The Telegraph
Since 1st March, 1999
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Study confirms doc flight worst fear

New Delhi, Nov. 6: India’s top-ranked medical school suffers from a skewed brain drain with general category graduates far more likely to seek foreign pastures than reserved category doctors, a study has revealed.

Sixty per cent of general category doctors who graduated from the All India Institute of Medical Sciences (AIIMS), New Delhi, now live outside India, in contrast to 29 per cent of reserved category graduates, the study said.

Researchers from the Harvard School of Public Health, Boston, and AIIMS tracked the movements of AIIMS graduates over a 12-year period (1989-2000) and found that 54 per cent of its graduates had emigrated.

But graduates who had entered AIIMS under a Scheduled Caste or Scheduled Tribe reserved category appear to display stronger ties to the nation. “It’s not clear why this is happening,” said Ajay Mahal, assistant professor at the Harvard School of Public Health and a co-author of the study.

“It’s possible they fall through the cracks during the competition, but it is also possible that by the time they graduate, there is convergence of medical skills, and they are very smart people who just choose to stay back in India,” Mahal told The Telegraph.

Among 341 general category graduates, 206 (60 per cent) had emigrated, while among 87 reserved category doctors who had graduated during the same 12-year period, only 25 (29 per cent) were outside India.

The study, just published in the Bulletin of the World Health Organisation, has bolstered long-lingering suspicions that India’s elite medical schools contribute disproportionately to the ranks of emigrant doctors.

“This confirms what we’ve suspected from anecdotal accounts,” said Kunchala Shyamprasad, the vice-president of the National Board of Examinations, a government agency that conducts post-graduate medical training.

“Our best medical schools are training doctors for health care delivery and research careers in the West,” Shyamprasad told The Telegraph.

This is the first detailed study to demonstrate through data that the best from India’s top medical school have emigrated.

Eighteen out of 25 graduates (77 per cent) who had received two or more awards during undergraduate studies have left India.

“You can’t stop people from leaving, but perhaps it’s time to think about charging full fare for people who decide to leave,” Mahal said. “I don't think the government has done a good job in making people pay for their (educational) fare — whether in medicine or other areas,” he said.

The researchers point out that simple head counts of doctors leaving are insufficient to capture the actual loss to the country if the best people leave. “When the best people leave, the nation also loses some capacity for training, leadership in medicine, and even managerial capacity,” Mahal said.

The researchers said the findings highlight a need to examine mechanisms that could be used to retain talent from top public institutions. One approach would be to rely on market mechanisms such as medical tourism that raise economic returns to health professionals and reduce incentives to migrate.

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