Opinion: COVID and immobility among Indian medical students

Heller Arokkiaraj*

*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).[1] Since 2013 China is a favoured country among Indian students to study medical degrees.[2][3][4][5][6][7] 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.[8] 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.[9]

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).[10]

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.[11][12] 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)[13] 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)[14].

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.[15]


[1] http://in.china-embassy.org/eng/sggg/t1861295.htm

[2] Government of India. 2013. Annual Report 2013-2014, New Delhi: National Board of Examination.

[3] Government of India. 2014. Annual Report 2013-2014, New Delhi: National Board of Examination.

[4] Government of India. 2015. Annual Report 2013-2014, New Delhi: National Board of Examination.

[5] Government of India. 2016. Annual Report 2013-2014, New Delhi: National Board of Examination.

[6] Government of India. 2017. Annual Report 2013-2014, New Delhi: National Board of Examination.

[7] Government of India. 2018. Annual Report 2013-2014, New Delhi: National Board of Examination.

[8] http://164.100.24.220/loksabhaquestions/annex/173/AU3923.pdf

[9] http://164.100.24.220/loksabhaquestions/annex/174/AU1729.pdf

[10] https://www.thehindu.com/news/national/coronavirus-with-new-curbs-china-makes-it-harder-for-its-nationals-in-india-to-return/article34401743.ece

[11] http://in.china-embassy.org/eng/sggg/t1861295.htm

[12] https://www.newindianexpress.com/states/kerala/2021/may/31/medical-students-want-to-return-to-china-seek-removal-of-impediments-2309660.html

[13] 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.

[14] https://www.hindustantimes.com/cities/mumbai-news/medical-students-studying-in-chinese-univs-approach-un-for-help-to-be-able-to-get-back-to-their-colleges-101617825749563.html#:~:text=Official%20data%20shows%20that%20in,in%20various%20programmes%20in%20China.

[15] https://blogs.lse.ac.uk/seac/2021/01/05/covid-19-and-international-student-mobility-some-reflections/

“From ‘Sea Turtles’ to ‘Grassroots Ambassadors’: The Chinese Politics of Outbound Student Migration.”

Research highlighted

Liu, Jiaqi M. “From ‘Sea Turtles’ to ‘Grassroots Ambassadors’: The Chinese Politics of Outbound Student Migration.” International Migration Review, (November 2021). https://doi.org/10.1177/01979183211046572.

Jiaqi Liu, University of California, San Diego

Global student migration is on the rise. As of 2017, over six-million tertiary students were studying outside their origin countries. International students exert enormous economic impacts, contributing $45 billion to the US economy alone in 2018. On the other side of the migratory channel, China has steadily established itself as the world’s largest source country of student migrants since 1998, when the earliest UNESCO data are available, with the global percentage of Chinese student migrants more than doubling from 7% in 1998 to 17% in 2017.

Given that China is the world’s most populous country, it may not be surprising that China also has the largest number of overseas students. However, the mammoth size of the Chinese student population abroad is not a historical constant. In 1978, when China began promoting large-scale outbound student migration, it had only 860 overseas students. In less than four decades, this number ballooned by 535 times to 460,000 in 2014. Scholars attribute this dramatic growth to a constellation of domestic factors, including the rising Chinese middle class and their conversion of economic capital into cultural capital, China’s competitive domestic education system, the Confucian pursuit of better education, the brokerage of commercial education agents, and pull factors in destination countries.

Nonetheless, the existing literature on international student migration/mobility (ISM) pays scant attention to China’s changing policies toward outbound student migration. Constrained by the prevalent immigration bias in migration studies, scholars tend to focus on host countries’ international education and post-graduation employment policies regarding inbound student migrants, while casting less attention on sending countries. This article, by examining China, the largest origin country of student migrants in the world, illuminates how home countries regulate and strategize about overseas students.

