Good Morning [%first_name |Dear Reader%],

It was early March. There we were, bleary-eyed and mildly irritated, straddling the invisible immigration control line at Delhi’s international airport, when I noticed something totally bizarre:

A long line of young students, some garlanded, curling around a smaller line of pet carriers. 

The pets looked as confused and frazzled as their owners, who’d been separated from other passengers in a strange way. It suddenly dawned on me that these were medical students on their way back from war-torn Ukraine. Sure enough, as we walked in step with them towards the exit, I saw them hive off and pool near placards that said “Tamil Nadu” or “Telangana”, where welcome committees were waiting to take their names down.

Their ordeal should have ended with the photo-ops of Operation Ganga.

Instead, these 18,000-odd students have spent the last four months unmoored and uncertain of where their medical career is headed. No college in India has space for them. The best their Ukrainian colleges can offer are patchy online classes. And the Indian government is yet to give any clear answers about making tweaks to India’s rigid university admission process. 

As I write this, the affected student body is organising itself for a hunger strike in Delhi, trying to stir up some political will. But Sai Krishna, an aspiring doctor who fled Kyiv Medical University in early March, has already made alternate plans.

There’s only Plan A

Krishna was bang in the middle of his post-graduate specialisation in surgery when the war broke out. He’s back home now in the Adilabad district of Telangana, biding time till he can get back to his studies. “My university has opened up a branch in Poland. I’m going to join there once my visa comes through,” he told me over the phone.

Krishna says he’s in a slightly better spot than some of his juniors, who’ve come back as half-baked undergraduates. Students in the first or second year of their studies have dropped out. The ones really stuck are those who’ve come back in their fourth or fifth years.

“When we came back from Ukraine, the state and central government made promises about accommodating us. But no action has been taken. Take my state for example. The chief minister of Telangana had talked about financial support for students who’d come back from Ukraine. He said the state institutions could take them in if the central government made a provision for it. Now, it’s no one’s responsibility,” Krishna says. 

The bureaucratic soup only gets worse. On Tuesday, the Union Minister of State for Health told the Lok Sabha in no uncertain terms that there was no legislative provision to accommodate these students. 

Sadly, Krishna and his contemporaries are stuck between two systems—one which propels them to go abroad, and another that prevents them from coming back. 

Clashing systems

First, there’s NEET, which is a nightmare—and the only way for Indian students to get into medical institutes, in India and abroad. The centralised test is allegedly riddled with problems, its preference for the CBSE board being only one of them. We addressed the NEET issue in a previous edition.

Under this system, approximately 7 lakh candidates end up vying for the 70,000-80,000 seats in government and private medical colleges. 

And before you ask why the government isn’t doing anything to increase the number of seats, the answer is: it is. But setting up medical colleges with proper faculty and facilities is a huge investment in both time and money. There has been an increase in new government medical institutes these past few years, which will hopefully lead to more seats. But the number of medical applicants has also gone up. 

So students who don’t get the top ranks have to either cough up Rs 70-80 lakh (US$87,600-US$100,000) for private college, repeat their attempt, or, you guessed it, head to a foreign university, often in countries such as Ukraine, China, or Poland. Costs aren’t as prohibitive there, with fees standing at around Rs 35-40 lakh (US$43,800-US$50,000). On social media, these foreign medical institutes are clearly still putting out the call:

Now imagine you’re one of these students. You’ve already done your MBBS in China and you want to come back to India to do your post-graduate degree, or practice medicine. 

You walk smack into the second system I was talking about. 

All medical students who’ve studied abroad need to clear the FMGE (Foreign Medical Graduate Exam) in order to practice medicine in India. The FMGE pass percentage—9.2%—is almost as dismal as the NEET pass percentage, which is 5%. “The FMGE doesn’t even have a key sheet [that students can refer to for the right answers]. You don’t get any information about what you did wrong on the test,” claims Krishna.

