WB Govt move on Ukraine-returned medicos throws up many questions

By Dr Sambit Dash

West Bengal Government while accommodating all the medical students who had returned from war-torn Ukraine, in various Government and private medical colleges in the State, has made a move that though beneficial to the distressed students, raises several questions, including that of the constitutional validity of the decision.
Indian students pursuing MBBS in Ukraine were in the limelight when they were stranded in the country post Russian invasion. The fact that there were nearly 20,000 Indian students in Ukraine was a surprise to many. After the successful evacuation of all the students, and the situation in Ukraine being still grim, the future of these students has been in jeopardy. These youngsters and their parents have been demanding that they be accommodated in Indian medical colleges.
The call for admitting these students in institutions in India has been supported by several chief ministers, with Odisha CM Naveen Patnaik and Tamil Nadu CM M K Stalin writing to Prime Minister Narendra Modi to facilitate such admissions. Not only CMs, regulatory bodies like AICTE had also urged technical institutions to accommodate the students using vacant seats of the current academic year. All these things of course with the knowledge that there are no rules supporting such transfer of foreign MBBS students to Indian medical colleges.
In midst of all these requests and appeals and the growing clamour for doing something about these students, West Bengal Chief Minister Mamata Banerjee announced a detailed plan as to how the State Government would allow the first and second year students, who have cleared NEET, to participate in counseling; how the second and third year students would be allowed to attend practical classes; how the fourth and fifth year students will get ‘observing seats’ in Government and private medical colleges and the sixth year students internship in Government hospitals.

Students’ Point of View

From the students’ point of view, this is an arrangement that would please them. One should empathise with their plight as they have been caught in the crosshairs. However, such empathy is hard to come by for a lot of people in India, especially in the backdrop of skewed demand-supply MBBS seats, who see students pursuing MBBS in foreign countries, barring the US, the UK, New Zealand and others that NMC allows for, as those lacking merit.
MBBS graduates from China (as this piece is being written the Chinese Government has said it will partially allow some students to rejoin their colleges) came back to India two years ago and are facing an uncertain future. In the absence of war and pandemic, there may still be other distressing situations leading to closure of colleges thus keeping Indian students in a limbo.

Constitutional arrangement

Entry 25, List III, Schedule VII of the Constitution places medical education in the Concurrent List. Both the Union and the State governments can enact laws listed in List III. However, the scope for State governments to enact laws is very limited. Take the example of NEET. With NEET being a bone of contention, particularly in Tamil Nadu, the State tabled the Bill titled ‘Tamil Nadu Admission to Undergraduate Medical Degree Courses Bill, 2021’ in September 2021, which aims to remove the requirement of qualifying for NEET to be eligible for being admitted to MBBS course. While this was tabled by the current DMK Government, earlier, the AIADMK government had attempted a similar move, albeit unsuccessfully.
Medical education in India is regulated by National Medical Commission (NMC), which replaced the Medical Council of India. Be it establishment of colleges, inspecting them, permitting admission numbers, awarding licences for practice, empaneling foreign medical colleges, all aspects of medical education in India are Centrally controlled. The NMC rules do not permit the transfer of Indian students pursuing MBBS abroad to Indian colleges.

What ahead?

It will be interesting to watch what happens to West Bengal Government’s decision to accommodate the Ukraine-returned MBBS students. Unless there is a change of rule by NMC, these admissions and subsequently awarding of degrees will raise question of validity. While there is an inherent political angle to these moves, it raises critical questions about medical education per se. Is placing medical education in Concurrent List and health in State List an incongruent idea? Would better federal policy be letting State governments take charge of medical education based on local needs? What would be the structure of entry point/s, i.e. entrance examinations, in such a situation?
Should there be a provision for accommodating students in case of wars, pandemics and natural disasters? What should take precedence, the future of the Indian students or sacrosanct rules? These and several other questions need to be looked into.
While this author was teaching in a twinning MBBS programme between Malaysia and India, in 2013, the Egypt situation got worse. Malaysia evacuated nearly 3,300 medical students from the strife-torn country. Students were accommodated in all Malaysian Qualifying Agency (Malaysian equivalent of NMC) affiliated colleges; a few came to our institution and joined the regular batches. The integration of Indian students from Ukraine will perhaps take much more than a State Government decree.

__ The author is Assistant Professor of Biochemistry at Manipal Academy of Higher Education (MAHE), Manipal. He comments on public policy, healthcare and issues of social interest. He tweets at @sambit_dash