TO BE A DOCTOR

Predicament of Indian medical students in Ukraine highlights gaps and absences in education system at home

IN FEBRUARY 2022, 18,000 Indian medical students studying in Ukraine were forced to return home after the country’s conflict with Russia escalated into a war. As a onetime exception, India’s medical education regulator, the National Medical Commission, allowed 4,000 of these students, who were in their final semesters, to complete their internship at home. With tensions between Russia and Ukraine showing little sign of abating, countries in Central Asia, Eastern and Southeastern Europe have become the preferred destination for a large number of the repatriated students. According to a report in this newspaper, 70 per cent of these MBBS aspirants are now pursuing their dreams in colleges in Serbia, Kyrgyzstan, Uzbekistan and Georgia. These countries are also attracting new batches of Indian students. These developments also point to the deficits in the Indian medical education system.

In July last year, Union Health Minister Mansukh Mandaviya told Lok Sabha that India added more than 220 medical colleges in the last five years. The number of medical seats grew more than 60 per cent to 1,07,950. However, medical college seats are still far less than the number of aspirants who leave school with the dream of becoming a doctor. Last year, for instance, more than two million students took the NEET examination for entrance to MBBS courses. In other words, the ratio of medical college seats to aspirants is about 20:1. The need to offer more opportunities to students who seek a medical career cannot be more pressing. A 2019 study by researchers commissioned by the National Institute of Educational Planning revealed that a large section of students who migrate for medical education come from aspirational middle and lower middle classes, including those from rural areas. NEET figures attest to the increase in the aspirational quotient of the medical profession — the number of students taking the test has increased almost three times in the past 10 years. But the examination remains extremely brutal — only the top 0.25 per cent make it to the elite colleges. Government institutions are more affordable than those run by private bodies, but they account for only about half of the seats on offer.

Experts have suggested a variety of ways out of the problem. In 2020, the Niti Aayog proposed linking private colleges to district hospitals to serve underserved areas. Another school of thought advocates enhancing the skills of paramedics and nurses to cater to nonspecialist demands of the medical sector. In other words, tweaks in medical pedagogy could significantly increase the numbers of the professionals, equivalents of the general practitioners today. Several European countries have deployed this strategy with great success. Moreover, MBBS graduates from foreign institutes have to undergo another rigorous test to practice in India. In several parts of Europe, in contrast, the transfer of credits ensures a relatively easier transition to hospital internship for migrants. In recent years, the government has initiated conversations to reform the educational landscape. It should conduct similar exercises to address the absences and shortfalls in medical education.