After four years of his MBBS education, Aditya Vashist, a 24-year-old student of the Kharkiv National Medical University in Ukraine is staring at an uncertain future, with the fear of losing a year of education or having to discontinue the course altogether. “I don’t know what we will do if the classes don’t resume. The city is being demolished, lecturers have fled the country to take refuge in neighbouring states and all the students are waiting to get some clarity on when and how the university will resume classes," says Vashist. While a usual day for Vashist a month ago was about attending classes and preparing for exams, is now just a constant wait for communication from the university. “I can’t do anything since classes aren’t being conducted, I can’t proceed with the course, we aren’t supposed to intern at this stage of my degree, it’s just a constant wait for clarity," he says. Russian troops invaded Ukraine on February 24 and since then the country has been in shambles with continuous bombings and destruction. Around 18,000 to 20,000 Indian students are enrolled in 33 medical universities in Ukraine. After the invasion, the Indian government organised special flights to evacuate the students from the disturbed state.
“It’s very difficult to attend classes right now, teachers are concerned about the uncertainty of operations of the university. Just today, while attending an online class we could hear sirens from our lecturer"s end, she ran to her basement to hide and the class got postponed," says Mohit Makekar, a second-year MBBS student of Danylo Halytsky Lviv National Medical University, Lviv whose classes resumed on March 14. While online classes have commenced for a handful of universities, students are worried about how long would they be able to manage online education. “The pandemic already made us miss out on practical, in-person classes, and now this war is adding to that. We can’t learn a nuanced course like MBBS online, we’re missing out of so much practical knowledge," says Tanya Bajpai, a fifth-year MBBS student at the National Pirogov memorial medical university in Vinnytsya, Ukraine.
The National Medical Council (NMC), the governing body of medical education in India, doesn’t permit online education for foreign medical graduates to attain a licence to practice in India. It’s a problem that Indian medical students locked out of China also faced when their universities switched to online teaching due to Covid-19.
The NMC also mandates Indian students abroad to complete the entire course, training, and internship, or clerkship, in the same foreign medical institution throughout the course of study. This makes the transfer to other universities outside Ukraine—a proposed alternative for Indian students under the current circumstances—impossible at the moment. “During the pandemic, most medical colleges in Ukraine switched to online delivery of courses, which is not recognised by the NMC. This, along with current policy guidelines around NEET (National Eligibility Cum Entrance Test) & NEXT (National Exit Test) criteria, credit transfer, and internships have increased the hurdles for a continued medical programme for students. Also, the current regulations do not permit credit transfer for Indian nationals who are pursuing MBBS outside the country," says Niranjan Jayakumar, chief international business officer and senior vice president at Manipal Global Education Services. “Ukraine follows the American Medical System whereas Indian medical colleges follow the British Medical System, which means several bridge courses will have to be brought in to consider transfers for students in India," he adds.
“Usually there is no consideration for waiver of education loans in a situation that is as disruptive as a war the same applies to a global pandemic," says Prateek Bhargava, founder and CEO, Mindler, a career guidance platform. “The obligation to repay the loan remains as is, and the principal amount sanctioned has to be returned. Some banks might oblige the borrowers by giving an extension but even in that case they would benefit by the higher returns," he says, adding that the only ray of hope is for the students to approach the lenders to work out a feasible solution.
While uncertainty looms large on the future of Indian students in Ukraine, what is adding to their woes is the lack of communication from Indian authorities on the next steps. “Ministers are promising us they’ll help in increasing the seats at the Indian medical universities to accommodate us as a one-time measure, but there is no communication from the NMC," says Bajpai. “Getting in an Indian university is one of the hardest things a medical student has to do in the course of their education it would seem unfair for the current students to let us join them in the middle of the course," she says. “Even if the NMC allows for transfer to universities outside Ukraine, the procedure would be very complicated. There would be differences in the cost structure, the course pattern, and it would be very difficult for us to cope with a completely new approach to learning. Ukraine is part of the European Credit Transfer System but a move to institutions outside the country is not easy. There will be many monetary and regulatory hurdles," explains Tobin Koshy, a fourth-year student at the Odessa National Medical University. Dr P Ravi Pachamuthu, chairman of SRM Groups and the chancellor of SRM University Delhi, worries this uncertainty might make the students lose confidence in medical education. “The situation right now will complicate these students’ future aspirations as a sudden break could stifle their ambitions of becoming a doctor. While also making them directionless in their career, since they are unclear with the current educational impasse are without any expert-based advice, mentoring and teaching to become qualified for medical service," he says.
NMC"s regulations for foreign medicine graduates provide a 10-year window for students to obtain their degrees, complete their internships (one year in Ukraine and India respectively), and apply for Foreign Medicine Graduates Examination to receive their licences. A medical student in Ukraine completes her studies in six years followed by two years of internship—one in Ukraine and another one year in India—making it a total of eight. “If we lose time to complete the course due to this war, our ability to become a licenced practitioner would take a hit," says Bajpai. “Students have only two years in which they have to qualify the Foreign Medical Graduate Examination (FMGE), following which they are licenced to practice in India. The NMC should consider revising the 10-year window period regulation," says Dr Rimy Dey, committee head, post graduate Studies, IMA-JDN (Indian Medical Association—Junior Doctors Network). “Sadly, the pandemic has already brought a standstill to the career of thousands of Indian medical students who were pursuing their medical courses in China and have been educationally languishing because they are unable to go back to their medical colleges. The Ukraine situation only adds to the argument as to why this revision of this stringent regulation is much needed," she adds.
There is a massive supply-demand gap in medical education in India. The dearth of available seats, especially for the general category, affordability concerns, and the complicated admission process make students opt for education abroad. This comes in the light of the fact that India has one government doctor for every 10,189 people, while the WHO recommends a ratio of 1:1,000. The country has a deficit of 600,000 doctors, and the nurse-patient ratio is 1:483, according to the Center for Disease Dynamics, Economics & Policy (CDDEP) report.
First Published: Mar 16, 2022, 11:12
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