For most MD/MS residents, the thesis feels like a giant, blurry obstacle somewhere between first year and final exams. Under the old MCI-era regulations (e.g., PGMER 2000), you were expected to submit and get your thesis accepted months before appearing for the final examination, with external examiners grading it separately from your clinical and viva performance.

Recent reforms by the National Medical Commission (NMC)—especially the Postgraduate Medical Education Regulations 2023 (PGMER-23) and the 2024 clarification on thesis submission—have kept the thesis mandatory but changed how it is evaluated and linked to exams. The thesis is now more tightly integrated with your final clinical/practical and viva assessment, instead of being a separate gatekeeping requirement.

Under PGMER-23:

• Every broad- and super-specialty trainee must still undertake thesis-related research and submit a dissertation.
• The thesis now contributes 5% (20 marks) within the clinical/practical + viva component.
• NMC has clarified that submission of the thesis is compulsory, but prior “approval” by the HoD or university cannot be used to bar you from appearing in the final exam—though universities can still set internal timelines for submission and processing.

In parallel, assessment trends in medical education are moving towards more structured practicals and viva voce, where examiners deliberately align questions with clear learning outcomes. It is increasingly obvious that your thesis is part of your overall clinical training, not a side project.

If you are in a DNB/DrNB programme under NBEMS, the core research skills and IMRaD-style format are similar, but the rules are more centrally standardised. Protocols typically must be submitted within 90 days of joining, the final thesis is capped at 80 pages (including text, tables, references, annexures), and an accepted thesis remains a prerequisite for eligibility to sit the final exams. This article focuses on the MD/MS pathway under NMC/university regulations, but the overall roadmap—topic → protocol → data → analysis → writing → viva—is broadly applicable and will be adapted in a separate DNB-specific guide.

This guide breaks the MD/MS thesis journey into clear, time-bound stages—from choosing a feasible topic and getting ethics approval to organising your data, working with a biostatistician, shaping the thesis document, and finally handling thesis-related viva questions—so you can treat it as a structured two-year learning exercise rather than a last-minute crisis.

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2. The big-picture timeline (Months 0–24)

Think of your thesis as a two-year project with overlapping phases:

This comprehensive guide serves as a roadmap for the MD MS thesis roadmap timeline India, breaking the MD/MS thesis journey into clear, time-bound stages.

• Months 0–3: Topic selection, protocol/synopsis writing, ethics approval
• Months 3–15: Data collection and follow-up
• Months 10–18: Data cleaning, preliminary analysis, tables/figures
• Months 15–21: Writing Introduction, Methods, Results, Discussion
• Months 21–24: Final checks, submission, and viva-oriented revision

Individual universities (and bodies like NBEMS for DNB/DrNB) specify more precise deadlines for synopsis and thesis submission—usually synopsis within the first 6 months and thesis submission several months before final exams. Always check your institution’s circulars.

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3. Stage 1 (Months 0–1): Choosing a feasible, exam-friendly topic

3.1 Start with the problem, not the title

Most residents pick topics because they “sound impressive” but later realise that:

• Case volume is low
• Key data aren’t routinely recorded
• Follow-up is unrealistic within training time

Instead, start by asking:

1. What common clinical problem do I see repeatedly in my unit?
2. What single question can I realistically answer in 18–24 months?
3. Is this feasible with our patient load, investigations, and available manpower?

Guidelines from universities and thesis-writing resources consistently emphasise relevance, feasibility, and clarity of objectives as key criteria for a good topic.

3.2 Apply three filters to your topic idea

1. Feasibility
   • Realistic sample size with your cases/month
   • Clear inclusion/exclusion criteria
   • Follow-up that fits within the course duration
2. Relevance
   • Addresses a genuine clinical or public health problem
   • Aligns with your department’s strengths or priorities
   • Has potential to generate publishable data
3. Exam-friendliness
   • Clear primary outcome (e.g., functional score, complication rate, mortality, lab marker)
   • Comparisons or associations that lend themselves to standard analyses (t-test, chi-square, regression)
   • Methodology that examiners can easily grasp and question during viva

3.3 Run your idea past your guide early

Before you get attached to a title, discuss with your guide:

• Clinical importance
• Feasibility of recruitment
• Data points currently recorded vs what needs to be added
• Whether the department has done similar work (to avoid duplication)

Many institutional guidelines recommend early guide involvement and departmental discussions to refine topics and avoid unworkable designs.