I asked him why he thinks the odds seem so stacked against these students. “It’s simple, they never wanted us to go abroad to study,” he says. 

For students that want to enter the system laterally, as an undergraduate, there’s also a fees and seats problem. Krishna says that someone has to take financial ownership for the student, especially if they’re being adjusted into a private institution, since it would be near-impossible for the returning students to cover the high costs. More than that, creating extra seats in the third or fourth year in a medical college would be harakiri, he adds. There would be serious protests from the existing students. 

Beyond these two issues, though, it’s hard to put a finger on why this absorption is so difficult. One potential reason could be the training imparted in foreign medical institutes versus what’s taught in India. (I was able to pick up some cues from student vlogs on YouTube, who’ve helpfully documented their experience for other aspirants). 

For example, there’s a law against using cadavers as part of medical training in Tbilisi, Georgia, which hosts a fair concentration of Indians in medical colleges. The student who posted the vlog also says there’s less exposure to a variety of medical ailments. The much smaller populations in these countries (excepting China, of course) doesn’t make for a very meaty practical experience. So, maybe the Indian government wants the FMGE as a checkpoint when these students come back. 

With each month they lose, Krishna says it’s going to get harder to catch up. He’s managed to find work in a local hospital as a sort of general practitioner, but only under the watchful eyes of a senior doctor. But he’s currently barred from applying to a government medical institute, or for any kind of higher studies in India. “It’s not like I didn’t do an MBBS,” he chuckles.

Krishna’s could potentially leave India again, and soon. But others like him might be stuck in limbo till the government decides what it wants to do. At the state level, the West Bengal government has absorbed their share of medical students at local institutions.

Source: The Indian Express

These students, though, are likely going to run into a fresh set of bureaucratic hurdles, since the central government isn’t having any of these DIY solutions at the state level. This is what the National Medical Council (NMC) has to say on that:

Back bench

The world of work, to put it mildly, is broken. No one wants a five-day work week anymore. People are still resigning in droves. And top it all, a recession looms. It’s a good thing there’s someone to capture this zeitgeist in a YouTube video.

Online creators are cashing in. According to data compiled by LinkedIn, job postings with the word “creator” have tripled since 2021.

Creators are now in vogue beyond the traditional consumer sectors of fashion, lifestyle, and technology, as the chart indicates. A ten-minute video to walk you through what to wear on your first job interview? Yes please.

Sensing money where the bright ring lights are, companies have put creators at the centre of their go-to-market strategies. That’s why LinkedIn has launched a Creator Accelerator Programme, which makes sense given its own data. Meta has also announced a billion-dollar fund which includes “seed funding to get creators started; bonus payments to reward those who are driving engagement on its sites, and heavy investing in monetization and creative tools.”

Even outside of promoting brands, the creator economy has spun out a new type of entrepreneur—someone who can create their own brand while creating content. One quick example from the edtech space is Physicswallah, or PW, which has evolved into a whole company with a billion-dollar valuation.

That’s why it’s not just LinkedIn and Meta in the game. Smaller, buzzier start-ups want a piece too. This is an email I received from Nas Academy this week. A “platform for creators, by creators”, Nas Academy has a new course on the market:

It’s truly impressive branding—a floating, online, no-bounds university to learn a handpicked set of skills, for a new type of employment. The full email goes on to explain how a range of jobs will unlock themselves for these freshly-minted creators once they’ve had about 100 hours of online classes.

This full-fledged course is a marked change from the bite-sized offerings that Nas Academy launched with. It’s a sign that the creator economy is still taking shape. The creator’s role is shifting too, and cleaving itself away from being just an “influencer”. 

A recent report from Inc42 sums it up well.

It’s a great time to be a content creator. But more than that, a content creator’s creator. That’s the new economy we live in now.

Thank you for reading today’s edition. I’m thrilled and thankful to say that you, readers of ESG, have sent me lots of ideas for pieces over the last week. Keep them coming in! You can reach me at [email protected]. 

Regards, 

Olina Banerji