MBBS returnees and hopefuls bear the burden of Ukraine War, even as Bangladesh emerges as top alternative for medical education

Aditi Tandon

ARUSHI JAIN Jain had been in Ukraine for less than two months when the war with Russia broke out, altering the course of her future. Back in New Delhi now, she is struggling to chart a new course.

“I have again registered for the National Eligibility-cum-Entrance Test (NEET-UG) 2022,” says the 21-year-old, who will on July 17 write the test for the third time in three years.

She is not alone in this race. Nearly one-third of the Indian students among the about 18,000 who returned from Ukraine have applied for NEET-UG 2022 again, hoping to better their ranks and land affordable government medical college seats.

“A large number of students who had just enrolled in Ukraine medical colleges have decided to write NEET-UG again rather than wait for things to change,” says Arushi, who had begun her six-year MBBS course in Ukraine on December 9, 2021.

She returned to India in early March and has since been preparing for medical entrance. Many of Arushi’s friends have, meanwhile, changed streams, diversifying into allied health sectors like rehabilitation, physiotherapy, pharmacy, and even dentistry and paramedical courses.

While students who were only beginning their study in Ukraine can afford to drop a year and try NEET-UG again, those at advanced levels of courses are staring at highly uncertain futures.

In these two months since 22,500 Indians came back from the war-torn country, most of them students, evacuees have formed an association to put pressure on the Health Ministry to act. Nearly 7,000 students submitted a memorandum to the PMO in mid-May urging absorption into local medical colleges as an exceptional measure. Things are no different for the new MBBS hopefuls with limited paying capacity at home.

Unstable atmosphere

“Parents are not keen to send wards to European countries neighbouring Ukraine because of the prevailing chaos. The region is hardly an option for Indian students in the foreseeable future and the load on domestic medical education is bound to rise phenomenally this year,” says Harish Kumar, member, Parents’ Association of Ukraine MBBS Students.

He is right. The number of NEET-UG applicants this year was 18,72,339, an increase of 16 per cent from last year’s 16,14,777. The data means 20 students will compete for one MBBS seat in 2022 — a ratio that was 11 in 2014 and has been rising.

Even agents who have been facilitating Indian students with MBBS studies abroad say parents would refrain from sending their wards to Eastern Europe for studies this year as the unstable atmosphere has created a psychological barrier.

Moreover, education in Poland, Hungary, Romania and other EU nations is much costlier than in Ukraine.

“Education in other European countries is very costly and MBBS seats, unlike in Ukraine, are limited in number. So transferring to colleges there won’t be easy. The new session in Ukraine colleges begins in September. Students are hoping to hear from the government ahead of that deadline. If domestic absorption plans fail, students would be left with no option but to seek transfer to countries like Poland, Hungary, Georgia, etc. But even for that, the government will have to guide. We have yet to hear a plan,” says Karan Sandhu, an agent.

An alternative nearer home

Asked what options new MBBS hopefuls have, Sandhu said a select group of East European nations would still be preferred over Ukraine and Russia, which continue to be deemed unsafe while China is yet to open up after Covid-19.

For a large number of students, Bangladesh is emerging as an alternative. Pass percentage of Bangladesh-returned Indian students writing the Foreign Medical Graduate Exam (the licensure test foreign graduates must clear to practise in India) has been the highest for a while.

In 2020, FMGE pass percentage of Bangladesh returned Indian MBBS degree holders was 35.8 as against 12.93 per cent for China, 16.01 per cent for Ukraine, 15.97 per cent for Russia, 33.7 per cent for the Philippines and 16.48 average of all countries.

“Bangladesh’s cost-effective MBBS education, similar course and demographic mix as in India, a fair share of Indian faculty and absence of language barriers could make it a preferred destination for students wanting to study abroad. With migration to Georgia, Armenia, Poland, Romania, Kyrgyzstan and Kazakhstan likely to be hampered due to continuing uncertainties, Bangladesh could be one option. Bangladesh charges zero visa fee from Indians. That could be an added advantage,” a former official at the National Board of Examination which conducts the FMGE says.

The returnees’ dilemma

With everything fluid as of now, Ukraine-returned students are pinning their hopes on the Supreme Court, which had recently directed the National Medical Commission (NMC) to formulate a scheme in two months to address the unprecedented situation and allow returnees to complete clinical training in Indian colleges.

Mohali-based Arjun Batish, who completed four years of MBBS course in Ukraine, returned to India on March 1 and has since been waiting for the government to keep its promised agenda for returnee students. The options for those who have completed three years or more in Ukraine are acutely limited, says Batish.

“Our preference would be absorption in Indian colleges for which the government would have to find seats in private and deemed institutions and offer affordable fee structures. All of us come from middle class families with limited paying capacity, which was why we went to Ukraine in the first place. The impression that only the academically weak students go to Ukraine, Russia, China and other countries to pursue MBBS is wrong. Many have good NEET-UG ranks and migrated only because they were unable to get a government seat and could not afford private courses which cost anywhere beyond Rs 1.5 crore as against Rs 50 lakh in Ukraine,” says Batish.

If the plan to absorb students in India falls through, the second option for returnees is academic transfer to colleges in countries like Poland, Georgia, Hungary, Romania, Kazakhstan and Kyrgyzstan.

For that to happen, the government will first need to amend the existing NMC Rules. The NMC notification dated November 18, 2021, titled “Criteria to consider foreign medical graduates applying for licence and permanent registration in India”, says, “The entire course, training and internship shall be done outside India in the same foreign medical institution throughout the course of study and no part of medical training and internship shall be done in India or in any other country other than from where the primary medical qualification is obtained.”

Indications that the Health Ministry was contemplating amendment to the above provision came on April 6 when External Affairs Minister S Jaishankar told Parliament that the government was in touch with Hungary, Poland, Romania, Czech Republic and Kazakhstan to secure the future of Indian students who had returned from Ukraine.

The Ministry of Finance even said it had asked the Indian Banks Association to discuss loan waiver for Ukraine returnees. As of December 31 last year, 1,319 students had availed of education loans worth Rs 121.61 crore to study in Ukraine.

Nothing has been heard on these matters since. Meanwhile, students are getting restive. Until the NMC reverts on whether it can raise MBBS seats (fixed under its own rules), evacuee students say they will continue attending online classes Ukraine colleges are offering to minimise the learning gap.

Virtual instruction though is hardly any match for the physical clinical exposure of wannabe doctors.

Foreign medical graduates

• Before 2019, students interested in taking a medical degree abroad were required to get an eligibility certificate from the government before leaving for their studies.
• Since 2019, the Health Ministry has made it mandatory for students to clear NEET-UG as a prerequisite to pursue medical education abroad.
• Now only those students who have appeared for NEET-UG are eligible to take the FMGE, the licensure test for Indians holding foreign degrees to practise in India.