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4. Stage 2 (Months 1–3): Protocol/synopsis, ethics approval, and registration

Once the topic is agreed upon, you formalise it into a protocol/synopsis.

4.1 Typical structure of a thesis protocol/synopsis

Most Indian universities and boards use a similar structure:

1. Title
2. Introduction (burden, gap, rationale)
3. Review of literature (focused, not a textbook chapter)
4. Aims and objectives
5. Materials and methods
   • Study design, setting, duration
   • Study population, inclusion/exclusion criteria
   • Sample size justification
   • Variables and measurements
   • Data collection tools/proforma
   • Statistical analysis plan
6. Ethical considerations
7. References (usually Vancouver style)
8. Annexures (proforma, consent forms, etc.)

Guidance articles emphasise that the protocol should show why the study matters, what gap it addresses, and exactly how you will conduct and analyse it.

4.2 Ethics committee and approvals

• Prepare your protocol + patient information sheet + consent forms.
• Submit to the Institutional Ethics Committee (IEC) as per local SOPs.
• Incorporate IEC suggestions carefully—this is often reviewed again at viva.

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5. Stage 3 (Months 3–15): Data collection without chaos

5.1 Design your data collection tools before the first patient

Before enrolling participants, finalise:

• Case record form (CRF)/proforma aligned with your variables and outcomes
• Standard operating definitions (e.g., “major complication”, “treatment failure”)
• A system to track eligible vs enrolled vs follow-up visits

Thesis guidelines from NBEMS and institutes like JIPMER explicitly recommend a pre-designed proforma and careful record-keeping to avoid missing critical variables.

5.2 Maintain a simple yet robust log

Maintain:

• Screening log: all patients assessed for eligibility
• Enrolment log: those included/excluded with reasons
• Follow-up log: visits, missing data, dropouts, deaths

This becomes incredibly useful when examiners ask about selection bias, loss to follow-up, and missing data during viva.

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6. Stage 4 (Months 10–18): Analysis plan and working with a biostatistician

6.1 Don’t wait till “all data are collected”

A common mistake is postponing statistics until the end. Better:

• Around 50–60% recruitment, meet your biostatistician with:
  • Protocol
  • Data dictionary (variable names and types)
  • A small anonymised dataset
• Confirm:
  • Primary and secondary outcomes
  • Which tests/models you’ll use
  • Whether your sample size and event rates are sufficient

Resources on thesis writing and protocol development repeatedly stress the importance of involving statistics planning early to avoid underpowered or poorly analysed studies.

6.2 Basic analysis structure

For a typical MD/MS clinical thesis:

• Descriptive statistics: means/medians, proportions
• Group comparisons: t-test / Mann–Whitney, chi-square/Fisher’s exact
• Association models (if needed): regression (linear/logistic), survival analysis

The aim is not to use exotic tests but to use appropriate, justified methods and be able to explain them simply.

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7. Stage 5 (Months 15–21): Writing the thesis (IMRaD & beyond)

Most institutional guidelines and teaching materials recommend the classic IMRaD structure with some front and back matter.

7.1 Standard thesis layout

1. Preliminary pages
   • Title page, certification, declaration, acknowledgements
   • Abstract, list of tables/figures/abbreviations
2. Main text
   • Introduction
   • Review of literature
   • Aims and objectives
   • Materials and methods
   • Results
   • Discussion
   • Summary and conclusions
   • Limitations
   • Future directions
3. Back matter
   • References (usually Vancouver style)
   • Annexures (questionnaires, proforma, ethics approval, consent forms)

Institutes like JIPMER, AIIMS and various universities publish explicit formatting guidelines (margins, font, line spacing, page limits) which you should follow closely.

7.2 Writing tips for each major section

• Introduction
  • 3–5 pages: burden → existing evidence → gap → rationale
  • End with a clear problem statement.
• Methods
  • Write in past tense and enough detail for replication.
  • Include design, setting, period, eligibility criteria, sample size calculation, variables, data collection, and statistical methods.
• Results
  • Use tables and figures sensibly; don’t repeat all numbers in full text.
  • Start with baseline characteristics, then primary outcome, then secondary outcomes.
• Discussion
  • Start with key findings in your context.
  • Compare to existing literature (similarities/differences).
  • Offer plausible explanations; acknowledge limitations; suggest implications.
• References
  • Follow the recommended style (usually Vancouver).
• Plagiarism & AI tools
  • Many universities now mandate a plagiarism check report and expect you to disclose AI use if any.
  • Always write in your own words and cite original sources.

