Globalization – Brain Drain

Indian flag photographic collage

So it is time to come back to the series on Globalization.

Human Capital Flight or Brain Drain is the migration of educated and skilled professionals from less developed places to more developed places. The usual reasons are going abroad for further education and settling there or taking jobs in developed countries for better salaries and living standards. While brain drain does result in financial profit for the persons migrating or their families they may remit money to, there are other less realized aspects of brain drain that also need to be considered.

Expense of education borne by less developed country, while fruits of the person’s service are reaped by developed countries.  Today’s outrage on Twitter was the government making it mandatory for doctors going abroad for further education to return to work in India after completing their education and reserves the right to enforce it by not issuing No Objection Certificates to doctors who don’t comply. The government of India estimates some 3,000 doctors who studied in government subsidized hospitals have left the country in the last one year. The annual cost of each student is about 31.31 lakh rupees, while fees charged are Rs.850/- per annum. The government is paying the difference per student that results in no gain to the citizens. 939 crores is no amount to sneeze at. In a country with high poverty, scarcity of medical professionals and tight budgets, this money should be better utilized or recovered.

As far back as 2001, the UNDP had estimated that India loses about $2 billion a year from IT professionals taking up jobs in the US alone.

Some argue that those working abroad remit money. But a country’s well being is not money alone. When 3000 doctors go abroad, there are supporting jobs that get reduced too. Less nurses, less ward boys, less patients treated, more losses due to ill health, less villages with access to healthcare… it is all interconnected – which is why governments subsidize – for development.

On a “for higher education” scale… a 2009 report by Associated Chambers of Commerce and Industry (Assocham) estimated that India lost around $10 billion annually in foreign exchange from an average 5 lakh students choosing to go abroad for further education every year and made a strong case for deregulating higher education. The concern of the Indian government that doctors going abroad for further education return to work in the country makes sense. But more is needed. here need to be more and better education facilities to keep the students in the country – which will also result in more jobs within the country. It is a cycle.

The government spends considerable money in education from basic schooling to subsidizing degrees that have costs well beyond the average man’s capacity to spend. This expense is intended as an empowerment of citizens as well as raising the skill capital of the country. Brain drain delays the development of the country. In his essay on Globalizing Inequality, P. Sainath quotes statistics from Africa from the Economic times, and puts them in a context of national interest.

…today, according to the Financial Times, the entire continent of Africa has just 20,000 engineers and scientists to serve a continent of six hundred million people, because today, there are more African scientists and doctors and engineers working in the United States than in all of Africa and much of this drain of medical personnel has come from South Africa – the country facing the world’s largest AIDS pandemic.

Lower employment in developed countries. Migrant professionals increase competition to native professionals and often work at lower salaries, resulting in increased unemployment for the local population. UK’s visa restrictions for professionals from 2010 came from rising unemployment in the country with hundreds of thousands unemployed IT professionals and engineers while 36,000 immigrated for jobs from outside the EU. As the economy tightens worldwide, these inequalities become more and more visible and resented.

But beyond this, there is also a social cost. When well educated people leave for more prosperous surroundings, their influence also leaves with them beyond their services. Educated minds lead to a more thinking society and increasing brain drain adds to the less developed areas remaining permanently mired in poverty and less world aware society.

Brain drain, or Human Capital Flight increases inequality and makes poorer countries poorer and richer countries richer. A few random examples come to mind. Michio Kaku, the scientist-activist calls the H1B America’s secret weapon. It is the visa for professionals to immigrate. Over half of America’s top professionals are non-Americans and they are driving the country’s prosperity, because they change the ratio of educated and skilled professionals in society – making the country skill dense and thus with more opportunity too. On the other hand, if India has one doctor for 1700 people, Ghana has one for 6700 people. 305,000 Malaysians migrated overseas between March 2008 and August 2009 compared to 140,000 in 2007. According to the official Chinese media, 65,000 Chinese last year secured immigration or permanent resident status in the United States, 25,000 in Canada and 15,000 in Australia in 2007. A 2007 study of Chinese students found that 7 out of 10 students enrolling abroad never return. And while it is true that lack of opportunity or oppression drives or abundant opportunity pulls these people, these numbers of people moving to greener pastures is also making the pastures greener, and their loss is desertifying the pastures they leave.

