Editorial

Forced into exile

Updated on: Mar 04, 2022

The plight of medical students in Ukraine once again brings to the fore the demand-supply gap for medical seats in India

These last few days, the nation has been consumed by the plight of Indian students caught in the crossfire in Ukraine and their desperate attempts to save their lives and escape from the war zone. Most of these students are from medical universities in different parts of Ukraine. This is not the first time that we’ve heard of medical students forced to return home from abroad in distress. Two years ago when the pandemic broke, medical students in China rushed back home after their universities were shut and lockdowns imposed in that country. Over 20,000 students are estimated to leave Indian shores each year primarily for China, Russia, Ukraine and the Philippines to study medicine, braving harsh weather and unfamiliar cultural conditions, besides unforeseen contingencies, such as in Ukraine today and in China in 2020. While a minuscule few are perhaps driven by the sheer idea of studying abroad, most are forced to do so because of the yawning gap in India between the demand for medical education and its supply, resulting in sky-high fees.

About 1.6 million students took the National Eligibility-cum-Entrance Test (NEET) in 2021, and 0.87 million of them cleared it. But the number of seats available is at best 0.15 million in about 700 medical colleges, going by the Prime Minister’s recent interaction with Ukraine-returned students. According to the Ministry of Health and Family Welfare, there are just over 90,000 seats in about 550 medical colleges, of which 276 are privately-run. The demand-supply gap remains huge. Little wonder then that the cost of an MBBS education in a private college can shoot up to ₹80 lakh-1 crore, while the NEET entrants who make it to government colleges spend less than ₹3 lakh. Clearly, the number of medical seats has to increase manifold to make medical care affordable to the deserving candidates.

The requirement of seats should also be determined on the basis of the doctor-to-population ratio; at present it is 1:1457, according to the reply to a Rajya Sabha question on July 2, 2019; the WHO norm is 1:1000. Extrapolating from the estimate of 9.26 lakh doctors at that time, about 11 lakh doctors can be estimated to exist today. For the current population we are about three lakh doctors short, and this is a moving target for a rising population. The WHO norm should be seen as the bare minimum in a vast country with challenging health demands. Meanwhile, the nurse-to-population ratio is quite as adverse. These shortages were never more keenly felt than during the height of the pandemic. While the supply-demand gap can take some time to close — despite the efforts to set up a number of AIIMS and other government medical colleges and the private sector players promising to pitch in — other steps can be considered to make medical education affordable. An interest subvention scheme from the government on bank loans to deserving students can be considered. A credible accreditation of colleges (learning from the erstwhile Medical Commission of India’s shenanigans) can help regulate fees. Students and their wards can make more informed choices. The focus should be on reducing the cost of medical education as much as on increasing seats.

Published on March 04, 2022
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