The other side of the reality is that it is impossible for a middle-class family to afford private medical education and seats in government medical colleges are few and therefore open only to the most meritorious. The promoters of private medical colleges, like engineering colleges, are often without any earlier exposure to education and of variable integrity and will extract as much from the market as they can.
Fees for a degree in private medical colleges can go up to Rs 1 crore when a government college charges between Rs 67,000 and Rs 3 lakh. No wonder, parents often find a medical degree in countries like Russia, China and Ukraine cheaper than a privately acquired one in India.
The prime minister has invited the private sector to take up a bigger role in delivering medical education. Anand Mahindra, head of the eponymous automobile group, has asked his educational complex in Hyderabad which delivers engineering, management and legal education to look into medical education also.
One reason why there are fewer private medical seats than engineering is that private deliverers have kept away from medical education which has to be imparted over a longer duration. This means simultaneously there will be more batches going through the course and thus there is a need for more infrastructure. An MBBS course, including internship, needs 5.5 years to deliver whereas a bachelor’s course in management takes three.
Thus private investment in medical education is best done by those entities which can live with a longer gestation period and that typically comes with a degree of commitment to the idea. Hence, the prime minister’s plea is best responded to by the corporate sector which has a longer perspective than other businesses.
A fundamental question remains. How have Russia, China and Ukraine come to acquire a degree of capability in delivering medical education which India has not been able to? The answer is that they are all more developed countries with a higher per capita GDP and a longer experience in the development process than India.
The desperation to get an affordable foreign medical education is apparent from the fact that leaving aside the top three countries and Kirgizstan whose degree holders appear for the qualifying Indian test, Nepal accounted for 7.6 per cent and Bangladesh 2 per cent in 2018-19 (the latest figures available). The question that India needs to ask is what have Nepal and Bangladesh got that India has not.