Many have recommended deporting/encouraging return of Pakistani professionals back to Pakistan as a possible solution for dealing with extremism by increasing powerful, influential voices who have seen the merits of a developed and inclusive society. Obviously no one imagined them to pick up guns and fighting wars with the Taliban, but the influence of thoughts that were more broad minded would dilute the influence of extremism and provide alternative ways of thinking for people at large. In other words, they would strengthen the moderate voice. It is no coincidence that reversal of brain drain was suggested as a developmental intervention.

Needless to say, I support the government’s decision to make it mandatory for doctors to serve in the country even if they go abroad for further education. In addition to doctors studying in government colleges, I think doctors studying in private colleges should also be required this, though for a shorter period. There are reasons – below.

  1. Whether a government or private educated doctor, the government still has made considerable contributions to making that education possible and in the cost that is possible in India. Consider, for example an Indian doctor and an American doctor working on similar jobs, paying off their education loans. Even if the Indian doctor gets paid less, guess who finds the payments easier? That is the difference in a developed and developing country, which makes a developing country more needy. I see nothing wrong in citizens with the capacity to pursue extensive education being expected to have a stake in helping develop the country.
  2. I think this should apply to all professionals, not only doctors, though doctors have more conspicuous investment and scarcity of professionals.
  3. This should not apply to those who do all their degree education abroad, since their investment is also in another country.

I got several significant comments, which I’d like to talk of here.

The medical students are already giving in a lot of effort for 7-8 years to go through a shabby education system. Give them adequate compensation/incentives to work in rural areas. Monetary/reduction in study term/preference in PG admission. ~ Raj Rambhia [1][2]

This, I think is a matter of education reform, and applicable to all students whether they continue working in India or abroad.

the question of how the students can “give back” is indeed a serious one. the number of students that manage to study medicine in India is largely due to government subsidized education. Two issues here 1. How do you get them to “pay us back” and 2. What about all who studied in private colleges.

1. Lets say, 4.5 years of studies and the avg. 10 lakh that the govt spends on a student can be reimbursed in 1 year of internship and 1 year of Bond. The bond already exists, and lasts 6 months long. Problem is, there is no enforcement. Is 6 months enough? will one year fix this? Difficult decisions to make. In the 6 months, of the docs who do it seriously, a large number of them see upwards of five hundred patients a week, many do twice as many. thats a few hundered thousand patients treated by the lot of them, does that cover the costs?

Now, they get to go abroad only after they finish the bond, and get a NOC. The new “law” adds a clause to the NOC, it says studies that you do on your own money, in your own time, also, now belong to the nation. Meaning, you come back, irrespective of how many years you have worked in India. and “given back”

2. What about all those who did not study in government colleges? Like me. My college made me do a bond, 2 years paid pittance and on call24x7, I enjoyed it, as did most others I know. Now, 3 years down the line i might want to go work in the US for 10 years, maybe my wife wants to do a PhD, but if I go by the j1 Visa, i cannot, my visa expires when I finish studying.

~ Uberschizo

I am not certain even in this instance the government is speaking of private colleges, though I support even if they are. Also, I am not certain the government means stints working in India for every higher education course. The impression I got was mandatory serving in India, which would be a one time deal. Let us see what clarifications emerge.

Additionally, I think for exceptional cases, there should be an alternative to reimburse the government for the money invested in their education in stead of working, though I hesitate to recommend this, because it isn’t only about money, but a professional less in the country. Also, extremely specialized doctors would find it far cheaper to pay back than invest time, but our country needs the neurosurgeons more than the money.

I think some of this also ought to be in reforming education so that students form attachments in the country and genuinely care about the need of the country, which will go a long way toward making this easier for all.

Another comment referred to this as a “communist” choice. I disagree. It is about as communist as the country making the specialized education possible and affordable or people earning more also paying taxes at higher rates. On the other hand, it is capitalist in an exploitative way to the interests of people of both countries to get educated using resources of a poorer country, depriving someone of them, and then going abroad to undercut salaries for doctors who have invested far more money to get qualified there.

In my eyes, while specific solutions may be good for specific groups of people, governments being responsible for entire countries, have a responsibility to make decisions that will help all. The decision to enforce professionals to serve in the country impacts thousands of lives beyond that student alone.

