Medical feat: Indian doctors, made in China

article dated: Jul 24, 2006
A stethoscope hanging around the neck of their wards is the dream of most Telugu parents cutting across social and economic status. Till a few years ago only a few lucky ones could realise this dream. A rejection from a medical college often meant the door to prosperity was closed forever.

The scenario has changed in the last four to five years. Pursuing medical education abroad, if the doors are closed in India, is no longer a rich kid's prerogative.

From long-time favourites like the United States and Russia, the one phrase that made Indian bazaars shudder, `Made in China,' has started making a mark in the field of education too.

With more than 5,000 Indian students and of them nearly 2,000 just from Andhra Pradesh, the medical degree from China is in great demand.

While management seats in India cost no less than Rs. 40 lakhs in some colleges, a Chinese package of less than Rs. 10 lakhs, inclusive of entire course tuition fee, hostel fee and living expenses squeezed in, surely is music to the ears.

World class

"The quality of medical education in China is world class and students need not have any apprehensions," says S. Jaipaul Reddy, Managing Director, St. Joseph's Consultants Pvt. Ltd. that admits students to 12 Chinese medical universities. Last year, he sent nearly 300 students to China while this year the number has crossed 750.

A prime reason for the growing craze is the introduction of English as a medium of instruction in the last couple of years. Mr. Jaipaul Reddy says the Chinese Government has allocated two billion dollars to 50 selected Government medical universities as part of its package to make them the best in the world by 2011.

"Each university has nearly US $ 200 crores and they are spending it to get the best of faculty from across the world and add more facilities to colleges and hospitals. They are already better equipped then most Indian medical colleges," says Mr. Reddy.

Admission procedure

Agrees V. Rajaram of Medico Abroad that sends aspiring medicos to Jinzhou Medical University and Dalian Medical University. "The attraction is not just lower fees but the hassle free admission procedures, followed by guidance of students," he says. To ensure that students don't feel home sick the consultants have set up kitchens with Indian cooks. Parents are constantly informed about their wards' academic records and the life there. "We not only guide them in admissions but keep a track of their life there," informs Mr. Reddy.

The simple admission procedure is a major factor. The Government of China has opened its medical education to the world recently so visas are quite easy to come by. The Ministry of Internal Affairs gives a JW-20 (similar to I-20 of American Universities) after receiving the admission letter. When student approaches the embassy an `X' visa is issued that is valid for 30 days. A student has to join within 30 days to get the visa extended.

Students with not less than 70 per cent marks in Intermediate are being admitted in Chinese universities. So there is no compromise on quality of students who come from more than 50 countries to study medicine.

Interestingly, Indians in Gulf too are impressed with Chinese medical education and preferring it to Indian colleges.

"It has come as a big boon for middle class families," says Mr. Srinivasa Rao, a taxi driver in the Gulf. His daughter is admitted in the Zinjhou Medical University.

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Medical feat: Indian doctors, made in China
By Erik Nilsson (China Daily) Updated: 2006-11-23

Since private medical university fees are too expensive for the average Indian, the dream of becoming a doctor was only within the reach of the well-off that is, until 2003, when Chinese universities touting low tuition threw open their doors to them.

Thousands of made-in-China Indian doctor hopefuls enrolled in Chinese medical universities eager to take advantage of this deal, which seemed too good to be true and, as they are finding out, might actually be.

Soon after enrolling, these students discovered something that troubles them.

"Our futures depend on luck now," said one 21-year-old second-year student studying at Tianjin Medical University (TMU) who declined to give his name for fear of getting "in big trouble" with the school.

"We can't stop now; it's too late. We're just hoping for the best, that by the time we graduate, the Medical Council of India (MCI) will recognize our degrees."

The Indian Embassy in Beijing estimates between 4,000 and 10,000 Indians study medicine at Chinese universities but said it is impossible to know the exact number because not all of them register with the embassy.

In 2004, more than 20 medical universities began aggressively recruiting Indian students, promising low tuition and English-language instruction. With 263 Indians enrolled in its medical programme, TMU has one of the largest Indian medical student populations in China, said Guo Fenglin, director of the school's International Exchange Department.

"This university provided us a guarantee that we could get a reliable deal so we would be allowed to practice medicine when we go home," said Prokash Kumar, 18, a second-year TMU student from Tamil Nadu. "The promise the university gives us, we believe they'll follow."

Kumar said he believes that as long as he passes the MCI Screening Test, he will be allowed to practise medicine in India because MCI will recognize the degree he will have earned. The university's syllabus, he pointed out, is nearly identical to those of India's universities, so he says he should be prepared for the test.

