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| STUDENT SECTION |
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| Year : 2023 | Volume
: 4
| Issue : 1 | Page : 79-81 |
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The pros and cons of studying MBBS abroad
Abhishek Kumar, Pragya Pandey
Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| Date of Submission | 08-Nov-2022 |
| Date of Decision | 05-Feb-2023 |
| Date of Acceptance | 01-Mar-2023 |
| Date of Web Publication | 26-Apr-2023 |
Correspondence Address:
Dr. Abhishek Kumar
Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/JME.JME_140_22
How to cite this article:
Kumar A, Pandey P. The pros and cons of studying MBBS abroad. J Med Evid 2023;4:79-81 |
Medical education is a well-known fascination among Indians, increasing yearly despite tough competition. The number of aspirants with a dream to become a doctor and secure a medical seat in the Indian government and private medical colleges has amplified to 18.72 lac people for 2022 compared to 16.15 lac in 2021.[1] Unfortunately, the total number of medical college seats available in India for them is only 91,927.[2] Due to this massive gap in the number of seats and medical aspirants, around tens of lac of them cannot secure a birth in the medical college in India.
All those unable to get the medical seat for the academic year will either be devastated seeing their dreams shattered, accept their failure and look for alternative courses available in India or continue their battle for the next academic year and join a coaching institute for preparation. A few hundred among them who are unwilling to wait for 1 more year or look for alternative courses will search for the best available alternatives to study medicine, thus leading them to migrate abroad to study MBBS.
For decades, many young Indians aspiring to become a doctor have been migrating to various countries. Above this, the countries that offer medical education to Indian students are increasing in number and offering attractive fee packages with scholarships to attract them.
The countries list extends from developed countries with high fee structures and world-class education, like the United States of America (USA), United Kingdom (UK), Germany, New Zealand, Australia and Singapore, to developing countries with budget fee packages like China, Russia, Philippines, Bangladesh, Kyrgyzstan, Kazakhstan, Ukraine, Georgia, Poland, Armenia, Nepal and so on. The National Board of Examination releases yearly data on the country-wise list of the performance of Foreign Medical graduate students in the Foreign Medical Graduate Examination (FMGE)[3],[4] [Table 1]. | Table 1: Selected country-wise list of the performance of foreign medical graduate students in the Foreign Medical Graduate Examination for years 2021, 2020 and 2019
Click here to view |
| Pros of Studying MBBS Abroad | |  |
No capitation fee
Indian students are only required to pay the admission/enrolment fees of the concerned colleges without any hidden donations or capitation fees. Admission to medical colleges abroad may require the assistance of genuine authorised consultants to help them with documentation and VISA and enrolment procedures, which comes with a nominal fee.
Budget-friendly
Altogether, overall course fees and other living expenses for all 5/6 years of medical courses abroad are cost-effective based on the countries' choices. If countries decided like the US, UK, Europe and Australia, the total fee and the cost of living might be comparatively equal to or even more than that of the private and deemed Indian medical colleges. But again, different scholarship schemes are made available by many developed countries. The fee structure for the complete course varies not only from country to country but also within a country, e.g. it varies in Russia from 29 lac to 50 lac, in Ukraine from 26 lac to 32 lac, in Belarus from 26 lac to 32 lac, in Poland from 61 lac to 70 lac, in the Philippines from 11 lac to 18 lac, in Bangladesh from 22 lac to 32 lac, in Nepal 56 lac and in China from 24 lac to 30 lac.[5]
Abundant seats
Getting a seat in medical colleges in many countries is comparatively easier than the limited 91,927 seats allotted through NEET ranks, reservations and quotas. NEET-qualified students can join medicine abroad without any hurdles in most colleges.
Global exposure
Young students studying abroad initially might not be very willing to live in a new environment far away from their families. Still, it gives them excellent exposure to the global environment. They will have good exposure to all the latest clinical techniques and first-hand exposure in their course duration, helping them extensively in their future.
Advanced technology
Most countries offering MBBS abroad follow quality and high technology to cater to the needs of local and international students. Most of the medical colleges catering to education are already equipped with high technologies in teaching; they are continuously enhancing the technical standard of their colleges to attract and maintain the flow of foreign students.