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28 thoughts on “Globalization – Brain Drain”

  1. I don’t have much knowledge about the healthcare sector. So my comments are mostly generic.

    agree that there needs to be accountability when the taxpayer’s money
    is invested by the government on someone. My objections are mainly from
    an individual’s point-of-view. The rules (or the suggestions for the
    rules), as they stand currently, seem harsh and unfair. The author of
    the article is outspoken about human rights, but I am surprised such
    rules aren’t being considered as a violation of human rights. I think
    these rules impose restrictions on one’s right to invest his/her time
    and money wherever and however he/she pleases.

    First of all, such a bond should only be applicable if the
    government is sponsoring the education. The government has no right to
    enforce such bonds on someone to whom it is not contributing the
    taxpayer’s money. One might argue that since the land (and other
    facilities) of the institution (and the home) are provided by the
    government, a non-government sponsored student also owes the government.
    But the student is paying the institution, which contributes towards
    the repayment of this debt through taxes paid by the institution.

    The current proposal is imposing an unconditional bond on all
    previously sponsored students, which is grossly unfair. When the
    government is sponsoring someone, the bond (being discussed) should be
    agreed to and signed by the participants before sponsoring. The terms of
    the agreement can’t be changed once signed. There should also be an
    opt-out and/or drop-out clause in the agreement. The student should be
    able to opt out of the scholarship and pay the fees directly. After the
    end of the education period, the student, who has received the
    scholarship, should be able to repay it instead of serving the country.
    The cost for these could be prohibitively high, but such an option
    should be provided.

    A serious drawback of the current proposal is the lack of a time
    period for serving the country after government sponsored education. The
    time period should be clearly mentioned in the bond signed before the
    scholarship is offered. For instance, engineering institutions in
    Singapore mandate that you work in the country for 18 months if you
    accept government scholarship during your masters; the choice rests with
    the student. This time period depends on the scholarship as well as the
    institute. For example, AIIMS can have a larger time period in their
    bond than other government institutes, since the government invests a
    lot more on AIIMS.

    Another factor that needs to be considered in the bond is the
    contributions made by the student while studying. For instance, a
    medical student might work in the institute-owned hospital while
    pursuing education and a research/PhD student might (work and) publish
    research papers while pursuing education. Such work by the student
    contribute towards repaying the government.

    In summary, the bond depends on the student and the scholarship
    offered by the government. I do not support the
    one-bond-to-rule-them-all currently being proposed.

  2. One Dr. Irfan Omar (UK) had made a very pertinent point that India does not recognize US medical degrees/fellowships, so those who’d be forcibly made to return to India would have a real raw deal.

  3. This might seem a minor aspect in the entire argument, but as far as I know, most students go to the US as ‘exchange’ students (on J1 visa), and as it is they’re obliged to return to their home country upon completing the residency – the very next day!

    So, the status quo for vast majority of students is anyway not going to change cuz they would, by the US law itself, have to return to India.

    1. Thanks for writing that post Ketan. I have skimmed through it and must go through it in detail (it really is long!). But I hope I understood it’s gist and agree with you.

      One thing that fascinated me is that the government could just as easily have publicised numbers for the amount of grants given to medical colleges. Instead, they released data for the most elite college in India. So a law applicable across the country will be decided based on numbers from only the most well-funded college and hospital in the country. There is not even an attempt to average out the amount of money the govt. spends on other colleges. Have you been to some colleges in say, Chattisgarh or even Yavatmal, Nanded, AP? The library in my own college was a sham.  When I hear armchair critics lamenting about subsidies and the ‘facilities’ provided and then demanding their pound of flesh, I feel like giving them a tour through the medical colleges across the country. If 31.31 lakh is the amount of money govt. spends on each student per year in these colleges, there is a scam right there.

      The purpose of releasing such arguably spurious numbers is apparent. If a fairly well-informed person like Vidyut is so easily taken in by these numbers, imagine how others who don’t look into these in detail would feel about this populist move.

      1. I hear you on the bad facilities. I am certainly not “taken in” by those numbers. In my view, those numbers are secondary. The lousy state of the education makes people not want to give back or rather they think they didn’t get much to give back.

        In my view education reform and brain drain are two distinct things. improving the learning conditions and facilities (as well as being realistic about expenses) are one aspect. The other is the fact that the country needs doctors quite desperately. 