"It would be the university's responsibility to help us out because we have relied on the university and would have relied on them for five or six years. We have followed the rules," he said. "If the degree is not recognized, that would mean we just wasted five years of our lives. That is not a trivial thing."

A chief officer with MCI did not respond to questions sent and re-sent over a week-long period by fax and e-mail.

His classmate, 18-year-old R.S. Ramya, of Kanyakumari, also said she is confident she will be allowed to practise medicine in India after she graduates from TMU and passes the test.

"The senior students we knew, they thought it was safe coming here, so if they are coming here, we know it's OK," Ramya said.

Many Indian medical students came to Chinese universities at the recommendation of educational agents, who assured them their certification would be recognized when they return home.

The agents also tell prospective students the courses will be taught in English, but the students at TMU don't agree how well their teachers speak it.

"Our teachers know English very well," Kumar said. "If we have some problem, we can explain in English, and they understand very well."

However, another TMU student who refused to give his name for fear of expulsion said he has serious problems understanding his instructors.

"You can hardly understand their pronunciation," he said. "Some teachers are good, our teachers are really co-operative and everything; it's not their fault they can't speak English, but it's also not our fault that we can't understand them. We told them to bring teachers from India, and they promised a couple of times that they would, but they haven't."

Gourangalal Das, first secretary at the Indian Embassy in Beijing, said that complaints about the English proficiency of instructors come from many universities across China, but added: "All of the students say that they've gotten better faculty and over time, the language ability of the instructors has improved. Many universities are bringing in foreign teachers, who are easier for students to understand."

Recognition is the key

Kumar and Ramya agreed that the appeal of studying at a Chinese university is the low tuition.

"A normal Indian cannot afford to attend a private medical college," Ramya said. "Coming here offers us a reasonable education at a reasonable cost."

TMU's five-year medical training programme is more or less typical of those offered in China. Critics in India say that the aggressive recruitment of Indian medical students is motivated by nothing less than money, and they offer as evidence that the minimum score on high school final exams required for admission at these schools is 70 per cent.

Guo confirmed the 70 per cent minimum score requirement at TMU but said the school always seeks better-qualified students.

Regarding money, TMU charges Indian students US$3,300 a year for tuition, which is near the top of the scale for Chinese universities. Last year, it was US$2,300, and next year it is expected to jump to US$4,100. Some medical universities in China charge as little as US$1,600 a year; the national average is US$2,000, Guo said.

That tuition fee is substantially less than Indian universities' charge, but if MCI does not recognize the degrees, getting them in China is worthless at any price.

"The problem is that China has degree and diploma recognition agreements with many countries maybe 50 or 60, especially in Europe but there are no bilateral agreements between China and India right now," Guo said. "For other countries, it is no problem. Even Americans study here, and their degrees are recognized."

He said the Ministry of Education and the Scholarship Committee of China are working to establish bilateral degree recognition agreements with their Indian counterparts.

Any Indian student who receives a medical graduate degree from a foreign country must meet three conditions to be a registered medical practitioner in India, Das said.

First, the students must pass MCI's Screening Test. Second, they must earn a medical degree from an institute listed in the World Directory of Medical Schools, published by the World Health Organization. Third, they must obtain the Eligibility Certificate from MCI according to the Eligibility Requirement for Taking Admission in an Undergraduate Medical Course in a Foreign Medical Institution Regulations, 2002.

Han Rui, a co-ordinating professor in TMU's International Exchange Department, said because MCI issues Eligibility Certificates to students before they go to China, "we believe MCI will honour their degrees. Otherwise, they would be going back on their promise. How could they face their students?"

The eligibility requirement was passed to avoid a repeat of the nightmare faced by Indian medical students who invested several years of study in inexpensive but dubious educations at Russian and Eastern European universities in the 1990s, Indian media reports say. Because the English-language instruction the students received there was of such poor quality, most failed the Screening Test when they returned. Some later petitioned the Supreme Court to overturn the MCI's decision and won a one-time waiver.

Concern has arisen that the China experience would repeat the European one eligibility certificates or not.

"No batch of Indian medical students in China has yet taken the MCI test, and it is difficult to predict," Das said. "Most universities claim that their syllabi conform to the MCI requirements."

Keeping track

He said the Indian Embassy has responded to students' complaints with visits to various universities.

