The Ukraine wake-up call

Concerted efforts should be made to make medical education affordable

Thousands of young Indians caught in the war between Russia and Ukraine have brought to the forefront an important debate on why overseas medical education is so popular and what India could do to contain the exodus of its students. Prime Minister (PM) Narendra Modi added to the narrative recently by urging corporate India to pitch in much more actively so that Indian students do not feel the need to go abroad, especially to smaller countries, for medical studies. The PM’s suggestion could work only if private players offer affordable medical courses in India. Also, the number of seats in India will have to increase significantly to reverse the current trend.

Currently in India, government and private medical seats are almost equally divided in a pool of around 90,000, even as some 1.6 million applied for the National Eligibility cum Entrance Test to qualify for the under-graduate course in 2021. Besides the demand and supply gap, the fee differential between the government and private courses is a major hurdle. Government medical colleges in India offer courses starting at Rs 67,000 and going up to Rs 3 lakh; it costs between Rs 80 lakh and Rs 1 crore to study medicine at private colleges; and colleges in China, Russia, Ukraine, and Belarus offer these courses much cheaper at Rs 20-45 lakh. As a direct fallout of the price difference and unavailability of sufficient seats, around 25,000 Indian students head out every year to study medicine overseas — approximately 60 per cent of the total go to China, Russia, and Ukraine. These foreign destinations are popular despite the need to learn the local languages and subsequently pass a strict screening test in India to get the licence to practise here.
 

In this backdrop to make India a hub for quality medical education, the government must play a proactive role in both increasing the number of seats for MBBS as well as helping private institutions bring down the cost. Some foreign colleges offering medical studies at a fraction of the cost in India get state subsidies. The Centre must engage in serious deliberations with states as well as industry to work on steps to reduce the price of courses offered by private institutions in India. Land acquisition for medical colleges should be made simpler. More than anything else, the authorities must review the mandatory requirements for medical colleges to run hospitals with a specified number of beds linked to the number of seats offered. A lighter regulatory burden, other than emphasis on quality education, may encourage more private players of repute and credibility into the stream. But, the quality of medical education should be the guiding principle while increasing the number of seats and working on cost advantage whether through state subsidies or any other means. According to a working paper published in the National Medical Journal of India, only 18 to 20 per cent of medical graduates who studied abroad could clear the Foreign Medical Graduate Examination in India. This exam is a must to be able to practise in India after obtaining a medical degree overseas.

Any effort by India to involve private players in a big way must ensure that future doctors are of international quality with Indian medical degrees. In sync with medical studies, the government’s budgetary spend on overall education too must go up significantly.