awareness regarding contemporary advances and developments.

• Be caring and empathetic towards patients and relatives and maintain ethical standards of treatment.

• Be able to share knowledge and skills with juniors, colleagues, and learners. 

The syllabus of some of the specializations is given here.

Gastroenterology

The course content contains the entire scope of surgical gastroenterology. Some of the important components of the gastroenterology syllabus are:

Endocrine Surgery

The syllabus of Endocrine Surgery touches upon the following areas:

Pediatric Surgery

While MCh in Paediatric Surgery gives a broad understanding of basic sciences related to it, some of the topics in the syllabus are:

Urology

The syllabus of Urology brings out the entire knowledge of urology and allied subjects. The important topics of this specialization include:

Neuro Surgery

The course content of Neuro Surgery is as follows:

The MCh course curriculum is designed to aid students to work at medical hospitals in India, treat and diagnose problems, start units of specializations and work effectively for national and international programs. The curriculum is directed towards students gaining:

• Knowledge

• Practical and Clinical Skills

• Thesis Skills

• Human Values

• Ethical Practices

• Communication Abilities, and

• Training in Research Methodology

A list of teaching-learning activities that a student has to undergo are:

• PG Orientation: During the first year, a PG orientation program is conducted to help students sharpen their communication skills and inform them of research methodology, biostatistics, and writing a dissertation.

• Journal Club: It is generally held once a week to make a checklist of the evaluated presentations and carry weightage for internal assessments.

• Subject-Based Seminars: The seminars are supposed to be held once in two weeks. Candidates have to make a defined number of presentations in a year that get evaluated.

• Ward Rounds: Ward rounds include service or teaching rounds. All students are supposed to attend the grand rounds that are conducted once a week.

• Pre-Operative Sessions: Here students present clinical history, examination findings, imaging, and operative plans.

• Teaching Activities: They must teach undergraduate students.

 Other activities apart from those mentioned above include:

• Outpatient clinics teaching

• Hands-on training in operation theatres

• Seminars

• Latest guidelines discussions

• Case presentations

• Case-based scenario

• Debates

• Online webinars

• National and international conferences and presentations

• Surgical videos

MCh courses lead to a plethora of opportunities in professional fields and are therefore preferred by medical graduates. Some of the career and job prospects after completion of the course can be:

• Students can apply for fellowship programs after completion of their MCh course. A brilliant academic profile helps in such cases.

• There are several surgical practice opportunities in government and private hospitals in India. Graduates can also work as surgeons overseas.

• They can also open a medical center or nursing home of their own and carry forward the legacy of learning.

• The MCh graduates can also choose a teaching career as a professor of surgery and train future surgeons.

• They can extend their expertise in research fields and contribute to the advancement of surgical technologies.

Some of the popular job profiles after MCh are:

• Neuro surgeon
• Urology surgeon
• General surgeon
• Plastic surgeon 
• Trauma surgeon

The lucrative career opportunities after MCh courses have been explained above. Students must also note that though the job requires them to take on huge responsibilities and challenges in day-to-day life, the salary structure makes it worth it and extremely rewarding. That said, the salary tends to vary according to specializations. The average salary of a few MCh professionals is discussed below:

The personal attributes that make a good surgeon after MCh courses are knowledge coupled with good people skills. They have to handle several patients in a day and perform tough surgeries. The skills they require to work efficiently are: 

• Caring Attitude: They must be caring towards the patients and treat them well so that the anxiety related to operations and surgeries is reduced.

• Punctuality: They are entrusted with the responsibility of saving the lives of people and therefore they have to be on time on most occasions. Besides, they must be able to manage their time effectively to handle several cases at a time.

• Ability to Cope with Stressful Situations: Surgeries are extremely stressful and one must know how to cope with stress and pressure. They must be cool-minded, trustworthy, and reliable.

• Communication Skills: MCh graduates must be able to work in a team and maintain communication with other healthcare professionals and patients.