The Centre has told the Supreme Court that the law does not allow undergraduate medical students, who fled the “war-like situation” in Ukraine, to be accommodated in Indian medical colleges.

Which laws is the govt talking about?

• There are no provisions either under the Indian Medical Council Act, 1956, or the National Medical Commission Act, 2019 to accommodate or transfer medical students.
• Till now, no permission has been given by the National Medical Commission to transfer or accommodate any foreign medical students in any Indian medical institute/university.

Why foreign undergraduates are not permitted?

• Absence of law: The extant regulations in India do not permit migration of students from foreign universities to India.
• No backdoor entry: The public notice cannot be used as a back door entry into Indian colleges offering undergraduate courses.
• Merit issue: The students had left for foreign universities for two reasons, poor marks in the National Eligibility cum Entrance Test (NEET) and affordability of medical education in foreign countries.
• High cost: Besides, these students, if admitted in Indian colleges, would again face the problem of affordability.

Why do Indians go abroad for medical studies?

• According to estimates from Ukraine, reported in the media, around 18,000 Indian students are in Ukraine (before Operation Ganga).
• Most of them are pursuing medicine.
• This war has turned the spotlight on something that has been the trend for about three decades now.

Preferred countries for a medical degree

• For about three decades now, Indian students have been heading out to Russia, China, Ukraine, Kyrgyzstan, Kazakhstan, and Philippines to pursue a medical degree.

Hype of becoming a Doctor

• Prestige: The desire to study medicine still holds a lot of value in the Indian community (the other is becoming an IAS officer).
• Shortages of Doctor: In many rural areas, people still look at doctors as god’s incarnate.
• Rarity of opportunity: The lack of equal opportunities exacerbated by the caste factor in the Indian context, has a great deal of impact on the prestige still associated with being a doctor.
• Social upliftment ladder: For years, certain communities were denied the opportunities, and finally they do have a chance at achieving significant educational status.

Why do Indians prefer going abroad?

• No language barrier: The medium of education for these students is English, a language they are comfortable with.
• Affordability: The amount spent on living and the medical degree are far more affordable than paying for an MBBS seat in private medical colleges in India.
• Aesthetics and foreign culture: People are willing to leave their home to study far away in much colder places and with completely alien cultures and food habits.
• Practice and OPD exposure: It broadens students’ mind and thinking, expose them to a whole range of experiences, and their approach to issues and crises is likely to be far better.

Doesn’t India have enough colleges?

(a) More aspirants than seats

• There are certainly far more MBBS aspirants than there are MBBS seats in India.
• In NEET 2021, as per a National Testing Agency press release, 16.1 lakh students registered for the exam, 15.4 lakh students appeared for the test, and 8.7 lakh students qualified.
• As per data from the National Medical Commission (NMC), in 2021-22, there were 596 medical colleges in the country with a total of 88,120 MBBS seats.
• While the skew is in favour of Government colleges, it is not greatly so, with the number of private medical institutions nearly neck-to-neck with the state-run ones.

(b) Fees structure

• That means over 50% of the total seats are available at affordable fees in Government colleges.
• Add the 50% seats in the private sector that the NMC has mandated must charge only the government college fees.
• In fully private colleges, the full course fees range from several lakhs to crores.

(c) Uneven distribution of colleges

• These colleges are also not distributed evenly across the country, with States such as Maharashtra, Karnataka, Tamil Nadu and Kerala having many more colleges.

What about costs?

• The cost factor on both sides of an MBBS degree is significant.
• The costs of an MBBS degree in a Government college tot up to a few lakhs of rupees for the full course, but in a private medical college, it can go up to ₹1 crore for the five-year course.
• In case it is a management seat, capitation fees can inflate the cost by several lakhs again.
• Whereas, an MBBS course at any foreign medical university in the east and Eastern Europe costs far less (upto ₹30lakh-₹40 lakh).

Way forward

• While PM Modi emphasised that more private medical colleges must be set up in the country to aid more people to take up MBBS, medical education experts have called for pause on the aspect.
• If the aim is to make medicine more accessible to students of the country, the path ahead is not in the private sector, but in the public sector, with the Central and State governments’ involvement.
• Starting private medical colleges by reducing the strict standards set for establishing institutes may not actually be the solution to this problem, if we think this is a concern.

Conclusion

• Creating more medical colleges will be beneficial for the country, if access and availability can be ensured.
• This will not be possible by resorting to private enterprise only.
• The State and Central governments can start more medical colleges, as recommended by NITI Aayog, by utilising district headquarters hospitals, and expanding the infrastructure.
• This way, students from the lower and middle socio-economic rung, who are otherwise not able to access medical seats, will also benefit.

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