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SPECIAL REPORT
Coming! The first wave of Chinese-made Indian doctors
By Vijaya Pushkarna
Photo: Imagesbazaar.com/ Imaging: Ajay Pingle
When Sandeep Verma dreamt of a stethoscope round his neck, he left his home in Joginder Nagar, Himachal Pradesh. Two years later, when the results were out, Sandeep had got only 54 per cent. Undeterred by marks, the son of a petty shop owner went through crash courses that trained students to clear medical entrance admission exams. Three years of failures followed. Recently, Sandeep's smile was back; as he was flying to Beijing to study medicine at Jilin University in Changchun.
Like Sandeep, about 5,000 Indian students took the flight to China in September to join 30 medical colleges that accept international students.

The enthusiasm, excitement and nervousness were almost palpable at the Indira Gandhi International Airport in Delhi where families from Jharkand, Punjab, Chhattisgarh, Himachal Pradesh, Rajasthan and Madhya Pradesh had gathered to bless and see off the future doctors in their families. The personal assistant to former Jharkand chief minister Babu Lal Marandi, a dhoti-clad, balding Ravindra Kumar Jain, had come from Bel Kundi village in Gredi district to see off his son Gautam Yadav, who completed his higher secondary with 65 per cent.

Said Gautam: "I took so many entrance exams. I could not make it even in Karnataka. I learnt of the medical colleges in China from my friend Mahendra Kishore. He, too, has joined Jilin University." A student of RMR Plus Two School, Patna, Mahendra secured 61 per cent in the higher secondary boards. Said Mahendra: "I could not get an MBBS seat anywhere in India. Now I have one for just Rs 7 lakh for the entire package."

It is the cost as well as the quality that is drawing Indian students to China, says Piush Kumar, director of The Career Makers, a Faridabad-based agency that has been sending students abroad for the last 12 years. Piush represents three Chinese universities in India: Sun Yat-sen University in Guangzhou, Sichuan University in Chengdu and Jilin University in Changchun. For Sun Yat-sen University, he is the sole agent in all SAARC countries. Said Piush: "A large number of Nepali students go to China, followed by those from Mauritius, Sri Lanka and Pakistan. But the highest number is from India."

Apparently, a good number of Indian students going to China are from Andhra Pradesh. Piush said that the cost for the five-year course plus a year's internship varied from Rs 7 lakh to Rs 11.5 lakh. The sum includes the tuition fees, board, lodging and flight charges. While this does not include additional living expenses and expenses of vacation trips home, it is less than what many colleges in India charge for a year, and the sums said to be paid for NRI seats.

Reportedly, most of the Chinese universities are about 70 years old and have hospitals with 3,000 beds each. Said Piush, "Almost all of them see three lakh patients in the OPD, and have half as many inpatients a year. The facilities are state-of-the-art, so the students undergo internship in a world class standard."
Another agent, Dr J.P. Gurjar, runs his Chaprana Career Consultancy Pvt Ltd from Jaipur, though he has been living in Nanchong in Sichuan province for the last two years. He teaches yoga at North Sichuan Medical College in Nanchong. Said Gurjar: "The Chinese teaching system is multimedia-based and thorough. The quality and standard are excellent. The hospitals are maintained well and the labs are all equipped with the latest machinery."

But when students who barely squeak through to a CBSE first division get admission, is that not an indication of poor standards? No, said Gurjar. " China is a huge country, with many, many medical colleges, with lots of seats," he said. "The scale is much bigger, and they focus on getting students from all over the world. And most importantly, it is not easy to get into a medical college there either." Reportedly, the students have to obtain 65 per cent in physics, chemistry, biology, and then pass an entrance test conducted by the agents in India. On reaching China, they have to clear a qualifying test. A student who does not clear it is given two chances at six-month intervals. Three consecutive failures will ensure a dismissal from the college. The qualifying test is a multiple-choice examination in English, physics, chemistry, biology and mathematics. The pass mark is set at 60 per cent. Said Gurjar, "Most Indian medical students do not concentrate on mathematics. But those wanting to go to China have to be reasonably good in maths, too."

