Why Indian medical students are forced to study abroad and how good policies can change the situation

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The plight of thousands of Indian students who were stranded in Ukraine amid the Russian invasion and who are now being brought back thanks to the commendable efforts of the government has again drawn attention to the fundamental weaknesses and problems associated with the education system of the country.

Every year, thousands of students go abroad to study. That’s not the surprising part. What is interesting is the field of study they will study – medicine – and the countries they choose for their higher studies – China, Ukraine, Azerbaijan, even Bangladesh, etc. .

Prime Minister Narendra Modi also raised this point during the inauguration of a webinar yesterday (26 February) on budget announcements for the health sector.

“Today our children go to small countries to study, especially in the field of medical education. Language is a problem there. They are still going there… Can’t our private sector enter this field in a big way? Can’t our state governments make good land allocation policies on this,” he said.

It is commendable that Prime Minister Modi is urging state governments to come up with good policies. Unfortunately, at the Center, he has gone into overdrive on some of the same old policies that have plagued the medical industry. To PM Modi’s credit, undergraduate places and postgraduate places have increased by 72% and 78% respectively since 2014 and will further increase when all the colleges that have been approved and sanctioned start operating. But most of this capacity expansion has occurred for government seats which present their own problems, some of which have been made worse by recent central government measures.

There are layers within layers when it comes to the classification of medical seats in India. At the basic level, there are two main divisions – government seats and private sector seats. Under the government, there are seats exclusively with the central government (where the Center quota policy is followed and 60% of the seats are reserved), seats in All India Quota which is a pool formed after the states ceded 15% of seats in colleges under them (here only SC/ST quota was tracked until Modi government introduced OBC quota last year), then there are 85% of seats with state governments that follow their own quota policies and give admissions to their homes (with Tamil Nadu having the most reserved places).

This means that when new colleges and new seats are added in Tamil Nadu, there is little additional benefit for non-reserved category students compared to when other states increase their capacity. Additionally, the Modi government’s decision to implement OBC reservation in AIQ has also reduced the capacity that would have otherwise been available to students in the non-reserved category in light of the addition of tens of thousands of seats since 2014. . and approach “one step back”. Overall, this is still progress, but it would require a significant expansion of seat capacity over the next few years to compensate for the limitations of the quota system.

This leaves the private sector as a useful avenue that could have acted as a fruitful partner for the government where the latter could focus on providing quality medical education to economically and socially backward people at affordable prices and leave the first deal with those who have missed out on the seats of government. But the private sector is also hampered by two main problems.

The first is the artificial scarcity that has been ensured for decades because it is extremely difficult for genuine eduppreneurs to open medical schools due to stifling regulations – it requires hundreds of millions of upfront investments, approvals of annual licenses, the requirement to create various teaching departments, the creation of an attached hospital with a certain number of beds, more approvals to even add seats/beds in already functioning colleges/hospitals, etc. , to name a few.

When the Modi government threw out the Medical Council of India and replaced it with the National Medical Commission (NMC), it had a historic opportunity to bring about transformational change. Not only has it not done so, but earlier this month it issued comprehensive guidelines to regulate fees for 50% of seats at private medical schools that will be forced to charge fees equal to what government colleges do. The government thinks it is helping to subsidize places for 50% of students studying in private colleges, but has lost sight of the fact that colleges will be forced to dramatically increase fees for the remaining 50% of places and that there may not be many takers for them. Even without these cross-subsidies, students are forced to go to Ukraine, Bangladesh, China and others due to low tuition fees.

The second problem in the private sector space is the dual regulatory structure that governs minority and non-minority colleges, where the former is much more advantaged because the protection afforded under section 30 of the constitution allows minorities to manage their colleges with a great deal of autonomy (and there is a good chance that they will be exempted by the judiciary from the regulation of NMC fees, which will further benefit them). It is not without reason that minority-run colleges dominate medical education and are nearly on par in number with non-minority ones. In addition, the majority of seats in minority colleges are reserved for people of their own religion – For example: approximately 84% of seats in CMC Vellore are reserved for Christians. Prime Minister Modi should have removed this discriminatory legal regime from day one in office. Alas!

Essentially, in India, caste dictates admission to government medical seats and religion/wealth in private medical colleges.

It is not yet too late. Rather than urging state governments to come up with good policies, Prime Minister Modi would be well advised to start with his government. Otherwise, we will continue to see the exodus of students abroad.

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