"Most of the complaints are from individual students and pertain to micro-level issues," Das said. "Macro-issues like curriculum, internship and practice, et cetera, the Embassy is proactively pursuing with the concerned authorities in India and the Chinese Ministry of Education."

But specifics of the dialogues are "not in the public domain," he said.

Guo confirmed the Embassy's visits to TMU to conduct investigations and regularly sends e-mails and faxes requesting information about its students.

He said that he also receives occasional complaints from Indian students, and the university tries to ensure quality instruction by using a two-pronged approach. First, teachers are scrutinized by a supervisory group of foreign and Chinese professors who visit their classes and evaluate their performance. Second, students submit written evaluations of their instructors.

"If the teachers aren't teaching very well, the students will come to my office and make complaints, and we replace the teachers," Guo said.

The first batch of Indian students will graduate in 2008. Then they will find out if their faith that their Chinese degrees will qualify them to practise medicine in India was justified.

For Ramya, it's not only a matter of career, but also of family.

"My parents are doctors," she said. "They are working at the hospital, and they are waiting for me to come and join them."

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article dated: October 18, 2004
After the United States, Britain and Australia, Indian students are now heading towards China for higher education.

Last month, some 230 Indian students joined various Chinese universities for medical studies.

India's higher education sector is undergoing a churning process these days. Although the country offers world-class education at competitive costs -- for instance the IITs and IIMs -- the number of foreign students enrolling in Indian universities has considerably dwindled in the last decade.

Like in foreign investment, China has outpaced India in capturing the international education market. Education experts who visited China say the Communist nation has become the most sought after study-abroad destination.

"India is just missing the international education bus. China has invested so much in higher education over the years that that the country is producing many more quality students than India. No wonder then that Indians too want to study in China," says S Gopinath, an education expert who regularly guides Indian students on getting admission to various Chinese colleges.

Asian Education Consultancy, a top consulting company in southern India, says medical education in China is of a higher quality and lower cost compared to India.

Last month, AEC sent 122 Indian students to the Three Gorges University in the Hubei province in Yichang in China.

"Medical education in India is so costly that only the rich can afford it. Now China is emerging as a hot destination for Indian students for medical education," says AEC Director Niyaz Mohammed.

Each Indian student to the Three Gorges University pays Rs 800,000, which includes accommodation, food and all expenses for the entire five-year medicine course. The amount has to be paid in parts on a yearly basis. Apart from this, students pay Rs 43,000 as airfare.

Mohammed says the education cost in China is cheap.

"Consider what you have to pay to become a doctor in India. Admission fee alone in some medical colleges in India runs into Rs 25 lakhs," he says.

Mohammed who has been to various Chinese colleges and universities says the higher education sector in China is vastly modernised compared to that in India.

India sends the largest number of students to America; 74,600 students enrolled in US colleges and universities in 2002-2003. But education experts feel in course of time, China will have the largest number of Indian students.

Experts like Gopinath and Mohammed point out the following reasons for the shift:

* China has Top 100 universities that are well resourced. China's universities turn out thousands of bachelor degree holders, similar to an Indian IIT graduate. They easily get admissions in the top universities of the world.
* China turns out more top candidates each year than India, as it has more world-class universities.
* China has opened up higher education for both private and foreign investment. Foreign investors can come in by tying up with local Chinese partners.
* Unlike India, China is experiencing a great deal of two-way international student traffic. China has become one of the world's great study-abroad destinations. Currently more than 60,000 foreigners study in Chinese universities, and that number is swelling each year.
* China is the number-one choice for US students who want to study in Asia. Very few Americans study in India.

As more and more foreign students including Indians travel to China for higher education, admissions of foreign students in Indian universities have fared badly over the years.

According to a study by the Association of Indian Universities, the number of foreign students in India shrunk from 12,765 in 1992-93 to 7,745 in 2003-04. The AIU study covered 277 major Indian universities.

The study says Malaysian students formed the largest foreign component in India this year -- 806. They were followed by Nepal (681students), Iran (472) and Kenya (442).

This was in sharp contrast to the position in 1992-1993 when Kenya sent 3,980 students to India. In 1993-1994, India had 1,421 students from Malaysia and 909 from Nepal.

AIU has listed two significant reasons for this decline in foreign students to Indian universities: the lackadaisical attitude from the government in promoting Indian universities abroad and the poor quality of education in most Indian universities.

AIU now wants the human resources development ministry to hold regular education camps in foreign countries to attract students.

"Universities from abroad are conducting large number of camps here to recruit Indian students. Why can't India chalk out a similar education strategy to attract foreign students," asks Gopinath.
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