What will it take to bring down cost of medical education in India?

Even as the Indian government scrambled all its resources and sent four ministers to evacuate thousands of students from Ukraine, the crisis has put a spotlight on the condition of the medical education system in the country.

In 2019, India had a doctor-population ratio of 1:1456 against the WHO standards of 1:1000. Besides, they are distributed unevenly between urban and rural areas, with the urban to rural doctor density ratio being 3.8:1.

Driven by high fees and a shortage of seats, 20,000 to 25,000 Indian students reportedly go abroad to study medicine every year. Russia, Ukraine, China, Georgia and Kyrgyzstan are among the most popular destinations.

While medical seats in government colleges cost between 60,000 rupees and 2.5 lakh rupees for the entire programme, it can cost anywhere up to 1.5 crore rupees in private colleges.

About 15.44 lakh candidates had appeared for the national-level medical entrance exam NEET last year, of the 16.14 lakh who registered.

Of them, 8.70 lakh candidates had qualified. But this does not mean all of them would get to do MBBS since India had just 88,120 MBBS seats spread across some 590 medical colleges as of December 2021. Just over half of these seats are in government colleges where the fees are affordable. 

So some of the seven lakh aspirants who have been left out despite qualifying NEET look for options in foreign countries. In countries like China, Philippines and Russia, medical education costs between 20-45 lakh rupees.

The reason for the high fees is the amount that is required to build the infrastructure to set up a private medical college. Narayana Health Chairman Dr Devi Shetyy wrote in a column in 2019 that it costs about Rs 450 crore and five years to build a government medical college, and thereafter costs about Rs 150 crore for annual maintenance. 

Every medical college approved for MBBS admissions should have 23 notified departments, attached teaching hospital, skills laboratory, museums and hostels for students and interns.

At the time of application, institutions with intakes of up to 150 MBBS students annually should have a fully functional hospital with 300 beds that has been operational for at least two years.

Colleges with annual intake of up to 150 students must have an air-conditioned central library of at least 1,000 square metres and 1% of the minimum books prescribed must be journals. These are just some of the mandated infrastructure requirements to start a medical college. 

In November 2020, the National Medical Commission removed the minimum land requirement of 20 acres for general areas and 10 acres for metro cities. 

Every year, lakhs of students leave the country in search of quality education. And their parents spend thousands of crores on their pursuit. So the crisis in Ukraine should serve as a wake-up call for the government and it should also take a cue from the country, which has made quality education affordable.

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