Theses come back for modification for a surprisingly small number of reasons, and the same ones repeat across specialties and institutions. Nearly all of them are visible in the document before it is submitted, which means nearly all of them can be removed in an afternoon by someone who knows what to look for.
The objective does not match the analysis
This is the most expensive error, because fixing it can mean reworking two chapters. The objective says you will compare something between two groups; the results report proportions in each group with no comparison. Or the objective promises to assess an association and the analysis reports only descriptive statistics. Or the objectives list four things and the results answer three.
The fix is mechanical. Write your numbered objectives on one sheet of paper. Beside each, write the table or figure that answers it and the test that was applied. Every objective must have a line. Every table in the results must trace back to an objective or to the baseline description. Anything unmatched on either side is either a missing analysis or an analysis you never promised, and the second kind usually belongs in an appendix or nowhere.
The sample size cannot be justified
An assessor who cannot reconstruct your sample size from what is written will ask for it, every time. A number with no formula behind it, assumed values with no citation, a calculation for a different outcome from the one you analysed, or a recruited sample well below the calculated one with no explanation are all routine grounds for a return.
Write the formula, the assumed values, the published source those values came from, the power, the alpha, the attrition allowance and the final figure, as a short paragraph in the methods. If you recruited fewer than you planned, say how many and why, and carry that into the limitations rather than leaving the assessor to find the discrepancy themselves.
Ethics approval is dated after data collection began
Institutional Ethics Committee[5] approval must precede any research on human participants, which is what the Indian Council of Medical Research's National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, 2017 require. A thesis whose data collection period starts before the date on its approval letter has a problem that no amount of rewriting fixes, and it is among the easiest things for an assessor to check, because both dates are printed in the thesis.
Check the two dates against each other now, not at submission. If your study period in the methods reads from a month earlier than the approval letter because that is when you started screening records, correct the methods to the truth and state what happened. A retrospective study needs its approval before the records are accessed, not before the period the records cover. If there is a genuine mismatch, it is a conversation with your guide and your ethics committee, and it is far better had early.
The same data in a table and a chart
Presenting one set of numbers twice, once as a table and once as a bar chart on the facing page, is a routine formatting objection and one of the simplest to fix. Choose one. A table when the reader needs the exact values, a chart when the shape of the distribution or a trend over time is the point. Never both for the same data, and never a pie chart of two categories that a single sentence would carry better.
While you are there: every table needs a number, a title above it that says population and variable, and a note defining every abbreviation in it, so the table can be read without the paragraph beside it.
The discussion does not discuss
A discussion that restates the results in words, or that summarises ten previous studies without ever bringing them into contact with your own finding, gets marked as not a discussion. The corrective is to lead each paragraph with your result and use published work as the material you argue with. Limitations should be specific and directional rather than a single line about sample size, and the closing recommendation should name what the next study ought to change.
Consent documentation is missing or incomplete
Assessors look for the participant information sheet and the consent form, in the language in which they were actually administered, usually as annexures. The common gaps are an English form for a population that consented in a regional language, no assent document where minors were involved, and a thesis on records or stored samples that does not say whether the ethics committee granted a waiver of consent. Say what was done, attach what was used, and where a waiver applies, name it and say who granted it.
The institution's own template was ignored
Margins, font size, line spacing, binding, the order of the preliminary pages, the wording of the certificate and declaration, the number of copies, whether a similarity report must be bound in, and the length limit are all set locally, and there is no general rule to follow. MDThesis does not and cannot tell you what your institution requires here. Get the current template from your department or university website, check the date on it, and format to it from the first chapter rather than reformatting 80 pages in the last week. For DNB and DrNB, the NBEMS[2] thesis guidelines cap the submitted thesis at 80 pages and set out the declarations required from the trainee, the guide and the head of the institution, so read the current version on the NBEMS portal rather than a senior's copy from three years ago.
Numbers that do not reconcile
Percentages that do not sum, a total in one table that differs from the total in another with no stated reason, a figure in the abstract that does not appear anywhere in the results, a p value in the text that contradicts the table. Each of these individually is small. Together they make an assessor doubt the dataset. Read the abstract last, against the final tables, and check that every number in it exists unchanged in the chapter it came from.
What happens if it does come back
It is recoverable, and it is common enough that it should not be treated as a catastrophe. For DNB and DrNB, the National Board of Examinations in Medical Sciences allows a modified thesis to be submitted within six weeks of the assessors' remarks, so the remarks arrive with a clock attached and the first thing to do is read them twice and plan the six weeks backwards. For MD and MS, the route after a modification is requested is set by your university, and the timelines differ, so ask your department for the specific process rather than assuming the NBEMS window applies to you. The National Medical Commission's clarifications issued in 2024 under the Post Graduate Medical Education Regulations 2023[1] confirmed that prior acceptance of the thesis is not a prerequisite for appearing in the final examination, which changes the consequence of a late modification considerably, though your university's own internal deadlines still stand.
A pre-submission pass that catches most of this
- Objectives sheet: every objective has a table and a test, and every table has an objective.
- Ethics approval date sits before the first day of data collection, and both dates appear in the thesis.
- Sample size paragraph contains formula, values, source, power, alpha and the final number.
- No dataset appears as both a table and a chart.
- Consent and information documents are annexed in the language used, or a waiver is named.
- Abstract numbers match the results chapter exactly.
- Reference numbers run in order of first appearance and every entry is cited.
- The document matches the current institutional template, checked against the copy on your university's own site.