Faridabad/Hyderabad/Mumbai/Bengaluru: Identifying the colour labels for blood samples was a challenge the moment Nitika Parashar first went to a pathology lab along with her sister, who also happens to be a medical student.
Blood samples for different tests require demarcation like different coloured bottles. A lavender top bottle, for example, is used for full blood count (RBC, WBC, etc); a blue top bottle is used for D-dimer test.
Knowing the specific colour labels used for blood tests is common for most medical students, but for 25-year-old Parashar, a final-year MBBS student from Jind, Haryana, who has had zero practical experience while studying medicine for the last two years, this was a tough ask.
Parashar is enrolled at the Hubei University of Medicine in Shiyan, China, and has been in India since January 2020.
She is among the thousands of students who returned to India in early 2020 after the Covid-19 pandemic struck, and haven’t been able to return to their universities since.
According to government data as of 2019-20, 23,000 Indian students were enrolled across various Chinese universities.
While they have been continuing their education online so far, lack of clarity from the Chinese government and the universities concerned about their return has put them in severe doubt about their future. Some even fear cancellation of their degrees. Lack of practical experience adds to their worries.
Last month, the Chinese foreign ministry said it is committed to the “coordinated return” of foreign students. However, there was no specific word on Indian students. “We are considering in a coordinated manner arrangement for allowing foreign students to return to China for their studies,” ministry spokesperson Zhao Lijian had said.
Sources in the Ministry of Health and Family Welfare told ThePrint that there is no immediate plan that the government has for these students, adding that it is waiting for China to open up visas. “This is a matter of the external affairs ministry and they should resolve it,” said a source at the health ministry.
ThePrint reached National Medical Council (NMC) Secretary Sandhya Bhullar and Health Secretary Rajesh Bhushan over calls and text messages to get a comment on the matter, but there was no response till the time of publishing the report.
In a statement last month, the Indian Embassy in Beijing said the “Ministry of Foreign Affairs (MFA) of China has assured the embassy that they are cognisant of the welfare of all foreign students, including Indian students, and have also conveyed that they will work on their early return to China in a coordinated manner and will continue contact with the embassy on this matter”.
“Chinese MFA also conveyed that the return of Indian students was not a political issue and they will not be discriminated in any manner while deciding on the return of foreign students to China to resume their education,” it said, adding that the assurance followed the “embassy continuously highlighting these issues with the relevant Chinese authorities in the last two years”.
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‘Have been studying online & through apps’
Sitting at a makeshift accommodation in Faridabad, from where she takes her online classes, Parashar spelt out how her lack of experience is affecting her education.
“I am in my final year of MBBS and I have been studying only online and through apps. I have had no hospital experience, I have not seen patients, I have not even seen a cadaver. I get very depressed sometimes as to how I am going to be able to become a doctor, I just hope my medical degree is not cancelled,” she told ThePrint.
“The only hope that I am clinging to now is to clear the FMGE so that I can practise medicine legally in India,” she said.
The Foreign Medical Graduate Exam (FMGE) is mandated by the medical education regulator, the National Medical Commission (NMC), for students who pursue their MBBS from certain countries, including Russia, Ukraine and China. Only once they clear the exam can they enrol for an internship in India and practise medicine.
Parashar has two siblings, both of whom are also medical students in government colleges. Her siblings are her biggest support system right now, and have advised her to focus on preparing for the FMGE so that she can learn the practical part during her internship in a hospital in India.
“My sister is pursuing her internship right now after completing her final year. She tells me about her experiences in the hospital and that is how I learn,” she added, noting that “not everyone is as lucky”.
Situation worse for those who returned in 1st year
The situation is much worse for students like Roopa Valladasa, who returned to India in her first year of MBBS education. Hyderabad-based Valladasa had just finished one semester when she left college to come back to India in January 2020.
A student of Xuzhou Medical University in Jiangsu province, Valladasa is now in the third year of her programme, and, so far, has never seen the inside of a laboratory. She said she is losing interest in her studies as studying online has become tedious.
“First year is just the basics but second and third year is where we get to start going to labs. My entire second year was online and even third year now. I never went to a lab or got any kind of practical training till now. I am worried what will happen next because the next two years are when we are usually taken to hospitals. If we are stuck here, how can we do that?” she said.
Roopa is part of several student groups on social media apps such as WhatsApp and Telegram — some of which even have as many as 4,000 students in a single group — that have been created to facilitate communication among students over their possible return, internship opportunities, etc.
“No amount of Twitter campaigns or meeting politicians is helping us. It’s like the government has turned a blind eye. When asked, our university says they are also equally helpless. My fourth year starts this September and I am really worried,” she said.
Rachita Kurmi, a 21-year-old living in Mumbai, is another student who came back in her first year of college.
She is enrolled at Shandong University in Jinan city. She went to China in 2019, spent her first semester there, came to India for winter vacation in January 2020 and couldn’t go back after that. Her batch had 70 students, out of which 40 were from India and all 40 came back. None of them has had any practical experience.
