It’s like our whole lives have paused abruptly. And we can do nothing about it,” says Akanksha Yadav, a third-year medical student who has just made the arduous journey back to her home in Lucknow from Ivano Frankivsk National Medical University in Ukraine.  

But Yadav is determined to pursue her medical degree. “I have already spent three years and cannot afford to change streams now. Besides, it has been a childhood dream of mine to become a doctor,” she says.  

Yadav, who had blisters on her feet from the long walk to the border, has now recovered physically, but the mental images refuse to fade. However, she is hopeful that some resolution will emerge to the collective problems of the students.  

Delhi-based Insha Stephen, her batchmate, says she has been in touch with her teachers in Ukraine and expects classes will resume online soon. “Fortunately my teachers at Ivano Frankivsk are not in bunkers but in their respective homes and say they can start taking classes online for us next week,” she says.  

Stephen says that a licensing exam and a vital part of MBBS education in Ukraine, which all third-year students have to take, which was due in June has been postponed now.  

Both Stephen and Yadav are evaluating all options and are connected with other students who have returned from Ukraine. The news that Karnataka has offered 1,000 seats to the Ukraine returnees — even though it is only to the state students — has filled them with hope. “If we get to study in India, there would be nothing like it,” says Stephen, adding that some medical colleges in Poland too have offered them admission.  

Meanwhile, she says, they have also got news that some of the other affected students are thinking of filing a PIL requesting the Indian government to give them seats in colleges here. “Our passport numbers and college details have been taken — let’s see what happens,” she says.   

Plight of students

Not so lucky are the students returning from Kharkiv and Kyiv. All classes are temporarily closed, for Fashi Allavuddin (21), a fifth-year medical student at VN Karazin Kharkiv National University. He was evacuated from Kharkiv to his home in Chennai. With only a year pending, he and his batchmates also seem to share a similar commitment to complete their MBBS degree.  

Allavuddin says students who went through a similar experience in 2014 when Russia annexed Crimea. “A lot of alumni from our university and neighbouring ones who faced similar uncertainties years ago reached out to us. They said that their demolished colleges were rebuilt and they were able to complete their course. Many are practising medicine in different parts of Tamil Nadu now,” he says, hopefully.  

To help Ukraine returnees, the National Medical Commission (NMC) has now allowed Foreign Medical Graduates in their final year with incomplete internships to appear for Foreign Medical Graduates Examination (FMGE) to secure internships in India. “I will be eligible in January 2024,” says Allavuddin.  

Though the fog of violent images from Kharkiv mists up our phone screens, for many students it was home away from home and the medical school was a site of stability, not chaos. “Everything changed overnight,” says a 22-year-old Sridhar Sanjeev Chinnasamy, who hails from Coimbatore, also studying medicine at VN Karazin University, reflecting on his time there. “It was a safe place. I have never experienced discrimination or felt unsafe. Locals are friendly and helpful. We all have an emotional bonding to the city,” adds Chinnasamy.  

Since learning lost cannot be made up later, a section of students are looking at options to enrol in a local medical college in Poland, Armenia, or Hungary, but it is no easy feat. According to Chinnasamy, “academic transcripts and official documents of some students are stuck with the university, and they are confused on how to proceed.”  

Though classes have come to a halt, their university has now rolled out a form to understand student willingness to attend online classes. Ukrainian medical universities are well-equipped with remote infrastructure because of Covid. “Most of 2021 and the whole of 2020 was online,” says Allavuddin.  

The way forward

The trauma of the war-affected students has put the spotlight on medical education in India and the painful lack of affordable options. It’s clear the system needs draconian change. As Stephen points out she opted for Ukraine because she would have completed her six-year education in ₹25 lakh versus over spending a crore here in India. Chinnasamy says a majority of the students come from middle- and low-income families.  

“It is very unfortunate that close to 18,000 students had to cut short their education and be forced to return. What is the way forward? This is a major policy decision that the Indian government and NMC have to jointly take. There is definitely capacity to absorb these students in Indian medical colleges, both government and private institutions. If 10 per cent supernumerary admission is allowed for students in each year, all of them can easily be accommodated,” says Lt Gen (Dr) MD Venkatesh, VC of a prominent medical college.  

But it is not a question of accommodation anymore. Students in the advanced stages of course completion in Ukraine may find it difficult to adapt to the current framework, especially since competency-based medical education was introduced in India in 2019. “The curricular mismatch needs to be addressed and gap analysis has to be performed. We need to be able to find out whether the Ukraine returnees will be able to merge into the current education system in India seamlessly,” adds Venkatesh.  

Educationist Chocko Valliappa, who runs the Sona group of institutions, says that over-regulation has led to this problem in India. In engineering, the fees at private colleges has been capped at ₹1.4 lakh annually by the Justice Srikrishna Committee and in Tamil Nadu, the state government has further capped it at ₹50,000 annually. There is no such cap in medical colleges. When capitation fees were done away with, the colleges simply raised the education fee.   

The solution is also to have more colleges, but the entry barrier is huge and licenses tough to obtain, plus rules like needing to be attached to a hospital. “Why not do away with licenses and instead institute a stringent examination every six months for the students and a compulsory stint at a district hospital to ensure quality standards,” he suggests.  

Allow more corporates to come into the field of medical education,” he prescribes. He also says states could follow Karnataka’s example which has permitted private colleges to be attached to government hospitals.  

There are multiple factors at play. It also needs to be kept in mind that there are Indian students pursuing medicine in countries besides Ukraine as well. Although there are no humanitarian crises in those countries, if those students demand that they be made eligible for these special provisions, then it will pave way for more problems, points out Venkatesh. 

“There are so many students who qualify in NEET but are not getting admissions into medical schools. Are we diluting standards here? Will this be a rightful denial of some students who weren’t able to get admissions into medical schools in India? Moreover, if the government decides to offer the programme at a reduced fee, then the current set of students may raise concerns,“ says Venkatesh.