A very surprising fallout of the ongoing Russia-Ukraine conflict is the public exposure of inadequacies in India’s medical education and the disproportionate demand for medical seats, and the thousands of students pursuing medical studies in Ukraine and Russia, apart from other countries. Medical education is highly sought after in India by excessively money-minded parents for their children, in the fond hope of making a killing in the matrimonial market, as also migrating to Western countries. To cater to this uniquely strange greed of Indian parents, many corrupt politicians and avaricious entrepreneurs have set up medical colleges and nurtured a prohibitively expensive ‘cash-capitation-fee’ extorting medical education, which was unaffordable for the common man.
In this buy your seat program, merit went for a toss, and the rich gobbled up all the seats and medical education earned the sobriquet of being an ‘elitist degree’. The few government medical colleges could cater to only a limited number of aspirants, and reservation restrictions made it impossible for many to get admissions. The policy makers, bureaucrats and medical education entrepreneurs conspired to ensure a continuous acute shortage of medical seats, to ensure that medical education remained a cash generating source for them.
Even advance bookings were in vouge to cater to the demand from wealthy families and the huge expatriate population residing in the Gulf countries. Predictably, this system perpetrated tax evasion on a mind-boggling scale, hawala and money laundering operations, and other social evils like drug consumption. The meritorious and economically weaker sections were left in the lurch and had to divert to other disciplines, as also hunting for fresh pastures to pursue their dreams of a medical education.
Enterprising educational agencies stepped in and discovered that in countries like China, Ukraine, Russia, Armenia, Georgia, and Poland, medical education was not much sought after, plenty of seats were available, low fees and cost of living, and no reservations of any kind were added attractions. In a very short span of time foreign medical education business picked up at a rapid pace.
The market today is flooded with agencies offering medical seats with zero capitation fees and a very reasonable fee structure. Hence the meritorious and the economically weaker segments are flocking in hordes for a foreign MBBS degree. A booming industry is in place catering to the air-travel, boarding and lodging facilities of these students in all these countries. This cosy arrangement was functioning smoothly till the recent and ongoing Russia-Ukraine conflict, disrupted everything.
The government and the public were shocked to learn about the staggering number of students studying medicine in just Ukraine. There are an estimated 45 Medical colleges and Universities in the small country of Ukraine. Indians constitute the largest segment of foreigners studying medicine and are estimated to be around 20,000 in number. The popular medical institutions for Indians are National Medical University O.O. Bogomolets, Sumy State University, Kiev Medical University of UAFM, and Kharkiv National Medical University.
The total cost of studying the entire MBBS course in Ukraine for 6 years is just about 16.25 lakh India Rupees, which is miniscule to what is extorted in India by Deemed-to-be-Universities. Average fees for a single year in Deemed-to-be-universities in India is about 16 Lakh Indian Rupees, excluding boarding and lodging charges. Thus, the financial burden for acquiring a medical degree in India will exceed more than a crore of Indian rupees, clearly unaffordable for the vast majority of students.
This is why Ukraine happens to be a popular medical education destination. This degree is also recognized throughout Europe for medical practice subject to passing the licencing examination of each country and their language proficiency requirements.
Ukrainian medical degree is valid in India but students have to successfully complete a Screening Test for Foreign Medical Graduates conducted by the National Board of Examinations. But, currently on the anvil is the proposed National Exit Test (NEXT), which will be a common final year undergraduate medical examination, for granting licence to practice as medical practitioners and for enrolment in the State Register and National Register.
The National Exit Test (NEXT) will become the single test for obtaining licence to practice medicine as a medical practitioner in India for both foreign and Indian medical degree holders. It will replace the current “Screening Test for Indian nationals with Foreign Medical Graduate Qualifications” which is in force since May 2002.
The acute shortage of MBBS graduates in India is estimated at around 600,000 and 2 million nurses, according to the Center for Disease, Dynamics, Economics & Policy (CDDEP), USA. This is a herculean task to resolve in the near foreseeable future. Only eleven among India’s 28 states meet the WHO recommendation, of doctor to patients ratio.
The present Russia-Ukraine conflict can be utilised to resolve to some extent the acute shortage of doctors in India. Though students who have studied medicine in Ukraine and other foreign countries can practice in India, it is subject to their passing the Foreign Medical Graduates Examination (FMGE). Herein lies the problem as the pass percentage is just 10 to 20%, giving rise to the suspicion that the standard of education may not be up to the mark. As a one time measure the government can consider putting these students through a crash course to update their knowledge and skills, and thereafter utilise them to ease the existing shortage.
Such a step will also pressurise the extorting Deemed-to-be-universities to scale down their fees. If Ukraine and a whole lot of other countries can fix a fee tariff of Rupees sixteen lakhs for a five-year MBBS course, why should our medical colleges charge the same amount for just one year? Apparently, there is some grave abnormality in the fee-fixation. The government needs to step in and scale down the fees and bring it on par with what is levied by other countries. This will be a major relief for thousands of students and their parents, as well as for Banks which are disbursing educational loans.
The ongoing Russia-Ukraine conflict can be intelligently utilised by the government to bring in much needed reforms in medical education. Though NEET Entrance Examination is in place, there are many disturbing reports coming in the public domain of various kinds of malpractices being indulged in by unscrupulous managements of Deemed-to-be-universities. If the function of seat allotments is taken over by the government it will curb many evils. Once the National Exit Test (NEXT) is implemented medical education can be standardized across the country. Meantime the government needs to work out a rehabilitation package for the displaced medical students of Ukraine. Let them get a fair chance and opportunity to supplement the nation’s inadequate medical workforce.
(The author is former Director General of National Academy of Customs, Indirect Taxes & Narcotics.)