        I find it really funny that it is almost the same set of people – not you specifically – who think the people of Koodankulam – who pretty much got nothing from the state – should give up their reservations over the nuclear plant “for the larger good” – something that is a change for life, but see a few years of mandatory service by doctors as something too much to ask.

        Some people are indeed more equal than others.

        1. I’m very glad you brought up Koodankulam. I was hesitating
          to bring it up because of the difference in magnitude between the two issues, although
          both are indeed changes for life, one more dramatic than the other. I will obviously
          not draw an equivalency between the threat of a nuclear disaster and the
          inability to work in your place of choice. But there are other aspects of the
          two issues that can be compared and since you brought it up, I’m going to run
          with it.

          Yes, I see the hypocrisy when many people support the nuclear
          plant for the greater good but will most likely not be willing to do the same
          sacrifice themselves. As far as I’m concerned, if I put myself even for a few
          minutes in the shoes of those people from Koodankulam, I cannot imagine giving
          up my home. So whatever the debate for ‘the greater good’ or the feasibility/safety
          of nuclear power, I support the rights of the people at Koodankulam to live
          where they want to. They, and others being asked to sacrifice for strange
          policy decision,  should not be made to
          move. It is disgusting that some people are not treated equal to others. But
          that is no excuse to keep perpetuating that same mistake to more and more

          Another reason why it’s good that you brought up Koodankulam
          is I remember that you rightly called out another blogger (I think Kaipullai)
          for using spurious numbers to support his point of view. You called it
          disinformation and/or ignorance. Yet in this blog post, you are making the same
          mistake or poor decision. I won’t ask you to take down the wrong numbers since
          this is your blog and you are free to write what you want. But as a commenter I
          can point out that it would be good practice and just plain decent to
          acknowledge that numbers like 939 crores may be very inaccurate. And clearly
          state that better data is needed before making decisions. For you this is
          secondary but numbers like these form a major basis for policy decisions. I’m
          seeing similar numbers and logical fallacies (using just the most well-funded
          institute to draw conclusions about the rest of the institutes in the country)
          cropping up elsewhere. (I do not like harping on the financial side of this
          issue but that is the way the issue is being framed, so I think I have to
          respond on that front. In the greater scheme of things, your post and my
          comments are probably totally inconsequential. But since we are doing this
          anyway, let’s at least try to do it right.) Also, you are using those data in
          your post to support your argument even if you consider them secondary. So yes,
          you are taken in by them. Those are numbers, not a belief or faith. Either you
          agree they are correct or you don’t.  No
          sense in using those numbers to reach a conclusion, then discrediting them but
          still hang on to the conclusion.

          One more reason why talking about Koodankulam is relevant
          here: As you pointed out in one of your posts, cutting the transmission –distribution
          losses, improving storage are some of the ways in which we may be able to deal
          with the power shortage without having to go for nuclear power. That is a
          nuanced and logical argument. A basic premise of those who call for nuclear
          plants is that they see it as a ready and easy solution to the problem.

          Something similar is happening with this debate about
          doctors having to forcibly come back. Forget for a moment the actual economics
          and taking away the right to work where you want. The basic premise that
          increasing the numbers of doctors is going to improve health outcomes is
          questionable. For all the talk of US being the magnet for doctors all over the
          world and for its reputation as providing the best health care, the reality is
          that in 2006, the United States ranked 39th for infant mortality,
          43rd for adult female mortality, 42nd for adult male mortality, and 36th for
          life expectancy internationally


          Those are astounding numbers for the purported world leader
          in healthcare. There are many reasons for this paradox but one thing that
          stands out is that having more and more doctors does not solve the problem. If
          anything it raises the costs of health care putting the entire system in
          jeopardy as is happening now in the US. And it will happening in India too.

          So what is the better way? The focus of clinical medicine is
          the individual patient. But public health focuses on communities and
          populations.  I wish the powers that be
          and the alert journalists and bloggers like you would be more aware of the
          significance of public health for the preventable conditions that plague India.
          Services for the conditions which cause the most mortality and morbidity like malaria,
          TB, diarrhea, providing vaccinations, anemia , safe childbirth, post partum
          care, family planning services  are not
          reliant on doctors. These can be and often are, provided by ancillary workers.(
          I won’t go into the very real prospect of job growth for rural sectors if more
          ancillary workers are trained for this purpose but the obvious potential is
          there). The recent good news about polio in India is an example. Do you think
          doctors sent in rural areas were responsible for that success? It was the
          public health setup, of which doctors are a small part, that was responsible. The
          irony is that the government won’t have to spend as much money and effort to
          improve the public health scenario in India as it might have to get doctors to
          work in rural areas. Some of the steps that I appreciate the govt. taking are opening
          up Indian Institutes of Public health across India (although that seems to be
          now entangled in the usual red tape) and starting the new short rural doctors

