Indian students in Ukraine: Questions over India’s medical education

The medical universities in Ukraine charge a low fee of Rs 20 lakh- Rs 25 lakh for MBBS course as against Rs one crore charged by private medical colleges in India, according to Prajjal Tiwari, a student from Madhya Pradesh who is currently studying medicine in Ternopil National Medical University in Ukraine.

Low MBBS fees attract Indian students to Ukraine. According to a website, ‘Study In Ukraine', a large number of students come to Ukraine because it is cheaper to pursue medical education there. It also said that the degrees earned in Ukraine are recognized across the world, including by World health Organization (WHO), European Council and other global bodies.

Other popular foreign destinations for Indian students to study medicine are China, Philippines and Bangladesh.

Speaking after inaugurating the webinar on Union Budget announcements on the health sector, Prime Minister Narendra Modi said on February 26 that Indian students have been going to “small countries for study, especially in medical education”, while making no direct mention of the situation of Indian students in Ukraine.

“Our children today are going to small countries for study, especially in medical education. Language is a problem there. They are still going…Can our private sector not enter this field in a big way? Can our state governments not frame good policies for land allotment regarding this,” he asked.

The doctor patient ratio of 1:1655 in India as against WHO norm of 1:1000 clearly shows the deficit of MBBS seats. While the government is working towards reaching the required ratio, there is a need to have a relook at the overall medical education in India.

The 562 medical colleges in the country haven’t been able to reach the optimal standards of education.

Students from India are heading for foreign universities to study medicine basically due to lack of adequate seats in medical colleges in India and high fees.

India has 84,000-odd MBBS seats, whereas 1.61 million students registered for NEET in 2021 for these seats. Many qualified Indian doctors and nurses also leave abroad to serve, due to higher salaries. Over 10% of doctors in the US are of Indian origin and more than 20,000 Indian doctors are currently practising in the National Health Service (NHS), UK.

With increasing global demand for qualified doctors graduating from India, scarcity of medical doctors is now a major problem in the country, making it imperative to focus on medical education.

Between 2014 and 2020, the number of medical colleges increased from 381 to 562; MBBS seats increased by around 56%, from 54,348 to 84,649; postgraduate seats increased by 80%, from 30,191 to 55,595.

Despite the increase in the capacity of under-graduate medical education, India’s healthcare system fails to provide adequate medical services to large parts of the country’s growing population, especially in rural regions.

According to the World Health Organization, the country has only 7.8 registered medical doctors per 10,000 people, compared with 18 doctors per 10,000 people in China, 21 in Colombia, and 32 in France.

What’s more, not all registered doctors in India are actively practicing, and many are poorly trained. Consider that the majority of allopathic (science-based) practitioners in the country - 57 percent - lack a formal medical education.

Cost of medical education in India is a prime concern. Hence, in early 2020, National Medical Commission (NMC) announced several fee regulations, as private colleges have a higher fee structure making it impossible for financially weak but meritorious students to study further.

The proposed norms will cap tuition fees for 50% MBBS and postgraduate medical seats in private medical colleges and universities. In November 2020, NMC relaxed the minimum standard requirement for land used in building medical colleges. NMC removed the mandate to have 20 acres of land for general areas and 10 acres for metropolitans.

Admissions bottlenecks and the high costs of medical study in India not only provide a breeding ground for corrupt practices in admissions or examinations, they also drive some 10,000 Indians abroad each year to study medicine in countries like China, Russia, Ukraine, and even Bangladesh.

Low fee, eradication of corrupt practices in private medical institutes, capacity building for 50% increase in medical seats every 5 years and better standards of education will not only take care of country's requirements of medical practitioners, but will also turn India into a global provider.

(V. Venkateswara Rao is an alumnus of IIM, Ahmedabad and a retired corporate professional. Views are personal).