Context

• Medical education is undergoing significant transformations worldwide. While there is a growing shortage of doctors, barriers to accessing medical education persist.
• As a result, an increasing number of students are seeking medical training abroad, leading to an internationalisation of medical education.
• However, this trend raises concerns about the quality and regulation of foreign medical programs.
• Therefore, now it is imperative to explore the global mobility of medical students, the specific challenges faced by Indian students, and the broader implications for medical education worldwide.

The Paradox of Medical Education

• On the one hand, many countries face an acute shortage of doctors, yet access to medical education remains restricted.
• Governments and professional bodies often limit the number of medical seats available, making it difficult for aspiring doctors to secure training in their home countries.
• Consequently, many students seek medical education abroad, contributing to a significant international movement of medical students.
• Despite this mobility, concerns persist regarding the quality of medical training in some host countries.
• Institutions in Ukraine, Russia, Kazakhstan, and the Caribbean have become popular destinations, yet their educational standards vary widely.
• This raises critical questions about the effectiveness of national regulations and the preparedness of graduates returning to practice in their home countries.

A Detailed Analysis of India’s Medical Education Crisis

• The Shortage of Medical Seats and Intense Competition
  • India has a severe shortage of doctors, with the doctor-to-patient ratio falling short of the World Health Organisation’s (WHO) recommended ratio of 1:1000.
  • While the demand for medical professionals is high, the availability of seats in medical colleges remains limited.
  • Each year, around 2.3 million students appear for the National Eligibility cum Entrance Test (NEET), the nationwide entrance exam for medical colleges.
  • However, with just 700+ medical colleges offering seats, only a small fraction of students, roughly one in 22, succeed in securing admission. This intense competition stems from multiple factors:
  • Limited Government Medical Seats
    • Public medical colleges in India offer a relatively small number of seats compared to the vast number of applicants.
    • Government-run institutions are highly sought after due to their lower tuition fees and better infrastructure, making them extremely competitive.
  • High Fees in Private Institutions
    • Private medical colleges, which constitute a significant portion of India’s medical education system, charge exorbitant tuition fees, often ranging between ₹50 lakh to ₹1 crore for an MBBS degree.
    • This makes medical education unaffordable for many middle-class and lower-income students.
  • Reservation Policies: While reservation policies help ensure access for marginalised communities, they also limit the number of open-category seats, making competition even tougher for general applicants.
• Implications: The Rise in Medical Students Studying Abroad
  • Due to these constraints, a growing number of Indian students are opting for medical education abroad.
  • It is estimated that over 20,000 Indian students travel to countries such as Russia, Ukraine (before the war), Kazakhstan, China, the Philippines, Nepal, and Mauritius to pursue medical degrees.
• Reasons why Indian students choose to study medicine abroad:
  • Affordability
    • Many foreign universities offer medical education at a significantly lower cost compared to Indian private medical colleges.
    • For example, medical programs in Russia, Ukraine, and China often cost between ₹20-40 lakh, making them a more viable option.
  • Lower Admission Barriers: Unlike India, where NEET ranks dictate admissions, many foreign universities have relatively relaxed entry requirements, making it easier for students to secure a seat.
  • English-Medium Programs: Many foreign medical schools, especially in Eastern Europe and Central Asia, offer MBBS courses in English, making them accessible to Indian students.

Government Initiatives Regarding the Expansion of Indian Medical Education

• Increase in Medical Seats
  • In the 2025 Union Budget, Finance Minister Nirmala Sitharaman announced that nearly 1.1 lakh medical seats had been added over the past decade, marking a 130% increase.
  • Additionally, the government plans to introduce 10,000 more seats in 2026, with a broader goal of adding 75,000 seats over five years.
• Establishment of New Medical Colleges: The government has focused on setting up new medical colleges, especially in underserved areas, through initiatives like Public-Private Partnerships (PPP).
• Reforms in Medical Licensing: The National Medical Commission (NMC) has introduced new guidelines to regulate foreign medical education and ensure that returning students meet national standards.
• Bringing Indian-Operated Institutions Abroad
  • Some Indian education groups, such as the Manipal Education and Medical Group (MEMG), have established medical colleges abroad, such as the Manipal College of Medical Sciences in Nepal and the American University of Antigua (AUA) in the Caribbean.
  • These institutions provide alternative options for Indian students while maintaining some level of quality control.

International Movement of Medical Students: A Widespread Phenomenon

• The international movement of medical students is not limited to the Global South.
• Western nations such as France, Germany, and Norway also face medical education shortages, prompting students to seek training in neighbouring countries.
• Central and Eastern Europe, including Romania, Hungary, and Poland, have become key destinations for students from Western Europe and even the United States.
• English-medium medical programs in non-English speaking countries cater to international students, often at high tuition rates.
• However, many of these institutions operate with minimal regulatory oversight, raising concerns about the quality of education and medical preparedness.
• The existence of for-profit medical schools catering exclusively to international students further complicates the situation, highlighting the need for greater scrutiny and quality control.

The Way Ahead: Balancing Demand and Quality

• The growing demand for medical education abroad presents both opportunities and challenges.
• On the one hand, international mobility allows students to pursue their aspirations and helps address global shortages of medical professionals.
• On the other hand, the lack of uniform quality standards poses risks to healthcare systems worldwide.
• Governments must strike a balance between increasing medical seats domestically and ensuring the quality of medical graduates.
• This requires significant investment in medical infrastructure, faculty, and accreditation processes.
• Moreover, stricter regulations on foreign medical degrees and licensing exams can help ensure that returning graduates meet national standards.

Conclusion

• The globalisation of medical education is an evolving phenomenon with far-reaching implications.
• While it offers a solution to limited access in many countries, it also raises concerns about educational quality, regulatory oversight, and healthcare workforce stability.
• Countries like India have recognised the problem and are taking steps to expand medical education, but more needs to be done.
• A coordinated global approach, involving stricter regulations and increased investment in medical training, is necessary to ensure that medical education remains both accessible and of high quality.