          But these changes being slow and painful do not receive the
          coverage and appreciation they deserve (how many people even know about the
          IIPHs/Public Health Foundation of India?) Populist but ineffective moves like
          the one proposed now based on dubious statistics get sensational headlines and
          eyeballs and are thus supported. Plus it conveniently fits the worldview about
          the elite and entitled doctors from rich homes not wanting to get their hands
          dirty or put up with a ‘little inconvenience’. Getting all judgmental and
          cynical (most journalists) without understanding the issues is the easiest job
          in the world.

          There is no apparent attempt at cost effectiveness research or
          outcomes evaluation to support the theory that forcing more doctors to work
          where they don’t want to (right now) is going to improve conditions. Of the
          doctors being trained now in India, and of those who will be made to return,
          how many are aware or practice public health? You will ensure that the doctors
          will be made to work in a rural area for a certain period. Forget what this
          will do to the doctor’s career and life choices. Will this contractor-like
          system work in the healthcare field? I have heard some examples from the
          education sector and the news is not encouraging. Any thought being spared for
          the increasingly invisible concept of doctor-patient relationships? Does it not
          make more sense to provide local ancillary workers familiar with the language
          and culture of a place and who have very good reasons to stay in the community,
          work opportunities there?

          These are the reasons I called this policy butt-headed in my
          previous comment.

          To me this outcry to get doctors to come back resembles what
          Republicans in the US are doing. They are belligerent about cutting funding to
          planned parenthood (saving about only 300-400 million dollars) but balk at raising
          the marginal tax for the rich (saving 4.7 billion $ per year for next 10yrs).  The data they are relying on for this is just
          plain wrong (abortion is not the primary service provided by PP, only abt 3%)
          but they want to attack PP since there is a ‘desperate’ need to save the lives
          of those unborn babies. Closing off PP is easy, convenient and will save money
          quickly. So they want that legislation. Taxing the rich is more logical but
          harder to digest and does not fit in with their ideas, so it is avoided.

          There is more to be said and addressed here, but I’ll return
          later. Thanks.

          1. You humble and overjoy me with the detail and attention with which you have read my work! Thank you. No words to tell you what a comment linking various trains of my thought feels like. You made my evening.

            About the numbers? I agree that the government figure 31.31 lakh per student is fairly unrealistic and have said so in an early comment myself. At the same time, that is what the government has officially stated. So I fail to see this as a misrepresentation exactly. The larger number is a product of multiplication with no specific rocket science from me.

            A admit that not having any clue on how much medical education costs, I took it at face value while writing the post. The first time it got questioned, I realized that it seems quite large. The money is a very small concern for my post – rather an excuse/justification by govt that I accept. The amount as such does not matter to my orientation on the subject.

            However I get your point that if we all seem agreed that the number is likely inaccurate, then being upfront on that is better, so that it is appropriately discounted in our thought process too. I will add a note to the post.

          2. Thanks!
            The 31.31 lakh figure may or may not be correct. But nevertheless, it is the amount for just one institute, which also happens to be the best and my guess is among the most well-funded. Touting that while making a case for policy change as the govt. is doing, is like citing the billions of dollars spent in the US defence budget to ask South Africa to cut defence costs because the ‘world’ is spending a lot on arms.Hence it is a misrepresentation. Since the 939 figure is derived from that (I know you calculated it , 🙂 I did the same since there was no citation), I question it too.

      2. Dailygrinder,

        Yes, I have been to at least Dhule’s Government Medical College, and I know what you’re talking about.

        In fact, to be honest, even for AIIMS that sort of spending does not really take place! I mean c’mon, they had to resort to enlisting “furniture” in counting of expenses! 😀 It’s not that AIIMS students enjoy air port lounge kind of facilities. Even in AIIMS, the spending student education are not that high, definitely not for the undergraduates. Moreover, if they’re spending that much on furniture, how long will that furniture last? Definitely more than 20 years? Why show all that spending as that done on students? Why, instead not show that furniture as spending on politicians who seek treatment there? Rs. 8,500 per month of rent on twin-sharing basis is **not** cheap by any standards. I’m sure any and all furniture used on a student can be recovered just only from 2-3 such months’ rent.

