neet: The money one needs to shell out to become a doctor in India
Gandhi, who has been in the business of education placements for 12 years, says many students, faced with the steep fees, will give up their dream of becoming a doctor despite making the cut in hyper-competitive National Eligibility cum Entrance Test or NEET. Scores will get duped by agents who promise them a seat in a government college with payoffs of Rs 15-30 lakh.
“I see many cases every year,” she says. Gandhi’s business is to find solutions by placing students in countries as diverse as Russia and Philippines, even Bangladesh, where the cost of becoming a doctor is less.
Too few seats
Prime Minister Modi inaugurated nine medical colleges in Uttar Pradesh this week. This is a drop in the ocean, though; all put together will add a mere 700 medical seats in a country with 1 doctor per 1,511 people against the WHO-mandated one per 1,000.
In a pandemic, this shortage of doctors can, and did, cost lives.
No correct estimate of number of undergraduate medical seats exists in the country. Most rough estimates are put out by coaching institutes. Gandhi estimates that roughly 40,000 undergraduate seats are in government colleges which offer subsidized medical education. Here, often the fees is below Rs 1 lakh for the entire MBBS course of five years.
The remaining 60,000 seats in India are in private colleges and deemed universities. These institutes charge an annual fees of between Rs 18 lakh to Rs 30 lakh. For a five-year course, that works out to a cost between Rs 90 lakh to Rs 1 crore.
Coaching cost, and suicides
This is not all. In high-stakes NEET, where over 16,00,000 aspirants will compete for 1,00,000 seats, aspirants need coaching to make the cut. The Justice A K Ranjan Committee, set up by the Tamil Nadu government to study if students in English-medium schools have an advantage, found that they did. The committee, which gave its report in September this year, says seats are going to affluent students with the cost of coaching a whopping Rs 10 lakh per individual.
The Tamil Nadu government’s probe was prompted by teen suicides in the state as medical aspirants from low-income homes, feeling hopeless, killed themselves.
While on the one hand aspirants are ending their lives, reasonably sure they will not be able to fulfill their dream of donning a white coat, successive governments have been unable, or unwilling to add to spending on health — which includes opening new colleges to create a pipeline of doctors and adding beds — leaving the average citizen vulnerable to disease.
Not just the horrific Covid shortages in April, in September, at least 12,000 people were bedridden in Uttar Pradesh’s Firozabad, with a
dengue outbreak that had the district in its grip. More than 100 died, 88 among them children.
The country watched viral videos of poor parents falling at the feet of administrators to save their children.
People scrambled for beds and doctors, and patient care cost at private hospitals skyrocketed. A daily wages worker, who lost his 5-year-old son to the fever, said a private hospital asked him for Rs 30,000 to start treatment.
India needs at least 1.8 million doctors, nurses and midwives to achieve the minimum threshold of 44.5 professional health workers per 10,000 population, says a World Health Organisation report in 2020.
‘The Covid-19 pandemic has exposed various fault lines in the country’s health sector. Low investment, sharp inter-state variations in the availability of health infrastructure and in health outcomes, supply side problems of doctors, paramedics, hospitals and inadequate number of healthcare centres like primary health care centres are some of the structural challenges that exist. Consequently, we find about 70 per cent of expenditure on health is out of pocket, one of the highest globally. High out-of-pocket expenditure poses the largest risk to the population living below, and at the margins of, the poverty line,’ says the report of the 15th Finance Commission, 2021-26, the first of its kind stock-taking of India’s health backbone in the pandemic.
Exodus of students
Other countries benefit when India becomes too costly for medical education. Apart from Russia, Kyrgyzstan and Kazakhstan being favourite destinations for medical students from India, Philippines, and now Bangladesh have emerged as meccas for medical aspirants.
‘A number of students aspiring to become doctors choose to take admission in medical colleges in foreign countries. The number of such students rose from 3,438 in 2015 to 12,321 in 2019,’ said the 15th Finance Commission report.
A Bangladesh ‘package’ costs a student Rs 25 lakh to Rs 40 lakh; in Philippines a medical student can complete an MBBS course for Rs 35 lakh and in Russia an aspirant can become a doctor for Rs 20 lakh, hostel included.
“Deserving candidates are going abroad,” says Gandhi.