Utilizing three qualitative methods, including a historical policy review, an ethnography in state-organized summer camps for overseas students, and interviews with student migrants and migration officials, I propose two main arguments. First, I argue that the Chinese outbound student migration politics – which I define as the collectivity of the homeland state’s policies, practices, and rhetorics toward overseas students – serves three policy objectives: economic, governmental, and geopolitical. These objectives, however, are not set in stone. Rather, their relative significance ebbs and flows, depending on the sending country’s specific socioeconomic and political conditions. As I show, following decades of prioritizing the economic and governmental impacts of student returnees (haigui, or colloquially “sea turtles”) in boosting the domestic economy and maintaining political stability, the Chinese state now gives growing weight to student migrants’ geopolitical value as “grassroots ambassadors” (minjian dashi) in expanding China’s global influence and enhancing national image abroad. This geopolitical reorientation has become particularly salient under the Xi Jinping leadership, as China adopts more assertive soft power strategies in pursuit of global supremacy.

Drawing on ethnographic and interview data, my second argument suggests that the geopolitics-focused reorientation of China’s OSM policy may not be well received among student migrants nor fully implemented by migration officials at the grassroots or local level. Whereas Chinese students faced surging espionage accusations across the world in recent years, I refrain from taking for granted the close political ties between the Chinese state and overseas students, as depicted in rhetorical flourish by the Western media and Chinese national strategies. Instead, I examine the on-the-ground disjuncture between the central Chinese state, student migrants, and frontline bureaucrats. Based on grounded empirical research, I shed new light on the OSM politics as a contentious field where state ambitions crosscut individual desires and where national grand plans are confronted with flexible local improvisation.

In particular, I conducted participant observation in three state-run, voluntary retreats for overseas students in an emigrant hometown in southeast China. Following my interviews with migration officials, I was invited by these trips’ organizers to participate in three such events. In the end, I carried out over 100 hours of participant observation in these trips over July and August 2019. The summer trips provided an ideal lens to closely examine the quotidian operation of outbound student migration policies, as well as the deep-running tensions between national grand plans, local bureaucratic improvisation, and student migrants’ own desires.

My tripartite model of outbound student migration politics – economic, governmental, and geopolitical – strives to facilitate scholarly dialogue between ISM and diaspora studies. While the burgeoning mobility paradigm emphasizes neoliberalism’s crucial role in promoting the transition from international education to labor immigration in destination countries, this article pushes China to center stage and examines the homeland state’s changing, yet-unabating, interests in regulating and positioning overseas students in both national policies and local implementation.

Author Bio

Jiaqi M. Liu is a PhD candidate at the University of California, San Diego, studying the political sociology of international migration.  Building on multidisciplinary training and professional experiences in sociology, international politics, and law, Jiaqi adopts mixed qualitative methods to explore the crossroads between international migration, diaspora politics, citizenship laws, and transborder governance. His articles have appeared at International Migration Review and Journal of Ethnic and Migration Studies and won the 2020 Aristide Zolberg Distinguished Student Scholar Award from the American Sociological Association.

Call for Papers: Special issue on ‘International Education in China’

The Beijing International Review of Education

Special Issue: International Education in China

(Issue 4, 2022)

Editors, Cathy Xie PING, Fazal RIZVI & Michael A. PETERS

International education has become a major strategic policy priority as China emerges as one of the major global forces shaping the new post-covid landscape in international education at both school and university levels. It is not only the largest source of international students with some 665,000 studying abroad (380K in the US and 164K in Australia alone) but also a major receiving country and increasingly Asian hub for well over 500,000 students, becoming a top destination for students from BRI countries wanting to study abroad (roughly 70%). International education in China is an important part of the plan for national rejuvenation and central both to further opening up of education and to the BRI: it has capacity to further enhance university rankings, encourage international research collaboration, and improve the level of international exchanges and cooperation, contributing to the processes of Chinese educational modernization. The Covid-19 pandemic has temporarily disrupted the flow and exchange of international students, a process exacerbated by US-China geopolitical tensions, at the same time as profiling the need for more ethical and equitable global partnerships for a sustainable new post-pandemic world that aim to strengthen global partnerships, regional networks and digital infrastructures, especially for rural areas. This special issue examines global challenges, sustainable futures and the multiple ways Chinese international education is creating a new pattern of opening up Chinese education to the world.

