Why are Indian students leaving the country to become doctors ?
(Is the quality of education better or something else?)

Dr. Satyawan Saurabh *

Due to the stiff competition for the few seats available in domestic medical institutions and the fact that some countries offer very low tuition fees, Indian students often choose to pursue medical education abroad. This allows them to receive high-quality medical education at a more affordable cost. Other attractive factors include exposure to various international medical practices, high tuition fees in private colleges, exposure to international medical practices, and high-quality education in some countries. Therefore, the main aim of these students is to pursue medical education and return to India. (Even though some may want to settle abroad, this trend may not be very different from those pursuing medical training in India). Therefore, their ability to pass foreign medical graduation exams is the main concern. Will the government abolish it and replace it with a single exam for all students, whether the degree is from India or abroad? The main issue is whether India has enough qualified medical professionals or if it is aimed at preventing people from pursuing medical education abroad.

There has been a rise in the number of medical students leaving India to study abroad, with over 30,000 students going abroad every year. According to data from the National Medical Commission, only 16 percent of foreign medical graduates pass the Foreign Medical Graduate Examination screening test.

Due to NEET competition, high tuition, and a lack of domestic seats, India's healthcare system is plagued, leading to an increasing reliance on foreign education. With low tuition costs, streamlined admission processes, and recognized degrees, many countries are preferred destinations for travel.

Due to these factors, an increasing number of students are bridging the gap by pursuing medical education outside India, guaranteeing that they can still fulfill their aspirations of becoming a doctor. Indian students prefer international medical courses due to the easy application and admission process. Students can study English or a foreign language. Tuition costs around Rs 200,000 to Rs 300,000 every year.

No capitation fee is required. Many international universities have received recognition from the World Health Organization and the Medical Council of India. Students are exposed to a multicultural setting that broadens their life experiences and knowledge.

With good educational quality, their degrees are recognized across international borders. Indian medical students are increasingly leaving the country due to intense competition for domestic seats. Students in India seek options abroad due to fierce competition, often in countries where medical regulations are lax.

Since India has only one medical seat for every 22 applicants, more than 20,000 students are forced to study abroad each year in countries such as China, Russia, and Ukraine. But the uneven quality of curriculum at many international medical schools affects students' employability and agility.

Foreign graduates' access to India's healthcare system is delayed because they must pass the Foreign Medical Graduate Examination and complete an internship. Of the 32,000 Indian students who took the Foreign Medical Graduate Examination last year, only 4,000 qualified. For these students and families, high tuition costs, unstable economies, and security threats in some countries are burdensome.

The conflict between Russia and Ukraine led to the displacement of more than 24,000 Indian medical students, resulting in financial losses and an uncertain academic future. India's shortage of doctors is getting worse as more foreign-trained medical professionals choose to practice abroad because of better opportunities there.

The first change is to expand the number of medical seats to meet the domestic demand for medical education. 10,000 more medical seats will be added in 2025; India has a five-year target of 75,000 additional seats.

Affordable medical colleges must be established to increase access to education in underprivileged areas. Access to medical education has increased by opening new government medical colleges and expanding AIIMS in tier-2 and tier-3 cities.

Private investment must be encouraged while maintaining high-quality instruction and reasonable costs. Institutions such as the Caribbean and Manipal College of Medical Sciences (Nepal) demonstrate that Indian institutions can grow domestically under a public-private partnership model. Reducing reliance on NEET is important by implementing more open admission processes and multiple entry routes.

Bridge courses and alternative admission systems have been suggested by the National Medical Commission in an attempt to broaden selection criteria. International campuses must be promoted by Indian universities to serve Indian students. The international expansion of the IITs and the Manipal Group suggests a model in which Indian medical schools operate internationally under Indian regulations.

To strengthen medical education and internships, we must implement reforms that guarantee the provision of high-quality healthcare. Bringing Indian medical education at par with international standards and mandatory internships in rural areas is needed. To emphasize patient care and practical skills, the Competency-Based Medical Education (CBME) curriculum was implemented in 2019.

Investing in state-of-the-art laboratories, clinical experience, and medical faculty training is a must. Modern simulation labs and e-learning platforms for medical colleges are needed through AIIMS and NMC reforms. Regular assessment of government and private medical schools is necessary to guarantee uniformity.

The National Exit Test (NEXT), administered by the NMC, seeks to standardize licensing exams for medical graduates from both India and abroad. Providing better working conditions, incentives, and higher salaries in both urban and rural areas is essential. The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) seeks to establish AIIMS-like institutions in underprivileged areas.

Using technology to increase access to training and healthcare is imperative. Healthcare delivery in remote areas has improved thanks to the e-Sanjeevani telemedicine initiative, which has enabled over 14 crore consultations. A three-pronged strategy to increase medical seats, regulate private college tuition, and strengthen FMG integration is essential.

The NMC's 2023 reforms regarding faculty standards and medical seat distribution are positive steps. Also, encouraging rural service and creating public-private partnerships can improve quality and access while guaranteeing India's independence. I have nothing bad to say about this migration to get medical education from India. In India, medical education is extremely expensive.

The barriers to entry are irrational. I feel that many more students are capable of becoming doctors. India desperately needs more doctors, especially those willing to work in the rural areas of the country. Medical education in Central Asia is not bad, given the achievements of these countries in healthcare.

Colleges there will function more effectively and sustainably if they use Indian student enrollment to increase capacity utilization and generate additional income. If this helps a group of Indian students become doctors, it is a win-win situation for both parties. There is also the possibility of failure. Some people may not be able to meet the requirements to work in India.

Some sub-agents or private contractors may withhold some relevant information in an attempt to attract more students. Then there may be emergency situations, such as the COVID-19 pandemic in China or the war in Ukraine. These may result in a group of students suffering significant losses. The Indian government's policy is not very good at helping students even in emergency situations.

The only action the Indian government has taken with regard to medical education abroad is to make the qualifying examination for practicing in India more stringent. The question of how tough such an examination should be is controversial. The main issue is whether there are enough qualified medical professionals in India or whether it is aimed at preventing people from pursuing medical education abroad.