Inter-cultural communication
They can experience global exposure in international colleges and learn to understand the various living conditions, standards and cultures of different countries by mingling with other international students. This enhances the communication skills of students, thus increasing their confidence levels.
| Cons of Studying MBBS Abroad | | |
Entrance examinations
Most colleges do not ask for or take any entrance examination to study medicine, but few countries will take the admissions based on the scores of different examinations like Medical College Admission Test and Graduate Medical School Admissions Test, Bio-Medical Admission Test, University Clinical Aptitude Test and International Medical Admissions Test,[6] Having no fixed standard protocol for admission with a reasonable fee structure, many people end up there. Some countries have stringent laws, especially regarding the patients' rights, making it difficult for the students to touch a patient and thus they need to gain the basic clinical skills required. The standards are very different between countries, and no reciprocal arrangement has been made with these countries for recognising their degrees. Even Indian Medical Graduates must appear for USMLE (United States Medical Licensing Examination) before practicing medicine in the US.
Language barriers
Learning local languages is made compulsory for some countries like China and most European countries like Germany, Italy, France and Ukraine. Still, in most countries, English-speaking skills are enough to survive. The language barrier problem arises when students are at hospitals and need to communicate directly with patients in their local languages.
Home food availability
Home country food availability is not always possible in most foreign countries and is one of the major cons to all Indian medical students. Although few colleges provide their students with their home countries' canteens, it is still a challenging task for most colleges in different countries. Hence, the students can gradually adapt to the local cuisines or cook their food.
Different cultures, food habits and disease variation
The students should also understand the culture and food habits of the local people so that they can understand how these factors affect a medical condition. Sometimes, these factors are quite different from what is available in India. Another problem students face during their learning is the vast variation in the spectrum of disease prevalence from their native countries. Due to variations in climate, environment, socioeconomic status and genetic makeup, common diseases are quite different. Although learning foreign laws while entering foreign countries is important, understanding the disease variations is also essential and a significant hurdle to overcome.
Extreme climatic condition
Few countries have extreme climatic conditions, which are unfavourable for Indian students to adapt to.
Foreign medical graduate examination
The fear of most Indian students and parents to send their child to study abroad MBBS is the consideration that they need to write a qualifying exam once they return after the course completion. Foreign medical graduates from countries like Russia, Ukraine, China, the Philippines, Bangladesh, Nepal and many others are allowed to practice in India only after clearing the FMGE. However, medical graduates from the United States, UK, Australia, Canada and New Zealand do not need to take the examination. Looking at the pass rate in the FMGE, on average, nearly 20% of the candidates clear this biannual examination. Among nearly 80% of candidates who do not qualify, some give up on their dream of pursuing medicine and adopt a different career. In contrast, others cling to it, especially since there is no cap on the number of attempts for the FMGE. Only a few return to the country where they graduated and practice medicine. Following are the data on the number of candidates who appeared and the number of candidates who declared a pass in FMGE [Table 2].[7] | Table 2: Number of candidates appearing for Foreign Medical Graduate Examination with passing rate from the year 2018 to 2021
Click here to view |
COVID-19 pandemic and foreign medical graduates
COVID-19 has affected millions worldwide in terms of mortality, morbidity and finances. The education system was also not an exception to this. Educational institutes worldwide suspended physical classes for many months and later shifted to online mode affecting many students. A similar situation was with FMGs, especially those in their final years. Those students who could not complete their clinical training at their respective medical colleges abroad had very uncertain futures till the Supreme Court of India intervened and directed the central government and National Medical Council (NMC) to frame policies to accommodate such students in the Indian medical education stream, thus introducing 2-year compulsory rotatory internship instead of 1 year.[8] Although it was a significant relief for FMGs from having an uncertain future, it has added 1 more extra year to their graduation, which in some countries was already 6 years.
| Conclusion | | |
Every country has pros and cons, but adequately understanding the conditions is the most promising factor in coping with the hurdles. When a student is about to select a country for medical education, one needs to understand and evaluate all the available pros and cons of the country and college prior. Many factors play essential roles in the future of the medical aspirant, like the choice of institution and the education system, values and exam patterns, discipline, the country's culture and budget. Making a proper decision is very critical and crucial. The students, parents and Indian government also need to be more vigilant regarding foreign medical colleges, especially spurious ones. The NMC has a well-framed guideline for establishing medical institutions in India and for the number of Students intake and conducts regular inspections for the same. Similar policies should also be framed for foreign institutes, with a provision of capping on the number of Indian students intakes each year, with the incorporation of reciprocity, to ensure the quality of teaching and training. This will not only enhance the essential knowledge and skills of foreign medical graduates and facilitate them in passing FMGE on the first attempt but will also ensure filling the massive gap in the doctor-to-patient ratio prescribed by the World Health Organization.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
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| 3. | Statistics at Glance [Internet]. National Board of Examinations in Medical Sciences. Available from: https://natboard.edu.in/stats. [Last accessed on 2022 Oct 27].  |
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[Table 1], [Table 2]
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