Can the students manage in a country handicapped with low English standards? Agents say that teachers for international students are excellent in English and that all classroom communication is in English. But all the students have a Chinese language class for 40 minutes a day. Their Chinese proficiency levels are tested as well. Apparently, most of them pick up spoken Mandarin easily, but find the Chinese alphabet slightly difficult.
Reportedly, the hostels come complete with broadband internet, washing machine and microwave oven. With Nepali cooks making dal makhani, tandoori roti and paneer tamatarwala, even the cuisine becomes a non-issue.

When his son Aayush did not make it to a medical college in India, Dr Ashok Gupta, who heads the department of orthopaedics in the Government Multi-Specialty Hospital in Chandigarh, sent him to Tianjin University near Beijing. He and wife Amita had done all the research before packing off Aayush. Before the admission, Gupta met the president and the dean of the International Medical School for Western Medicine to check the faculty, syllabus, methods of teaching, the lab facilities, and clinical component. Said Gupta: "About 80 to 90 per cent of the teachers are Chinese, but most of them have been educated and have even taught in the UK and USA and have a very western orientation to medical education. The remaining teachers are citizens of English speaking countries. I even met an Indian, an Australian and a Canadian doctor teaching there."

Yet, taking up the MBBS course in China is not easy, said Gupta. The initial problem is to understand their accent, but the use of multimedia minimises this. He said Aayush could have faced similar language and food problems even if he had gone to a medical college in Karnataka! Amita said that the teething problems were over in six months. What amazed her most was the infrastructure at the medical colleges there.
Any student planning to go abroad should first apply to the Medical Council of India for an eligibility certificate. Without the certificate, the students will not be permitted to take the screening test on returning to India. To be eligible to study abroad and take the screening test, a student has to be 17 years old, and have 50 per cent average in higher secondary exams, the foreign university must be approved by the World Health Organisation and the country which awards the degree must allow the student to practise medicine within that country.

Doctors say that the screening test is quite hard and that the pass percentage has been low in the previous years. So what if a student does not clear? China has recently allowed two MNCs to open multi-specialty hospitals in Beijing and Shanghai and Indian students are already exploring the possibility of working in these places.
Sanjeevanee Chitre, studying in the Wuhan University School of Medicine in Hubei province, is confident that recognition of her degree will not be a problem. What clinched her family's decision was that there were already a few senior students from her school doing their MBBS in China. An annual fee of around $3,650 made it a much more affordable choice than a paid seat in India, she said.

Beijing has been self-critical about the international worth of its medical degrees. This led to imposition of strict controls on the medical colleges accepting international students. A few months ago, the Chinese government cleared 30 medical universities to accept international students and fixed a ceiling for their intake. Six of these colleges, however, have not been allowed to accept students this year for technical reasons.
The government has also started a programme titled Quality Control Standards for Undergraduate Medical Education in English for International Students. The programme regulates everything from admission to facilities, curriculum, internship, qualification of teachers, eligibility of students, examinations, evaluation, and granting of degrees.
All the colleges cleared are state-run. The Indian embassy in Beijing has suggested to the Medical Council of India that eligibility certificates should be given only to students of the 24 approved colleges.

The MCI has warned students against ads promising an MBBS from a foreign university, with part of the training or internship in India. The MCI authorities said that no foreign university was allowed to open a centre in India and that students should complete their internship in their own colleges.
Other than medicine, a few Indian universities and institutes teaching journalism and mass communication, design and media arts have tied up with Shanghai Jiao Tong University (SJTU), and are exploring possibilities of linking up with six other universities.

Medical education in government medical colleges in India is highly subsidised, less than ten thousand rupees per annum. In 4.5 years they may pay less than 40,000/- which the student could recover in the subsequent year internship when they get a stipend of three thousand per month. The government does have a point in insisting that the rural poor need to be served by students coming out of the college.

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