*Assistant Professor, Department of Social Work, Rajiv Gandhi National Institute of Youth Development, Sriperumbudur, Tamil Nadu, India
In recent years, China has been an important destination for international student mobility (ISM). The country has attracted significant numbers of international students from Asian continent (59.95 percent). Since 2013 China is a favoured country among Indian students to study medical degrees. Due to the COVID19 outbreaks, the Government of India organized three special flights to evacuate 766 persons on January-February 2020, including students from the city of Wuhan as well as other cities of Hubei Province in China in view of the continuing lock down of Hubei Province. As of 16 September 2020, three evacuation flights and five repatriation flights under Vande Bharat Mission had been operated from China for bringing back stranded Indians, including students.
The Covid-19 pandemic has made students return home and attend online classes remotely in India. It has caused immobility among Indian medical students who are enrolled in MBBS degree in China. Most of the Indian medical students have returned to India since the pandemic outbreak. In this article, we tried to reflect key challenges faced by these students, particularly those in their fifth and final (sixth) years of studies.
In 2019, the author conducted an online interview with Sheela, a student who was pursuing her fourth year of MBBS degree in Chongqing Medical University, China. At that time, she was in India for the winter break. Yet having studied in China for four years, she was eager to return to China to complete her fifth year and start her internship in the final year. But after rising Covid-19 infections in China, borders were closed, and a travel ban was imposed. Therefore, her plan to go back to China was disrupted by Covid-19. She said “For everyone it is only online classes. Most of the students have returned to India. Only some one or two Indian students are staying back in China for doing internship”. The immobility has been a major concern for a number of Indian students enrolled in the universities in China, most of them are unable to return to China due to the travel ban to China from India since November last year (The Hindu, 2021).
Like Sheela, a few other students who spoke to the author felt stranded in India. Why did we focus on the fifth and final year students? In the undergraduate degree (MBBS) course for foreign students in Chinese universities, in the fifth year, they have only practical classes and in the sixth year they have to do internships in hospital, this is essential for the course completion. Sheela commented, “For theory, no problem…but on the other hand, we miss the practical classes. They tried teaching online, like showing the videos. Though it was not much effective and informative…”. Another student Ram, who is also in the fifth year narrated as “In first four years we only have theory classes… in fifth year we have only practical, but this time they have made those practical into online classes…so it is difficult for us learn, so I feel I am not gaining enough practical knowledge which is important for medical students”. Due to Covid-19, the immobility and online classes constraints prevented these medical students from acquiring practical knowledge which they could only obtain from lab visits. Ram continued to say that “There is a difference better seeing practical in video (online) than we go to lab and learn the same”.
On 15 March 2021, the Embassy of the People’s Republic of China in India issued an important notice which states that persons going to China have to take Chinese-made Covid-19 vaccine and holding the Certificates of Vaccination is mandatory. While talking to a student Kumar, he also reflected that students may face immigration restrictions based on the vaccination. On the other hand, from Sheela, we came to know that international medical students were disadvantaged compared to local (Chinese students) in terms of reopening university campus to attend classes, access to lab, internship and to access other facilities. She mentioned that “for the Chinese students campus was reopened in late May or June 2020. Only for the foreign students, they are yet to reopen”. This has raised issues experienced by international medical students compared with domestic students who study medicine in the same home university. Besides, what emerged was a diverse set of factors that immobility caused in the medical degree programme such as a) unable to learn the clinical/practical skills effectively, b) visa extension for expired visa. However, students are still waiting for a decision from China.
“I might have to extend my stay in China to complete the internship if visa is issued” says Priya. Anju a fifth year student said that “Our seniors completed their fifth year in 2020, but so far they did not do the internship”. From these narrations we can understand that immobility has caused the fifth year students (2020), now in sixth year, and those who are in their fifth year (2021) who are yet to complete their internship in China dearly, as they are yet to get the course completion certificates. For the author’s postdoctoral research work (2019-2020), interviews were conducted among Indian medical students who face multiple challenges in realising their dreams to become medical doctors in India after their medical degrees from China, Russia, and Ukraine. Like other skilled migrants, Indian students move to countries such as China-they need to pass their medical degree, qualify foreign medica graduate examination (FMGE) in India, accumulate clinical skills during their clinical internship in India and apply license for medical practice in India. The key ambition of the interviewed students is to return and contribute to health care in India. The different waves of Covid-19 have added to the many challenges that the fifth and final year medical students face.
In the year 2020, the author jointly published an article in the ‘The Wire’, where we mentioned that the Indian medical students were uncertain about the universities reopening date due to pandemic. Perhaps, now it has been more than two years and while seeing the changes in the time, we note that these students’ immobility continues to receive little attention. Although some universities in China develop new applications for online classes, arranged recorded sessions, and hybrid classes, students are now still unsure whether they will be able to attain practical and clinical knowledge and also about their return to China. Meanwhile, recently, Indian medical students enrolled in universities in China appealed to the UN to lift the border restrictions, it states that ‘they are being deprived of learning from practical surgical classes which is not possible online” (Hindustan Times, 2021).
To conclude, a student Anju said that “May be around in August or in September (2021) university may reopen. But I don’t know. Actually, the plan was in March (2021). But here (India) the cases are increasing, so again they put on halt. So, they are saying August or September. But that is also unsure”. This essay tries to bring out the problematic experiences and challenges faced by Indian medical students at Chinese universities. One consequence of the pandemic has shown the ways in which international students are treated, in this case, the long term request from the medical students to enter China to complete their degrees has been neglected. Finally, as stated by Johanne Waters in 2021, we need to think about ways to respond ethically to embodied experiences of international students – not to see them as disembodied cash cows.
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 The Foreign Medical Graduates Examination-screening test has been introduced through Screening Test Regulations 2002. As per the regulations, “An Indian citizen/Overseas citizen of India possessing a primary medical qualification awarded by any medical institution outside India who is desirous of getting provisional or permanent registration with Medical Council of India or any State Medical Council on or after 15.03.2002 shall have to qualify a screening test conducted by the prescribed authority for that purpose as per the provisions of section 13 of the Act.