Possible themes:

  1. Multiple purposes of IE: intercultural, diplomatic, commercial
  2. The international schools movement: leadership and innovation
  3. Technologies of IE
  4. Recruitment of globally mobile students, internationalization of the curriculum & global regimes of accreditation and quality  assurance
  5. Student experiences and the provision of institutional support
  6. Franchise and overseas campuses and regional hubs
  7. Knowledge economy and transnational production and application of knowledge through research collaborations
  8. IE, interculturalism and global citizenship education
  9. Shifting geopolitics and IE as soft power

This list is not exhaustive to re-examine international education in contemporary world. We especially welcome articles on international schooling.

Please send an expression of interest to Cathy Xie Ping (cathyping.xie@bnu.edu.cn), Fazal Rizvi (frizvi@unimelb.edu.au) or Michael A. PETERS (mpeters@bnu.edu.cn) with title and abstract (300 words) before the end of Febuary for planned publication this year. 

About Beijing International Review of Education (BIRE)

The Beijing International Review of Education is a new start-up journal published by Brill Academic Publishers (https://brill.com/) starting in 2019. The Beijing International Review of Education aims to publish articles that are of interest not only to academics and policy makers but also teachers and members of the public. All articles in this journal will undergo rigorous peer review, based on initial editor screening and double-blind peer review. The journal publishes four issues per year.

Migrant Children in State/Quasi-state Schools in Urban China: From Access to Quality?

Research Highlighted

Yu, H. (2021) Migrant Children in State/Quasi-state Schools in Urban China: From Access to Quality? London: Routledge. DOI: 10.4324/9781003220596

Abstract

In China, over fourteen million children of compulsory education age are involved in the rural-to-urban migration. Over the past two decades the national and local governments have achieved great progresses in enrolling eighty percent of migrant children in state schools. This situation brings a new question regarding the quality of education: does enrolling in a state school mean that the migrant children can now enjoy equal educational resources and expect to have outcomes equal to the local children? Rooted in rich qualitative data from five Chinese metropolitan cities, this book highlights the changing landscape of urban state school sector under the pressure of recruiting a tremendous number of migrant children and examines the quality of education from different angles. It identifies the demographic changes in many state schools of becoming ‘migrant majority’ and the institutional reformation of ‘interim quasi-state’ schools under a low cost and inferior schooling approach. It also digs into the ‘black box’ of cultural reproduction in school and family processes, revealing both a gloomy side of many migrant children’s academic underachievement as a result of troubled home-school relations and a bright side that social inclusion of migrant children in state school promotes their adaptation to the urban life. The book concludes that migrant children’s experiences in state (and quasi-state) school turn them into a generation of ‘new urban working-class’. This book will be of interest to scholars, students, practitioners and policymakers to better address educational equality for migrants and other marginalised groups.

In China, internal migrants account for the main part of the migrant population. During the last three decades of urbanisation, millions of rural labourers have left their hometowns to work in urban areas. In 2019, there were 135 million rural-to-urban migrant labourers nationally (National Bureau of Statistics 2020) with 14.27 million migrant children of compulsory education age studying in schools (Ministry of Education 2020). In recent years, around 80% of migrant children are enrolled in state schools nationwide. For those migrant children who have enrolled in local state schools, many of them have achieved progresses in their social inclusion and academic performance, yet they still face challenges in terms of equal educational outcome if compared with their local counterparts. This book aims to examine the new question regarding the quality of education that migrant children receive in the urban schooling field: does enrolling in a state school mean that the migrant children can now enjoy equal educational resources and expect to have outcomes equal to the local children?