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8. Stage 6 (Months 21–24): Submission, examiner expectations, and viva

8.1 Submission and evaluation under current NMC framework

Under PGMER 2023 with subsequent clarifications:

• Thesis submission remains mandatory, but prior acceptance is not required to sit the exam.
• The dissertation contributes 20 marks (5%) within the clinical/practical + viva components.
• Evaluation is typically by an external examiner from outside the state during the practical/viva.

Universities may still require submission several months before the exam to allow internal processing, so always check your specific circulars.

8.2 What examiners typically look for in the thesis

Based on university guidelines and examiner surveys, examiners look for:

• Clarity of research question and objectives
• Appropriateness of study design and methods
• Ethical conduct and documentation
• Coherence between methods, results, and conclusions
• Reasonable understanding of statistics and limitations
• Quality of writing, referencing, and formatting

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9. How your thesis links to the viva: what to prepare for

The viva voce is a structured or semi-structured dialogue where examiners ask questions and you respond, often integrating your thesis, clinical reasoning, and broader subject knowledge.

For the thesis component, expect questions like:

1. Why did you choose this topic?
2. How is your study design appropriate for your research question?
3. How did you calculate your sample size?
4. What are your inclusion/exclusion criteria and why?
5. What biases could affect your results?
6. Why did you use this particular statistical test?
7. How do your findings compare to key studies in the literature?
8. What are the clinical implications and limitations of your work?

To prepare:

• Re-read your thesis as if you’re an examiner looking for gaps.
• Make a one-page summary of your study (question, design, outcomes, key results).
• Keep 3–5 landmark papers in your area ready to quote.
• Be honest about limitations; examiners often value self-awareness over perfection.

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10. Common mistakes and how to avoid them

1. Starting late
   • Fix: Finalise topic and protocol within the first 3–4 months of joining.
2. Unrealistic topic (rare disease, huge follow-up, overly complex design)
   • Fix: Apply feasibility + relevance + exam-friendliness filters and discuss early with your guide.
3. No clear primary outcome
   • Fix: Define one main endpoint and power your sample size/analysis around it.
4. Poor data quality (missing key variables, inconsistent records)
   • Fix: Use a structured proforma; train juniors/nurses if they are helping with data entry.
5. Last-minute statistics
   • Fix: Meet your biostatistician midway; pre-plan tables and analysis.
6. Copy-pasted literature review
   • Fix: Read, summarise, and critically appraise; use plagiarism checks; cite properly.
7. Not linking thesis to viva prep
   • Fix: Use your thesis as a learning scaffold for viva, not as a separate burden.

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Take-home message

Your MD/MS thesis is not just a hurdle; it is a 2-year structured opportunity to learn how to ask clinical questions, design studies, work with data, and communicate results—skills that will serve you for the rest of your career.

If you break it into stages—topic → protocol → data → analysis → writing → viva—and start early, the thesis becomes manageable, and sometimes even enjoyable.

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Sample reference list (adapt to Vancouver style)

1. Mahajan R. Postgraduate Medical Education Regulations 2023: a commentary. Indian J Anaesth. 2024.
2. National Medical Commission. Post-Graduate Medical Education Regulations, 2023. NMC; 2023.
3. National Medical Commission. Clarification on Mandatory Requirement of Dissertation/Thesis Submission. Letter No. 1069(11)/2023-PGMEB-NMC; Sept 7, 2024.
4. National Board of Examinations in Medical Sciences (NBEMS). Guidelines for Thesis Protocol and Thesis Submission. NBEMS; c. 2021.
5. Government Medical College & Hospital, Chandigarh. Format for Thesis Protocol. GMCH; 2019.
6. Rastogi A, et al. How to write a thesis protocol. J Integrat Med. 2023.
7. JIPMER. PG Dissertation Guidelines 2020. Puducherry; 2020.
8. SGRD University of Health Sciences. Guidelines for Preparing MD/MS Thesis.
9. Imran M, et al. Structured and unstructured viva voce assessment in medical education. J Pak Med Assoc. 2019.
10. BMC Med Educ. Structured viva validity, reliability, and acceptability as an assessment tool. 2023.