The Hindu Editorial Analysis- 14th February 2025 | Current Affairs & Hindu Analysis: Daily, Weekly & Monthly - UPSC PDF Download

The Problematic Globalization of Medical Education

Why is it News?

• There is a worldwide shortage of doctors, but access to medical education is still limited. This situation is causing more students to move internationally for their medical studies.
• However, this trend raises important concerns about the quality of education and the challenges of regulating foreign medical programs.

Global Medical Education Trends

• There is an increasing shortage of medical doctors around the world.
• Despite this, governments and medical professionals are often against expanding access to medical education.
• As a result, more medical students are moving internationally to study in different countries.
• Medical education, which was once global, is now regulated by individual nations. However, due to the rising health demands, it is becoming international once again.

International Medical Students and Quality Concerns

• While the exact number of students studying medicine abroad is unclear, estimates suggest it is over 200,000.
• Many of these students are enrolled in medical schools that have questionable standards of education.
• Before the onset of conflict in certain regions, one country alone had approximately 24,000 foreign medical students, primarily from South Asia.

Medical Education Challenges in One Country

• A country in South Asia is experiencing a shortage of doctors, leading to fierce competition for limited medical seats.
• Each year, around 2.3 million students attempt the national medical entrance exam, but only one in 22 secures a spot.
• Due to the high demand for medical education, over 20,000 students choose to study medicine abroad.
• The primary reasons for this trend include the limited number of government medical seats and the high tuition fees charged by private institutions.
• Popular destinations for these students include Russia, Ukraine (prior to the conflict), Kazakhstan, the Philippines, China, Mauritius, and Nepal.

Indian-Controlled Foreign Medical Institutions

• Some medical institutions located abroad are managed by Indian education groups.
• For instance, a medical college in Nepal and a Caribbean medical school run by an Indian organization are examples of such institutions.
• These schools primarily serve Indian students and extend the reach of Indian education overseas.

Challenges of Studying Abroad

• Students pursuing medicine overseas must pass a national licensing exam to practice in their home country.
• Additionally, they are required to complete a medical internship upon their return.
• Those aiming to practice in foreign countries must adhere to the licensing regulations of those nations.
• The disparity in the quality of medical education across the globe has prompted strict regulatory measures by various governments.

Recent Policy Developments

• A recent government budget speech has underscored the progress made in the field of medical education.
• Over the past decade, the government has increased undergraduate and postgraduate medical seats by 1.1 lakh, marking a 130% rise.
• Future plans include the addition of 10,000 seats in 2026 and 75,000 seats over the next five years to accommodate the growing demand for medical education.

Medical Education Beyond the Global South

• The phenomenon of students seeking medical education abroad is not limited to the Global South; it is observed worldwide.
• Western nations such as France, Germany, and Norway are facing shortages in medical seats, prompting students to pursue their studies in neighboring countries.
• Numerous students from the United States are enrolling in medical programs in Hungary, Poland, Ireland, the Caribbean, and the United Kingdom.
• Medical universities located in central and eastern Europe are attracting international students by offering English-medium programs.

Conclusion

• Governments are aware of the growing demand for qualified doctors, especially with an aging population.
• However, finding solutions to increase medical education capacity is expensive and often meets resistance from current medical professionals.
• The high number of students seeking medical education abroad highlights the demand, but many foreign institutions lack the necessary quality control.
•  There is a pressing need for greater attention to ensure that medical education standards are upheld globally.

 China’s dam project opens the floodgates of concern

What’s the News?

• China is planning to build a large hydroelectric dam on the Yarlung Zangbo River in Tibet. This river is called the Brahmaputra in India. The project has raised concerns in India about water security, environmental impact, and bilateral relations.
• Currently, there is no formal water-sharing agreement between India and China, making it difficult to manage the transboundary river cooperatively.

Introduction

• China is set to construct a significant hydroelectric dam on the lower stretch of the Yarlung Zangbo River in Tibet. This river, known as the Brahmaputra in India, is crucial for millions in northeastern India and Bangladesh.
• The dam is part of China’s shift from coal to renewable energy under its 14th Five-Year Plan (2021–2025). While this transition is commendable, the project raises concerns for India regarding its environmental impact, water flow, and diplomatic relations.

Legal Concerns in International Water Law

• The construction of the dam poses legal challenges under international water law. The UN Watercourses Convention (1997) emphasizes fair and reasonable use, preventing significant harm, and cooperation in managing shared water resources. However, neither China nor India is a signatory to this convention.
• China adheres to its own water management principles, positioning itself as a cooperative upper riparian state. In contrast, lower riparian states like India accuse China of using water as a geopolitical tool.
• India relies on rivers originating in Tibet for one-third of its water supply, making it vulnerable to China’s unilateral actions. Concerns have been raised about Chinese water projects, and expired water-sharing agreements on the Sutlej and Brahmaputra rivers are hoped to be renewed with improved India-China relations.
• In the absence of a formal agreement, the Expert Level Mechanism (ELM) continues to address water-related issues between the two countries.

Environmental Risks and Seismic Concerns

• The dam is being constructed in a region prone to seismic activity, raising the risk of structural failure in the event of an earthquake. A significant earthquake in Tibet in January 2025, which caused over 120 deaths and more than 150 injuries, underscores the region’s vulnerability.
• Furthermore, large-scale dam construction disrupts river ecosystems, affects sediment flow, threatens biodiversity, and increases riverbank erosion. This impact is not limited to India but extends to Bangladesh, as the Brahmaputra flows into Bangladesh after passing through India.

Bangladesh’s Stance and Regional Implications

• In contrast to India, Bangladesh has not raised substantial concerns regarding the dam project. Political changes in Bangladesh, particularly after the government’s shift in August 2024, have altered its foreign policy priorities.
• Bangladesh’s improving relations with China have also influenced its position on the hydroproject. Other lower riparian states, such as Nepal, Bhutan, and Pakistan, may similarly be affected by water-related activities in Tibet.

Challenges in Regional Water Cooperation

• South Asian countries face difficulties in establishing a strong regional organization to collectively negotiate transboundary river management due to political tensions.
• The water dispute between India and China is intertwined with broader political relations, complicating efforts to form a regional water alliance.

Way Forward

• Recent diplomatic engagements between India and China offer hope for renewing expired water-sharing agreements.
• Building trust and improving information-sharing on transboundary rivers can help alleviate concerns.
• While China assures India that the dam will not affect water flow, India remains cautious and vigilant.
• The Expert Level Mechanism (ELM) is seen as the most suitable platform for ongoing discussions and cooperation on water management issues.