Putting the overall research question into the specific context of five Chinese metropolitan cities, namely, Beijing, Shanghai, Guangzhou, Shenzhen and Foshan, the empirical analysis in this book focuses on the kinds of schooling experiences that migrant children have after they have enrolled in state (or quasi-state) schools. As global metropolises, the five cities can present acute examples of common problems related to migrant children’s education in metropolitan areas in China. In addition, since Beijing, Shanghai and the Pearl River Delta region have different histories and differ in terms of socio-cultural, economic and political contexts, they can provide a useful contrast. The total number of participants in the five cities is 126, including: 16 government officers, 25 school leaders (including 19 headteachers, one chairman of the board of directors and 5 department heads), 20 teachers, 34 migrant parents, 17 migrant children, 8 local parents and 6 local children.

To describe each of the eight chapters in more detail:

Chapter 1 presents the research background and context by introducing the issue of Chinese internal migrant children’s schooling. Chapter 2 tries to conceptualise quality of education in a context of migration. It conceptulises three dimensions of educational quality in a context of migration and education, including accessibility, equivalence, responsiveness.

Chapter 3 focuses on the quality of education in state school, specifically the migrant majority state school, which is currently the predominant mainstream schooling channel for migrant children. It concludes with an identification of a ‘sandglass dilemma’ which restrains the improvement of educational quality of migrant majority state schools for migrant children. In Chapters 4&5, the focus shifts to the quality of education in another main schooling channel for migrant children, which is conceptulised an ‘interim quasi-state school system’. Chapter 4 elaborates the formation of three main types of quasi-state schools, including government-purchased private school, government-controlled private school, and senior secondary state school recruiting migrant children in junior secondary stage, respectively. Chapter 5 further examines three characteristics of the ‘interim quasi-state school system’, including belongingness to the state sector, offering quasi-state education, and interim nature. The whole system is treated as an emergency mechanism for solving the migrant children’s schooling problem, rather than as regular schools offering high quality education. While realising the children’s right to education, this system does not guarantee them a “good” education.

Chapters 6 examines the role of parental involvement in shaping the academic performance of migrant children in school. It examines how the intersection of rural origin, migration status and working-class identities shapes the parents’ habitus and their exertion of capital in the urban education field. Chapter 7 examines social inclusion of migrant children in urban schools. It further identifies three aspects of migrant children’s urbanized habitus and gain of cultural capital in the urban field of cultural reproduction, including their manner of speaking, ways of behaving, self-presentation, and their appreciation of extra-curricular hobbies. Empirical findings identify a well-integrated relationship between migrant and local children, which contributes to the production of a generation of ‘new urban citizens’, yet in the meantime reproduces the migrant families’ class status as low-skilled labourers.

Chapter 8 presents the concluding thoughts of this thesis. It highlights the changing landscape of urban state school sector under the pressure of recruiting a tremendous number of migrant children and examines the quality of education from different angles. It identifies the demographic changes in many state schools of becoming ‘migrant majority’ and the institutional reformation of ‘interim quasi-state’ schools under a low cost and inferior schooling approach. It also digs into the ‘black box’ of cultural reproduction in school and family processes, revealing both a gloomy side of many migrant children’s academic underachievement as a result of troubled home-school relations and a bright side that social inclusion of migrant children in state school promotes their adaptation to the urban life. The book concludes that migrant children’s experiences in state (and quasi-state) school turn them into a generation of ‘new urban working-class’.

Author Bio

Dr Hui Yu, South China Normal University, China

Hui Yu (PhD, IOE) is Associate Professor (tenured) in the School of Education at South China Normal University, China. As a Bourdieu-informed sociologist, Dr Yu’s particular research interests include sociology of education with a focus on policy processes and social class equalities in China. His ongoing research projects focus on education of rural-to-urban migrant children and parental involvement in urban China, adopting Bourdieusian theoretical resources.

