What the Plight of Students in Ukraine Reveals about Medical Education in India
The plight of 18,000 Indian medical students trapped in Ukraine’s war zones has led to widespread concerns.
Why go abroad?
- The number of seats available for medical education in India is far less than the number of aspirants. Of the 1.6 million students who appeared in the National Eligibility cum Entrance Test (NEET) in 2021, only 88,120 made it into the 562 medical colleges in the country.
- The low MBBS course fees charged by the medical institutions between ₹30 lakh- Rs35 lakh compared to around ₹1 crore (including donation) charged in India.
- Ukrainian and Russian medical colleges are even recognised by the World Health Organisation (WHO).
- Additionally, unlike in India, there are no medical examinations that are conducted for the medical students to get admissions.
- On return, they need to pass a qualifying examination before they are permitted to intern in the institutions recognised by the Medical Council of India (MCI).
- The passing rates for qualifying exams were disappointingly low due to:
- Training standards varied widely across foreign institutions.
- The language of instruction was not English.
- The curriculum in foreign colleges differed in several respects from that taught in India. A student training in Russia or Ukraine is unlikely to learn much about kala-azar or malaria.
- Foreign medical graduates started taking coaching classes. That spawned another industry.
- Shortage is due to MCI boards imposing rigid conditions to restrict the number of medical colleges, as well as due to limited government investment in the health sector.
- Even if the private sector is provided land at a concessional rate for starting new medical colleges, they will face a faculty crunch and poach from government medical colleges.
- Handing over district hospitals to the private sector, as proposed by some, will exacerbate inequities in healthcare.
- It is essential that we increase the number of medical colleges, especially in states that have a low number of such seats.
- State governments must be supported to invest in the upgradation of district hospitals.
- Specialist posts in many clinical disciplines that are needed for the MBBS programme already exist in the district hospitals. These specialists can be designated as faculty for a new medical college attached to the district hospital.
- Common classrooms can be created by virtually linking several of the medical colleges in a state, to share some of the faculty for classroom teaching.
- A centrally sponsored scheme aims to set up 157 new medical colleges attached to existing district/referral hospitals in areas that do not have any medical college. This will reduce urban-rural disparities in healthcare and also help to scale-up training.
What about the young students returning from Ukraine?
- It is unlikely that they will be able to resume their education there and present regulations do not permit them to continue their education in Indian medical colleges.
- Even if the NMC permits it as a special case, other students who qualified the NEET but did not make the cut for medical admission, and stayed back in India, might protest.
- The government could perhaps support these students by enrolling them in a BSc (Public Health) programme that can be run by schools of public health and medical colleges. They can graduate in three years to commence careers in public health, where their earlier medical education can add value.
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