        The only aspect missing in my analysis is that of postgraduate research. Yes, if an institute provides facilities like electron microscopy, flow cytometry, PCR, etc., and data from which need not always be of direct use to the patients, then one may say that the government is **spending** on students (as against spending on patients). But even then in theory as well as in practice, the data thus obtained is supposed to be of use to patients in general, later on.

        Yes, you have very aptly put: “If 31.31 lakh is the amount of money govt. spends on each student per year in these colleges, there is a scam right there.” 🙂

        I’d been planning to do that kind of blog post since long, but Vidyut’s (and also sort of Uberschizo’s) falling in that trap prompted me to write all of that down. 🙂

        1. Arunabha Karmakar

          In your blog you forgot to subtract the Rs 850 paid per student per year X 100 students X 5.5 years. That is another almost Rs 4.675 lakh returned to the government right there.

  4. Also one needs to question the need to subsidize higher education – have a robust education loan system – than be burdened by subsidies.

  5. Disagree- At best the govt has a say on govt educated doctors. That for how long, am i to be a bonded labor because i went to a subsidized gvot college? A time bound bond for the subsidized education received is understandable, all else is unjustified. We also forget the influence the diaspora has at a larger scale. to me it seems to be a case of sour grapes more than anything else. If I have paid for a private education (which ever be the field) I should be free to pursue higher education and a career any where in the world. 

    Natural law of nature people will gravitate to where they find job satisfaction and a desired life. What India needs to work on is to make India a desirable destination for the best talent world over to come and work in, rather imprison people here. though this will take hard work of creating a free open fair society. (when have we loved hard work??)

    Instead of locking down people and demotivating them – We need to look at a solution that creates an atmosphere that attract the best in the world. (In some areas there are early signs of this happening) the current suggested solution if it applies for non-subsidized education and with out time limits for subsidized (once i have served time, i am free) – the rule is oppressive and hence not desirable

  6. I’ll follow up with a detailed comment later on, right now just wanted to post a correction.

    The Rs 850 per annum fees is for AIIMS only (and could be for a handful of other central government hospitals too). It is Rs 970 actually for outstation candidates (the bulk of students there.) And AIIMS takes in only 50 students per year.

    The study by AIIMS admin needs to be put in the public domain for verification of  the numbers of 31.31 lakhs. Even if that figure is accurate, do you really think that that is the same expense borne by other medical colleges for each student?

    For government hospitals in maharashtra alone, for the general category candidates, the annual fees was around Rs 9500 – 10,000 in 2000-06. This is obviously still subsidized but definitely not comparable to the generalized figure of Rs 850 and the grossly alarmist figure of Rs 939 crore calculated by you.

    If we are talking about students leaving over the past 3 years, how many of the 3000 would be from AIIMS (200?, 300?, 500?) and how many from other govt. and private hospitals? and

    If you account for the above and the fees paid by students of private institutions, the 939 crore figure will be reduced very significantly. I wouldn’t be surprised if that figure is less than what doctors abroad remit back to India in direct or indirect ways.

    Of course, this is purely a monetary argument. The other things you mentioned about skills and human resource are worth addressing and I will do so soon.

    And before parting, I’ll touch on the taboo topic  – students pay different fees to the government based on their caste. Yes, they do. There are complete and in some cases partial fee waivers for students from the reservation categories. Please don’t turn away your attention in disgust just yet because I’m bringing in that angle here. Because we are talking about 50% reservation here, more in TN. I am not argiung against the differential fees or even the caste based quotas here. I’m saying that the cost of educating students is not the same for every student. Educating close to 50% of the class is more expensive for the govt. Some pay more, some pay nothing or less. Will the government factor in that too when calculating the burden of brain drain? I’m pretty sure they won’t. Sweeping genralizations as made by the govt. (and by you here) are part of the reason why we have butt-headed policies that have got us in this mess.

  7. Don’t force, encourage. Most would stay here only if they were cared for. 

    And why not focus on reverse brain drain? Encourage doctors who haven’t studied here to come and settle down as well!