Email: hui.yu@m.scnu.edu.cn 

ORCiD: orcid.org/0000-0002-9651-502X

The Foreign Bully, the Guest, and the Low-income Knowledge Worker: Performing Multiple Versions of Whiteness in China

Research highlighted:

Lan, S. (2021). The foreign bully, the guest, and the low-income knowledge worker: Performing multiple versions of whiteness in China. Journal of Ethnic and Migration Studies.

Dr Shanshan Lan, University of Amsterdam

With the rise of China as the world’s second largest economy, more and more white Westerners are moving to China to pursue better job or business opportunities. In addition to the so-called transnational elites, there is an increasing number of middle-stratum white migrants who work as English teachers, self-initiated entrepreneurs, locally hired staff in transnational companies, lecturers in Chinese universities, and artists or creative workers in China’s media and cultural sectors. Unlike the transnational elites who usually have limited social interactions with local Chinese (Yeo and Willis 2005), this new group often depends on professional and social networks with local Chinese to consolidate their business or career opportunities. Scholars have noted the decline of social privileges associated with white skin in many Asian societies (P.C. Lan 2011; Lundström 2014; Maher and Lafferty 2014). The diversification of the white population in China matches the expansion of job markets for “foreigners” from coastal areas to smaller cities in the interior of the country. Due to the recent tightening in immigration controls and the rising tides of popular nationalism in Chinese society, the lived experiences of non-managerial and non-elite white migrants are increasingly marked by considerable tensions between privileges and precariousness (Farrer 2019; S. Lan 2021; Lehmann 2014; Leonard 2019; Stanley 2013).  However, little has been written on how different groups of white migrants make sense of and try to cope with this daily experience of precariousness.

       This paper focuses on two research questions: What are the opportunities and challenges faced by white migrants in different fields of employment and different geographical locations under the evolving nature of multiple Chinese gazes? How do various groups of white migrants engage with, negotiate, or resist the Chinese gazes through quotidian racialized performances? Existing literature on international migrants in China mainly focuses on black Africans in Guangzhou (S. Lan 2017; Bodomo 2012; Haugen 2012). The relative absence of whites in migration studies literature points to the racialization of “migrant” as a category reserved mainly for non-white people (Lundström 2017). This research denaturalizes whiteness as an invisible norm by rethinking it in a context of international labor migration and cross-cultural interaction. The paper attends to social stratification within the white population in China by moving beyond the binary between transnational corporate elites, who are often considered as privileged migrants (Camenisch and Suter 2019; Farrer 2019), and foreign English teachers, who are stigmatized as occupying a lower status within the expatriate community (Leonard 2019; Stanley 2013). Instead, it focuses on a group of middling migrants (Lehman 2014), namely self-initiated migrants who are neither recruited by transnational companies nor by talent schemes of Chinese universities, nor by commercialized brokers (as is the case of many foreign English teachers). I argue that although these white migrants have little control of the multiple and contradictory ways that they are racialized in Chinese society, they still demonstrate a certain degree of agency in manipulating the Chinese gazes for their benefit through strategic performances of different versions of whiteness. In this vein, the paper highlights the situational nature of whiteness, which is mediated by nationality, gender, class, Chinese language skills, and length of stay in China.

Author Bio

Shanshan Lan is Associate Professor in the Department of Anthropology at the University of Amsterdam and a member of the Moving Matters research group. She received her Ph. D. in Cultural Anthropology from the University of Illinois, Urbana-Champaign. She had worked as a Mellon Postdoctoral Fellow at Northwestern University and Connecticut College in the United States. Before joining the University of Amsterdam, she was a Research Assistant Professor in the David Lam Institute for East-West Studies, Hong Kong Baptist University. Lan is the Principal Investigator of the ERC project “The reconfiguration of whiteness in China: Privileges, precariousness, and racialized performances” (CHINAWHITE, 2019-2024). Funded by the European Research Council, this project examines how the western notion of whiteness is dis-assembled and re-assembled in the new historical context of China’s rise as a global superpower.