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Will Ukraine be the tipping point in India’s medical education system?

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Will the Ukraine crisis result in a long overdue deep revamp of India’s medical education system? 

The unfolding Ukraine crisis has exposed, once again, the many dark ironies of India’s medical education system. With most Indian families unable to afford an MBBS degree in India, thousands of aspiring medicos are forced to travel overseas to countries where governments still subsidise medical education.

Just as the COVID-19 pandemic forced us to introspect and rejuvenate our health and healthcare systems, will the Ukraine crisis result in a long overdue deep revamp of India’s medical education system? Can digital solutions play some part? Can public-private partnerships step in to fill the gaps more vigorously?

The difference in the cost of medical education is steep: a six year course in Ukraine costs Rs 15-20 lakhs, whereas its Rs 50 lakh-Rs 1.5 crore in one of India’s private medical colleges for a 4 and a half year course. Government medical colleges in India are the most affordable, but there is a huge demand-supply gap. Of the estimated 18000 Indian students in Ukraine, the majority are expected to be medical students.

If the Indian government ramped up seats in government medical colleges and offered more affordable medical education here, we could prevent this brain drain. While it is true that an increasing number of such students are coming back to India to take the Foreign Medical Graduates Examination (FMGE), which they must pass to practice in India, they face a disconnect in what they have been taught and what is required. Experts point to the low pass percentage, blaming it on learning in a foreign language, and also on differently oriented health care systems.

Perhaps acknowledging that the government sector is not as agile as it needs to be and may not have an immediate solution, Prime Minister Modi himself appealed for more private sector involvement in this field. Significantly, he also nudged state governments to frame “good policies for land allotment regarding this so that more doctors and paramedics are produced here.” He was speaking in a recent webinar discussing allocations in the union budget for the health sector, indicating that the private sector could be assured of good returns

While it is true that this is the ideal solution, will the private sector step in? The shortage of medical staff in India predates COVID-19, and it is well-known that the brain drain has increased. There are many doctors who give back to their motherland, returning to India and setting up world-class hospital chains, like the Apollo Hospitals Group, to name just one of them, building on their experience and expertise. But, there are still too few to make enough of a difference.

Even as civilians flee Ukraine and medical students line up to return, doctors, nurses and paramedical staff from a dozen nations, including India, have reportedly registered to help out in this humanitarian crisis. Global agencies are stepping in, setting up emergency care teams at borders. While MSF was forced to stop its activities within Ukraine, they have used deployed telemedicine to train 30 surgeons from eastern Ukraine for trauma care. As we hope for a speedy and humane solution to the Ukraine crisis, may be this situation will result in solutions to this long pending problem.

While Ukraine is running short of key medical supplies, many companies would like to send in supplies but have no way to transport them. Associations like the World Medical Association (WMA) are stepping in to amplify efforts of organisation like the Polish charity Doctors for Doctors.

Every crisis is an opportunity to change. Let us hope that we reach that tipping point in India’s medical education sector soon. Otherwise, we’ll be left facing the health battle without an army.

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