With limited opportunities at home, more and more Indian students are choosing China for medical education

By Xu Ming Source:Global Times Published: 2017/6/25 17:36:02

○ China has become the top destination for medical education for Indian students who want to become doctors

○ What worries Indian students who study medicine in China the most is the MCI screening test they will face back in India after obtaining the degree

Indian medical students get clinical practice at a hospital in Nantong, East China's Jiangsu Province. Photo: CFP

Arun Krishnan checks on a patient. Photo: Courtesy of Arun Krishnan

Arun Krishnan, who has studied medicine for six years in China, has mixed feelings about leaving China next month.  

On Wednesday, the 25-year-old student successfully got the certificate that takes him a step closer to his dream of becoming a doctor in India. But the excitement is mixed with anxiety. The certificate he got from China alone could not guarantee him a decent job as a doctor in India. After finishing the study in China, he needs to pass another exam back in India to be qualified as a doctor.

Krishnan is one among a growing number of Indians who are choosing to study medicine in China as a springboard to realizing their dream of becoming a doctor, as it is nearly impossible for the majority of those aspiring to be doctors to get into medical colleges in their homeland.

Final hurdle

It is the Medical Council of India (MCI) screening test that worries these Indian students the most, even when they receive their degree from China.

If they want to study abroad, they need to go to universities approved by the MCI, and after they finish the study, they also need to pass the FMGE Screening Test the MCI organizes, in order to be recognized as a doctor, with exceptions for degrees from a few developed countries like the US, the UK and Australia.

"Without passing the exam, it's impossible to work in a majority of hospitals in India, especially the government ones. Recently, some private hospitals started to employ these doctors but the pay is too low, there is no job security and in some cases it's also illegal," Krishnan said. They also need to clear the FMGE and pass local exams to work in most foreign countries, with a few exceptions of small countries like Mauritius and Afghanistan,

It is a nightmare haunting Krishnan from the very first day in China. "Next month, I will be going to New Delhi for coaching classes to prepare for the FMGE and will take it in December," he said. "To be honest, the biggest challenge is after the six years, the FMGE exam."

From 2005 to 2015, while the number of students taking the exam doubled, the success rate fell from 50.12 percent to 10.7 percent and in 2014, the success rate was as low as 4.93 percent, a record low in history, the Times of India reported.

"On average, 15 percent of the almost 10,000 students pass the exam every time (in June and December), and sometimes even lower," said Krishnan who has been paying close attention to the exam. Many students pass it after several attempts.

As he revealed, there were petitions submitted to the government to remove the FMGE exam or make it mandatory for the graduates of Indian colleges, too. "But till now there is no result."

Fortunately, there are improvements. Some Chinese universities are trying to help Indian students by inviting professors from India to teach these students preclinical subjects and help them prepare for the test.

"Last year Guangzhou Medical University invited professors from DIAMS and MIST, two famous institutions in Delhi that provide coaching for preparation of the FMGE exam. They gave us classes about how to prepare for the FMGE exam and also invited to join their institutions. These were really helpful," said Krishnan.

Top destination

Starting from 2004, China began to open doors to foreign students who want to study medicine. At present, the MCI lists 45 public Chinese medical institutions which offer 3,470 seats to international students. These medical colleges, which have been approved by China's Ministry of Education, all provide courses taught in English.

The medical education has led to a surge in the number of Indian students in China in the past decade. Statistics from Project Atlas show that, by 2015, the number of Indian students in China reached 16,694, from 765 only 10 years ago. And among them, 80 percent chose medicine as their major.

An analysis from the New Delhi-based Institute of Chinese Studies published in 2016 shows that, between 2005 and 2012, among the most preferred destinations to study medicine abroad, China topped the list.

In India, doctors are well paid and have a good reputation. The profession offers an easy way of upward social mobility for the ordinary people in a society with deep-rooted caste system. Meanwhile, access to medical education is extremely limited.  

As Krishnan revealed, India doesn't have many government medical universities and seats are limited, which means the competition is fierce, and private universities are so expensive that only students from rich families can afford.

He compared the national medical examination in India to gaokao, but with fewer seats. Krishnan became interested in the study of medicine at the end of high school and tried the national medical entrance test but failed to pass.

"Every year a lot of students sit in admission tests for medical colleges in India. For colleges under government, which have less fees, the success rate is only 20 percent and the remaining are forced to choose either private medical colleges with exorbitant fees or study abroad," Krishnan said. "China has become the top foreign destination for the study of medicine."

Nitish Gupta, who is now in his third year in Tianjin Medical University, did not even try the national medical exam, knowing he could not do well enough to pass it. He said there are 105 students in his class and 45 of them are from India, with the rest mostly from Sri Lanka. Coming from an average family in India, China is probably the best destination his parents could afford.

Prospective students in India can obtain information about Chinese colleges in various ways. It is reported that as early as 10 years ago the advertisements about Chinese medical colleges started to get into county-level areas in India. Now advertisements are common in newspapers and on social media. Even Krishnan himself has shared much information about MBB programs in China on his WeChat account.

According to Krishnan, students studying in developed countries like the US and the UK don't need to pass the FMGE exam when coming back, but the fees in those countries are really high. "The US and the UK are more expensive than China or Russia, and more expensive than (private colleges in) India too."

Besides the affordable fees, Indian students believe Chinese medical universities have good equipment, laboratory facilities and technology.

"It is cheap, there are a lot of patients and a variety of diagnoses, and the technology and instruments in medical field have improved a lot."

As Krishnan understands, India still faces a shortage of doctors as a populous country. "A huge demand for doctors is also one of the reasons why many students come to China to study."


Studying in China

 For most Indian students, food and language are the two biggest obstacles. Besides medicine studies, they are asked to take separate classes for Chinese and they need to pass HSK 4 exams to get the degree.

To Krishnan, the extra difficulty for medical students in China also lies in the internship practice. Language, particularly dialect, is a problem, and meanwhile, as foreign students, they sometimes could not win the trust of the patients.

"Some of the patients in Guangzhou only speak Cantonese and we are taught Putonghua only, and sometimes some patients prefer not to be diagnosed by us," Krishnan told the Global Times, "Sometimes our professors convince the patients and also help with the translation."

Gupta is still in the process of getting used to China.

"From the standpoint of studying, Tianjin is good because we have a good laboratory. Some teachers are also good, and local people are helpful," he said.

Mostly coming from middle-class families who have limited incomes, these students are basically living a frugal life in China.

Krishnan said he regretted sometimes that he couldn't travel or explore China a lot due to the limited time and money. There are also students who would do part-time jobs in China to earn pocket money.

Newspaper headline: Second opinion

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