Teaching qualifications

India reviews medical school costs amid Ukrainian exodus

[NEW DELHI] A move by India to make medical education more affordable comes as thousands of Indian medical students trapped in war-torn Ukraine are evacuated facing an uncertain future.

Of the 20,000 students who have fled the Eastern European country since Russia began its military invasion on February 24, 18,000 were studying medicine. Most have crossed the border to neighboring countries like Poland and Hungary to board special flights home.

Their plight has highlighted the large number of young Indians enrolling in medical schools in Russia, the former Soviet republics and China to make up for a severe shortage of places in the heavily subsidized public sector and the high costs of medical education. private medical education in India.

The government ordered last month that half of the 43,815 that medical places available at private sector colleges be opened at costs comparable to those charged by public medical schools beginning with the academic year beginning May 16.

A note issued by the National Medical Commission, the regulatory body for medical education and the profession, says private medical institutions must adhere to the “not-for-profit” principle. It states that while the operating expenses of a medical school can be recovered from the fees charged to students, “no excessive expense and no element of exorbitant profit should be allowed to be added to the fees”.

Prime Minister Narendra Modi’s office said in a tweet on March 7 that his government had decided that “half of the seats in private medical schools will be charged the same as public medical schools.” The decision, according to the tweet, “would benefit poor and middle-class children.”

However, the move is seen as far from sufficient to meet India’s demand for medical training or the demands of public health services in the country of 1.4 billion people.

Mira Shiva, founding member of the People’s health movementrecount SciDev.Net that it is just a band-aid applied to serious problems in medical education.

“To begin with, the government should increase rather than gradually reduce budget spending on health and education and change a policy that leaves these critical social sectors at the mercy of private enterprise”

Mira Shiva, People’s Health Movement

“To begin with, the government should increase rather than gradually reduce budget spending on health and education and change a policy that leaves these critical social sectors at the mercy of private enterprise,” she said. .

The Indian Current health expenditure as a percentage of GDP is 3.01 according to the World Bank and shows a downward trend. Similarly, current expenditure on education as a percentage of GDP is 3.5. These two figures are considered largely insufficient.

Shiva said it would have been more meaningful for the government to consider subsidizing medical education in both the public and private sectors while making information about the medical education sector readily available to the public.

In 2021, 1.6 million candidates registered for the National Eligibility and Entrance Test to compete for 88,370 Bachelor of Medicine, Bachelor of Surgery (MBBS) places, of which about half are in medical schools heavily subsidized and run by the state, while the other half are in private institutions.

Those who make it to state colleges receive heavy subsidies. For example, the annual membership fee in two of the best medical colleges in Delhi, the Lady Hardinge Medical College and the Maulana Azad Medical College, is less than 30 USD. But those who manage to secure a place in one of the 218 private medical schools have to pay fees that are usually two or three times more expensive than what a student might have to pay in a country like Ukraine.

According to Shiva, apart from high costs, the quality of education in most private medical schools is lacking due to the low salary offered to teaching staff. “Professors have been known to resort to private clinical practice to supplement their income and this carries over to the general academic atmosphere,” she said.

Reghunath Kumaran, an Indian psychiatrist currently working in Canada, says it is unfair to put all private medical schools on the same footing. “Maybe I lacked the intelligence to attend a government medical school, but I have consistently outperformed those in public institutions in various examinations since qualifying. I think the selection process is faulty,” did he declare.

Suma Balanprofessor at the Amrita Institute of Medical Sciences, Kochi, said, “It would be more correct to say that there are some private colleges that are better than many public colleges while others are not. Of course, the cost-benefit ratio cannot be compared, but that is only because public colleges are subsidized by the government.

According to Balan, competition for medical school places is tough because a career in medicine is highly glorified in school, at home, and in society, regardless of ability. “India’s MBBS selection system does not consider actual aptitude, the only criteria being the ability to do well on a multiple-choice exam and, in the case of private institutions, the ability to pay the fees,” he said. she added.

“Many politicians have strong interests in creating large numbers of private medical schools – one reason fees have gotten out of control, with some colleges charging the equivalent of US$30,000 in annual fees.” It’s more than the cost of the set six-year medical course in Ukraine.

However, many Indian medical graduates from Ukraine or other countries must pass a rigorous qualifying exam in order to obtain a license to practice. About 80% of them fail on the first attempt, while many never pass subsequent attempts and are forced to settle for related careers like hospital management.

Others go abroad to acquire postgraduate or higher degrees. Often, they move to countries where the demand for qualified doctors is high, just to be able to support their families and be assured of a decent career advancement.

India tops a list of foreign-born (94,862) and foreign-trained (70,539) doctors working in OECD countries, according to to a 2017/2018 survey.

This piece was produced by the Asia and Pacific office of SciDev.Net.