    1. That would happen, if as a country we were a desirable destination.. takes lot more hard work for the political class.. why do that when you can lock people up, shut and seal their rights to speak and so on…. we have paradise on earth happening….

  8. The glaring problem with the forced bond is that we dont have the infrastructure or the money to pay for the ones that come back this way. brain drain sounds bad, but happens because it makes no sense for a person to slog it 15 years to become a professional and then not have options for learning and growth and good professional experience in his home country. I wonder where the figure of 31 lakh comes from, and how do you justify the private colleges coming under the rule?

    1. Infrastructure will have to be developed like so many things in a developing country.

      Money… we actually save money fighting brain drain.

      15 years? and no options for learning and growth? sounds excessive to club everything kindergarten onwards into that medical degree, but later need justifications for only a private degree. That said, it is an important question. Perhaps the govt should give a committment for job placements or waive the requirement?

      31 lakhs is the govt figure packaged with the announcement – which sounds quite “scamful”, unless doctor education needs really scandalous amounts of expense. on the other hand, considering accommodation and all? maybe not? I don’t know. Needs investigation.

      1. CMC, vellore, which spends an obscene amount on students does not claim spending more than half that amount, the govt. figures are a scam for sure. 

        15 years was a hyperbole for MBBS, the real figure is around 7 years. because you start slogging after tenth and if you are very smart you get through in the first attempt. (no shameless plug intended :)) 

        If you dont, you slog for another year or two before you make it, in which case it is 8-9 years.

        After MBBS, if you are the top 5% you directly enter MD, which is 3 years, making it a total of 10 years for the top 5% and upto fifiteen or more for the rest of us, not counting bond. 🙂 

        I am in the 14th year of having decided to go to med school-  and it is only now that I am planning a PG .

        Yes, this shit eats away your life like nothing else does. 

        And as for lack of growth, and learning, ask around. and look at the research that indians in indian medical colleges publish vs indians abroad do. world of a frigging difference. 

        These are the institutional problems. Not saying greed and materialism and selfishness have  no role, but these problems are real and unless some of them are solved, the brain drain will not be reversed. Btw, engineering, much less expensive, still, much higher drain. reverse drain now, because the system has place for them. 

        1. Without any disrespect to you or your perspective intended, wouldn’t these be problems of the system rather than specifically for people immigrating abroad?

          So, yes, the system sucks, and like everything in the country needs an overhaul. No debate there. At the same time, why would a doctor going abroad be exempt from our national inefficiency epidemic? As opposed to doctors staying here, for example.

          1. I think it makes a lot more sense to ask people to work in India for 2 years before they leave. the govt also subsidizes gas, does not mean we have to cook only healthy food, eat patriotically and suchlike. Concessions are the right of a nation that is socialist. if all who have received concessional anything were to pay it back, we would have time for nothing. The question right back at you, why doctors, why not cooking gas users? 

          2. Good question, this cooking gas one. In my eyes, a matter of time. I don’t think every paying back has to take substantial time, or mean occupation. At the same time, I think if we are to exit our self image of poverty and move to self-dignity, it is important we find ways people can pay back.

            In my eyes, the trick is in finding *ways* people can pay back. So that everyone can, and we all contribute to a shared whole.

            Won’t happen overnight. People with more conspicuous belongings (tax) or benefits (subsidies) will happen sooner than others, but my instinct is that this is a step on that path and it feels welcome.

          3. Any rule that is oppressiveness and limiting can not make sense. Reduce rules. If we are short of doctors, bring them in – Seemed to happen with pilots why not doctors – knock of subsidies and use that money to pay docs… the issue with the line of thinking of this law is we could justify – 
            ban Indians from working abroad, for in some convoluted way we all will have rcvd some govt support. and say only people with out higher education/BPL, can work abraod. solves the problem of brain completely. may be add to the exception all political intrest groups that can win you an election

        2. Agree…more so as principle we do not need oppressive and autocratic laws…opens up more venues of money making for people siting in the right places..

      2. Official accommodation (on twin sharing basis) within AIIMS campus for MD Opthalmology junior resident costs somewhere around Rs. 8,500 per month, which is only slightly lower than the prevailing market rate in neighboring areas. I don’t know about other posts/courses. But that’s far from subsidized, though the monthly stipend is around Rs. 44,000.

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