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Doctors without borders

Why should India restrict qualified doctors from abroad?

Written by Anna Stratis |
July 23, 2009 12:32:00 am

A staggering 10 per cent of graduates from Indian medical colleges are practicing abroad,mainly in four nations: the UK,the US,Canada and Australia. This represents 60,000 Indian physicians supplying these developed nations,according to a prominent US medical journal. The total number of NRI physicians practising internationally far exceeds this number. This “brain drain” comes as India faces a mounting physician shortage,which impacts rural populations and the urban poor.

Concerned about this shortage,the government has encouraged foreign medical graduates of Indian origin to return to practise in India via the qualificatory FMGE Screening Test. This is a laudably broadminded scheme. But there’s a catch: only Indian citizens or persons of Indian origin may apply. Yet,given the need for innovative strategies to boost physician numbers here,India should allow non-Indian foreign physicians to enter the Indian medical profession.

I am a Canadian citizen and have recently completed all training and licensing requirements to practice as a family physician in Canada. Despite my European heritage,my aspirations for medical practice lie exclusively within India; my

reasons for this have matured over the course of seven trips to India,made over five years of my medical training. I foresee an exciting medical career in India,particularly as the infrastructure of primary care is improving in this country with the introduction of postgraduate training programmes in family medicine. Many NRI physicians are returning to India to practise after years spent abroad,attracted by the new availability of world-class opportunities here. They cite a

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passion to make a real difference in their work. I too yearn to join them — yet current regulations from the Medical Council of India state that a foreign national without Indian heritage or citizenship cannot obtain a permanent licence to practise medicine in India.

In comparing the medical licensure regulations of India and Canada,I was surprised to learn of significant discrepancies. An international medical graduate (IMG) does not need to be a Canadian citizen to pursue Canadian medical licensure. Permanent resident status via entrance as an immigrant or refugee is all that is required. Once immigration is complete,an IMG of any nationality with a medical degree from a WHO-recognised medical school is immediately eligible to be request accreditation for medical practice. Contrastingly,there is no permanent resident status under which a non-Indian foreigner may pursue medical licensure in India. A foreigner without Indian heritage must wait eight years after permanently settling in India before being eligible to apply for citizenship,and could wait many years thereafter for citizenship to be granted. And,for persons without Indian heritage,India does not permit dual citizenship. The prospect of giving up the identity of one’s birth country is a formidable barrier to pursuing Indian licensure.

This is a challenge: to look broadly at the potential benefit that India may gain from liberalisation of these regulations in order to welcome more international physicians to practise in India. India’s growing reputation for exciting work pportunities has ignited enthusiasm among foreign nationals everywhere. The potential for international exchange of human resources is demonstrated beautifully within India’s IT industry,which welcomes foreigners to partake regardless of origin. Canada has long enjoyed the profound benefits from the contributions of Indian physicians,who have enhanced our medical profession through their unique training perspective. By embracing international collegiality through relaxation of citizenship requirements for foreign physicians,India too may enjoy a stronger,more diverse health care system. Opponents of change may hypothesise that foreign physicians might rob jobs from Indian nationals,but in the face of millions of Indians lacking access to a physician,this belief holds no footing. To ameliorate this risk,a 2- or-3- year “return of service” agreement may be devised to mandate compulsory service in an underserved area for all foreign physicians.

Could I be the only foreign physician who is interested in working in India despite holding no ethnic ties to this country? Given the rising profile of new opportunities within medicine in India,this is impossible. However,after reviewing the nearly impenetrable citizenship requirements for entry into the Indian medical profession,I might be one of the few who have persisted to inquire seriously. Given the opportunity to pursue medical licensure in India,I would persevere through the necessary hardship at each step of training,as do the IMGs in my country with admirable spirit. In this new global world,where international borders are becoming increasingly permeable to the exchange of new ideas across cultures,I would challenge Indian authorities to extend this concept to the field of medicine. Canada,for example,continues to maintain exemplary medical standards while welcoming immigrants from every nation to pursue qualification for medical practice. For the benefit of its people,why would India not reciprocate?

The writer is a Canadian-born family physician living in Delhi

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First published on: 23-07-2009 at 12:32:00 am
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