Kurmi said studying online has been exhausting. What makes things worse is that she has no information about a possible return.
“We do not get much information about when we can return to China because the media in China is quite filtered and the college says that there is no intimation from the government,” she added.
Her classes and exams were conducted on WeChat and DingTalk, but, because of the Indian government’s ban on Chinese apps, both stopped working for them.
“In the absence of the apps, email was the only way of communication with university or teachers. But Microsoft Teams was introduced last semester and the college is continuing this semester on Teams. But teachers are not used to the software and it is too intricate and complex for them, hence we are facing difficulties,” she added.
She is now hoping to appear for the screening exams for the UK and the US so that she can practise medicine in those countries. Similar to the FMGE, other countries have their own screening exams for medical graduates who wish to practise there.
“I have thought about appearing for screening exams for the US and the UK. Right now, this is the only way in which I can establish some value for my degree, otherwise everyone in India thinks that students who go to study in China have fake degrees,” she said.
Had this situation not arisen, she had plans to settle in India and work here as a doctor.
“It was never my plan to go to the US, UK or even China. I wanted to study medicine in India but there is so much competition here and for private medical colleges, fees is just too much. Why would I leave India?” she said.
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The cost factor
A fourth-year MBBS student currently living in Mumbai, enrolled in Nanjing University of Chinese Medicine, is also worried about her future. Had everything been on track, she would have completed her MBBS in 2023 and begun her mandatory one-year internship this year.
Back in India, she is cooped up at home, attending online classes five days a week.
“We don’t know whether we will be able to go back and complete our internship or whether we will be allowed to do it here in India. Naturally, we won’t be given preference here,” the student said on condition of anonymity. “We don’t know if our certificate will even be accepted here despite the university being recognised by the erstwhile MCI (Medical Council of India, predecessor of NMC). We want clarity from the government.”
She has always dreamt of being a doctor but is now unsure if she will be able to complete her course or practise in India, the student added. She has many doubts and no solution to her problems. Her parents, who did their research before enrolling their daughter in a Chinese university, are also disappointed.
Her father, who works as a regional manager at a firm in Tamil Nadu’s Coimbatore, told ThePrint that the family chose Nanjing University since it was recognised and registered with the erstwhile MCI.
“My daughter even registered on the MCI portal to pursue her medical studies in a recognised university but now nobody is taking any responsibility for the courses and universities they vetted,” he said.
Before his daughter’s programme started in 2018 at Nanjing University, he had to raise Rs 7 lakh just for the documentation, travel, eligibility and admission process.
“We had to go via an agent who told us of the university. Fees for my daughter’s course of Rs 2.5 lakh per annum excluded hostel expenses. She also needed to study Mandarin for six months since it is mandatory,” the father said. “The biggest concern is, in 2018, 1 RMB (Chinese currency renminbi) was equivalent to Rs 9.1. But today it is Rs 12.25 — a 25 per cent growth,” the father added.
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Some find a way out
However, not everyone is struggling, some students have managed to clear the FMGE and are enrolled in an internship in India.
Rohith T.G. from Pavagada, Karnataka, a 23-year old MBBS student is one of those who could clear the FMGE and is now interning with St Martha’s Hospital in Bengaluru — a one-year internship is mandatory for him to qualify his medical course in China.
Although he has a ‘provisional certificate’, with which he could manage to get an internship in the city, he would still need his original certificate from the university in China to apply for PG programmes here.
Rohith, who is a student of Yangzhou University in Jiangsu, returned to India in January 2020 for his semester holidays and has been stuck here since. By now, Rohith could have graduated from Yangzhou University.
His fourth- and fifth-year, two crucial years that ideally include exposure to hospitals, were done via online classes through recorded videos.
“We are taken to hospitals, we get clinical awareness, and practical training. But I did not get anything. I learnt all of it through my online class,” said Rohith.
“Our university puts pre-recorded videos on an app and students can watch those videos as per their convenience — no one will even ask you if you do not watch them. Neither is there any professor to clear doubts or anything. I took help from my sister, who is doing her PG, and also some of my friends studying MBBS in India to get my doubts cleared. I also got some Indian medical textbooks and started reading them,” he added.
“The first day of my internship here at the hospital, I told my seniors that I didn’t get any practical training, so I don’t know anything. Even the basics like how to handle a wound and all, I didn’t know practically. Theory I could tell them but I could not do it practically on any patient. They understood my situation and were kind enough to help me,” he said.
Rohith hopes that his university in China might chalk out a plan on how students can get their original graduation certificate, without which applying to postgraduate courses is impossible.
“After our mandatory internship, we have a graduation exam at the university. Only if you qualify that, you’re given your graduation certificate. My seniors finish their internship in three months or so and they don’t know what to do next or how they can go back to China. Neither has the university told us anything,” he said.
Inputs from Purva Chitnis and Anusha Ravi Sood
(Edited by Amit Upadhyaya)
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