Brain drain 2017: why do medical students need to emigrate to become doctors in 2017?

This article was exclusively written for the Sting by Mr Ankit Raj, a final year MBBS student from Kasturba Medical College, Manipal, India. He is related to the International Federation of Medical Students Associations (IFMSA). However, the opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one. The term ‘Brain-Drain’ is not new to the Indian media and medical professionals. There are currently 40,838 doctors of Indian origin in USA and they account for 5% of all doctors and 20% of all International Medical Graduates employed in the US workforce. It is noteworthy that India provides the largest number of International Medical Graduates to the US in absolute numbers. With 59,523 physicians of Indian origin working in the English speaking Western world (the US, UK, Australia and Canada combined), India is by far the single largest source of emigrating physicians in the world.[i] Despite having one of the largest medical education systems in the world with 405 medical colleges enrolling 40,525 students each year, one third of the freshly qualified physicians leave India every year for residency training and/or practice abroad.[ii][iii] The most evident reason for the said ‘Brain-drain’ is the cast-based reservation of post-graduate seats in medical colleges. Extremely high competition coupled with the cast-based reservation in medical colleges persuades any general category, middle class medical student to aim for a residency spot in developed countries like USA, UK and Australia. The archaic, single paper, objective-patterned entrance test along with unreasonable, sky-rocketing cut-offs provides an impetus for students who know their clinical skills and research acumen will be better judged in western world. Most of the medical students after completing their residency settle in these countries owing to better facilities, higher quality of life and deserving recognition for their hard work and excellence. Owing to such high emigration of young physicians and medical students from India, you would expect the government to make a pertinent and considerable move but sadly, Indian government continues to fail. Extremely low expenditure on health, corruption and nexus between politicians and private medical institutions push the government to take policies based on their vote-bank rather than urgency and need. The increasing trend of brain-drain persuaded the Indian government to launch few policies, many of them being immature and one-sided. To curb the migration of medical students to US for residency and a job later, the health ministry has suspended issuing ‘no obligation to return to India’ (NORI) certificate which is essential for Indian doctors to settle in other countries, most noticeably USA. Rather than taking such unnecessary baby steps, the government should openly interact with physicians and medical students to look for a more decisive step in right direction. Increasing post-graduation seats, scrapping-off caste-based reservation in post-graduation, improving infrastructure, providing loans and tax-breaks for setting up high-end infrastructure and developing medical curriculum are some of the minor yet decisive initiatives that could bring a major change. Notwithstanding, the departure of very best human resources at a time when India is reeling under severe doctor-shortage is an urgent and consequential issue that needs drastic resolution and a brave, un-biased approach from government and a resolute determination from medical students. References [i] Mullan F. The Metrics of the Physician Brain Drain. N Engl J Med 2005;353:1810-8. [ii] Search Colleges and Courses. Medical Council of India. (Accessed 12 July 2013, at http://www.mciindia.org/InformationDesk/CollegesCoursesSearch.aspx) [iii] Supe A, Burdick WP. Challenges and issues in medical education in India. Acad Med 2006;81:1076-80. About the author Ankit Raj is a final year MBBS student from Kasturba Medical College, Manipal, India and a member of IFMSA. He is passionately interested in global health, global surgery, digital health and medical curriculum. Currently, he is also serving as a part of Education team at International Student Surgical Network (InciSioN).